AIM: To evaluate myocardial relaxation function changes in an adriamycin-induced cardiomyopathy model using the transmitral flow velocity to mitral annular velocity ratio (E/E'), a strong positive relationship with left ventricular filling pressure and a good indicator for evaluating left ventricular diastolic relaxation abnormality. METHODS: Twenty-eight Japanese rabbits were divided into two groups. Adriamycin was administered at cardiomyopathy model. 8 rabbits served as controls receiving the same amount of saline once a week for a total of 8 weeks. Conventional and tissue Doppler echocardiography (TDE) were performed at baseline, 4th, 6th,8th, 10th and 12th week. RESULTS: In the adriamycin-treated group, LV chamber diameter significantly increased, while ejection fraction and fraction shortening significantly decreased in 10th and 12th week (P ＜0.05). The significant changes were firstly found in 10th week. Mitral annulus systolic peak velocity (S') by TDE significantly decreased in 8th, 10th and 12th week ( P ＜0.05). The significant changes were firstly found in 8th week. The ratio of E/E' significantly increased in 6th,8th, 10th and 12th week (P ＜ 0.05). The significant changes were firstly found in 6th week. In the control group, no significant changes were found in all parameter by tissue Doppler conventional echocardiography (P ＞0.05). CONCLUSION: Myocardial function is reduced in adriamycin-induced rabbit model of dilated cardiomyopathy. The relaxation parameter (E/E') by TDE changes is earlier than contraction indices S' by TDE and conventional echocardiography in adriamycin-induced cardiomyopathy rabbits, which provides a new sensitive and reliable method to evaluate LV relaxation function.

Objective To investigate the relationship between the expression of the survivin gene and CpC methylation in exon 1 of the survivin gene in CA tissue, and to study the expression of survivin protein in CA tissue and its modulation mechanism. Methods Tissue samples were obtained from the CA lesions of 30 patients, normal cervix of 10 female controls, and normal foreskin of 10 male controls. Immunohistochemistry was carried out to detect the expression of survivin protein in these specimens, RT-PCR to measure the mRNA expression of survivin, and methylation specific PCR (MSP) to analyze the methylation status of CpG island in the survivin gene exon 1. Results The positivity rate of survivin protein and mRNA was 90% (27/30) and 93.3% (28/30) in CA tissue specimens, respectively, 5% (1/20) and 5% (1/20) in control tissue specimens, respectively; there was a significant difference between the two groups of specimens in both the parameters (x2 = 35.187, 38.437, both P < 0.01). The demethylation of CpG island in the survivin gene exon 1 was observed in 86.7% (26/30) of the CA tissue specimens and in 15% (3/20) of the control tissue specimens (x2 = 10.865, P < 0.01). There was a positive correlation between the demethylation status of CpG island in exon 1 and the mRNA expression of survivin gene (x2 = 13.929, P = 0.014). Conclusions The expression of survivin protein in CA tissues might be associated with the demethylation of CpG island in exon 1 of the survivin gene, and may play a certain role in the development of CA.

BACKGROUND: Tissue Doppler echocardiography (TDE) has been proved to evaluate general and local function of heart but less reported on adriamycin-induced cardiomyopathy following bone marrow stromal cell (BMS) transplantation.OBJECTIVE: To evaluate myocardial function of an adriamycin-induced cardiomyopathy rabbit model following BMS transplantation using TDE.DESIGN, TIME AND SETTING: A randomized animal control study was performed at Laboratory of Ultrasound, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from September 2002 to December 2003.MATERIALS: A total of 28 male adult Japanese rabbits weighing (2.0+0.2) kg were used in this study. Adriamycin was used to induce cardiomyopathy model in 20 rabbits.METHODS: Twenty-eight male Japanese rabbits were randomly divided into three groups: cell transplantation group (n=10),PBS group (n=10), and sham operation group (n=8). BMSs were isolated from cell transplantation group at the 8th day. On the 12th week, cells were labeled with 4, 6-diamidino-2-phenylindole (DAPI), and then epicardial directly injected into the myocardium of the same rabbits in thoracotomy surgery. Non-cell only culture fluid PBS was injected in PBS group. Sham operation group underwent thoracotomy surgery with the same volume of saline injection.MAIN OUTCOME MEASURES: Left ventricular function was assessed by conventional and tissue Doppler echocardiography before and 4 weeks after surgery. Histological examination including apotisis study and DAPI fluorescent were assessed after sacrificed.from (4.0+1.1) cm/s to (5.3+1.2) cm/s (P ＜ 0.05) around the inject site, but the improvement of global myocardial function was not found by conventional echocardiography. In PBS and sham operation group there were no differences in global and myocardium at 4 weeks after transplantation. Histological findings showed that the injury of the myocardium around the injection site was relieved with less apoptosis.

Objective To investigate the characteristics and the diagnostic value of the tissue strain imaging in constrictive pericarditis(CP).Methods Twenty-six patients and thirty controls underwent comprehensive echocardiography with apical four chamber tissue Doppler imaging and strain imaging.Peak strain of the middle segments of the inter-ventricle septum and left ventricular lateral wall was recorded.The peak strain difference and strain ratio between the two segments were calculated.Results In patients with CP peak strain of the left ventricle lateral wall was significantly lower than that of the septum[(-5.60?3.46)% vs(-14.14?4.11)%,P

The feasibility of bone marrow stromal cells autologous transplantation for rabbit model of dilated cardiomyopathy induced by adriamycin was studied. Twenty rabbits received 2 mg/kg of adriamycin intravenously once a week for 8 weeks (total dose, 16 mg/kg) to induce the cardiomyopathy model with the monitoring of cardiac function by transthoracic echocardiography. Marrow stromal cells were isolated from cell-transplanted group rabbits and were culture-expanded on the 8th week. On the 10th week, cells were labeled with 4,6-diamidino-2-phenylindole (DAPI), and then injected into the myocardium of the same rabbits. The results showed that viable cells labeled with DAPI could be identified in myocardium at 2nd week after transplantation. Histological findings showed the injury of the myocardium around the injection site was relieved with less apoptosis and more expression of bcl-2. The echocardiography found the improvement of local tissue movement from (2.12+/-0.51) cm/s to (3.81+/-0.47) cm/s (P<0.05) around the inject site, but no improvement of heart function as whole. It was concluded bone marrow stromal cells transplantation for dilated cardiomyopathy was feasibe. The management of cells in vitro, the quantity and the pattern of the cells transplantation and the action mechanism still need further research.

Objective To observe the pathophysiological change of right heart remodeling model of beagle dogs caused by tricuspid regurgitation. Methods Six beagle dogs were separated to TR group and sham operation group randomly and equally. The anterior and posterior leaflets of tricuspid valve of beagle dogs from TR group were cut off under direct vision on the beating heart. The echocardiography data were measured pre-operation and post-operation 3, 6, 12 months respectively and autopsy results were acquired after the sacrifice of two animals who had been raised for 18 months. Results The operation was successful and survival 100%. The weight of TR group increased, and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction. The autopsy of TR group found myocardial fibrosis , liver cirrhosis and ascites. All of the results indicated the occurrence of right heart remodeling and right heart failure. There is no significant difference in sham operation group before or after operation. Conclusion The myocardial fibrosis is one of the pathological basis of right heart remodeling.

The volume-time curve change in patients with normal left ventricular (LV) diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography (RT3DE). LV diastolic dysfunction was defined by E'0.05). It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.
Diastole/physiology ; Echocardiography, Three-Dimensional/*methods ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Dysfunction, Left/*ultrasonography ; Ventricular Function, Left/*physiology

The volume-time curve change in patients with normal left ventricular (LV) diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography (RT3DE). LV diastolic dysfunction was defined by E'＜A' in pulse-wave tissue Doppler for inter-ventricular septal (IVS) of mitral annulus. In 24 patients with LV diastolic dysfunction, including 12 patients with delayed relaxation (delayed relaxation group) and 12 patients with pseudo-normal function (pseudo-normal group) and 24 normal volunteers (control group), data of full-volume image were acquired by real-time three-dimensional echocardiography and subjected to volume-time curve analysis. EDV (end-diastolic volume), ESV (end-systolic volume), LVEF (left ventricular ejection fraction), PER (peak ejection rate), PFR (peak filling rate) from RT3DE were examined in the three groups. Compared to the control group, PFR (diastolic filling index of RT3DE) was significantly reduced in the delayed relaxation group and pseudo-normal group (P＜0.05). There were no significant differences in EDV, ESV, LVEF, PER (P＞0.05). It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.

Objective To investigate the surgical technique and outcomes of replacement of chordae tendineae in mitral valve repair, and evaluate the value of real-time three-dimensional transesophageal echocardiography in the perioperative period. Methods Thirty-one patients with mitral valve prolapse underwent mitral valve repair using chordae tendineae replacement concomitant with implantation of valveplasty ring. A 4-0 Goretex sutures was used for reconstruction of artificial chordae. Realtime three-dimensional transesophageal echocardiography was performed in all the patients during the preoperative, intraoperatire, and postoperative periods. The length of the chordae tendineae under the A1 section of the anterior leaflet and the P1 section of the posterior leaflet were measured and considered the normal length of chordae tendineae by real-time three-dimensional transesophageal echocardiography preoperatively. These pre-determined normal chordal lengths helped intraoperatively to approximate the length of the artificial chordae used and postoperatively to gauge the success of the procedures. The same values were used again postoperatively to gauge the success of intervention. Full flexible valveplasty rings were used in all the patients.Results There was no operative death. The mean cardiopulmonary bypass (CPB) and aortic cross clamp time were ( 142. 0 ±31.2 ) min and (98.0 ± 22.5 ) min, respectively. One patient' s intraoperative echocardiography upon termination of CPB showed persistent severe mitral regurgitation and was converted to mitral valve replacement. This patient was not included in the study group. The mean number of artificial chordae per patient was (2.0 ± 1.5 ) , range from 1 to 3. The mean preoperatively measured normal chordal length was ( 21.0 ± 2.5 ) mm, and the mean postoperative artificial chordal length was ( 20.0 ± 2.2 )mm. The difference was not significant. The follow-up interval was from 3 to 30 months and the follow-up rate was 98%. During the follow-up period, there was no late death. Trace mitral regurgitation (MR) was detected in 15 patients, mild and moderate MR were detected in 1 for each. No severe MR was detected. The freedom from reoperation was 100% during follow-up.There were no documented artificial chordae ruptures. Conclusion Conclusion Artificial chordal replacement with Gore-tex suture in mitral valve repair in this group of patients with mitral valve prolapse appears to have satisfactory early and mid-term results. Real-time three-dimensional transesophageal echocardiography plays a critical role in this technique. Real-time threedimensional transesophageal echocardiography can exactly predict the length of artificial chordae, which is helpful to improve the outcomes of mitral valve repair. However, longer term follow-up and larger series are required to validate our findings.

OBJECTIVETo evaluate the clinical effect of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death.

METHODSAccording to ACC/AHA Guideline of ICD implantation (2005), 35 patients successfully received ICD/CRT-D implantation for primary prevention of sudden cardiac death in our hospital from January 2006 to December 2009. All the patients were followed up for a mean of 2 years.

RESULTSDuring the follow up, 11 (31.43%) patients experienced ventricular arrhythmic episodes, for which 16 defibrillation therapies and 75 anti-tachycardia pacing (ATP) therapies were delivered without mistaken shock or death. The incidence rate of NVM was 100%, that of PVT was 66.67%, Brugada syndrome 50%, HCM 25% and DCM 16.67%. Of these episodes, the incidence of VF episodes among PVC patients was 87.5% (14 beats), ventricular tachycardia PVC was 82.28% (65 times), 5 beats in NVM patients, 4 beats in HCM and Brugada syndrome patients, and 1 beat in DCM patients. No ICD implantation-related complication was detected, and no ventricular tachycardia induced syncope occurred in these cases. All patients showed improved quality of life after the implantation.

CONCLUSIONICD implantation can prevent malignant ventricular arrhythmia episodes, especially for PVT, NVM and Brugada syndrome in high risk SCD patients, demonstrating the value of implantation of ICD as a primary prevention in high-risk SCD patients.

Adult ; Aged ; Death, Sudden, Cardiac ; epidemiology ; prevention & control ; Defibrillators, Implantable ; Female ; Humans ; Male ; Middle Aged ; Primary Prevention