Relationship between macrophage infiltration in the coronary plaque and downstream myocardial perfusion in mice / 中华超声影像学杂志

Objective:To explore the relationship between macrophage infiltration in the coronary plaque and downstream myocardial perfusion in mice.Methods:The experimental group consisted of 20 ApoE knockout mice models of the coronary plaque established by feeding with cholesterol-rich diets, and the control group consisted of 20 sex- and age-matched C57BL/6 mice with the same genetic background as ApoE mice.Adenosine stress myocardial contrast echocardiography was performed on all experimental animals to obtain the values of A, β and A×β of the left ventricular myocardium in anteroseptal and posterior walls both in the resting status and during adenosine stress. Concentrations of serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined using mouse enzyme-linked immunosorbent assay kits according to the manufacturer′s instructions. The degree of macrophage infiltration in the coronary plaque was evaluated by pathological immunohistochemistry staining and the correlations with the above indicators were analyzed.Results:There were no statistically significant differences in heart rate and left ventricular structural parameters between two groups (all P>0.05). The experimental group had a lower left ventricular ejection fraction( P=0.021), and higher weight and serum levels of triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, IL-6, and TNF-α than the control group (all P<0.05). The values of A, β and A × β of the left ventricular myocardium in anteroseptal and posterior walls in the experimental group were significantly lower than those in the control group during adenosine stress (all P<0.05). In the experimental group, the value of the macrophage infiltration found in the plaque of the left main coronary artery correlated positively with the level of serum TNF-α ( r=0.63, P=0.003) and negatively correlated with the values of A×β of the left ventricular myocardium in anteroseptal and posterior walls during adenosine stress ( r=-0.74, P<0.001; r=-0.72, P<0.001; respectively). Conclusions:Myocardial perfusion in ApoE knockout mice models of the coronary atherosclerosis was related with degree of macrophage infiltration in the coronary plaque, and macrophages may play a role by releasing inflammatory mediator TNF-α.

Evaluation of left atrial structure and function by three-dimensional echocardiography in paitents with apical hypertrophic cardiomyopathy / 中华超声影像学杂志

Objective:To investigate the changes of left atrial structure and function in patients with apical hypertrophic cardiomyopathy (ApHCM) by three-dimensional (3D) echocardiography.Methods:From September 2020 to December 2022, 112 patients with ApHCM(ApHCM group) diagnosed at Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology and 41 age- and sex-matched normal controls(control group) were finally enrolled. In 'pure’ ApHCM patients, cardiac hypertrophy was confined to the apical segment below the papillary muscle. The wall thickness of apical and intermediate segments in 'mixed’ ApHCM patients increased, but the wall thickness of apical segment was the largest. Two-dimensional(2D) and 3D volume and strain parameters of left atrium were compared between control group and ApHCM group, 'pure’ and 'mixed’ ApHCM patients.The correlations between 2D and 3D volume and strain parameters of left atrium and intraclass correlation coefficient (ICC) of those parameters were analyzed. The ROC curve was performed to determine the cutoff values of 3D left atrial volume abnormalities in all subjects. Logistics regression analysis was performed to analyze the impact factors of the left atrial enlargement in patients with ApHCM.Results:Compared with the control group, 2D left atrial maximum volume index (2D LAVimax), 2D left atrial minimum volume index (2D LAVimin), 3D left atrial maximum volume index (3D LAVimax), 3D left atrial minimum volume index (3D LAVimin), and 3D left atrial presystolic volume index (3D LAVipreA) significantly increased in ApHCM group( Z=-6.54, -6.38, -6.98, -7.40, -6.96; all P<0.001). However, 2D left atrial ejection fraction (2D LAEF) ( Z=-3.75, P<0.001), 2D left atrial expansion index (2D LAEI) ( t=-4.15, P<0.001), 3D left atrial ejection fraction (3D LAEF) ( Z=-5.09, P<0.001), 3D left atrial expansion index (3D LAEI) ( t=-5.49, P<0.001), 2D left atrial reservoir strain (2D LASr) ( t=-12.03, P<0.001), 2D left atrial conduit strain (2D LAScd) ( t=7.91, P<0.001), 2D left atrial contractile strain (2D LASct) ( t=6.06, P<0.001), 3D left atrial reservoir strain (3D LASr) ( t=-9.23, P<0.001), 3D left atrial conduit strain (3D LAScd) ( t=7.12, P<0.001) and 3D left atrial contractile strain (3D LASct) ( t=4.78, P<0.001) significantly decreased in ApHCM group. Compared with the 'pure’ ApHCM group, 2D LAVimax, 3D LAVimax, 2D LAVimin, 3D LAVimin, 3D LAVipreA in patients with mixed ApHCM increased more significantly, while 2D LAEF, 2D LAEI and 2D LASr decreased more significantly. The measurements of left atrial volume and strain by 3D echocardiography were significantly correlated with 2D measurements ( P<0.05). The correlations between 2D LAVimax and 3D LAVimax, 2D LAVimin and 3D LAVimin, 2D LAEF and 3D LAEF, 2D LASr and 3D LASr, 2D LAEI and 3D LAEI ( r=0.91, 0.93, 0.72, 0.76, 0.57; all P<0.05) were more than moderate. The repeatability of 3D left atrial strain was lower than 2D results, while the repeatability of 3D left atrial volume was higher than 2D results. ROC curve analysis showed that 3D echocardiography parameters could identify left atrial volume abnormality in all subjects. The cutoff values of 3D LAVimax, 3D LAVimin, 3D LAVipreA in all subjects were 36 ml/m 2, 18 ml/m 2 and 27 ml/m 2, respectively. Multivariate binary logistic regression analyses showed that ratio of LV systolic obliteration to cavity was independent factor affecting left atrial enlargement in ApHCM patients( OR=1.20, P<0.001). Conclusions:Three-dimensional echocardiography is significant for the accurate evaluation of left atrial structural changes in patients with ApHCM. Ratio of left ventricular systolic obliteration to cavity was an independent impact factor of left atrial enlargement in ApHCM patients.

Transapical beating interventricular septal resection under the navigation of three-dimensional transesophageal echocardiography for the treatment of hypertrophic obstructive cardiomyopathy / 中华超声影像学杂志

Objective:To evaluate the efficacy and safety of immediate intraoperative transapical beating-heart septal myectomy (TA-BSM) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and explored the clinical value of three-dimensional transesophageal echocardiography (3D-TEE) during the procedure of TA-BSM.Methods:One hundred and thirty-seven HOCM patients who underwent TA-BSM surgery in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 2022 to March 2023 were selected.During the operation, 3D-TEE was used to locate the position of the myocardial circumcision system and navigate the range of myocardial circumcision. The interventricular septal thickness( IVST) and peak pressure gradient of the left ventricular outflow tract (LVOT-PG) were measured, and the degree of mitral systolic anterior motion (SAM) and mitral regurgitation (MR) were evaluated in HOCM patients before and after the operation. The range of the incisal margin was measured, and the number of resection knives and the weight of the removed myocardium were recorded.Results:TA-BSM under 3D-TEE navigation was successfully performed in 137 HOCM patients. The number of resection was 7(5, 9), and the weight of the removed myocardium was 5.6(3.4, 8.9)g. During the operation, there were no adverse events such as death, aortic valve injury, and iatrogenic interventricular septal perforation. Compared with those before the operation, the wall thickness of basal and middle segments of the anterior and posterior interventricular septum decreased significantly (all P<0.001), and LVOT-PG decreased significantly ( P<0.001). After TA-BSM, the number of patients with SAM≥3 decreased from 94 cases (68.6%) to 2 cases (1.5%), and the number of patients with MR≥3+ decreased from 86 cases (62.8%) to 9 cases (6.6%)(all P<0.001). For the patients with different degrees of ventricular septal hypertrophy (mild, moderate, and severe), the postoperative IVST and LVOT-PG were significantly lower than the preoperative values, and the degree of MR and SAM signs was relieved considerably. The length of the incisal margin, the weight of excised myocardium, and the number of resection in the group with extensive septal hypertrophy in all three regions were significantly higher than those in the group with localized interventricular septal hypertrophy in single or two areas (all P<0.05). Conclusions:3D-TEE can guide and monitor the process of TA-BSM myocardial resection in real-time. By accurately evaluating the IVST and the range and hemodynamic characteristics of HOCM patients, it can effectively relieve LVOTO and significantly reduce MR to ensure the safety and effectiveness of TA-BSM in HOCM patients with different degrees and ranges of hypertrophy.

The relationship between vulnerability of coronary atherosclerotic plaque and downstream myocardial perfusion and myocardial strain in mice / 中华超声影像学杂志

Objective:To investigate the relationship between vulnerability of mouse coronary artery plaque and downstream myocardial perfusion and myocardial strain.Methods:Thirteen ApoE knockout mice with stable coronary plaques (stable plaque group)and 13 ApoE knockout mice with vulnerable coronary plaques(vulnerable plaque group) were selected as the experimental group, and 15 sex- and age-matched C57BL/6 mice with the same genetic background as ApoE mice were chosed as the control group. Myocardial contrast echocardiography (MCE) was carried out to quantify regional myocardial perfusion at rest and during adenosine stress using a Vevo 2100 system (Visual sonics). Replenishment curves of myocardial contrast were obtained, and rates of signal rise (β) and plateau intensity (A) were recorded. MBF was estimated by the product of A and β. Speckle tracking imaging combined with adenosine stress test was used to evaluate the longitudinal strain of left ventricular myocardium in mice. The vulnerability of the plaque was assessed by histopathology in serial tissue sections of proximal and middle left coronary artery according to the previously reported method.Results:There were no significant differences in body weight, heart rate, left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular mass and ejection fraction among the three groups( P>0.05). The levels of serum triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein in stable plaque group and vulnerable plaque group were significantly increased when compared with those in control group (all P<0.05). The pathological results showed that the coronary luminal stenosis rates in the stable plaque group and the vulnerable plaque group were (74.3±4.9)% and (75.5±7.1)% respectively, with no significant difference between the two groups( P>0.05). MBF of the middle anterior septum and left ventricular posterior wall in the experimental groups were significantly decreased when compared with that in the control group both in the resting status and during adenosine stress(all P<0.05). There were no significant differences in the MCE parameters between the stable plaque group and the vulnerable plaque group at rest( P>0.05). However, during adenosine stress, MBF of the vulnerable plaque group was decreased more significantly than that of the stable plaque group ( P<0.05). Compared with the control group, the values of longitudinal strain of the left ventricle in both experimental groups were decreased during resting status, without statistical significance (all P>0.05), but decreased significantly during adenosine stress and with more decrease in the vulnerable plaque group (all P<0.05). Conclusions:For the same degree of coronary artery stenosis in mice, the coronary artery vulnerable plaque group has less downstream myocardial perfusion and myocardial strain than the stable plaque group during adenosine stress. That is, the plaque vulnerability can affect the downstream myocardial perfusion and myocardial strain in the mouse model.

Evaluation of left ventricular rotation and twist in patients with constrictive pericarditis after pericardiectomy with speckle tracking echocardiography / 中华超声影像学杂志

Objective:To evaluate the left ventricular rotation and twist in patients with constrictive pericarditis (CP) after pericardiectomy by using speckle tracking echocardiography (STE), and observe its trend over time.Methods:A total of 29 patients with CP from Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2014 to December 2017 underwent echocardiography 1 week before and 1 month, 6 months, 12 months after pericardiectomy. STE was performed to obtain peak values of basal and apical rotation and left ventricular twist. Twenty-nine healthy subjects were recruited as controls in the same period.Results:The left ventricu1ar apical rotation[before surgery(6.62±3.19)°, 1 month after surgery(7.07±4.02)°, 6 months after surgery(7.88±4.46)°, 12 months after surgery(7.85±4.51)°], the left ventricu1ar twist [before surgery(10.50±4.94)°, 1 month after surgery(9.42±5.40)°, 6 months after surgery(9.59±4.62)°, 12 months after surgery(9.70±4.45)°] were significantly lower in patients with CP than those in controls [(11.22±5.17)°, (16.35±5.21)°](all P<0.05); while basal rotation in patients with CP after surgery among different time points were all significantly lower than those in controls[1 month after surgery(-3.85±3.20)°, 6 months after surgery(-3.49±2.09)°, 12 months after surgery(-3.53±2.01)°; controls(-5.57±2.78)°] (all P<0.05), with no significant difference between patients with CP before surgery (-5.22±3.14)° and controls (-5.57±2.78)°( P>0.05). There were no significant differences in left ventricular twist, basal and apical rotation in CP groups before and after surgery among different time points (all P>0.05). Conclusions:Although the left ventricular global function of patients with CP in the long postoperative period seems "normal" , the left ventricular twist, basal and apical rotation are still significantly lower than those in controls. STE can be used to assess the changes of left ventricular twist and rotation in patients with CP long-term after pericardiectomy.

Effects of adenosine stress on left ventricular myocardial strain mechanics in healthy rabbits / 中华超声影像学杂志

Objective:To explore the changes of myocardial strain mechanics in healthy rabbits in the physiological condition by using speckle tracking echocardiography (STE) combined with adenosine stress.Methods:Twenty healthy rabbits underwent STE both at rest and during adenosine stress. The dynamic original images of 3 consecutive cardiac cycles of the standard views from the left ventricular (LV) short axis and apical long axis were acquired and analyzed by the Echo PAC workstation. The procedure was performed to obtain LV global longitudinal peak strain, global circumferential peak strain, and global radial peak strain both at rest and during adenosine stress.Results:There were no significant differences in heart rate and LV structural and functional parameters between baseline and adenosine stress ( P>0.05). After adenosine stress, LV global longitudinal peak strain and global circumferential peak strain increased significantly when compared with those at rest ( P<0.001), while LV global radial peak strain did not change significantly( P>0.05). Conclusions:Adenosine stress echocardiography combined with STE can be used to evaluate the characteristics of myocardial strain mechanics in rabbits in the physiological condition. This research provides reference value for the application of adenosine stress echocardiography in rabbit models with cardiovascular disease in future.

Effects of adenosine stress on myocardial perfusion in healthy mice / 中华超声影像学杂志

Objective To explore the effects of adenosine stress on myocardial perfusion in healthy mice by myocardial contrast echocardiography ( MCE) . Methods MCE was carried out to quantify regional myocardial perfusion at rest and during adenosine stress using a VEVO 2100 system in 26 C57BL/6 mice . Echocardiography images from standardized parasternal long axis and short axis at papillary muscle level were consecutively acquired in real‐time . All dynamic images were recorded for off‐line analysis . Left ventricular myocardial perfusion quantitative parameters were acquired both under resting status and during adenosine stress . Replenishment curves of myocardial contrast were obtained and myocardial blood flow ( MBF) was calculated . Results Twenty‐six experimental animals successfully underwent MCE before and during adenosine stress . T here was no significant difference in heart rate ,left ventricular structure and functional parameters before and during adenosine stress ( all P ＞0 .05) . Rates of signal rise β values which were used to estimate blood velocity of middle anterior septum and posterior wall in left ventricular long‐axis view and anterior wall ,lateral wall ,inferior wall and septal wall in short‐axis view at papillary muscle increased significantly during stress compared with those at rest ( all P ＜0 .05 ) . T here was no significant difference in the plateau intensity A values( all P ＞0 .05 ) . T he MBF in each segment of the myocardium increased significantly during stress compared with those in resting state ( all P ＜0 .05) . Conclusions T he physiological characteristics of myocardial perfusion in mice before and during adenosine stress were preliminarily obtained ,w hich provided a basis for the application of adenosine stress echocardiography in cardiovascular disease models such as coronary heart disease in mice .

Assessment of scoliosis in adolescence and adults by 3-D ultrasound imaging:a pilot study / 中华超声影像学杂志

Objective To assess scoliosis in adolescence and adults by three-dimensional ( 3-D ) ultrasound imaging . Methods A commercial available ultrasound instrument with a magnetic sensor system was used for long distance 3-D ultrasound imaging .Specific phantoms were imaged to evaluate the precision of this imaging system . Twenty healthy adults and 20 patients with scoliosis were imaged by 3-D ultrasonography and radiography . The deformity angle of the patients with scoliosis was measured on the reconstructed coronal plane ( C plane) of 3-D ultrasound imaging . The relevance between the curvature measured by ultrasound and the Cobb angles originated by radiography were evaluated . Results There was no significant difference between the angles of the phantom measured by the 3-D ultrasound imaging system and that measured by an angle gauge ( P = 0 .479) . The transverse process ,vertebral arch and acoustic shadow of the central spinous process of spines in healthy adults can be displayed on the reconstructed C plane by 3-D ultrasound imaging . The morphology of scoliosis in all the twenty patients can be observed on the reconstructed C planes ( multi-layers) by 3-D ultrasound imaging ,which accorded well with that observed on radiograph . In 9 patients ,part of the spinal segment could not be totally displayed on one single coronal plane and no additional measurement was carried out . In 11 patients ,all the segments of the spine could be clearly displayed on a single coronal plane and the curvature of scoliosis was then measured . There were no significant differences between the angle measured on 3-D ultrasound imaging and the Cobb angle measured on radiograph( P =0 .974) and the two measurement methods have high correlation( r =0 .991 , P <0 .0001) . Conclusions The commercial available 3-D ultrasound imaging system applied in this study offers a viable method to assess scoliosis in adolescence and adults in a reliable and radiation-free manner .

Reproducibility of contrast-enhanced echocardiography for measurements of left ventricular ejection fraction and left ventricular volume in patients undergoing cancer chemotherapy / 中华超声影像学杂志

Objective To assess the reproducibility of contrast-enhanced echocardiography and conventional echocardiography for measurements of left ventricular ejection fraction(LVEF) and left ventricular volume in patients undergoing cancer chemotherapy. Methods One hundred and two patients undergoing cancer chemotherapy were divided into satisfactory image group(36 subjects) and unsatisfactory image group(66 subjects) according to the quality of the recorded images.High frame rate two-dimensional and three-dimensional images were recorded from apical long-axis view,four-chamber view and two-chamber view of left ventricle. Contrast-enhanced echocardiography was performed in the unsatisfactory image group.Two equally experienced examiners measured the LVEF and left ventricular volume in all patients by EchoPac software. Results The reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography were low for measurements of LVEF in unsatisfactory image group ( P < 0.01).But they were improved significantly with contrast-enhanced echocardiography ( P > 0.05 ). The reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography for measurements of left ventricular end-diastolic volume in unsatisfactory image group were also improved by performing contrast-enhanced echocardiography ( P > 0.05). The reproducibilities for measurements of left ventricular end-systolic volume were well in both group.Conclusions The reproducibilities for measurements of LVEF and left ventricular volume are improved in patients undergoing cancer chemotherapy with unsatisfactory images by using contrast-enhanced echocardiography.

Effects of adenosine stress on myocardial strain in healthy mice / 中华超声影像学杂志

Objective To explore the effects of adenosine stress on myocardial strain in healthy mice by speckle tracking imaging (STI).Methods A high-resolution rodent ultrasound machine Vevo 2100 was used to perform conventional transthoracic echocardiography at baseline and after intravenous infusion of adenosine in 34 C57BL/6 mice.Echocardiography images from standardized parasternal long axis and short axis at papillary muscle level were consecutively acquired in real-time.All dynamic images were recorded for off-line analysis.Left ventricular myocardial mechanical strain parameters were acquired both under resting status and during adenosine stress.Results Thirty-four experimental animals successfully underwent STI before and during adenosine stress. There was no significant difference in heart rate,left ventricular structure and functional parameters between before and after the adenosine stress ( P >0.05).Global peak longitudinal strain value in left ventricular long-axis view was significantly increased during stress compared with those at resting status ( P < 0.05);while there was no significant increase in the global peak circumferential strain and global peak radial strain values in short-axis view at papillary muscle ( P >0.05).Conclusions Myocardial strain is obtained in healthy mice before and after adenosine stress.This provides an evidence to the application of stress echocardiography in mice with coronary heart disease or other cardiovascular disease in the future.

Production of a dual model probe for photoacoustic imaging and fluorescence imaging targeting integrinαvβ6 / 中华超声影像学杂志

Objective To develop a probe for photoacoustic imaging and fluorescence imaging targeting integrin αvβ6 . Methods The probe was separated by RP‐HPLC .Molecular weight and the maximum absorption wavelength of the probe were detected by mass spectrum instrument and optical spectrum instrument . Various concentrations of the probe were detected by photoacoustic imaging and fluorescence imaging . The stability of the probe was evaluated when exposed under laser . Targeting of the probe on integrinαvβ6 was evaluated in cell uptake assay with integrinαvβ6 positive and negative cells . The minimum number of cells that could be detected by photoacoustic imaging and fluorescence imaging was also evaluated . Results The probe ICG‐peptide was separated from reaction mixture by RP‐HPLC .The probe had a retention time of 21 .4 minutes and m/z of 4 727 . The labeling ratio of the probe was 1∶1 . The maximum absorption wavelength of the probe was 790 nm . The photoacoustic signal was linearly dependent on the concentration of the probe . The fluorescence signal was linearly dependent on the concentration of the probe when the concentration was smaller than 1 .5 × 10 -5 mol/L . The lowest concentration of the probe that could be detected above the background by photoacoustic imaging and fluorescence imaging was 0 .09 × 10-5 mol/L and 0 .05 × 10-5 mol/L ,respectively . No obvious decrease of the photoacoustic signal was observed after the probe was scanned 20 times ( each time lasted for 1 min) by laser . There existed differences ( P <0 .001) in cell uptake of the probe with various concentrations and reaction time between A431 cells (αvβ6 positive) and 293T cells (αvβ6 negative) . Cell uptake was inhibited by the addition of 5μmol/L unlabeled peptide in A431 cells ( P = 0 .001 ) . The lowest number of the labeled A431 cells detected by photoacoustic imaging and fluorescence imaging was 0 .4 × 106 and 0 .05 × 106 ,respectively . Conclusions The dual functional photoacoustic and fluorescence probe targeting integrin αvβ6 was successfully developed . The targeting and sensitivity of the probe makes it potentially useful in early detection of αvβ6 positive tumors .

Evaluation of left ventricular systolic function in different layers myocardium in patients with hypertrophic cardiomyopathy by two-dimensional speckle tracking echocardiography / 中华超声影像学杂志

Objective To assess the systolic function in left ventricular subendocardial myocardium , midmyocardium and subepicardial myocardium in patients with hypertrophic cardiomyopathy (HCM ) by two‐dimensional speckle tracking echocardiography .Methods A total of 32 patients with HCM and 32 healthy adults were included in the study .All standard measurements were obtained from the left ventricular short‐axis views at the levels of mitral annulus ,papillary muscle and apex ,and apical four‐chamber ,two‐chamber ,and long‐axis views .Two‐dimensional speckle tracking imaging was employed .The global peak systolic radial strain ,peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured .Results In patients with HCM and the control group ,the peak systolic longitudinal strain and circumferential strain reduced from subendocardial myocardium to subepicardial myocardium .The global peak systolic radial strain in patients with HCM was significant lower than that in the control group . And in patients with HCM ,peak systolic longitudinal strain in subendocardial myocardium ,midmyocardium and subepicardial myocardium was significant lower than those in the control group .Conclusions Peak systolic longitudinal strain and circumferential strain are reduced from subendocardial myocardium to subepicardial myocardium .Myocardial systolic function is impaired in patients with HCM .In patients with HCM ,longitudinal strain of each layer is lower ,but circumferential strain is mainly reduced in midmyocardium and subepicardial myocardium compared with that in the control group .

Assessment of left ventricular twist in patients with chronic kidney disease by two-dimensional speckle tracking echocardiography / 中华医学超声杂志（电子版）

ObjectiveTo analyze the characteristics of left ventricular (LV) twist and discuss the relationship between LV ejection fraction (LVEF) and LV twist in patients with chronic kidney disease (CKD) by two-dimensional speckle tracking imaging (2D-STI).MethodsForty-six patients with CKD and 30 healthy controls were enrolled in this study. After conventional echocardiography, LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method and the LVEF was calculated. And relevant parameters of LV rotation and twist were measured by speckle tracking imaging. Correlation analysis of LVEDV, LVESV and LV peak rotation and twist were analyzed respectively. ResultsCompared with the control group, LV peak twist and the apical rotation were decreased in CKD patients, which was statistically significant (t=0.002 and 0.020, bothP<0.05). The inferior wall and posterior intermediate septum of basal segment were significantly decreased (t=0.044 and 0.041, both P<0.05). Pearson correlation analysis revealed LV apical peak rotation had a relationship with LVEDV and LVESV (r= 0.355 and 0.409, bothP<0.01).Conclusion2D-STI is an practical noninvasive method which can analyze LV twist accurately and recognize LV systolic dysfunction of CKD patients sensitively.

Evaluation of left atrial functions in patients with constrictive pericarditis after pericardiectomy by two-dimensional speckle tracking echocardiography / 中华超声影像学杂志

Objective To evaluate the changes of left atrial (LA)functions in patients with constrictive pericarditis (CP)after pericardiectomy by two-dimensional speckle tracking echocardiography (STE).Methods A total of 41 patients with CP underwent echocardiography before and after pericardiectomy.The procedure was performed to obtain global LA longitudinal strain,the septal and lateral walls'longitudinal strain,including peak negative strain (NS),peak positive strain (PS),and total strain (TS),using speckle tracking echocardiography.Thirty-five healthy volunteers were recruited as controls. Results After pericardiectomy,global LA peak negative strain and total strain of CP increased significantly (P 0.05).And three components of LA longitudinal strain were still lower than normal (P <0.005).LA lateral wall's total strain,peak positive strain and peak negative strain improved apparently after pericardiectomy (P <0.005),only peak negative strain increased in LA septum (P < 0.01 ).Conclusions In the early postoperative period,LA reservoir and contractile function presented significant improvements,even notable in the lateral area when compared with septum.However,all three parts of LA function were still lower than normal.STE can regionally estimate LA functions in patients with CP after pericardiectomy.

Study on aorta elastic properties in experimental mouse model of atherosclerosis by ultra-high frequency ultrasound / 中华超声影像学杂志

Objective To assess the aorta elastic properties in the procession of atherosclerosis by ultra‐high frequency ultrasound ,and to detect the relationship between the aorta elastic properties and the atherosclerotic plaque burden .Methods Mice deficient for the apolipoprotein E (ApoE‐/‐) with high‐cholestrol diet were studied as an age‐dependent model of atherosclerosis .At 8 ,16 ,24 and 32 weeks of age , the blood pressure in the ascending aorta was measured by catheter ,and the aorta mechanical properties were assessed by measuring aortic elastic modulus of the ascending aorta with ultra‐high frequency ultrasound .The plaque burden was assessed by high‐frequency ultrasound and Masson′s trichrome stain , separately .Results Vessel thickness at the lesion‐prone sites of the lesser curvature of the aorta and the proximal brachiocephalic artery increased with age ,consistent with the Masson′s trichrome staining which showed age‐dependent worsening of atherosclerosis in the mice model .Elastic modulus of the aorta significantly increased from 8 to 32 weeks of age in E‐/‐mice .There was a statistically difference between any two groups .Conclusions With the progression of atherosclerosis and the increased plaque burden ,aorta mechanical properties deteriorated in Apo E‐/‐mice .Ultra‐high frequency ultrasound was a potential tool for assessment of plaque burden and aorta mechanical properties in mouse model .

Assessment of global left ventricular strain by three-dimensional speckle tracking imaging in patients with chronic renal failure / 中华超声影像学杂志

Objective To evaluate global left ventricular(LV) strain of patients with chronic renal failure(CRF) by three-dimensional speckle tracking imaging(3D-STI) and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia (pre-dialysis),and 20 healthy controls.Global peak longitudinal strain (GPSL),global peak area strain(GPSA) and global peak radial strain(GPSR) were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups(F =13.28,4.65,4.68,P ＜ 0.01) as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48(GPSL),4.19(GPSA),4.72(GPSR),P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 (GPSL),P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF(r =-0.679,-0.781,0.719,P ＜0.01).Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

Evaluation of left ventricular rotation and twist by speckle tracking echocardiography in heart transplant recipients / 中华超声影像学杂志

Objective To evaluate the left ventricular rotation and twist in the cardiac allograft by speckle tracking echocardiography.Methods Twenty-six heart transplant recipients underwent echocardiographic studies at 1st,3rd,6th and 12th month after heart transplantation.Twenty-six healthy subjects served as controls.Parasternal basal and apical short-axis images of left ventricle were recorded and then were analyzed using EchoPAC software.The curves of basal and apical rotation and left ventricular twist were obtained,Peak values of basal and apical rotation and left ventricular twist were measured and then statistically analyzed.Results There were no significant differences in left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) between heart transplant recipients and controls (P ＞0.05).The left ventricular twist,apical rotation were significantly lower in heart transplant recipients at 1 st,3rd,6th and 12th month after surgery than those in controls (P ＜0.05) ;while basal rotation in heart transplant recipients had no significant difference when compared with controls (P ＞0.05).The left ventricular twist,apical and basal rotation in heart transplant recipients among 1 st,3rd,6th and 12th month after surgery had no significant difference (P ＞ 0.05).Conclusions Although the LVEF and LVFS of cardiac allograft seemed normal,the left ventricular twist,apical rotation were still significantly lower in heart transplant recipients than those in controls.Speckle tracking echocardiography can be used for accurate assessment of left ventricular twist in heart transplant recipients.

Long term prognosis and risk factors of percutaneous microwave ablation treatment of recurrence hepatocellular carcinoma after hepatectomy / 中华超声影像学杂志

Objective To explore the therapeutic results of percutaneous microwave ablation for patients with recurrence primary liver cancer after surgery and the factors influencing the survival after ablation therapy.Methods 102 patients who underwent hepatectomy for primary liver cancer in April 1998 to December 2010,and subsequent microwave ablation for recurrence hepatocellular carcinoma,were enrolled.Long term survival rates and prognostic factors after ablation were analyzed.Results The 1,3,5,and 7 year overall survival rates after ablation were 73.5％,53.5％,40.5％ and 17.7％.The 1,3,and 5 year overall survival rates for patients within one year recurrence after hepatectomy were 63.3％,38.9％,and 27.1％,respectively,which was significantly lower than that for patients after this time period in which the 1,3,and 5 year overall survival rates were 86.3％,72.3％ and 63.0％,respectively (P =0.003).Univariate analysis revealed that recurrence tumor size more than 3 cm,multiple tumors,poor Child-Pugh score,and AFP level ＞100 μg/L were risk prognostic factors of overall survival for patients who underwent ablation.Multivariate analysis identified multiple tumors,poor Child-Pugh score,and AFP level ＞ 100μg/L were the factors affecting overall survival.Conclusions Microwave ablation is of high clinical application value and is an effective minimally invasive treatment for recurrence hepatocellular carcinoma.Microwave ablation is equally effective when used in late recurrence,single tumor and tumor size≤3 cm.