In this study, 120 patients with rheumatic heart disease undergoing valve replacement were randomly divided into the control group and the Qishen group, with 60 cases in each group. Before the operation, the control group was given routine heart and diuretic treatments and placebo of Qishen Yiqi dropping pills for seven days (0.5 g each time, three times a day); While the Qishen group was given Qishen Yiqi dropping pills for seven days (0.5 g each time after meal, three times a day) on the basis of the routine treatments. The right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (SV) and right ventricular ejection fraction (RVEF) were detected after the operation. The results showed that patients in the two groups showed significantly lower right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and stroke volume (SV) decreased than that before the operation, but with significantly higher Ejection fraction (RVEF) significantly than that before the operation. However, the Qishen group showed a significantly lower right heart function reduction than the control group, with the statistical significance in the differences (P < 0.05). This indicated that the pretreatment with Qishenyiqi Drop Pills showed a remarkable efficacy in the improvement of right ventricular function after valve replacement.
Aged ; Cardiac Valve Annuloplasty ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart Valve Diseases ; drug therapy ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Perioperative Care ; Ventricular Function, Right ; drug effects

OBJECTIVEAlthough several reports documented the association of congenital hypothyroidism (CH) and left ventricular (LV) function in infants or neonates, right ventricular (RV) function in neonates with CH has not been previously studied. The aim of the present study was to assess RV function in neonates with CH before and after thyroxine substitution therapy by quantitative tissue velocity imaging (QTVI) and tissue tracking imaging (TTI).

METHODSFifty-two neonates aged 18-28 days (25 males and 27 females) with CH and 35 healthy neonates aged 18-28 days (16 males and 19 females) were studied by QTVI, TTI as well as conventional pulsed-wave Doppler echocardiography (PWD). The standard apical four-chamber view for long-axis motion of the right ventricle was used for echocardiographic evaluation. Peak systolic displacement (D), peak systolic velocity (Vs), peak early (Ve) and late (Va) diastolic velocity of tricuspid annule were measured, Ve/Va ratio was calculated as well. Transtricuspid flow velocity during early diastole (E) and late diastole (A) were also measured by pulsed-wave Doppler echocardiography. PWD and E/A ratio were calculated too. For each neonate, serum hormone levels of TSH, TT(3), TT(4), FT(3) and FT(4) were measured with a standard chemiluminescent immunoassay. After 1 month of levothyroxine (L-T(4)) substitution therapy in CH neonates, all the echocardiographic evaluations and biochemical tests were re-evaluated. Correlation analysis was also made between serum thyroid hormones levels and right ventricular function.

RESULTSThe indices of right ventricular diastolic function by PWD (E and E/A ratio) in CH group were (45 +/- 10) cm/s and (0.8 +/- 0.3), respectively. Compared with controls, E and E/A ratio in CH neonates were significantly lower (P < 0.001, respectively), while A did not differ between the two groups (P > 0.05). QTVI and TTI showed that right diastolic function (Ve and Ve/Va ratio) as well as right systolic function (Vs and D) in CH group were (3.69 +/- 1.38) cm/s, (0.74 +/- 0.19) cm/s, (4.38 +/- 0.63) cm/s and (0.52 +/- 0.12) cm, respectively. CH neonates had significantly lower Ve, Ve/Va ratio, Vs and D of tricuspid annular velocity (P < 0.001, respectively), whereas there was no significant difference in Va between the two groups (P > 0.05). After 1 month of substitutive therapy, CH neonates showed a significant increase of Ve, Ve/Va ratio, Vs, D, E, and E/A ratio, (6.92 +/- 1.86) cm/s, (1.13 +/- 0.22), (5.92 +/- 1.03) cm/s, (0.78 +/- 0.17) cm, (61 +/- 10) cm/s and (1.1 +/- 0.4), respectively (P < 0.001). Those parameters were positively correlated with serum TT(3), TT(4), FT(3) and FT(4) levels (P < 0.01, respectively), and were negatively correlated with serum TSH levels (P < 0.01, respectively).

CONCLUSIONSOur findings suggest that neonates with CH are associated with right ventricular subclinical systolic and diastolic dysfunction, which can be reversed by early L-T(4) substitution therapy. QTVI and TTI are valuable methods to evaluate right ventricular function in neonates. Systolic and diastolic velocities of the tricuspid annulus measured by QTVI and TTI are useful and accurate to assess RV function in neonates.

Adult ; Blood Flow Velocity ; Child, Preschool ; Congenital Hypothyroidism ; physiopathology ; Diastole ; drug effects ; physiology ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Female ; Heart Ventricles ; drug effects ; physiopathology ; Humans ; Male ; Systole ; drug effects ; physiology ; Thyrotropin ; pharmacology ; Thyroxine ; blood ; pharmacology ; Tricuspid Valve ; physiopathology ; Ventricular Function, Left ; drug effects ; physiology ; radiation effects ; Ventricular Function, Right ; drug effects ; physiology

This investigation evaluated the effect of continuous milrinone infusion on right ventriclular (RV) function during off-pump coronary artery bypass graft (OPCAB) surgery in patients with reduced RV function. Fifty patients scheduled for OPCAB, with thermodilution RV ejection fraction (RVEF) <35% after anesthesia induction, were randomly allocated to either milrinone (0.5 microgram/kg/min) or control (saline) group. Hemodynamic variables and RV volumetric data measured by thermodilution method were collected as follows: after anesthesia induction (T1); 10 min after heart displacement for obtuse marginal artery anastomosis (T2); after pericardial closure (T3). Cardiac index and heart rate increased and systemic vascular resistance significantly decreased in milrinone group at T2. Initially lower RVEF of milrinone group was eventually comparable to control group after milrinone infusion. RVEF did not significantly change at T2 and T3 in both groups. RV end-diastolic volume in milrinone group consistently decreased from the baseline at T2 and T3. Continuous infusion of milrinone without a bolus demonstrated potentially beneficial effect on cardiac output and RV afterload in patients with reduced RV function during OPCAB. However, aggressive augmentation of intravascular volume seems to be necessary to maximize the effect of the milrinone in these patients.
Ventricular Function, Right/*drug effects ; Phosphodiesterase Inhibitors/*pharmacology ; Milrinone/*pharmacology ; Middle Aged ; Male ; Humans ; Heart Rate/drug effects ; Female ; Echocardiography, Transesophageal ; *Coronary Artery Bypass, Off-Pump ; Blood Pressure/drug effects ; Aged

OBJECTIVETo observe the effect of Shufei Granule (SG) on right ventricular function in patients with chronic pulmonary heart disease (CPHD).

METHODSOne hundred CPHD patients were randomly divided into two groups, the control group (n = 40) treated with fleroxacin 0.2 g twice per day by intravenous dripping and diprophylline 0.2 g 3 times per day orally, the treatment group (n = 60) treated with SG 10 g 3 times a day orally additionally besides the treatment given to the control group. The therapeutic course for both groups was 3 weeks. The changes of the cardiac function, the right ventricular function [A peak velocity (VA), E peak velocity (VE), VA/VE, systolic pulmonary artery pressure (SPAP), pre-ejection period (PEP), right ventricular ejection time (RVET), PEP/RVET], and blood-gas analysis were investigated, the condition of clinical symptoms and signs as well as tongue pictures were observed also.

RESULTSThe total effective rate was 91.6% in the treated group, significantly higher than that in the control group (70.0%, P < 0.01); the improvements in symptom score, cardiac function and the other laboratory indexes were all superior in the treatment group to those in the control group (P < 0.05, P < 0.01).

CONCLUSIONSG is an effective drug for improving right ventricular function in CPHD patients.

Adult ; Aged ; Chronic Disease ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Dyphylline ; therapeutic use ; Female ; Fleroxacin ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pulmonary Heart Disease ; drug therapy ; physiopathology ; Ventricular Function, Right ; drug effects