OBJECTIVETo study the role of Tei index in the evaluation of left ventricular dysfunction in neonates with hypoxemia.

METHODSFifty-two neonates with hypoxemia (20 mild, 16 moderate, 16 severe) and 40 normal neonates (control group) were enrolled. On postnatal days 1, 3 and 7, Doppler echocardiography was used to measure the indexes reflecting systolic and diastolic cardiac functions: ejection fraction of left ventricular (LVEF), E/A ratio of mitral value and Tei index of left ventricular (LV-Tei).

RESULTSLVEF and E/A ratio of left ventricular in the moderate hypoxemia group were significantly lower than those in the control group on postnatal days 1 and 3 (P<0.01). LVEF and E/A ratio of left ventricular in the severe hypoxemia group were significantly lower than those in the control group on postnatal days 1, 3 and 7 (P<0.01 or 0.05). Compared with the control group, LV-Tei increased significantly in the mild hypoxemia group on postnatal day 1 and increased significantly in the moderate and severe hypoxemia groups on postnatal days 1 and 3 (P<0.01). There was a negative correlation between PaO2 and LV-Tei in the hypoxemia group on postnatal days 1 and 3 (r=-0.50, P<0.05; r=-0.71, P<0.01 respectively).

CONCLUSIONSLV-Tei can be used as a sensitive indicator for the evaluation of left ventricular dysfunction in neonates with hypoxemia.

Echocardiography, Doppler ; Female ; Humans ; Hypoxia ; physiopathology ; Infant, Newborn ; Male ; Ventricular Dysfunction, Left ; diagnosis ; Ventricular Function, Left

OBJECTIVETo evaluate transient deceleration wave intensity (W2) of carotid artery on left ventricular diastolic function.

METHODS40 patients with hypertension and 43 healthy volunteers were enrolled and W2 of carotid artery of the both sides were measured. The parameters of left ventricular diastolic function by traditional and tissue Doppler imaging and NT-proBNP (N-terminal probrain natriuretic peptide) were measured.

RESULTS(1) W2 is not different between two sides of carotid artery. W2 in hypertension was lower than the control, especially in left side(1126 +/- 996 mmHg x m/s3 vs 1690 +/- 1126 mmHg x m/s3, P < 0.01). (2) The correlation of W2 and else parameters were analyzed. There were notably decreasing in left ventricular diastolic function of the hypertensive group than the control, for example, the ratio of peak velocity of early filling of mitral flow to peak early diastolic motion velocity of mitral annulus (E/Em, 9.37 +/- 3.32 vs 7.39 +/- 1.83, P < 0.01) and NT-proBNP (94.6 +/- 48.5 vs 45.2 +/- 13.8, P < 0.01). (3) The correlation analysis showed negative relation between W2 and E/Em (r = - 0.46, P < 0.05) and negative relation between W2 and NT-proBNP (r = -0.21, P < 0.05).

CONCLUSIONNew carotid W2 by non-invasive technology for hemodynamics is a deserving parameter in early evaluating left ventricular diastolic function.

Adult ; Carotid Artery, Common ; physiopathology ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Ventricular Dysfunction, Left ; diagnosis ; physiopathology ; Ventricular Function, Left

The methods for evaluating left ventricular diastolic function completely and simply are lacking in our country at present. To solve this problem, we presents in this paper a novel method, which is developed according to certain algorithms and mathematic models and is carried out by a MATLAB program. This method mainly obtains dP/dt loops, and calculates four important indices, including left ventricular end-diastolic pressure (LVEDP), Maximal decrease in velocity of left ventricular pressure (--(dP/dt)max), Time constant of ventricular isovolumic relaxation (tau) and Chamber stiffness (Kd), according to the changes of left ventricular pressure. The results obtained from the experiment of isolated rat hearts during ischemia/reperfusion have demonstrated the usefulness and validity of this method. Therefore, with the use of tau and Kd as indicators, this is a sensitive and effective method for evaluating the left ventricular diastolic function, and it can be applied to early detection of left ventricular diastolic dysfunction.
Algorithms ; Animals ; Blood Pressure ; Diastole ; Humans ; In Vitro Techniques ; Male ; Models, Cardiovascular ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology ; Ventricular Dysfunction, Left ; diagnosis ; physiopathology ; Ventricular Function, Left ; physiology

The present study aimed to investigate the impact of hypothyroidism on left ventricular systolic function using real-time three-dimensional speckle tracking imaging (RT3D-STI). Thirty hypothyroidism patients and forty healthy volunteers were recruited and received RT3DSTI measurement of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). A comparison of differences between the hypothyroidism patients and those in the healthy group was carried out and we obtained the results as followings. The values of GLS were (-18.93 +/- 3.89) vs. (-21.44 +/- 1.99), with P < 0.01, GRS were (51.13 +/- 11.95) vs. (56.10 +/- 5.76), with P < 0.0; and GAS were (-31.63 +/- 5.38) vs. (-34.40 +/- 2.32), with P < 0.01, i.e. they were lower in hypothyroidism group than those in the health group. While GCS were (-17.75 +/- 1.92) vs. 17.03 +/- 3.45), with P > 0.05, which were not significantly different between the two groups. In linear regres sion, GLS showed significant correlation with both TSH (b = -0.69, P < 0.01) and FT3 (b = 0.71, P < 0.01). Meanwhile, the GRS (b = 2.98, P < 0.05) and GAS (b = 3.11, P < 0.05) linearly correlated with FT3 level. In conclusion, the present study shows that the global longitudinal and radial moves of left ventricular are weaker in patients with hypothyroidism than healthy controls. And the impairment of left ventricular function would aggravate as FSH rises or FT3 declines.
Case-Control Studies ; Echocardiography, Three-Dimensional ; Heart Ventricles ; physiopathology ; Humans ; Hypothyroidism ; complications ; Imaging, Three-Dimensional ; Reproducibility of Results ; Systole ; Ventricular Dysfunction, Left ; complications ; diagnosis ; Ventricular Function, Left

Tei-Index is a useful echocardiographic parameter for evaluating global cardiac function. Conventionally, a value and b value, which the calculation of Tei index is based on, are measured in different cardiac cycle. Therefore, accuracy of Tei index is damaged by cycle dependent variation, especially in patients with arrhythmia. The newly established Dual Doppler modality allows a synchronous measurement of both a value and b value. This study was aimed to explore the value of Tei index measured by Dual Doppler in cardiac function estimation in patients with hypertension. One hundred and forty patients with hypertension were recuited and divided into three groups according to cardiac function. The a value and b value were generated from the transmitral and transaortic flow spectrum of the same cardiac cyle by Dual Doppler modality. The results showed that Tei index was significantly higher in the cardiac dysfunction group than in the control group. There was a high correlation between Tei index and NYHA cardiac performance. Tei index measured by Dual Doppler modality is a highly reproducible parameter with high sensitivity and specificity for cardiac function estimation, even for patients with arrthymia.
Adult ; Aged ; Echocardiography, Doppler, Color ; Female ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis ; etiology ; physiopathology ; Ventricular Function ; Young Adult

OBJECTIVETo evaluate left ventricular (LV) function and twist in patients with diabetic cardiovascular autonomic neuropathy (CAN) by two-dimensional speckle tracking imaging (STI).

METHODSSTI was performed in 56 subjects with type 2 diabetes mellitus (DM) (35 with DM only: group A, 21 with CAN: group B) and 34 normal subjects (Control) from LV short-axis view. LV peak systolic, peak early (E') and peak late (A') diastolic circumferential strain in 18 myocardial segments were measured at the levels of mitral annulus, papillary muscle and apex and the rotation at mitral annulus and apex levels were also measured. LV peak systolic and the ratio of E' and A' of global and three levels, twist, untwisting rate and untwisting half-time were calculated.

RESULTSIn group A, compared with control group, LV peak systolic radial circumferential strain has no significant difference (P > 0.05), E'/A' was reduced (P < 0.05), twist at aortic valve closure and twist at mitral valve opening were significantly increased (P < 0.05), untwisting rate reduced, and untwisting half time delayed. In group B, compared with control group and group A, circumferential strain parameters [(-12.64 ± 6.49)% vs. (-19.11 ± 9.98)% and (-21.14 ± 10.13)%, P < 0.05] and E'/A' [(0.90 ± 0.35) vs. (1.24 ± 0.47) and (1.98 ± 0.63), P < 0.05] were significantly decreased, twist at aortic valve closure [(19.08 ± 5.62)° vs. (16.57 ± 2.84)° and (14.36 ± 4.06)°, P < 0.05] and twist at mitral valve opening [(13.99 ± 2.31)° vs. (11.36 ± 2.63)° and (9.04 ± 5.63)°, P < 0.05] were significantly increased, untwisting rate [(0.40 ± 0.28)%/ms vs. (0.46 ± 0.14)%/ms and (0.53 ± 0.21)%/ms, P < 0.05] reduced, and untwisting half time [(489.61 ± 97.14) ms vs. (445.21 ± 54.53) ms and (410.60 ± 50.23) ms, P < 0.05] delayed.

CONCLUSIONSpeckle tracking imaging could be used to evaluate early changes on LV twist deformation and LV systolic function in patients with type 2 diabetes mellitus.

Diabetes Mellitus, Type 2 ; diagnosis ; physiopathology ; Diabetic Neuropathies ; diagnosis ; physiopathology ; Diagnostic Imaging ; methods ; Diastole ; Female ; Humans ; Male ; Middle Aged ; Rotation ; Stroke Volume ; Systole ; Ventricular Dysfunction, Left ; physiopathology ; Ventricular Function, Left

Intraventricular hydrodynamics is considered an important component of cardiac function assessment. Vector flow mapping (VFM) is a novel flow visualization method to describe cardiac pathophysiological condition. This study examined use of new VFM and flow field for assessment of left ventricular (LV) systolic hemodynamics in patients with simple hyperthyroidism (HT). Thirty-seven simple HT patients were enrolled as HT group, and 38 gender- and age-matched healthy volunteers as control group. VFM model was used to analyze LV flow field at LV apical long-axis view. The following flow parameters were measured, including peak systolic velocity (Vs), peak systolic flow (Fs), total systolic negative flow (SQ) in LV basal, middle and apical level, velocity gradient from the apex to the aortic valve (ΔV), and velocity according to half distance (V1/2). The velocity vector in the LV cavity, stream line and vortex distribution in the two groups were observed. The results showed that there were no significant differences in the conventional parameters such as left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left atrium diameter (LAD) between HT group and control group (P>0.05). Compared with the control group, a brighter flow and more vortexes were detected in HT group. Non-uniform distribution occurred in the LV flow field, and the stream lines were discontinuous in HT group. The values of Vs and Fs in three levels, SQ in middle and basal levels, ΔV and V1/2 were higher in HT group than in control group (P<0.01). ΔV was positively correlated with serum free thyroxin (FT4) (r=0.48, P<0.01). Stepwise multiple regression analysis showed that LVEDD, FT4, and body surface area (BSA) were the influence factors of ΔV. The unstable left ventricular systolic hydrodynamics increased in a compensatory manner in simple HT patients. The present study indicated that VFM may be used for early detection of abnormal ventricle contraction in clinical settings.
Adult ; Echocardiography, Doppler, Color ; methods ; Female ; Humans ; Hyperthyroidism ; complications ; diagnostic imaging ; physiopathology ; Image Interpretation, Computer-Assisted ; methods ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis ; physiopathology ; Ventricular Function, Left ; Young Adult

OBJECTIVETo investigate the effect of Ningxintong Granule (NXTG) on left ventricular diastolic dysfunction (LVDD) in patients with coronary heart disease (CHD) of qi-deficiency and blood-stasis syndrome in Chinese medicine.

METHODSSeventy-six CHD patients with LVDD of qi-deficiency blood-stasis syndrome were randomized into two groups. The 36 patients in the control group were treated by Western medical conventional treatment alone, and 40 patients in the treated group were treated by NXTG (Consisting of milk vetch root, pueraria root, ligustici, ilex-puhesceus, manchurian wildginger, 10 g in each package) and Western medical conventional treatment in combination, one package each time, thrice daily, 4 weeks as one therapeutic course. The left ventricular function (LVF) of all patients (including Emas, Amas, E/A, DT and IVRT) was evaluated by Doppler echocardiography before and after treatment, and the changes of clinical effectiveness and TCM syndrome effectiveness were observed.

RESULTSCompared with the control group after treatment, Emas, E/A increased, while Amas, DT, IVRT decreased showing statistical difference (P < 0.05). The therapeutic effects in the treated group were significantly better (P < 0.05).

CONCLUSIONNXTG with qi-enriching and blood-activating actions shows favorable effect in treating CHD patients with LVDD.

Aged ; Coronary Disease ; diagnosis ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Qi ; Ventricular Dysfunction, Left ; drug therapy ; Ventricular Function, Left

OBJECTIVETo evaluate the clinical value of quantitative tissue velocity imaging (QTVI) in detection of regional wall movement abnormalities in patients with coronary artery disease (CAD).

METHODSThe segmental left ventricular wall motion velocity was measured in 45 normal subjects and 48 patients with CAD, and the parameters of QTVI were analyzed between the two groups.

RESULTSVelocity decrement and wave form alterations were shown in abnormal segmental movements in the CAD group. There were obvious differences in the velocity between normal and abnormal segment.

CONCLUSIONQTVI is valuable in quantitative and sensitive evaluation of regional wall movement abnormalities for non-invasive diagnosis of CAD.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; diagnosis ; diagnostic imaging ; physiopathology ; Echocardiography, Doppler ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Ventricular Dysfunction, Left ; diagnosis ; diagnostic imaging ; physiopathology

OBJECTIVETo investigate the effect of Manshuailing Oral Liquid (MSL) on left ventricular diastolic dysfunction (LVDD) in patients with heart disease.

METHODSNinety patients with LVDD were randomly divided into the conventional treated group (Group A, treated by conventional treatment with western drugs of cardiotonic, diuretic, coronary dilator, etc.) and the Chinese drug treated group (Group B, treated by conventional treatment plus MSL 2 times a day, 100 ml each time), 45 in each group. After 4 months treatment, the total heart failure coefficient (HFC) and cardiac functions were re-determined.

RESULTSAfter treatment, in both groups, the HFC lowered significantly (P < 0.05 or P < 0.01), the left ventricular peak velocity of early diastolic rapid filling (Emas) quickened, the left atrial systolic peak velocity (Amas) slowed down and Emas/Amas (E/A) enhanced, the isovolumetric relaxation time shortened. However, comparison between the two groups showed significant difference (P < 0.05) in either item, Group B was superior to Group A (P < 0.05). In the 62 patients with mixed heart failure, i.e. both systolic and diastolic dysfunction of left ventricle, Group B was superior to Group A in increasing ejection fraction, cardiac output and thickening rate of left ventricular posterior wall (P < 0.05).

CONCLUSIONMSL could improve the heart function of patients with LVDD, and alleviate their clinical symptoms.

Aged ; Cardiac Output, Low ; drug therapy ; physiopathology ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Ventricular Dysfunction, Left ; drug therapy ; physiopathology ; Yang Deficiency ; drug therapy