Evaluation of Pulmonary Hypertension Using Tricuspid Regurgitation Spectrum / 中国医学影像学杂志

Purpose The mean pulmonary artery (MPAP) has been widely used as an important parameter to diagnose and evaluate pulmonary hypertension (PH).The purpose of this paper is to compare the efficacy of two methods in evaluating PH,including estimating pulmonary artery systolic pressure (PASP) using Doppler ultrasonography to measure tricuspid regurgitation (TR) velocity,and directly using the peak velocity of TR.Materiasl and Methods From January 2012 to June 2013,eighty patients with left-to-right shunt congenital heart diseases (CHD) planned for closure procedure in Tangdu Hospital of the Fourth Military Medical University and the General Hospital of Shenyang Military region were included in this prospective study,who underwent right heart catheterization to measure pulmonary artery pressure,and underwent Doppler ultrasonography to measure the peak velocity ofTR.Results Using catheter-measured MPAP of≥ 25 mmHg as diagnostic reference,the false positive rate was 62.96％,and the false negative rate 0％ when the estimated PASP of ＞30 mmHg determined by TR method was used to diagnose PH.There was high diagnostic agreement when peak velocity of TR was used to diagnose PH.When 320 cm/s and 340 crn/s were used as diagnostic cutoff values,false positive rates were 14.81％ and 7.41％,and false negative rates were 15.91％ and 20.45％,respectively.Conclusion In patients with left-to-right shunt CHD,peak velocity of TR measured on echocardiography can be used to diagnose PH which overcomes the high false positive rate in estimation method.It is more suitable to diagnose PH when the MPAP is used as the diagnostic criterion.

Application of superior vena cava spectra in prediction of pulmonary hypertension / 中华超声影像学杂志

Objective To analyze the changes of superior vena cava SVC spectra in patients with pulmonary hypertension PH and screen the proper parameters of SVC to predict PH Methods Eighty patients with congenital heart disease who underwent right heart catheterization for the measurement of pulmonary artery pressure were included SVC Doppler ultrasound was performed before the catheterization The cut-off point of SVC parameters in the prediction of PH was analyzed using receiver operator characteristic curve ROC curve Results Eighty subjects were included and there were 61 patients in PH group and 10 patients in the control group whose spectra pattern had four waves The data of the 9 subjects whose SVC spectrum were not four waves were excluded from the analysis Diagnostic criteria for PH was pulmonary artery systolic pressure PASP more than 30 mmHg measured by right heart catheterization The analysis of the peak velocity of SVC waves showed that ventricular systolic wave S reduced ventricular reversal wave VR reduced and the ratio of atrial reversal wave and ventricular systolic wave AR S increased in the PH group Compared with the control group their differences were statistically significant t =2 244 2 063 -2 896 P =0 028 0 043 0 005 The ROC curve showed that the ratio of AR S had better diagnostic effect than other parameters On the ROC curve of AR S when the ratio of AR S was 0 45 the sensitivity was 73 77% and specificity was 80 00% respectively for predicting PH When AR S was used to distinguish the control group from patients with moderate and severe PH group the sensitivity was 82 86% and specificity was 80 00% respectively Conclusions Using the ratio of AR S 0 45 as a cut-off for prediction of PH shows a good sensitivity and specificity which might be an alternative method for assessing PH alternative method for assessing PH.

Establishment of a canine model with acute thrombo-embolic pulmonary hypertension guided by echocardiography / 中华超声影像学杂志

Objective To establish a canine model with acute thrombo-embolic pulmonary hypertension monitored by echocardiography. Methods Simulated the pathophysiologic process of acute thrombo-embolic pulmonary hypertension in human, the canine model was developed. The femoral vein puncture and the right heart catheterization to monitor pulmonary artery pressure were operated guided by echocardiography, while the autologous blood clot was injected to the contralateral femoral vein. The criteria of model was the pulmonary artery systolic pressure was higher than 30 mmHg. Results Echocardiography can accurately guide the placement of right heart catheterization and ancillarily observe the pressure testing of pulmonary artery. Of twenty seven healthy experiment dogs, twenty four models with acute thromboembolic pulmonary hypertension were successfully developed. The successful rate was 88.9 %. Conclusions This canine model with acute thrombo-embolic pulmonary hypertension guided by echocardiography is easy to operate and its repeatability is good.

Inhibitory effect of cyclosporin A on growth and collagen synthesis of rat cardiac fibroblasts induced by arginine vasopressin / 药学学报

Aim To investigate the effects of cyclosporin A (CsA) on growth and collagen synthesis of cardiac fibroblasts (CFs) induced by arginine vasopressin (AVP). Methods CFs of neonatal Sprague-Dawley rats were isolated by trypsinization and cultured; growth-arrested CFs were stimulated with 1×10-7 mol·L-1 AVP in the presence or absence of CsA (0.05, 0.5 and 5 μmol·L-1). MTT and flow cytometry techniques were adopted to measure cell number and analyze cell cycle respectively. Collagen synthesis was determined by measurement of hydroxyproline content in culture supernatant with colorimetry. Calcineurin activity was estimated by chemiluminescence. Trypan blue staining to test the viability of CFs. Results 0.05, 0.5 and 5 μmol·L-1 CsA inhibited the increase of CFs number induced by 1×10-7 mol·L-1 AVP in a dose-dependent manner, with the inhibitory rates by 12%, 24% and 29%, respectively (P＜0.05). Furthermore, cell cycle analysis showed 0.5 μmol·L-1 CsA decreased the S stage percentage and proliferation index of CFs stimulated by AVP (P＜0.05). In culture medium, the hydroxyproline content induced by AVP decreased by 0.5 and 5 μmol·L-1 CsA (P＜0.05), with the inhibitory rates of 29% and 33%, respectively. CsA completely inhibited the increment of calcineurin activity induced by AVP (P＜0.01), but CsA itself had no effect on the baseline of calcineurin activity and CFs viability. Conclusion CsA inhibits proliferation and collagen synthesis of CFs by virtue of blocking calcineurin signaling pathway and might provide a novel target for prevention and treatment to cardiac fibrosis.

Calcineurin mediates the collagen synthesis of rat cardiac fibroblasts induced by arginine vasopressin / 医学研究生学报

Objective:To investigate the effects of calcineurin signaling pathway on the collagen synthesis of rat cardiac fibroblasts(CF) induced by arginine vasopressin(AVP). Methods:CF of neonatal Sprague-Dawley rats were secured by trypsinization and Cultured.Collagen content of CF culture medium was estimated by hydroxyproline colorimetry.Calcineurin activity was determined with spectrophotometer.Results:① AVP increased the content of hydroxyproline in culture medium of CF in a concentration dependent manner.But in the presence of 0.5 ?g/ml cyclosporin A(CsA),the specific inhibitor of calcineurin,the hydroxyproline content of culture medium in corresponding AVP+CsA group was significantly lower than that of 10~(-7) mol/L AVP or 10~(-6)mol/L AVP group(both P