ABSTRACT
SUMMARY OBJECTIVE: The objective of this study was to evaluate the right ventricular myocardial performance index) based on echocardiography in very low birth weight premature neonates, close to hospital discharge. METHODS: This was a prospective cross-sectional study that included premature neonates with birth weight <1,500 g and gestational age <37 weeks at the Intermediate Neonatal Unit of Bonsucesso Federal Hospital from July 2005 to July 2006. The infants underwent two-dimensional color Doppler echocardiography, being the right ventricular myocardial performance index evaluated close to hospital discharge. We compared the neonatal and echocardiographic variables in neonates with and without bronchopulmonary dysplasia. RESULTS: A total of 81 exams were analyzed. The mean birth (standard deviation) weight and gestational age were 1,140 (235) g and 30 (2.2) weeks, respectively. The incidence of bronchopulmonary dysplasia was 32%. The mean right ventricle myocardial performance index (standard deviation) of the sample was 0.13 (0.06). We found a significant difference in aortic diameter [non-bronchopulmonary dysplasia 0.79 (0.07) vs. bronchopulmonary dysplasia 0.87 (0.11) cm, p=0.003], left ventricle in diastole [non-bronchopulmonary dysplasia 1.4 (0.19) vs. bronchopulmonary dysplasia 1.59 (0.21) cm, p=0.0006], ventricular septal thickness [non-bronchopulmonary dysplasia 0.23 (0.03) vs. bronchopulmonary dysplasia 0.26 (0.05) cm, p=0.032], and "a" measurement [(= sum of the isovolumetric contraction time, ejection time, and isovolumetric relaxation time) when calculating the myocardial performance index (p=0.01)]. CONCLUSION: Higher "a" interval in neonates with bronchopulmonary dysplasia suggests right ventricle diastolic dysfunction. We conclude that the right ventricle myocardial performance index is an important indicator both of ventricular function and for serial follow-up testing of very low birth weight premature neonates, especially those with bronchopulmonary dysplasia.
ABSTRACT
Objective To investigate the related factors and prognosis of pulmonary hypertension (PAH) in hemodialysis (HD) patients for early diagnosis and intervention of PAH.Methods A retrospective cohort study was conducted in 183 long-term hemodialysis patients with complete follow-up data from January 1,2010 to December 30,2015 from the blood purification center of the Third Affiliated Hospital of Sun Yat-sen University.The follow-up deadline was December 30,2017,and the endpoints were death and cardiovascular events.The clinical data,laboratory examinations,cardiac color Doppler ultrasound parameters and prognosis of patients with and without PAH were compared.Multivariate logistic regression was used to analyze the risk factors for PAH in HD patients.The survival rates were calculated by Kaplan-Meier method,and the survival curves were compared by Log-rank test between the two groups.A multivariate Cox proportional hazard regression model was used to examine the association between PAH and all-cause mortality in HD patients.Results Of the 183 hemodialysis patients,79(43.2％) were female,104(56.8％) were male,and the age was (56.1±16.9) years,of which 72(39.3％) were complicated with PAH.Compared with the non-PAH group,patients in the PAH group was older and had a longer duration of dialysis (both P ＜ 0.05).The left atrial diameter (P=0.002) and the proportion of valvular calcification (P=0.004) were significantly higher in the PAH group than that in the non-PAH group.Logistic regression analysis showed increased age (OR=1.027,95％ CI 1.001-1.053,P=0.041) and increased duration of dialysis (OR=1.129,95％ CI 1.004-1.269,P=0.042) were risk factors for PAH in HD patients.After a median follow-up of 27.8 months,Kaplan-Meier survival analysis showed that all-cause mortality was higher in the PAH group than that in the non-PAH group ~x2=5.636,P=0.018).The main cause of death in two groups was cardiovascular event.Afteradjusting for age,diabetes mellitus,duration of dialysis,valvular calcification,and hypertension,Cox regression showed that PAH increased the risk of all-cause mortality in HD patients (HR=1.894,95％ CI 1.083-3.313,P=0.025).Conclusions HD patients complicated with PAH are more common and the prognosis is poor.Increased age and increased duration of dialysis may be risk factors for PAH in HD patients.Regular color Doppler echocardiography is helpful for early detection and diagnosis of PAH.
ABSTRACT
To explore diagnostic significance of treadmill exercise test (TET) combined echocardiography (ECG) for coronary heart disease (CHD) and its severity .Methods :Clinical data of 400 patients who were initially diagnosed as CHD were retrospectively analyzed .With coronary angiography as gold standard ,sensitivities and spe‐cificities of single TET ,single ECG and TET + ECG ,and positive detection rate of different number of diseased vessels were analyzed .Results : Compared with single TET and single ECG ,there was significant reduction in sensi‐tivity (80.67%,68. 07% vs.54.20%) and significant rise in specificity (74.07%,64.82% vs.90.74%) in TET +ECG , P＜0. 01 all.Along with number of diseased coronary vessels rose ,positive detection rates of single TET ,sin‐gle ECG and TET + ECG increased .Compared with single TET and single ECG ,there were significant rise ? In positive detection rates of single vessel coronary disease (72. 32%,56. 25% vs.83.93%) ,double vessel coronary disease (85. 92%,71. 83% vs.97. 18%) and multi vessel coronary disease (90. 91%, 87.27% vs.98. 18%) in TET+ ECG , P＜0.05 or ＜0. 01. Conclusion :Diagnostic specificity of TET + ECG is significantly better than those of single TET and single ECG ;when number of diseased coronary vessels gets more ,positive detection rate of TET +ECG is more significant .
ABSTRACT
Objective To evaluate the efficacy and safety of chloral hydrate combined with dexmedetomidine for sedation during echocardiography in pediatric patients with Williams-Beuren syndrome.Methods Eighteen pediatric patients diagnosed with Williams-Beuren syndrome by genetic testing,aged 5-58 months,scheduled for elective echocardiography under sedation,received oral chloral hydrate 50 mg/kg.Vital signs were measured every 5 min,and sedation was assessed using Ramsay sedation score.When Ramsay sedation score＜4 points 20 min later,intranasal dexmedetomidine 1 μg/kg was given as rescue sedative.Medicine used,vital signs,onset time,moderate and deep sedation duration and emergence time were recorded.Results The success rate of sedation with chloral hydrate alone was 38.9％ and with chloral hydrate and dexmedetomidine 61.1％.The onset time,sedation duration and emergence time were (15.7+1.9) min,(75+26) min and (52+25) min,respectively,in pediatric patients received chloral hydrate alone.The onset time,sedation duration and emergence time were (33.2±3.4) min,(83±49) min and (61±46) min,respectively,in pediatric patients received chloral hydrate and dexmedetomidine.The onset time was significantly prolonged in pediatric patients received chloral hydrate and dexmedetomidine than in pediatric patients received chloral hydrate alone (P＜0.05).Heart rate,respiratory rate and SpO2 were stable during sedation in all pediatric patients,and nausea and mild vomiting were found in 3 pediatric patients received chloral hydrate and in 6 pediatric patients received chloral hydrate and dexmedetomidine,and no other adverse reactions were observed.Conclusion Oral chloral hydrate 50 mg/kg combined with intranasal dexmedetomidine 1 μg/kg provides reliable sedative efficacy and exerts less influence on respiratory and circulatory function with higher safety when used for echocardiography in pediatric patients with Williams-Beuren syndrome.
ABSTRACT
Objective To investigate the clinical value of dynamic electrocardiogram (ECG),heart color Doppler ultrasound in the diagnosis of the paroxysmal atrial fibrillation .Methods A total of 130 cases of suspected paroxysmal atrial fibrillation in Zhejiang Rongjun Hospital were included in the study .The patients received routine ECG,dynamic ECG,heart color Doppler ultrasound examination ,the examination results were analyzed .The clinical comprehensive diagnosis was used as the diagnostic reference ,the diagnostic sensitivity,specificity,accuracy of three methods in the diagnosis of paroxysmal atrial fibrillation were compared .And the consistency coefficient of three examination results and clinical diagnosis of paroxysmal atrial fibrillation was compared .Results The sensitivity, specificity and accuracy of the heart color Doppler ultrasound in diagnosis of paroxysmal atrial fibrillation were 94.23%,96.15%,94.61%,respectively,which of the dynamic ECG were 97.12%,100.00%,97.69%,respectively, which of the routine ECG were 83.65%,76.92%,82.31%,respectively.The diagnostic sensitivity ,specificity and accuracy of the heart color Doppler ultrasound were higher than those of the routine ECG (χ2＝5.915,4.127,9.646, all P＜0.05).The diagnostic sensitivity,specificity and accuracy of the dynamic ECG were also higher than those of the routine ECG(χ2＝10.843,6.783,17.094,all P＜0.05),the differences of the heart color Doppler ultrasound and dynamic ECG were not statistically significant (χ2＝1.045,1.020,1.664,all P＞0.05).The consistency coeffi－cient of the heart color Doppler ultrasound ,dynamic ECG with the results of clinical diagnosis were 0.735,0.762, respectively,which was higher than that of the routine ECG .Conclusion Dynamic ECG,heart color Doppler ultra－sound in the diagnosis of paroxysmal atrial fibrillation has higher accuracy ,sensitivity and specificity,which can be used as the main means of diagnosis of paroxysmal atrial fibrillation .
ABSTRACT
Purpose To discuss the ultrasonic cardiogram of cardiac rhabdomyoma,and to analyze the change trend of single and multiple rhabdomyoma before and 6 months after childbirth.Materials and Methods Eleven fetuses diagnosed as cardiac rhabdomyoma prenatally from January 2014 to January 2016 were analyzed retrospectively,and the tumor size,number and anatomical location were recorded by ultrasound.The 11 fetuses were divided into single group and multiple group,and both groups were reviewed the changes to tumors during pregnancy and within postnatal 6 months.Results For 11 cases with rhabdomyoma,6 cases were in the multiple group,with tumors growing in 5 cases,and tumors unchanged in 1 case,and 5 cases were in the single group,with all tumors unchanged.The prenatal difference between the two groups was statistically significant (P＜0.05).After six months follow-up of 11 fetuses with cardiac rhabdomyoma,tumor regression occurred in 2 cases of the multiple group,tumors were unchanged in 4 cases,tumor regression occurred in 2 cases of the single group,tumors were unchanged in 3 cases,and there was no significant difference between the fetuses in the two groups within postnatal 6 months (P＞0.05).Conclusion The cardic rhabdomyoma has a tendency to increase in the prenatal period,and the increase may be significant in the multiple group.The rhabdomyoma is relatively stable within 6 months follow-up after birth,and there is a partial regression trend,without significant difference between single and multiple groups.
ABSTRACT
Purpose Unilateral absence of pulmonary artery is a rare congenital pulmonary arterydysplasia whose untypical symptom often leads to missed diagnosis or misdiagnosis.Diagnostic and follow-up values of ultrasound cardiogram to pediatric congenital unilateral absence of pulmonary artery (UAPA) are explored in this paper.Materials and Methods Ultrasound cardiogram images of 35 UAPA patients confirmed by surgery or CT angiography in Guangzhou Women and Children's Medical Center from May 2009 to July 2016 were analyzed retrospectively,and images characteristics of the correctly diagnosed and missed diagnosis or misdiagnosed ultrasound cardiogram were analyzed.Results Among these 35 UAPA patients,21 cases were on the right side,14 cases on the left side,16 cases single UAPA and 19 cases combined with other intracardiac malformations.27 cases were initially diagnosed by ultrasound cardiogram,7 cases were missed diagnosed and 1 case misdiagnosed,with 77.1％ diagnosis accuracy.UAPA ultrasound cardiogram showed that normal bifurcation structure of pulmonary artery disappears.Main pulmonary artery continued to be one-side pulmonary artery,running to left or right and forming left branch or right branch of pulmonary artery.Pulmonary artery of the one-side absence of pulmonary segment supplied blood through aorta or other branches or vessels on the other side.After receiving unilateral pulmonary artery reconstruction surgery,ultrasound cardiogram of 8 patients of one month indicated that average flow rate of close-end anastomosis was (1.22± 0.17) m/s and far-end (2.17± 0.56) m/s.Conclusion Ultrasound cardiogram is efficient for UAPA preoperative diagnosis.Meanwhile,it is convenient,noninvasive and efficient in assessing anastomosis and pressure of pulmonary artery after surgery.
ABSTRACT
Purpose To evaluate the left ventricular systolic and diastolic function in patients with pulmonary hypertension (PH) using three-dimensional speckle tracking imaging (3D-STI) combined with two-dimensional ultrasound (2D ultrasound),and to investigate the effects of different-degree PH on left ventricular function.Materials and Methods Fifty-two patients who were diagnosed as PHin the First Hospital of Jilin University from September 2011 to November 2015 were retrospectively analyzed,and based on pulmonary artery systolic pressure (PASP),they were assigned into mild group (PASP 36-49 mmHg,n=20),moderate group (PASP 50-70 mmHg,n=18) and severe group (PASP＞70 mmHg,n=14).Besides,healthy volunteers were selected as control group (n=30).All the subjects accepted 2D and 3D imaging,their left ventricular diastolic diameter (LVDd),left ventricular ejection fraction (LVEF),left atrial maximum volume index (LAVI),PASP,e',E/e',etc.,were obtained by 2D ultrasound,and their left ventricular global longitudinal strain (GLS),left ventricular global radial strain (GRS),left ventricular global circumferential strain (GCS),left ventricular global area strain (GAS),etc.,were obtained by 3D-STI.The data of different groups were compared,and the correlation between PASP with left ventricular systolic and diastolic function was analyzed.Results E/e'and LAVI in moderate group and severe group were significantly higher than those in control group,and the differences were statistically significant (P＜0.05);the absolute values of GLS and GAS in moderate group were lower than those in control group (P＜0.05);the absolute values of GLS,GRS,GCS and GAS in severe group were all lower than those in control group,and the differences were statistically significant (P＜0.05).The correlation analysis showed that among 2D parameters,the correlation between LAVI and PASP was better (r=0.56,P＜0.01);among 3D strain values,the correlation between GLS absolute value and PASP was better (r=0.60,P＜0.01).Conclusion 3D-STI combined with 2D ultrasound can effectively assess the left ventricular systolic and diastolic dysfunction in patients with PH,which provides theoretical support for early clinical intervention.
ABSTRACT
Purpose To investigate the diagnostic value of fetal echocardiography in total anomalous pulmonary venous connection (TAPVC),and to analyze the reasons ofmisdiagnosis so as to improve accuracy of prenatal diagnosis.Materials and Methods The prenatal echocardiographic data of 24 cases of TAPVC confirmed by postnatal echocardiography and prenatal MRI from October 2001 to December 2015 in Children's Hospital Affiliated to Nanjing Medical University and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.Results In 24 cases,there were 14 fetuses of supracardiac type,7 cases of intracardiac type,2 cases of infracardiac type,and 1 case of mixed type.15 fetuses had TAPVC only,whereas 9 cases were associated with other cardiovascular anomalies,most commonly including bilateral right atria,single atrium,single ventricle,common atrioventricular valve and pulmonary stenosis.On 4-chamber views,the common sonographic sign was absent of pulmonary venous return to the left atrium in 24 cases (100.0％),and the presence of venous confluence between left atrium and descending aorta was observed in 22 cases (91.7％).In all 24 cases,1 case was missed diagnosis,and 3 cases were misdiagnosed as persistent left superior vena cava,common pulmonary vein atresia and patent left atrial cardinal vein.Conclusion TAPVC can be accurately diagnosed by fetal echocardiography,but it is prone to be misdiagnosed.
ABSTRACT
Purpose To summarize the clinical and echocardiographic characteristics of congenital quadricuspid aortic valves (QAV) so as to improve the understanding of QAV and the accuracy of preoperative diagnosis.Materials and Methods The clinical and echocardiographic data of 7 patients with QAV at the First Affiliated Hospital of Nanchang University were retrospectively studied,and the features such as the aortic valve (AV) leaf number,echo,shape,opening and closing movements,and its hemodynamics were observed and compared with surgical follow-ups.Results Five out of the 7 patients had chest tightness,chest pain,fluster,shortness of breath,and 2 others had no discomfort.The echocardiography presented that all the cases had moderate or severe aortic valve regurgitation.4 patients were diagnosed as QAV,2 patients were not diagnosed definitely,and the rest 1 was misdiagnosed.6 patients underwent aortic valve replacement and were all confirmed with QAV,among whom 2 patients were combined with infective endocarditis,and 1 patient was with aortic dilatation.All the surgical operations were successful and the patient's physical conditions were good after surgery.Conclusion Echocardiography plays an important role in diagnosis of aortic valve,but it is possible to be missed or misdiagnosed.Most QAV patients have good prognosis,but close follow-ups are needed when QAV is combined with other complex deformity or has induced secondary damages.
ABSTRACT
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.
ABSTRACT
Objective To investigate the changes of cardiac structure and function in patients with hepatolenticular degeneration (HLD).Methods From March 2010 to February 2011,90 HLD patients who did not receive formal treatment (observation group) and 30 healthy people (control group) were collected and analyzed with color Doppler echocardiography in the Institute of Neurology,Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Based on the clinical manifestations,cases were divided into hepatic type group (n =31),brain type group (n =42) and brain-visceral type group (n =17).According to the Child-Pugh classification,patients were divided into Child A group (n =71),Child B group (n =10) and Child C group (n =9).Results (1) The left atrial diameter ((28.00 ± 3.11),(29.62 ± 3.44) mm) and left ventricular diameter ((45.69 ± 3.75),(47.10-± 4.73) mm) of HLD patients in brain-visceral type group and hepatic type group were larger than that of the control group ((24.86 ± 2.63),(41.93 ±3.56) mm;t =3.143,4.761,P=0.018,0.000;t=3.764,5.167,P=0.018,0.000).The left atrial diameter and left ventricular diameter of hepatic type group were significantly larger than the brain type group (26.06 ± 3.68,43.34 ± 3.88;t =3.557,P =0.000;t =3.751,P =0.001).The value of E/A in the hepatic type group (1.57 ± 0.37) was significantly lower than the control group (1.93 ± 0.20;t =-0.352,P =0.006).(2) The left atrial diameter ((31.29 ± 1.70),(34.67 ± 1.97) mm) and left ventricular diameter ((48.29 ± 2.81),(53.67 ± 2.67) mm) of Child B and C groups were significantly larger than the control group ((24.86 ± 2.63),(41.93 ± 3.56) rm;t =6.429,9.810,P =0.000,0.000;t =6.357,10.738,P =0.000,0.000),and the Child A group ((26.42 ± 3.05),(43.89 ± 3.76) rm;t=4.871,8.252,P=0.000,0.000;t =4.399,8.780,P=0.003,0.000).The value of E/A of Child B and C groups (1.58 ± 0.32,1.26 ± 0.39) was lower than that of the control group (t =-0.347,0.662,P=0.020,0.000);At the same time,the value of E/A of Child C group was significantly lower than that of Child A group (1.80 ± 0.33;t =-0.530,P =0.000).Conclusions The HLD patients may have cardiac structural and functional changes,mainly manifested as left atrial and left ventricular enlargement and cardiac diastolic dysfunction,whereas a serious impact has not yet been found in systolic function.And the changes of cardiac structure and function were related to the degree of liver cirrhosis in patients with HLD.
ABSTRACT
Purpose To establish normative reference ranges of fetal azygos vein between gestation 20.0 and 40.0 weeks and analyze the possible correlation between azygos vein diameter and gestational age.Materials and Methods Retrospectively analyzed the data which collected from pregnant women with singleton pregnancies,1375 fetuses with normal outcome were included.The gestation was from 20.0 weeks to 40.0 weeks.The research objects were divided into 5 groups according to their gestational age and were examined standardized.The fetal normal reference value of azygos vein and its correlation with gestational ages were analyzed.Results The normal reference value of the fetal azygos vein diameter was established.We found that a significant increase linear between the diameter of fetal azygos vein and the gestation age.There was no obvious correlation with sex.The ratio of azygos vein and descending aorta inner diameter was about 0.36.There was on obvious changes in different gestational ages.Conclusions Fetal echocardiography technology can accurately assess fetal cardiac structure,the establishment normal reference value of azygos vein diameter could provide guidance for fetal echocardiography examination.
ABSTRACT
Purpose Estimation of the degree of pulmonary artery stenosis (PS) in children patients before treatment can provide an important basis for the choice of treatment.This study explores the accuracy of non-invasive continuous wave Doppler (CW) and electrocardiogram (ECG) in estimating the degree of PS in children patients.Materials and Methods Sixty consecutive cases of PS children were collected from January 2012 to August 2016 in the General Hospital of Shenyang Military.The right ventricular pressure was estimated by measuring cross-pulmonary artery pressure gradient by CW,or estimated by measuring the amplitude of the V1R wave by ECG,which was then compared with that measured by cardiac catheterization respectively.Results The right ventricular pressure estimated by measuring cross-pulmonary artery pressure gradient by CW was positively correlated with that measured by cardiac catheterization (r=0.88,P＜0.05).The right ventricular pressure estimated by measuring the amplitude of the V1R wave by ECG was also positively correlated with that measured by cardiac catheterization (r=0.83,P＜0.05).Conclusion The right ventricular pressure estimated by CW or ECG has good consistency with that measured by cardiac catheterization.Both CW and ECG can be used as noninvasive methods for estimating the degree of PS in children.
ABSTRACT
Objective To assess the efficacy of cardiac resynchronization therapy (CRT) using real-time three-dimen?sional echocardiography (RT-3DE) and speckle tracking imaging (STI) in patients with heart failure. Methods Thirty-one patients with chronic heart failure were examined by RT-3DE and STI before CRT and 3, 6 months after CRT. The values of left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured. RT-3DE was used to evaluate the minimum regional volume for 16 segments (Tmsv-16SD) and the ratio of Tmsv16SD to R-R interval, and the maximum time difference (Tmsv-16Dif). STl was used to evaluate the ratios of standard deviation of the time to peak longitudinal radial and circumferential strain to R-R interval (Tls-16SD%, Trs-16SD%,Tcs-16SD%) from the beginning of Q wave of electrocardiography to the point minimal systolic volume of all 16 segments and the maximum time difference. Results The values of LVEDV and LVESV were smaller 3 and 6 months after CRT than those before CRT. The value of LVEF was significantly improved after CRT (P < 0.05). The values of Tmsv-16SD%, Tmsv-16Dif%, Tls-16SD%, Trs-16SD%, Tcs-16SD%and T-Dif%were gradually decreased after CRT (P<0.05). The values of Tmsv-16SD%, Tmsv-16Dif%,Trs-16SD%and Tcs-16SD%were negatively related with LVEF (r=-0.79,-0.82,-0.69 and-0.74(P<0.05). The better consistency was found between RT-3DE and STI methods(Kappa=0.77). Conclusion Re?al-time three-dimensional echocardiography and speckle tracking imaging can provide more accurate quantitative informa?tion of cardiac resynchronization therapy for assessment of treatment and prognosis in patients with heart failure.
ABSTRACT
Objective To review and summarize the experience of surgical treatment of primary cardiac tumors in children from a heart center of China.Methods The pathological studies of 11 cases of primary cardiac tumor (except myxoma) were retrospectively analyzed.Results The mean age for all patients was (23 ± 16) months,and the average weight was 3.1 ～ 15.3 (13 ± 5.7) kg at the time of the established diagnosis.The most common reason of admission was the heart murmur,and the most common pathological type of cardiac tumors was rhabdomyoma (5 cases),followed by fibrous tumor (3 cases),angiofibroma (2 cases),and fibrosarcoma (1 case).All of the patients underwent tumor resection due to the corresponding symptoms.One of them,the operation findings showed the aortic root,superior vena and sinoatrial node were involved into the tumor body,and therefore,the tumor debark resection was performed and the child died 2 years later due to the remained tumor progression.One of other children (pericardial fibrosarcoma) died 1 year late because of tumor recurrence.The others were followed-up for duration of 2 ～9 years and all kept in good condition.Conclusions The surgical resection is mandatory for children suffering with symptomatic primary cardiac tumors and the short-term and long term surgical outcomes for the majority are acceptable.
ABSTRACT
Objective To investigate the effectiveness and safety of intranasal different dose of dexmedetomidine for pediatric echocardiography sedation and to discuss the factors concerning recovery.Methods In a single-blinded randomized clinical trial,183 children were studied with a range of 2months and 33 months of age,and American Society of Anesthesiologists(ASA) physical status Ⅰ to Ⅱ.Those children were divided randomly into one of three groups.Groups D1,D2,and D3,which were received intranasal dexmedetomidine 1.0,1.5,and 2.0 μg/kg,respectively.The induction time,recovery time,examination time,and total sedation time were compared.The success rate of sedation and the occurrence of any side-effects with the drug were compared.Sex,age,weight,dose,induction time,and examination time were used as independent valuations,the recovery time was used as dependent valuation,and then the multiple linear regression analysis was performed to filtrate and formulate the valuable factors influencing recovery time.Results The induction time had no significantly difference among groups (P ＞ 0.05).The recovery time of group D3 was longer than group D1 and group D2 (P ＜ 0.05).The total sedation time of group D3 was longer than group D1 (P ＜ 0.05).The success rate of sedation and the incidence of sideeffects had no significantly difference among groups (P ＞0.05).Children's weight and medicine dose were found to affect recovery time.Conclusions Intranasal dexmedetomidine 1 ～ 2 μg/kg could be used effectively and safely in children undergoing echocardiography examination.Weight and dose were considered as key indexes to predict recovery time.
ABSTRACT
Purpose To analyze the echocardiographic features of peripartum cardiomyopathy (PPCM) using Logistic regression, and to screen the indexes which can be used for the prognosis of PPCM. Materials and Methods Fifty patients who were diagnosed as PPCM by echocardiography were divided into recovered group (30 cases) and non-recovered group (20 cases), all the patients underwent echocardiography, left ventricular end-diastolic diameter (LVEDd) was measured in the parasternal long axis view, left ventricular ejection fraction (LVEF) was measured using Simpson biplane method in the apical four-chamber and two-chamber view to look for the evidence of left ventricular thrombosis, if complicated with pulmonary hypertension, continuous wave Doppler was used for measuring the peak velocity of tricuspid valve regurgitation, and estimating of pulmonary artery systolic pressure, Logistic regression model was established and receiver operating characteristic (ROC) curve was generated to evaluate the prediction value of Logistic regression model. Results Compared with non-recovered group, there was statistically significant difference of LVEDd, LVEF, left ventricular thrombosis, pulmonary hypertension and re-checked LVEF (t= -4.33, 7.64 and 11.54, P0.05). Three sonographic features LVEDd, LVEF and left ventricular mural thrombus) could be used for the establishment of Logistic model (χ2=5.14, 11.59 and 14.58, P<0.05). The prediction accuracy of the model was 90.0% (45/50, P<0.001) and the area under ROC curve was 0.945±0.030 (P<0.001). Conclusion Logistic regression analysis can be applied for the screening of ultrasound index for PPCM, LVEDD, LVEF and left ventricular wall thrombus can predict the prognosis of PPCM accurately.
ABSTRACT
Purpose To explore the relationship of Tei index and the concentration of plasma brain natriuretic peptide (BNP) in patients with dilated cardiomyopathy. Materials and Methods Fifty healthy individuals (control group) and fifty dilated cardiomyopathy patients (study group) were recruited in this study. BNP level was measured by enzyme-linked immunosorbent assay (ELISA). Color Doppler echocardiography were performed to measure the cardiac indices including left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), interventricular septal thickness at diastole (IVSd), left ventricular ejection fraction (LVEF). Tei index was then calculated. The indices between the two groups were compared and correlation of Tei index and BNP with cardiac indices was analyzed. Results LVEDd, LVESd, Tei index, and BNP were significantly higher in study group than those in control group (t=14.4, 23.4, 21.9 and 22.3, P<0.01). IVSd and LVEF were significant lower in the study group (t=12.4 and 12.5, P<0.01). BNP was negatively correlated with LVEF (r= -0.266, P<0.05), and positively correlated with Tei index and LVEDd (r=0.401 and 0.326, P<0.05). Tei index was negatively correlated with LVEF and E/A (r= -0.480 and - 0.241, P<0.05), and positively correlated with LVEDd (r=0.375, P<0.05). Multiple stepwise regression analysis showed that the variates of BNP stepwise regression equation were Tei index, LVEF and LVEDd (t=5.984, -2.477 and 2.326, P<0.05); after correcting LVEF, the stepwise regression analysis showed closer relationship between Tei index and BNP (t=2.728, P<0.05). Conclusion There is correlation between Tei index and BNP. Tei index may be a good index for accurately estimating global ventricular function.
ABSTRACT
Objective To investigate the values of echocardiographic parameters for predicting the spontaneous closure of the ductus arteriosus in preterm infants .Methods A retrospective study of 110 preterm infants from October 2013 to October 2014 in our hospital was done .Examination was done at 1 ,3 ,7 d with echocardiography for those infants .Diameter of left atrium(LA) ,aotic root(AO) and arterial canal‐related parameters (the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus) at first .Preterm infants in this study were divided into two groups .The early patent ductus arterisus group included ones whoes ductus didn′t closed spontaneous in 7 d ,and the control group included ones whoes ductus closed spontaneous in 7 d ,and then the echocardiographic parameters between the two groups were compared .Results (1)The rates of ductus arteriosus sponta‐neous closure in preterm infants at 3 ,7 d were 70 .9% (78/110) ,78 .2% (86/110) ,respectivly .(2)When compared with the control group ,The rate of LA/AO in patent ductus arterisus group were higher than that of the control group(P<0 .01);The smallest width of ductal color Doppler flow jet in patent ductus arterisus group were bigger than that of the control group(P<0 .01);The maximum velocity at the ductus in patent ductus arterisus group were lower than that of the control group(P<0 .05) .(3)The best critical points of the LA/AO ,the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus of the spontaneous ductus arteriosus closure in preterm infants were 1 .32 mm ,2 .56 mm and 185 .5 cm/s ,respectivly .Conclusion Echo‐cardiography plays a significant role in prediction of the spontaneous closure of the ductus arteriosus in preterm infants .