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

null

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

null

《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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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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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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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

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

CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao

期刊论文

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

null

期刊论文

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

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

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

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

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