BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden ...BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden and become narrower due to plaque buildup-cholesterol and other material-on their inner walls.As a result,the heart muscle cannot receive the blood or oxygen it needs.Most heart attacks happen when a blood clot suddenly cuts off the hearts'blood supply,causing permanent heart damage.AIM To analyze the relationship between the left ventricular ejection fraction(LVEF),left ventricular strain(LVS),and coronary stenosis.METHODS A total of 190 participants were enrolled in this trail.The control group comprised 93 healthy individuals,and observation group comprised 97 patients with coronary heart disease who were hospitalized between July 2020 and September 2021.Coronary lesions were assessed using the Gensini score,and the LVEF and LVS were measured using magnetic resonance imaging(MRI).The interaction between the LVEF and LVS was examined using a linear regression model.The relationship between LVEF and coronary stenosis was examined using Spearman’s correlation.RESULTS The LVEF of the observation group was lower than that of the control group.The left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)of the observation group were significantly higher than those of the control group(P<0.05).The longitudinal and circumferential strains(LS,CS)of the observation group were significantly higher than those of the control group;however,the radial strain(RS)of the observation group was significantly lower than that of the control group(P<0.05).LVS,LS,and CS were significantly negatively correlated with the LVEF,and RS was positively correlated with the LVEF.There were significant differences in the LVEF,LVESV,and LVEDV of patients with different Gensini scores;the LVEF significantly decreased and the LVESV and LVEDV increased with increasing Gensini scores(P<0.05).In the o展开更多
BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and le...BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and 展开更多
Objective： Comparison of global end-diastolic volume index （GEDVI） obtained by femoral and jugular transpulmonary thermodilution （TPTD） indicator injections using the EV1000NolumnView device （Edwards Lifesci- e...Objective： Comparison of global end-diastolic volume index （GEDVI） obtained by femoral and jugular transpulmonary thermodilution （TPTD） indicator injections using the EV1000NolumnView device （Edwards Lifesci- ences, Irvine, USA）. Methods： In an 87-year-old woman with hypovolemic shock and equipped with both jugular and femoral vein access and monitored with the EV1000NolumeView device, we recorded 10 datasets, each comprising duplicate TPTD via femoral access and duplicate TPTD （20 ml cold saline） via jugular access. Results： Mean femoral GEDVI （（674.6±52.3） ml/m2） was significantly higher than jugular GEDVI （（552.3±69.7） ml/m2）, with P=-0.003. Bland-Airman analysis demonstrated a bias of （＋122±61） ml/m2, limits of agreement of -16 and ＋260 ml/m2, and a percentage error of 22%. Use of the correction-formula recently suggested for the PiCCO device significantly reduced bias and percentage error. Similarly, mean values of parameters derived from GEDVI such as pulmonary vascular permeability index （PVPI; 1.244±0.101 vs. 1.522±0.139; P〈0.001） and global ejection fraction （GEF; （24.7±1.6）% vs. （28.1±1.8）%; P〈0.001） were significantly different in the case of femoral compared to jugular indicator injection. Fur- thermore, the mean cardiac index derived from femoral indicator injection （（4.50±0.36） L/（min.m2）） was significantly higher （P=0.02） than that derived from jugular indicator injection （（4.12±0.44） L/（min.m2））, resulting in a bias of （＋0.38±0.37） L/（min.m2） and a percentage error of 19.4%. Conclusions： Femoral access for indicator injection results in markedly altered values provided by the EV1000NolumeView , particularly for GEDVI, PVPI, and GEF.展开更多
Objective To investigate the relations between the pathological contraction of the valve and sub-valvular apparatus in rheumatic mitral stenosis and end-diastolic volume of left ventricle. Method From 1990-2004, 90 pa...Objective To investigate the relations between the pathological contraction of the valve and sub-valvular apparatus in rheumatic mitral stenosis and end-diastolic volume of left ventricle. Method From 1990-2004, 90 patients with only moderate or severe rheumatic mitral stenosis （mitral group）, and 24 patients with combined moderate or severe rheumatic mitral stenosis and significant aortic regurgitation （ combined valves group）, diagnostically confirmed by surgery and pathology, were measured using echocardiaogram the end-diastolic volume and diameter, stroke volume and ejection fraction of left ventricle. Result Compared with mitral group combined valves group showed slight increases of end-diastolic volume and diameter （116.49 ± 37.93 ml and 136.72±70.67 ml, respectively; 49.34 ± 6.71 mm and 51.08 ± 8.32 mm, respectively; both P 〈 0.05）, and slight decreases of ejection fraction, but significant increases of stroke volume （71.37 ± 25.01 ml and 91.06 ± 36.67 ml, respectively; P〈0.05） of left ventricle. Conclusion The pathological shortening of mitral valve and sub-valvular apparatus caused by long-term rheumatic disease is the main cause of decreased left ventricular volume in mitral stenosis.展开更多
背景慢性阻塞性肺疾病(COPD)患者通常合并右心功能不全,合并感染性休克时应用中心静脉压(CVP)指导液体治疗的价值甚微。随着超声在重症医学科的广泛应用,床边获取患者左心室流出道速度时间积分(VTI)已成为可能,VTI近似于心脏每搏量,用...背景慢性阻塞性肺疾病(COPD)患者通常合并右心功能不全,合并感染性休克时应用中心静脉压(CVP)指导液体治疗的价值甚微。随着超声在重症医学科的广泛应用,床边获取患者左心室流出道速度时间积分(VTI)已成为可能,VTI近似于心脏每搏量,用这一参数反映患者的容量反应性较中心静脉压具有明显优势。目的探讨VTI指导COPD合并感染性休克患者液体治疗的临床效果。方法选取2017年3月—2018年6月江苏省苏北人民医院重症医学科收治的COPD合并感染性休克患者。采用随机数字表法将患者分为CVP组、全心舒张末期容积指数(GEDVI)组和VTI组。CVP组根据CVP进行液体治疗,使CVP达到15 mm Hg为终点;GEDVI组根据GEDVI进行液体治疗,使GEDVI达到800 ml/m^(2);VTI组根据液体治疗后VTI增加幅度指导液体治疗,直至VTI增加<15%。收集患者的临床资料[年龄、性别、入ICU时急性生理与慢性健康状况评分系统(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、平均动脉压、CVP、血乳酸水平、氧合指数以及合并肺动脉高压情况]及液体治疗前后相关数据(患者6 h液体复苏量,6 h、24 h去甲肾上腺素用量,24 h液体复苏量,24 h血乳酸水平,24 h血乳酸清除率,72 h APACHEⅡ评分、72 h SOFA评分,肾脏替代治疗率,机械通气时间,ICU住院时间,病死率)并比较。结果 3组患者6 h液体复苏量、6 h去甲肾上腺素用量、24 h血乳酸水平、24 h血乳酸清除率、72 h APACHEⅡ评分、72 h SOFA评分、肾脏替代治疗率、机械通气时间、ICU住院时间、病死率比较,差异无统计学意义(P>0.05)。GEDVI组、VTI组24 h液体复苏量多于CVP组(P<0.05)。VTI组24 h去甲肾上腺素用量少于CVP组及GEDVI组(P<0.05)。结论以VTI指导的COPD合并感染性休克患者的液体治疗,能准确评估患者所需液体治疗量,明显降低患者去甲肾上腺素用量。展开更多
文摘BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden and become narrower due to plaque buildup-cholesterol and other material-on their inner walls.As a result,the heart muscle cannot receive the blood or oxygen it needs.Most heart attacks happen when a blood clot suddenly cuts off the hearts'blood supply,causing permanent heart damage.AIM To analyze the relationship between the left ventricular ejection fraction(LVEF),left ventricular strain(LVS),and coronary stenosis.METHODS A total of 190 participants were enrolled in this trail.The control group comprised 93 healthy individuals,and observation group comprised 97 patients with coronary heart disease who were hospitalized between July 2020 and September 2021.Coronary lesions were assessed using the Gensini score,and the LVEF and LVS were measured using magnetic resonance imaging(MRI).The interaction between the LVEF and LVS was examined using a linear regression model.The relationship between LVEF and coronary stenosis was examined using Spearman’s correlation.RESULTS The LVEF of the observation group was lower than that of the control group.The left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)of the observation group were significantly higher than those of the control group(P<0.05).The longitudinal and circumferential strains(LS,CS)of the observation group were significantly higher than those of the control group;however,the radial strain(RS)of the observation group was significantly lower than that of the control group(P<0.05).LVS,LS,and CS were significantly negatively correlated with the LVEF,and RS was positively correlated with the LVEF.There were significant differences in the LVEF,LVESV,and LVEDV of patients with different Gensini scores;the LVEF significantly decreased and the LVESV and LVEDV increased with increasing Gensini scores(P<0.05).In the o
文摘BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and
文摘Objective： Comparison of global end-diastolic volume index （GEDVI） obtained by femoral and jugular transpulmonary thermodilution （TPTD） indicator injections using the EV1000NolumnView device （Edwards Lifesci- ences, Irvine, USA）. Methods： In an 87-year-old woman with hypovolemic shock and equipped with both jugular and femoral vein access and monitored with the EV1000NolumeView device, we recorded 10 datasets, each comprising duplicate TPTD via femoral access and duplicate TPTD （20 ml cold saline） via jugular access. Results： Mean femoral GEDVI （（674.6±52.3） ml/m2） was significantly higher than jugular GEDVI （（552.3±69.7） ml/m2）, with P=-0.003. Bland-Airman analysis demonstrated a bias of （＋122±61） ml/m2, limits of agreement of -16 and ＋260 ml/m2, and a percentage error of 22%. Use of the correction-formula recently suggested for the PiCCO device significantly reduced bias and percentage error. Similarly, mean values of parameters derived from GEDVI such as pulmonary vascular permeability index （PVPI; 1.244±0.101 vs. 1.522±0.139; P〈0.001） and global ejection fraction （GEF; （24.7±1.6）% vs. （28.1±1.8）%; P〈0.001） were significantly different in the case of femoral compared to jugular indicator injection. Fur- thermore, the mean cardiac index derived from femoral indicator injection （（4.50±0.36） L/（min.m2）） was significantly higher （P=0.02） than that derived from jugular indicator injection （（4.12±0.44） L/（min.m2））, resulting in a bias of （＋0.38±0.37） L/（min.m2） and a percentage error of 19.4%. Conclusions： Femoral access for indicator injection results in markedly altered values provided by the EV1000NolumeView , particularly for GEDVI, PVPI, and GEF.
文摘Objective To investigate the relations between the pathological contraction of the valve and sub-valvular apparatus in rheumatic mitral stenosis and end-diastolic volume of left ventricle. Method From 1990-2004, 90 patients with only moderate or severe rheumatic mitral stenosis （mitral group）, and 24 patients with combined moderate or severe rheumatic mitral stenosis and significant aortic regurgitation （ combined valves group）, diagnostically confirmed by surgery and pathology, were measured using echocardiaogram the end-diastolic volume and diameter, stroke volume and ejection fraction of left ventricle. Result Compared with mitral group combined valves group showed slight increases of end-diastolic volume and diameter （116.49 ± 37.93 ml and 136.72±70.67 ml, respectively; 49.34 ± 6.71 mm and 51.08 ± 8.32 mm, respectively; both P 〈 0.05）, and slight decreases of ejection fraction, but significant increases of stroke volume （71.37 ± 25.01 ml and 91.06 ± 36.67 ml, respectively; P〈0.05） of left ventricle. Conclusion The pathological shortening of mitral valve and sub-valvular apparatus caused by long-term rheumatic disease is the main cause of decreased left ventricular volume in mitral stenosis.
文摘背景慢性阻塞性肺疾病(COPD)患者通常合并右心功能不全,合并感染性休克时应用中心静脉压(CVP)指导液体治疗的价值甚微。随着超声在重症医学科的广泛应用,床边获取患者左心室流出道速度时间积分(VTI)已成为可能,VTI近似于心脏每搏量,用这一参数反映患者的容量反应性较中心静脉压具有明显优势。目的探讨VTI指导COPD合并感染性休克患者液体治疗的临床效果。方法选取2017年3月—2018年6月江苏省苏北人民医院重症医学科收治的COPD合并感染性休克患者。采用随机数字表法将患者分为CVP组、全心舒张末期容积指数(GEDVI)组和VTI组。CVP组根据CVP进行液体治疗,使CVP达到15 mm Hg为终点;GEDVI组根据GEDVI进行液体治疗,使GEDVI达到800 ml/m^(2);VTI组根据液体治疗后VTI增加幅度指导液体治疗,直至VTI增加<15%。收集患者的临床资料[年龄、性别、入ICU时急性生理与慢性健康状况评分系统(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、平均动脉压、CVP、血乳酸水平、氧合指数以及合并肺动脉高压情况]及液体治疗前后相关数据(患者6 h液体复苏量,6 h、24 h去甲肾上腺素用量,24 h液体复苏量,24 h血乳酸水平,24 h血乳酸清除率,72 h APACHEⅡ评分、72 h SOFA评分,肾脏替代治疗率,机械通气时间,ICU住院时间,病死率)并比较。结果 3组患者6 h液体复苏量、6 h去甲肾上腺素用量、24 h血乳酸水平、24 h血乳酸清除率、72 h APACHEⅡ评分、72 h SOFA评分、肾脏替代治疗率、机械通气时间、ICU住院时间、病死率比较,差异无统计学意义(P>0.05)。GEDVI组、VTI组24 h液体复苏量多于CVP组(P<0.05)。VTI组24 h去甲肾上腺素用量少于CVP组及GEDVI组(P<0.05)。结论以VTI指导的COPD合并感染性休克患者的液体治疗,能准确评估患者所需液体治疗量,明显降低患者去甲肾上腺素用量。
