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Incremental value of contrast echocardiography in the diagnosis of left ventricular noncompaction

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《医学前沿（英文）》 2016年 第10卷 第4期   页码 499-506 doi: 10.1007/s11684-016-0473-8

摘要：

Contrast echocardiography with left ventricular opacification (LVO) improves the definition of endocardium in two-dimensional echocardiography (2DE). This study was aimed to determine whether LVO offered added diagnostic value in noncompaction of left ventricular myocardium (NCVM). A total of 85 patients (40±20 years, 54 males) with suspected NCVM were subjected to transthoracic 2DE and LVO, and 40 healthy volunteers were examined with 2DE and assigned as control subjects. The location of NCVM, the thickness ratio of noncompacted to compacted myocardium (NCR), and the cavity size and ejection fraction of LV were quantified. Results revealed that NCVM was mainly located in the LV medium (53.2%), apical (46.2%) segments, and lateral wall (39.8%). The NCR obtained through LVO was greater than that detected through 2DE (4.2±1.3 vs. 3.3±1.2, P<0.001), and higher inter-correlations and less intra- and inter-observer variabilities were determined in the former than in the latter. The NCVM detection rates were also increased from 63.5% via 2DE to 83.5% via LVO and 89.4% via 2DE combined with LVO (2DE+ LVO) (P = 0.0004). The LV cavity size was greater and the LV ejection fraction (LVEF) was lower in the NCVM patients than in the control group (P<0.01). In the NCVM group, the LV cavity size was higher and the LVEF was lower in LVO than in 2DE (P<0.01). In conclusion, contrast echocardiography contributes significant sensitivity and reproducibility to routine transthoracic echocardiography in NCVM diagnosis. Therefore, this technique should be clinically performed to diagnose suspected NCVM.

关键词： echocardiography     left ventricular noncompaction cardiomyopathy     echo contrast media    

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Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports

CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao

《医学前沿（英文）》 2007年 第1卷 第3期   页码 338-342 doi: 10.1007/s11684-007-0065-8

摘要： Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of primary myocardial disease characterized by the regional or global replacement of right ventricular myocardium by fatty and fibrolipomatous tissues. The ARVC, usually presenting with different clinical manifestations and pathological changes, were mainly seen in young men and is one of the main causes of sudden death in the young. Here two autopsied cases of Chinese men aged 30 and 23 years old who appeared healthy but died suddenly while at work are reported respectively. One of the victims had extensive and severe pathological changes in his heart involving the left ventricular wall as well as the ventricular septum and the right atrium. Not only was there a global fatty and fibrolipomatous tissue replacement of the right ventricular myocardia, but also mild sarcoplasmic coagulation in the myocardium and focal lymphocytic infiltration in the myocardial interstitium of the right ventricular wall. In addition, slight atherosclerosis of the coronary artery and intimal thickening of the sino-atrial node were observed. It is believed that there are no marked differences in the pathological changes of ARVC between Chinese patients and patients from western countries. The etiology and pathogenesis of ARVC could not be explained by a single cause or factor and they are probably related to various congenital and acquired causes or factors.

关键词： sarcoplasmic coagulation     acquired     ventricular myocardium     sino-atrial     autopsied    

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Challenges and opportunities in improving left ventricular remodelling and clinical outcome following

《医学前沿（英文）》 2021年 第15卷 第3期   页码 416-437 doi: 10.1007/s11684-021-0852-7

摘要： Over the last half century, surgical aortic valve replacement (SAVR) has evolved to offer a durable and efficient valve haemodynamically, with low procedural complications that allows favourable remodelling of left ventricular (LV) structure and function. The latter has become more challenging among elderly patients, particularly following trans-catheter aortic valve implantation (TAVI). Precise understanding of myocardial adaptation to pressure and volume overloading and its responses to valve surgery requires comprehensive assessments from aortic valve energy loss, valvular-vascular impedance to myocardial activation, force-velocity relationship, and myocardial strain. LV hypertrophy and myocardial fibrosis remains as the structural and morphological focus in this endeavour. Early intervention in asymptomatic aortic stenosis or regurgitation along with individualised management of hypertension and atrial fibrillation is likely to improve patient outcome. Physiological pacing via the His-Purkinje system for conduction abnormalities, further reduction in para-valvular aortic regurgitation along with therapy of angiotensin receptor blockade will improve patient outcome by facilitating hypertrophy regression, LV coordinate contraction, and global vascular function. TAVI leaflet thromboses require anticoagulation while impaired access to coronary ostia risks future TAVI-in-TAVI or coronary interventions. Until comparable long-term durability and the resolution of TAVI related complications become available, SAVR remains the first choice for lower risk younger patients.

关键词： surgical aortic valve replacement     trans-catheter aortic valve implantation     left ventricular hypertrophy and fibrosis     myocardial force-velocity relationship     His-Purkinje pacing     renin-angiotensin system inhibitors     coronary access impairment    

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Assessment of global and regional left ventricular twist and displacement in anterior myocardial infarction

Wei HAN MM, Ming-Xing XIE MD, Qing LV MD, Xin-Fang WANG MD, Li ZHANG MM,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 71-76 doi: 10.1007/s11684-010-0006-9

摘要： The recent development of 2-dimensional strain (2D strain) imaging can provide a powerful alternative for assessing left ventricular (LV) torsion. This study was conducted to evaluate the global and regional left ventricular twist by 2D strain in patients with anterior wall myocardial infarction (AMI). A total of 55 AMI patients were divided into two groups according to their ejection fraction (EF) values (group A: LVEF≥50%; group B: LVEF<50%), and 35 normal people served as the control group. Using 2-dimensional strain software, global and regional LV rotation and displacement were obtained at two planes. Compared with the control group, patients of group A showed reduced peak LV twist of the anterior and anterior-septal wall (9.26±1.89 10.74±2.67; 9.71±1.71 11.36±2.29, both <0.05), but the radial displacement and global twist were maintained (>0.05). Differently, regional and global LV twist and radial displacement in patients of group B deceased significantly, especially in the anterior and anterior-septal wall, as compared with patients in the control or group A (both <0.05). Moreover, a strong correlation was noted between peak twist and radial displacement; the twist-displacement loop was markedly distorted in patients of group B. This study demonstrated that 2D strain has a potential ability for quantification of left ventricular global and segment twist and radial displacement in patients with coronary artery disease.

关键词： echocardiography     twist     two-dimensional strain imaging     coronary artery disease    

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Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction

Hui Wang, Yang Zhang, Zhujun Shen, Ligang Fang, Zhenyu Liu, Shuyang Zhang

《医学前沿（英文）》 2021年 第15卷 第1期   页码 70-78 doi: 10.1007/s11684-020-0749-x

摘要： Recent studies have shown that acute blood glucose elevation in patients with ST-segment elevation myocardial infarction (STEMI) suggests a poor prognosis. To investigate the effect of fasting blood glucose (FBG) on the risk of heart failure (HF) and left ventricular systolic dysfunction (LVSD) in non-diabetic patients undergoing primary percutaneous coronary intervention (PCI) for acute STEMI, we retrospectively recruited consecutive non-diabetic patients who underwent primary PCI for STEMI in our hospital from February 2003 to March 2015. The patients were divided into two groups according to the FBG level. A total of 623 patients were recruited with an age of 61.3±12.9 years, of whom 514 (82.5%) were male. The HF risk (odds ratio 3.401, 95% confidence interval (CI) 2.144–5.395, <0.001) was significantly increased in patients with elevated FBG than those with normal FBG. Elevated FBG was also independently related to LVSD (β 1.513, 95%CI 1.282–1.785, <0.001) in a multiple logistics regression analysis. In conclusion, elevated FBG was independently associated with 30-day HF and LVSD risk in non-diabetic patients undergoing primary PCI for STEMI.

关键词： myocardial infarction     percutaneous coronary intervention     diabetes mellitus     fasting glucose     heart failure    

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Hyperglycemic memory in diabetic cardiomyopathy

《医学前沿（英文）》 2022年 第16卷 第1期   页码 25-38 doi: 10.1007/s11684-021-0881-2

摘要： Cardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

关键词： diabetes     diabetic cardiomyopathy     hyperglycemic memory    

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Machine learning modeling identifies hypertrophic cardiomyopathy subtypes with genetic signature

《医学前沿（英文）》 2023年 第17卷 第4期   页码 768-780 doi: 10.1007/s11684-023-0982-1

摘要： Previous studies have revealed that patients with hypertrophic cardiomyopathy (HCM) exhibit differences in symptom severity and prognosis, indicating potential HCM subtypes among these patients. Here, 793 patients with HCM were recruited at an average follow-up of 32.78 ± 27.58 months to identify potential HCM subtypes by performing consensus clustering on the basis of their echocardiography features. Furthermore, we proposed a systematic method for illustrating the relationship between the phenotype and genotype of each HCM subtype by using machine learning modeling and interactome network detection techniques based on whole-exome sequencing data. Another independent cohort that consisted of 414 patients with HCM was recruited to replicate the findings. Consequently, two subtypes characterized by different clinical outcomes were identified in HCM. Patients with subtype 2 presented asymmetric septal hypertrophy associated with a stable course, while those with subtype 1 displayed left ventricular systolic dysfunction and aggressive progression. Machine learning modeling based on personal whole-exome data identified 46 genes with mutation burden that could accurately predict subtype propensities. Furthermore, the patients in another cohort predicted as subtype 1 by the 46-gene model presented increased left ventricular end-diastolic diameter and reduced left ventricular ejection fraction. By employing echocardiography and genetic screening for the 46 genes, HCM can be classified into two subtypes with distinct clinical outcomes.

关键词： machine learning methods     hypertrophic cardiomyopathy     genetic risk    

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Drug-coated balloon-only strategy for percutaneous coronary intervention of left main coronary artery

《医学前沿（英文）》 2023年 第17卷 第1期   页码 75-84 doi: 10.1007/s11684-022-0950-1

摘要： This retrospective single-center registry study included all consecutive patients who underwent percutaneous coronary intervention (PCI) for a de novo left main coronary artery lesion using drug coated-balloon (DCB)-only strategy between August 2011 and December 2018. To best of our knowledge, no previous studies of DCB-only strategy of treating de novo left main coronary artery disease, exist. The primary endpoint was major adverse cardiovascular events (MACEs) including cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). The cohort was divided into two groups depending on weather the lesion preparation was done according to the international consensus group guidelines. Sixty-six patients (mean age 75±8.6, 72% male), 52% of whom had acute coronary syndrome, underwent left main PCI with the DCB-only strategy. No procedural mortality and no acute closures of the treated left main occurred. At 12 months, MACE and TLR occurred in 24% and 6% of the whole cohort, respectively. If the lesion preparation was done according to the guidelines, the MACE and TLR rates were 21.2% and 1.9%. Left main PCI with the DCB only-strategy is safe leading to acceptable MACE and low TLR rates at one year, if the lesion preparation is done according to the guidelines.

关键词： drug-coated balloon     left main     high bleeding risk     predilatation     calcifield lesion     percutaneous coronary intervention    

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Temporal echocardiography findings in patients with fulminant myocarditis: beyond ejection fraction decline

Houjuan Zuo, Rui Li, Fei Ma, Jiangang Jiang, Kun Miao, Haojie Li, Eike Nagel, Marijana Tadic, Hong Wang, Dao Wen Wang

《医学前沿（英文）》 2020年 第14卷 第3期   页码 284-292 doi: 10.1007/s11684-019-0713-9

摘要： The features of myocardial strains from speckle-tracking echocardiography (STE) have not been well defined in fulminant myocarditis (FM) patients. In this study, changes in the left ventricular ejection fraction (LVEF) and global and layer-specific myocardial strains over time were monitored. We aimed to determine the echocardiographic patterns of FM and ascertain their significance in FM treatment. Twenty patients who were clinically diagnosed with FM and received mechanical life support were prospectively enrolled. Conventional echocardiographic measurements were obtained, and serial strain echocardiography was performed from admission to hospital discharge until LVEF recovery (>50%). Global/regional peak systolic longitudinal strains (GLS/RLS) and layer-specific longitudinal strains were quantified, and their changes with time were monitored in 14 FM patients. All patients had severely impaired cardiac function. Steep improvement in LVEF and GLS were observed within 6 days. Layer-specific strain analysis showed that reduction at admission or recovery at discharge in the endocardium and epicardium strains were equal. In conclusion, FM patients who received mechanical circulatory supports exhibited steep improvement in ventricular function within 6 days. The patchy and diffused distribution pattern of reduced RLS and equally and severely impaired strain in the endocardium and epicardium are valuable features in the diagnosis of FM.

关键词： fulminant myocarditis     acute myocarditis     2D speckle tracking echocardiography     left ventricular function     global longitudinal strain    

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Evaluation of potential failure of rock slope at the left abutment of Jinsha River Bridge by model test

Zhiming ZHAO, Xihua WANG

《结构与土木工程前沿（英文）》 2013年 第7卷 第3期   页码 332-340 doi: 10.1007/s11709-013-0206-x

摘要： Jinsha River Bridge is located on Tiger Leaping Gorge town, China. The left bank slope composes of moderately thick layer of slate overlain by schistose basalt, and where rocks are controlled by two sets of joint planes. To evaluate the stability of the rock slope under bridge foundation, model test and calculation model based on the geological parameters and the slope stability was simulated and analyzed using Universal Distinct Element Code (UDEC) and Finite Element Mehod (FEM). According to model test, failure mainly initiated at the toe with shear movement along the joint planes, eventually resulting in the sliding along the slope surface and formation of tension crack at the crest of the model. This result coincide with the UDEC model, which shows that slope surface will produce loosening damage and slipping expected along the joint planes under different loading conditions. Moreover, the result of FEM analysis indicates that the rock mass under the main pier has potential shear failure region. So, the bridge foundation should be strengthened to prevent the slope failure under external forces.

关键词： slope stability     strength properties     model test     numerical analysis    

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Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature

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《医学前沿（英文）》 2014年 第8卷 第2期   页码 259-263 doi: 10.1007/s11684-014-0321-7

摘要：

Although significant breakthroughs have been achieved in tuberculosis management, we still encounter numerous difficulties in diagnosis and treatment of the disease. Additionally, a new challenge, multidrug-resistant tuberculosis (MDR-TB) with unspecific clinical presentation, often results in delayed diagnosis. In this paper, we reported a case of disseminated tuberculosis with rare presentation of ventricular fibrillation, which proved resistant to both isoniazid and rifampicin. A review of literature showed that ventricular fibrillation or tachycardia in tuberculosis patients with pericarditis or myocarditis has been sporadically reported in the past, but none has been conducted involving patients with MDR-TB infections.

关键词： tuberculosis     MDR-TB     ventricular tachycardia    

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Familial amyloid cardiomyopathy masquerading as chronic Guillain-Barre syndrome: things are not always

null

《医学前沿（英文）》 2017年 第11卷 第2期   页码 293-296 doi: 10.1007/s11684-017-0516-9

摘要：

Familial amyloid cardiomyopathy is a challenging condition that mimics many other diseases, particularly in patients with pronounced neurological presentations and unexplained or equivocal cardiac abnormalities. In this case, a 57-year-old man was admitted for outpatient cardiological evaluation of progressive right heart failure and limb paraesthesias. The patient presented with hypertension, chronic Guillain-Barre syndrome, and sick sinus syndrome. Transthoracic echocardiograms showed a thickened ventricular wall and enlarged atrium. Tissue Doppler showed a restrictive filling pattern. Transthyretin (TTR)-associated amyloidosis, which was revealed by abdominal fat-pad biopsy and DNA analysis, explained the concurrence of independent pathological features, including neuropathy and cardiac involvement. Genetic testing identified a G>T mutation in exon 4 of the transthyretin (TTR) gene. This mutation resulted in the alanine-to-serine substitution at amino acid position 117. Moreover, genetic testing confirmed that the patient’s asymptomatic son carried the same amyloidogenic TTR mutation. Given these findings, the diagnosis of familial amyloid cardiomyopathy, which was misdiagnosed as chronic Guillain-Barre syndrome, was proposed.

关键词： transthyretin (TTR) cardiac amyloidosis     sick sinus syndrome     chronic Guillain-Barre syndrome    

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cannulation of superior vena cava for a hemodialysis patient with an original dysfunctional catheter on the left

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 445-448 doi: 10.1007/s11684-017-0520-0

摘要：

Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter (CUFF) and guided by digital subtraction angiography (DSA) and multidetector computed tomography venography (MDCTV). The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate, right internal jugular, subclavian, and femoral veins. The distal end of the superior vena cava was localized clearly by the original CUFF under DSA. Directed at the distal end of the superior vena cava, a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area. This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein. We believe that our study can provide a new alternative for inserting central venous catheter for such patient.

关键词： superior vena cava     intervention     vascular access exhaustion     catheterization     tunneled cuffed hemodialysis catheter    

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Analytical solution for SH wave propagating through a graded plate of metamaterial

Jinfeng ZHAO, Yongdong PAN, Zheng ZHONG

《机械工程前沿（英文）》 2011年 第6卷 第3期   页码 301-307 doi: 10.1007/s11465-011-0238-7

摘要：

A physical model for the shear horizontal (SH) wave propagating from left-handed material (LHM) through a graded or transition layer to right-handed material (RHM) has been proposed in this paper. After the comparison of the basic wave equations of the electromagnetic, longitudinal, and SH waves, it is found that they take similar differential form. The analytical solutions have been found for power law, hyperbolic, and polynomial profiles. Numerical waveforms of the amplitude and phase of the displacement are obtained for the corresponding profiles. It is found that the waveforms are symmetric for the power law and hyperbolic profiles, and that the waveform for the polynomial profile is shifted and non-symmetric. The shift along with the anti-symmetric profile may provide a way to monitor the wave behavior of the metamaterials.

关键词： left-handed material (LHM)     metamaterial     shear horizontal (SH) wave    

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基于一种全新的优化多变量非等距模型对中国汉族成人左心室多普勒超声心动图测值生理性变异的校正方法 Article

姚桂华, 陈湘云, 杨文静, 张青, 刘静, 梁欢, 孙慧, 许耀, 王丽, 徐金锋, 张澄, 孙丰荣, 张梅, 曾雪迎, 张运

《工程（英文）》 2022年 第16卷 第9期   页码 115-122 doi: 10.1016/j.eng.2021.05.007

摘要：

多数左心室（LV）多普勒超声心动图参数测值随年龄和性别显著变化，因此有必要对其生理性差异进行校正。本研究旨在验证：不同的多普勒参数测值与生物学特征变量间呈异速非线性相关，且其校正常数与校正指数各不同。共测量了1224名健康成人的23个LV多普勒参数。随机选择70%数据（A组）建立优化多变量非线性模型（OMAM），在30%数据（B组）和183名超重人群数据（C组）中验证OMAM的可靠性，并与基于体表面积（BSA）的单变量等距模型（SVIM）进行比较。结果显示，校正前，23个LV多普勒参数均与一个或多个生物学特征变量显著相关，B组中47.8% (11/23)的参数存在性别间差异，经OMAM校正后，81.8% (9/11)的参数消除了性别间差异。OMAM对B组和C组数据的校正成功率分别为100% (23/23)和82.6% (19/23)，建立了独立于生物学特征变量的多普勒参数的OMAM参考值，而基于BSA的SVIM校正成功率为零。不同的LV多普勒参数与一个或多个生物学特征变量呈异速非线性相关；本研究建立的OMAM成功校正了因生物学特征变量差异对健康和超重人群多普勒测值的生理性影响，其校正效果显著优于传统的SVIM。然而，OMAM针对其他种族、肥胖和疾病状态人群的适用性仍需进一步探究

关键词： 多普勒超声心动图     生理性变异     非等距模型     正常参考值    

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标题 作者 时间 类型 操作

Incremental value of contrast echocardiography in the diagnosis of left ventricular noncompaction

null

期刊论文

Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports

CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao

期刊论文

Challenges and opportunities in improving left ventricular remodelling and clinical outcome following

期刊论文

Assessment of global and regional left ventricular twist and displacement in anterior myocardial infarction

Wei HAN MM, Ming-Xing XIE MD, Qing LV MD, Xin-Fang WANG MD, Li ZHANG MM,

期刊论文

Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction

Hui Wang, Yang Zhang, Zhujun Shen, Ligang Fang, Zhenyu Liu, Shuyang Zhang

期刊论文

Hyperglycemic memory in diabetic cardiomyopathy

期刊论文

Machine learning modeling identifies hypertrophic cardiomyopathy subtypes with genetic signature

期刊论文

Drug-coated balloon-only strategy for percutaneous coronary intervention of left main coronary artery

期刊论文

Temporal echocardiography findings in patients with fulminant myocarditis: beyond ejection fraction decline

Houjuan Zuo, Rui Li, Fei Ma, Jiangang Jiang, Kun Miao, Haojie Li, Eike Nagel, Marijana Tadic, Hong Wang, Dao Wen Wang

期刊论文

Evaluation of potential failure of rock slope at the left abutment of Jinsha River Bridge by model test

Zhiming ZHAO, Xihua WANG

期刊论文

Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature

null

期刊论文

Familial amyloid cardiomyopathy masquerading as chronic Guillain-Barre syndrome: things are not always

null

期刊论文

cannulation of superior vena cava for a hemodialysis patient with an original dysfunctional catheter on the left

null

期刊论文

Analytical solution for SH wave propagating through a graded plate of metamaterial

Jinfeng ZHAO, Yongdong PAN, Zheng ZHONG

期刊论文

基于一种全新的优化多变量非等距模型对中国汉族成人左心室多普勒超声心动图测值生理性变异的校正方法

姚桂华, 陈湘云, 杨文静, 张青, 刘静, 梁欢, 孙慧, 许耀, 王丽, 徐金锋, 张澄, 孙丰荣, 张梅, 曾雪迎, 张运

期刊论文