Objective To assess segmental ventricular wall motion abnormalities in patients with coronary artery heart disease by velocity vector imaging (VVI).Methods Eight-six patients of chest pain having underwent coronary angiography were selected,and were divided into myocardial ischemia group (31 cases),myocardial infarction group(25 cases) and normal group (30 cases) according to test results.All the patients were checked with ultrasonic cardiogram in specified time.Systolic rotation angle and speed,diastolic rotation speed in the bottom and apex heart of each segment (anterior,anterior septum,posterior,lateral,inferior wall,interval) was analyzed by VVI.Results Rotary motion of the left ventricle was not consistent in different segment in myocardial infarction group,and the extent and form was different compared with that in normal group.Compared with that in normal group,bottom and apex heart angle of rotation of each segment in myocardial infarction group showed significant difference (P ＜ 0.01 or ＜ 0.05).The rotation angle of each segment in apex and bottom heart between myocardial ischemia group and normal group had no statistical significance (P ＞0.05).In bottom heart:the systolic rotation speed on anterior wall,anterior septum,posterior wall and lateral wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed on anterior wall,anterior septum,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The systolic rotation angle between two groups was not statistically significant (P ＞ 0.05).The diastoic rotation speed on anterior interval septum in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant compared with that in normal group (P ＞ 0.05).In apex heart,the systolic rotation speed in anterior wall,anterior septum,posterior wall in myocardial infarction group was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05),and the diastolic rotation speed in anterior wall,posterior wall,lateral wall,inferior wall was statistically lower than that in normal group (P ＜ 0.01 or ＜ 0.05).The diastolic rotation speed on anterior and inferior wall in myocardial ischemia group was statistically lower than that in normal group (P ＜ 0.05),and the systolic rotation angle and speed,diastolic rotation speed in other segment was not statistically significant (P ＞ 0.05) compared with that in normal group.Conclusion VVI technique in ultrasonic cardiogram can check out difference between myocardial ischemia and myocardial infarction incipiently.

Research has shown mutations in the voltage-gated sodium channel gene SCN2A to be associated with developmental delays and infantile seizures in patients with early-onset epileptic encephalopathies (EOEEs). Here, we report the case of an infant with a de novo SCN2A mutation with EOEE who had medically refractory seizures that improved with a ketogenic diet (KD) implemented at an age less than 2 months. On the day of his birth, the infant presented with a pattern of convulsions with dozens of episodes per day. An initial video electroencephalogram revealed poor reactivity of background activity, with multiple partial episodes starting from the right temporal region, and abnormal electrical activity in the right hemisphere. The seizures previously were not controlled with successive therapy with phenobarbital, topiramate, and levetiracetam. Genetic testing revealed the presence of a mutation in the SCN2A gene (c.4425C>G, p.Asn1475Lys). The infant’s seizures decreased significantly with a combination of KD and medication. The present case exemplifies the potential for personalized genomics in identifying the etiology of an illness. Furthermore, the KD appears to feasible in infants younger than 2 months and might elicit good responses to EOEE associated with SCN2A mutation.