BACKGROUND: To study the characteristics of ventricular function in Pulmonary Hypertension (PH) Patients with different shape of Interventricular Septum (IVS) by cardiac magnetic resonance (CMR). METHODS: 36 PH patients diagnosed by right heart catheterization accepted CMR. According to the morphology of IVS, the patients were divided into two groups: the non-deformation group (10 patients) and the deformation group (26 patients). The ventricular function parameters were as follows: RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and myocardial mass index (MMI). RESULTS: ANOVA analysis showed that the differences of RVEDVI, RVESVI, RVSVI, RVCI, RVEF, RVMMI, LVEDVI, LVESVI, LVSVI and LVCI were significant among the three groups. Compared with control group, RVSVI (P=0.017), RVEF (P<0.001), LVEDVI (P=0.048) and LVSVI (P=0.015) decreased in IVS non-deformation group. Compared with IVS non-deformation group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.002) and RVMMI (P=0.017) were increased in IVS deformation group; while RVEF (P=0.001), LVEDVI (P=0.003), LVSVI (P<0.001) and LVCI (P=0.029) were decreased. Compared with the control group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.004) and RVMMI (P=0.003) were increased in the IVS deformation group, while RVEF (P<0.001), LVEDVI (P<0.001), LVESVI (P<0.001), LVSVI (P<0.001), LVCI (P<0.001) were decreased. CONCLUSIONS Ventricular function is different in PH Patients with different IVS shape. The IVS shape can represent the changes of ventricular function in PH patients.
Adult ; Aged ; Female ; Heart ; diagnostic imaging ; physiopathology ; Humans ; Hypertension, Pulmonary ; diagnosis ; diagnostic imaging ; physiopathology ; Lung Neoplasms ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Stroke Volume ; Ventricular Function ; Ventricular Septum ; diagnostic imaging ; physiopathology

PURPOSE: Impaired left ventricular (LV) global longitudinal strain (GLS) and the presence of microalbuminuria indicate early cardiac and renal dysfunction. We aimed to determine the relationships among 24-h ambulatory blood pressure (BP) variables, LV GLS, and urine albumin creatinine ratio (UACR) in hypertensive patients. MATERIALS AND METHODS: A total of 130 hypertensive patients (mean age 53 years; 59 men) underwent 24-h ambulatory BP monitoring, measurements of peripheral and central BPs, and transthoracic echocardiography. Patients with apparent LV systolic dysfunction (LV ejection fraction < 50%) or chronic kidney disease were not included. LV GLS was calculated using two-dimensional speckle tracking, and UACR was analyzed from spot urine samples. RESULTS: In simple correlation analysis, LV GLS showed the most significant correlation with mean daytime diastolic BP (DBP) (r=0.427, p < 0.001) among the various BP variables analyzed. UACR revealed a significant correlation only with night-time mean systolic BP (SBP) (r=0.253, p=0.019). In multiple regression analysis, daytime mean DBP and night-time mean SBP were independent determinants for LV GLS (β=0.35, p=0.028) and log UACR (β=0.49, p=0.007), respectively, after controlling for confounding factors. Daytime mean DBP showed better diagnostic performance for impaired LV GLS than did peripheral or central DBPs, which were not diagnostic. Night-time mean SBP showed satisfactory diagnostic performance for microalbuminuria. CONCLUSION: There are different associations for daytime and night-time BP with early cardiac and renal dysfunction. Ambulatory BP monitoring provides more relevant BP parameters than do peripheral or central BPs regarding early cardiac and renal dysfunction in hypertensive patients.
Blood Pressure/physiology ; *Blood Pressure Monitoring, Ambulatory ; Echocardiography ; Female ; Heart/*physiopathology ; Humans ; Hypertension/diagnostic imaging/*physiopathology ; Kidney/*physiopathology ; Kidney Function Tests ; Male ; Middle Aged ; Regression Analysis ; Systole/physiology ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left/physiology

According to the increasing need for accurate staging of hepatic fibrosis, the ultrasound (US) elastography techniques have evolved significantly over the past two decades. Currently, US elastography is increasingly used in clinical practice. Previously published studies have demonstrated the excellent diagnostic performance of US elastography for the detection and staging of liver fibrosis. Although US elastography may seem easy to perform and interpret, there are many technical and clinical factors which can affect the results of US elastography. Therefore, clinicians who are involved with US elastography should be aware of these factors. The purpose of this article is to present a brief overview of US techniques with the relevant technology, the clinical indications, diagnostic performance, and technical and biological factors which should be considered in order to avoid misinterpretation of US elastography results.
Disease Progression ; Elasticity Imaging Techniques/instrumentation/*methods ; Fatty Liver/complications/diagnostic imaging ; Humans ; Hypertension, Portal/complications ; Liver/*diagnostic imaging/physiopathology ; Liver Cirrhosis/diagnostic imaging/pathology

OBJECTIVETo study changes of left ventricular remodeling (LVR) in hypertension patients with carotid atherosclerosis (CAS) of phlegm-dampness syndrome (PDS).

METHODSDoppler ultrasonography data of CAS were observed in 223 hypertension patients with CAS (as the hypertension group, including 119 patients of the PDS group and 104 of the non-PDS group), 81 CAS patients with non-hypertension, and 19 non-hypertension non-CAS patients (as the control group). The difference in the degree of LVR was compared among the above groups.

RESULTSThe left ventricular posterior wall thickness (LVPWT), inter ventricular septum thickness (IVS), E/A were higher in the hypertension group than in the non-hypertension group (P < 0.05). The left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic diameter (LVESD), stroke volume (SV) were higher in the soft plaque hypertension group and the soft plaque non-hypertension group than in the hard plaque group, the thickening intimal group, and the normal intimal group (P < 0.01 , P < 0.05). The LVEDD, LVESD, and SV were higher, and the ejection fraction (EF) was lower in the PDS hypertension group than in the non-PDS hypertension group (all P < 0.05). Of them, LVEDD, LVESD, and SV were higher in the soft plaque group than in the hard plaque group (P < 0.01), the thickening intimal group (P < 0.01) and the normal intimal group (P < 0.05). There was no statistical difference in PDS hypertension between the soft plaque group and the hard plaque group (P > 0.05).

CONCLUSIONThe hypertension patients with CAS of PDS might be correlated to LVR, and LVR was more obviously in the soft plaque patients.

Aged ; Aged, 80 and over ; Carotid Artery Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Female ; Humans ; Hypertension ; diagnosis ; diagnostic imaging ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ultrasonography ; Ventricular Remodeling

OBJECTIVE: To determine the association between carotid atherosclerosis and renal function in hypertensive patients. METHODS: A total of 2 809 hypertensive patients aged (56.59±10.79) years were enrolled. Carotid intima-media thickness (cIMT) was derived via B-mode ultrasonography and chronic kidney disease (CKD) was evaluated by the estimated glomerular filtration rate (eGFR) with Cockcroft- Gault method. The patients were divided into 3 groups: a normal group, a thick group, and a plaque group according to the results of carotid ultrasonography. RESULTS: The eGFR of the normal group was (111.09±25.61) mL/(min.1.73m(2)), that of the thick group and the plaque group was (94.45±27.14) mL/(min.1.73m(2)) and (85.98±26.92) mL/ (min.1.73m(2)). Binary logistic analysis showed that age (OR=3.590), smoking status (OR=1.543), systolic blood pressure (OR=1.018), diastolic blood pressure (OR=0.977), fasting plasma glucose (OR=1.132), triglyceride (OR=0.873) and eGFR (OR=0.986) were significantly correlated with cIMT. Subgroup analyses on different genders showed that eGFR was a significant independent risk factor in men (OR=0.991) but not in women. CONCLUSION The thicker the cIMT, the lower the eGFR in hypertensive patients. With the development of cIMT, eGFR gradually decreases and contributes to the occurrence and development of early-stage atherosclerosis in hypertensive patients.
Aged ; Atherosclerosis ; Blood Pressure ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; Carotid Intima-Media Thickness ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Renal Insufficiency, Chronic ; Risk Factors ; Smoking

BACKGROUNDPulmonary hypertension (PH) is a set of pathophysiological syndromes characterized by increased pulmonary artery pressure and pulmonary vascular resistance, resulting in increased right ventricular afterload. The left and right ventricles interact through hemodynamics. What impact will PH have on synchronization and function of the left ventricle (LV)? The aim of this study was to evaluate the synchronization of the left ventricular wall motion and left ventricular function in patients with varying degrees of PH using velocity vector imaging (VVI) technology.

METHODSSixty patients with chronic PH served as the experimental group, and 20 healthy volunteers served as the control group. According to the different degrees of pulmonary artery systolic pressure, the experimental group was divided into three groups: mild, moderate, and severe PH groups. The time to peak systolic longitudinal velocity (Tvl), the peak systolic longitudinal velocity (Vsl), the peak diastolic longitudinal velocity (Vel), the peak systolic longitudinal strain (Sl), and strain rate (SRl) in 18 segments were measured in each group.

RESULTSTvl in the control group and each group with PH was reduced from basal to apical segment, and in control group Tvl in various segments of the same wall and in different walls showed no significant difference (P > 0.05). With increase in pulmonary artery pressure, Tvl values measured showed an increasing trend in groups with PH. In groups with PH, Vsl and Vel of each wall were reduced sequentially from basal to apical segments, showing gradient change; Vsl and Vel values measured showed a decreasing trend with increase in pulmonary artery pressure, in which the differences of Vel values measured in the control group and the mild PH group were statistically significant (P < 0.01), and the differences between other groups were statistically significant (P < 0.01). In groups with PH, Sl and SRl in basal segment and the middle segment of each wall were decreased; the difference between groups was statistically significant (P < 0.01).

CONCLUSIONSAsynchronization of the LV and decreased left ventricular function were present in patients with chronic PH; VVI technology can accurately evaluate left ventricular function in patients with PH, and indicators such as Tvl, Vsl, and Vel are valuable.

Adult ; Aged ; Echocardiography ; Elasticity Imaging Techniques ; Female ; Heart Ventricles ; diagnostic imaging ; physiopathology ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Function, Left ; physiology

We sought to explore the feasibility of global area strain to assess left ventricular global systolic function in patients with essential hypertension and normal ventricular geometry. Thirty-five essential hypertensive patients with normal ventricular geometry and 30 normally healthy persons as controls were enrolled in this study. The two groups were comparable for age, sex ratio, height, weight, body mass index (BMI), and heart rate. Blood pressures (BPs) were significantly higher in the hypertension group than the control group. Two-dimensional echocardiography and three-dimensional speckle tracking imaging were performed. Left ventricular global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), LV volumes, ejection fraction (EF), sphericity index (SPI), left ventricular end-diastolic and end-systolic mass (EDmass and ESmass) and LV mass index (EDmassI and ESmassI) were obtained. Compared with those of the controls, GAS, GLS, GCS, GRS were significantly reduced in hypertensive patients Call P < 0.001). GAS (r = 0.672, P < 0. 001), GLS (r = 0.587, P < 0.001), GCS (r = 0.639, P < 0.001) and GRS (r = 0.685, P < 0.001) were correlated with EF in the pooled population. GAS showed an excellent correlation with GCS (r = 0.905, P < 0.001), GLS (r = 0.892, P < 0.001) and GRS (r = 0.990, P < 0.001). EF measured with 3D-STI was significantly lower in group of hypertension (P < 0.001) than that in the controls. There were no significant differences between the two groups in cardiac output, sphericity index, EDmass and ESmass, LV mass index (EDmassI and ESmassI) calculated with 3D-STI. The study showed that GAS could identify early changes of left ventricular global systolic function in hypertensive patients with normal ventricular geometry.
Adult ; Aged ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

OBJECTIVETo evaluate left atrial function in essential hypertension patients with different patterns of left ventricular geometric models by real time three-dimensional echocardiography (RT-3DE) and left atrial tracking (LAT).

METHODSOne hundred and thirty-three patients with essential hypertension were divided into four groups according to criteria proposed by Ganau et al: 36 patients in normal pattern group (I), 34 patients in concentric remodelling pattern group (II), 33 patients in concentric hypertrophy pattern group (III), and 30 patients in eccentric hypertrophy pattern group (IV). Thirty-two healthy volunteers were enrolled in this study. RT-3DE and LAT were used to obtain the volume-time and emptying fraction curves, and then the maximal volume, minimal volume, stroke volume, presystolic volume, ejection fraction, systolic filling rate, early diastolic emptying rate and late diastolic emptying rate of the left atrium were measured. Conduit volume and passive emptying volume of the left atrium were calculated.

RESULTSLeft atrial indexes, conduit volume, passive emptying volume, and early diastolic emptying rate decreased, while the other indices increased in the group I compared with the control group (all P<0.05). Compared with the control group, I and II groups, the left atrial volume parameters manifested change in the group III and group IV (all P<0.01). Left atrial ejection fraction measured by RT-3DE or LAT, and late diastolic emptying rate were lower in the group IV compared with the group III (all P<0.05). There was no difference in left atrial conduit volume, passive emptying volume, and early diastolic left atrial emptying rate between the group II and group I (all P>0.05). There was a positive correlation between RT-3DE and LAT in evaluating left atrial function.

CONCLUSIONSLeft atrial booster pump function decreases in the eccentric hypertrophy pattern. Left atrial conduit function is unchanged in the normal pattern and the concentric remodelling pattern groups. RT-3DE and LAT technology can be used for quantitative evaluation of left atrial volume and function.

Adult ; Aged ; Atrial Function, Left ; Cardiomegaly ; diagnostic imaging ; physiopathology ; Echocardiography, Three-Dimensional ; Female ; Heart Atria ; diagnostic imaging ; physiopathology ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Models, Cardiovascular

OBJECTIVE: To analyze the characteristics of left ventricular rotation and twist in patients with essential hypertension (EH) of different left ventricular configurations by 3-dimensional speckle tracking echocardiography (3D-STE). METHODS: A total of 106 EH patients were divided into 4 groups: a left ventricular normal configuration (LVN) group (n=30), a concentric remodeling (CCR) group (n=31), a concentric hypertrophy (CCH) group (n=29), an eccentric hypertrophy (ECH) group (n=16), and a control group of 30 healthy subjects. The parameters of LVEF, peak basal rotation (Prot-B), peak apical rotation (Prot-A), left ventricular peak apical rotation (LV-rot), and left ventricular peak apical twist (LV-tw) were compared. RESULTS: The left ventricular mass index in the EH groups, which kept increasing, was higher than that in the normal control group (P<0.05). Compared with the normal control group, LVN and ECH group, the left ventricular posterior wall thickness, interventricular septum at end-diastole, and relative wall thickness significantly increased in the CCH and CCR group (P<0.05). LVEF showed no significant difference among the normal control, LVN, CCR and CCH group (P>0.05), but LVEF was lower in the ECH group than in other groups (P<0.05). Compared with the normal control group, Prot-B, Prot-A, LVrot and LVtw were significantly higher in the LVN, CCR and CCH group (P<0.05), but decreased in the ECH group (P<0.05). CONCLUSION 3D-STE can evaluate the left ventricular rotation and twist in EH patients with different configurations, and reflect changes in the left ventricular systolic function in EH of different configurations.
Adult ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology ; Ventricular Remodeling ; physiology

OBJECTIVETo investigate the characteristics of pulmonary valve annular motion by quantitative tissue velocity imaging (QTVI) in children with pulmonary hypertension.

METHODSThe pulmonary valve annular motion was assessed by QTVI in 32 children with pulmonary hypertension and 32 healthy children. The QTVI sample volume was set at the point of pulmonary valve annulus to acquire speed-time curve and the parameters from the views of parasternal aortic short-axis or subxiphoid right ventricular outflow long-axis. The parameters of pulmonary valve annular motion of children with pulmonary hypertension were compared to those of normal children.

RESULTSThe speed-time curve of pulmonary valve annulus was similar with that of tricuspid annulus in normal children. Compared to normal children, the ratio of Ea/Aa (the velocity parameter of pulmonary valve annular motion) was significantly lower in children with pulmonary hypertension (0.68 ±0.36 Compared with 1.18 ±0.43, P<0.001); and the value of QTVI-Tei index at the pulmonary annulus was significantly higher (0.82 ±0.34 Compared with 0.37 ±0.05, P<0.001). The QTVI-Tei index was positively correlated with the resistance of pulmonary vessel (r=0.556, P<0.001).

CONCLUSIONThe ratio of Ea/Aa is decreased, the value of QTVI-Tei index is increased and QTVI-Tei index is positively correlated with the resistance of pulmonary vessel in children with pulmonary hypertension.

Child, Preschool ; Echocardiography, Doppler, Pulsed ; Female ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Infant ; Infant, Newborn ; Male ; Pulmonary Valve ; diagnostic imaging ; physiopathology