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find Keyword "心脏功能" 10 results
  • The Relationship Between Cardiac Dysfunction and the Changes of Adenosine Triphosphate Enzyme in Myocardial Cells after Blunt Chest Trauma

    Objective To investigate the changes and roles of myocardial adenosine triphosphate enzyme(ATPase) in the mechanism of cardiac dysfunction after blunt chest trauma(BCT). Methods Thirtysix rabbits were divided into 6 groups with random number table, control group, 2 h group, 4 h group, 8 h group, 12 h group and 24 h group, 6 in each group. The models of BCT were established with BIMⅡ biological impact machine, catheterization technique was used through the right jugular artery into the left ventricle measure its pressure. The hemodynamics and the activities of ATPase in myocardial cell plasm, homogenate and mitochondria were measured at preinjury(control group), 2 h, 4 h, 8 h, 12 h and 24 h postinjury. Results Left ventricular endsystolic pressure(LVESP), the maximal ascending rate of left intraventricular pressure(+dp/dtmax), isovolemec pressure(IP) and the maximal physiological velocity(Vpm) decreased significantly at 2 h group after BCT(Plt;0.05), and recovered to preinjury level in 4 h, 8 h and 12 h group during 4-12 h after BCT; isovolumic relaxation phase left ventricular pressure descending time constant (T). Left ventricular enddiastolic pressure(LVEDP) and the maximal descending rate of left intraventricular pressure(-dp/dtmax) were significantly higher (Plt;0.05, 0.01). The activity of ATPase in homogenate, mitochondria and cell plasm decreased significantly at 2 h group and 4 h group after BCT(Plt;0.05, 001, respectively), and 8 h group and 12 h group recovered after BCT. There was negative correlations between [CM(159mm]LVEDP and -dp/dtmax and the decrease of the activity of Na+-K+-ATPase in homogenate(r=-0.674, -0.691, Plt;0.05), the Ca2+-ATPase in homogenate(r=-0.613,-0.642, Plt;0.05), the Na+-K+-ATPase in mitochondria(r=-0.622,-0.616, Plt;0.05),the Ca2+-ATPase in myocardial cell plasm(r=-0.672,-0.658, Plt;0.05), the Na+-K+-ATPase in myocardial cell plasm(r=-0.627,-0.632,Plt;0.05),and the Mg2+-ATPase in myocardial cell plasm(r=-0.677,-0.661, Plt;0.05). Conclusion The left ventricular function is impaired obviously after BCT, especially in diastolic phase. The decrease of the activity of ATPase in myocardial cells may be one of the reasons of cardiac dysfunction after BCT.

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • The Changes of Cardiac Functions after Blunt Chest Trauma in Rabbits

    Objective To investigate the changed rules of the cardiac functions in rabbits and to provide theoretical gists for clinical diagnosis and treatment after blunt chest trauma(BCT). Methods Using the models of moderate to severe BCT with BIM-Ⅱ Bio-impactor in 20 rabbits to examinate the cardiac functions with cardiac catheterization, the single photonemission computed tomography(SPECT) and the Doppler echocardiography at preinjury and 1h, 2h, 4h, 6h, 8h, 12h and 24h after BCT. Results Central venous pressure( CVP), left ventricular enddiastolic pressure (LVEDP) and the decreasing time constant of left intraventricular pressure (T) at 24h after trauma were higher obviously than those before trauma (Plt;0.05,0.01). The -dp/dtmax at 24h after trauma was lower markedly than that before trauma (Plt;0.05 ). The ejection fraction(EF),1/3 EF, 1/3 ejection rate(1/3ER) and the ratio of 1/3 filling rate (1/3FR) to 1/3ER of the right ventricle at 24h after impacted were lower markedly than those before impacted (Plt;0.05). The peak filling rate, 1/3 filling fraction, 1/3 filling rate, the ratio of peak filling rate to peak ejection rate and the ratio of 1/3FR to 1/3ER of the left ventricular at 24h after impacted were lower obviously than those before impacted (Plt;0.05, 0.01). Conclusion The cardiac functions are changed significantly after BCT. The expressions of the right ventricular dysfunctions mainly are systolic dysfunction while the left ventricular dysfunctions are mainly diastolic dysfunction after BCT. All the cardiac catheterization, SPECT and the Doppler echocardiography are beneficial to the diagnosis of cardiac dysfunction after BCT. The SPECT is more exactitude and the Doppler echocardiography is more cheaper.

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • 胸部撞击伤后血流动力学与体内细胞因子含量变化及意义

    目的 探讨胸部撞击伤(CIT)后血流动力学和体内部分细胞因子含量变化及意义,为临床诊断和治疗CIT提供依据. 方法 选取12只健康成年兔,采用BIM -Ⅱ型生物撞击机作成CIT模型,监测伤前、伤后2小时、4小时、8小时和24小时血流动力学改变,同时测定血浆内皮素-1(ET-1)、心钠素(ANF)和肿瘤坏死因子-α(TNF-α)含量.结果 CIT后血流动力学发生明显改变,左心室舒张期末压(LVEDP)和左心室内压最大下降速率(-dp/dtmax)在伤后24小时仍较伤前明显增高(t=3.302, 2.737; Plt;0.01, 0.05);伤后血浆ET-1含量进行性增高,24小时达高峰(t=3.387, Plt;0.01);ANF含量降低,伤后8小时降至最低(t=2.562, Plt;0.05);TNF-α含量在受伤前后无明显变化(t=0.637,Pgt;0.05). 结论 CIT后血流动力学及体内部分细胞因子发生明显改变,这可能是引起CIT后心脏功能障碍的原因之一.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • 体外循环缺血-再灌注心肌肌钙蛋白I丢失与心功能障碍的关系

    目的 探讨体外循环缺血-再灌注心肌肌钙蛋白I(TnI)丢失与心功能障碍的关系. 方法 12条雄性杂种狼犬,按体外循环升主动脉阻断时间不同分为两组:组Ⅰ(n=6):主动脉阻断25分钟;组Ⅱ(n=6):主动脉阻断150分钟.分别于转流前、主动脉开放后10分钟、30分钟、60分钟时测定动脉和冠状静脉窦血清TnI浓度,同时监测围术期冠状静脉窦血流量和血流动力学. 结果 再灌注后冠状静脉窦血清TnI浓度持续高于动脉血清TnI浓度(P<0.01),提示心肌丢失TnI.组Ⅱ与组Ⅰ比较,组Ⅱ心肌TnI丢失水平更显著,且终止体外循环后心脏指数、每搏指数、左心室每搏作功指数均显著降低(P<0.05). 结论 体外循环缺血-再灌注心肌TnI丢失程度与心功能障碍的发生密切有关,提示心肌细胞TnI丢失很可能是导致缺血后心肌功能障碍的分子基础之一.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 体外循环缺血-再灌注后心肌胰岛素抵抗现象的初步研究

    目的 求证体外循环缺血-再灌注后存在心肌胰岛素抵抗现象的假设。 方法 12条雄性杂种狼犬,按体外循环升主动脉阻断时间的不同分为两组,组Ⅰ(n=6):主动脉阻断25分钟;组Ⅱ(n=6):主动脉阻断150分钟。分别于转流前、主动脉开放后10分钟、30分钟和60分钟测定冠状静脉窦血流量和血流动力学,并同时采集动脉和冠状静脉窦血测定血浆葡萄糖、乳酸、胰岛素、C肽、胰高血糖素、皮质醇和生长激素浓度的动态变化。 结果 缺血-再灌注后血浆葡萄糖、乳酸、胰岛素、C肽、胰高血糖素、皮质醇和生长激素浓度与转流前比较均有不同程度的明显增高,再灌注10~30分钟达峰值(P<0.05),同时心肌对葡萄糖的摄取、利用有严重障碍。与组Ⅰ比较,组Ⅱ上述生化指标均明显增高,且心肌葡萄糖摄取、利用障碍持续时间更长,停机后心功能明显下降。 结论 在体外循环缺血-再灌注机体胰岛素抵抗同时,亦存在明显的心肌胰岛素抵抗现象,其程度随体外循环时间延长而增强,并与心功能障碍的发生密切有关。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • EFFECTIVENESS OF MINIMALLY INVASIVE SURGERY FOR PECTUS EXCAVATUM IN ADULTS

    ObjectiveTo investigate the effect of anterior chest wall depression on the cardiac function and the effectiveness of minimally invasive surgery for pectus excavatum by comparing cardiac function and morphology between pre- and post-operation. MethodsBetween August 2009 and December 2010, 102 adult patients with pectus excavatum were treated with minimally invasive surgery, including the primary operation in 95 cases and the reoperation in 7 cases. There were 84 males and 18 females, aged 18-57 years (mean, 23.4 years). The haller index (HI) was 4.59 ± 1.51. Of 102 patients, 59 were classified as pectus excavatum type I and 43 as type II; 42 had clinical symptoms and 19 had the physical sign of heart. The preoperative chest CT examination showed cardiac compression in all patients and heart displacement in 74 patients. The left ventricular ejection fraction (LVEF) was 68.9% ± 6.2%. ResultsThe procedure was successful in all patients, and no death or serious complication occurred. The patients were followed up 12-28 months (mean, 21 months). The clinical symptoms and cardiac physical sign of the patients disappeared after operation. HI was 2.70 ± 0.33 at 12 months after operation, showing significant difference when compared with preoperative HI (t=5.83, P=0.00). According to Nuss’s evaluation method, the results were excellent in 99 patients and good in 3 patients. CT examination showed complete relief of cardiac compression in 101 patients and mild cardiac compression in 1 patient; the heart position was normal at 12 months after operation. Electrocardiogram returned to normal in 4 patients having abnormal electrocardiogram. LVEF was 70.5% ± 4.8% after operation, showing no significant difference when compared with preoperative LVEF (t=1.08, P=0.30). ConclusionThe main effects of pectus excavatum in adults on heart are compression and displacement. Cardiac compression may be relieved efficiently and the patient’s clinical symptoms can be abated by minimally invasive surgery.

    Release date:2016-08-31 05:39 Export PDF Favorites Scan
  • Influence of Heart Valve Replacement and Concomitant Bipolar Radiofrequency Ablation on Recovery of Cardiac Function

    ObjectiveTo evaluate the mid-term recovery of cardiac function after heart valve replacement and concomitant bipolar radiofrequency ablation for atrial fibrillation (AF). Methods Clinical data of 191 patients with heart valve disease and AF in the same surgical team of Xinqiao Hospital from January 2011 Jan to December 2013 was retrospectively analyzed. Heart valve replacement was performed for a control group (n=93), which includes 31 males and 62 females with their age of 48.33±7.55 years and AF duration of 4.80±2.03 years. Valve replacement and concomitant bipolar radiofrequency ablation was performed for a synchronism ablation group (n=98), which includes 27 males and 71 females with their age of 46.95±7.70 years and AF duration of 5.06±2.26 years. The echocardiogram, electrocardiogram and complications at hospitalization, 6 months, 1 year and 2 year after operation were analyzed. ResultsNo in-hospital death occurred. There were statistical differences in aortic cross-clamp time, cardiopulmonary bypass time, tricuspid ring, ICU stay, total volume of postoperative drainage between the two groups. All the patients were followed up for 2 years. Two years postoperatively, in the synchronism ablation group, 85 patients (86.73%) were followed up, 1 patient with cerebral embolism, 2 patients with cerebral hemorrhage. In the control group, 85 patients (91.40%) were followed up, 4 patients with cerebral embolism, 2 patients with cerebral hemorrhage. There were no death, cardiac rupture, and permanent cardiac pacemaker implantation in the two groups during the follow-up. One year and 2 years postoperative fractional shortening of the synchronism ablation group was significantly higher than those of the control group (37.18%±5.35% vs. 34.72%±6.40%, P=0.007; 37.95%±7.99% vs. 35.18%±5.15%, P=0.008). One year and 2 years postoperative left ventricular ejection fraction of the synchronism ablation group was significantly higher than that of the control group (66.27%±6.99% vs. 63.33%±8.14%, P=0.012). The rate of self-feeling cardiac function improvement in 1 year and 2 years after surgery of the synchronism ablation group was significantly higher than that of the control group (85.39% vs. 72.94%, P=0.005; 84.71% vs. 68.24%, P=0.005). ConclusionCardiac function of the mid-term after the valve replacement and concomitant bipolar radiofrequency ablation for atrial fibrillation obviously improves.

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  • Effect of cardiac systolic and diastolic dysfunction on the prognosis of patients with coronary artery disease

    Objective To explore the role of systolic and diastolic dysfunction in the prognosis of Chinese patients with coronary artery disease (CAD). Methods CAD patients who underwent coronary arteriography in the Department of Cardiology of West China Hospital between July 2008 and June 2012 were included in this study. All the patients underwent color Doppler echocardiographic examination. Based on patients’ systolic and diastolic cardiac function, left ventricular ejection fraction (LVEF) <55% was as the systolic dysfunction and the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity (E/e’) >15 was as the diastolic dysfuntion. They were divided into normal cardiac function group (LVEF≥55%, E/e’ ratio≤15), systolic and diastolic dysfunction group (LVEF<55%, E/e’ ratio>15), diastolic dysfunction group (LVEF≥55%, E/e’ ratio>15) and systolic dysfunction group (LVEF<55%, E/e’ ratio≤15). The end points of follow-up were all-cause death and a major cardiovascular event (MACE). Results A total of 985 patients with complete echocardiographic report were included in this study. During the follow-up of (21.4±9.7) months, 46 patients (4.7%) died, and 52 (5.4%) had a MACE. Systolic dysfunction concomitant with diastolic dysfunction group and systolic dysfunction group patients had a higher risk of 36-month all-cause death (4.8%, 10.7%,P<0.001) and a higher risk of 41-month MACE (8.6%, 7.6%,P=0.028). Single factor analysis of all-cause death mortality showed that compared with the normal group, all-cause death mortality was the highest in systolic and diastolic dysfunction group (P<0.05), followed by diastolic dysfunction group (P<0.05) and systolic dysfunction group (P>0.05). Single factor analysis of MACE showed that compared with the normal group, MACE was still the highest in systolic and diastolic dysfunction group (P<0.05), followed by systolic dysfunction group (P<0.05) and diastolic dysfunction group (P>0.05). A multivariate Cox regression model analysis showed that compared with the normal group, the risk of all-cause death was the highest in the systolic and diastolic dysfunction group [hazard ratio (HR)=2.96, 95% confidence interval (CI) (1.34, 6.54),P=0.007], followed by the systolic dysfunction group [HR=1.91, 95%CI (0.67, 5.42),P=0.224] and the diastolic dysfunction group [HR=0.95, 95%CI (0.40, 2.23),P=0.905]. Conclusion Compared with normal patients, patients with either systolic or diastolic dysfunction have a poorer prognosis, and patients with systolic dysfunction concomitant with diastolic dysfunction have the poorest prognosis.

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • 超声评价慢性肾衰竭心脏功能的研究进展

    慢性肾衰竭的发病率和死亡率很高,严重威胁着人们的健康及生命。血液透析能够延缓慢性肾衰竭的进程,但心血管疾病仍是慢性肾衰竭维持性血液透析患者的主要并发症,也是慢性肾衰竭患者的首要死亡原因。慢性肾衰竭心脏结构和功能与预后密切相关,因此,准确评价慢性肾衰竭心脏的结构与功能,对临床诊断及其治疗具有重要意义。该文从超声医学角度,介绍了目前评估慢性肾衰竭心脏结构及功能的方法。

    Release date:2017-12-25 06:02 Export PDF Favorites Scan
  • Nilotinib-loaded gelatin methacryloyl microneedles patch for the treatment of cardiac dysfunction after myocardial infarction

    The study aimed to evaluate the therapeutic effect of nilotinib-loaded biocompatible gelatin methacryloyl (GelMA) microneedles patch on cardiac dysfunction after myocardial infarction(MI), and provide a new clinical perspective of myocardial fibrosis therapies. The GelMA microneedles patches were attached to the epicardial surface of the infarct and peri-infarct zone in order to deliver the anti-fibrosis drug nilotinib on the 10th day after MI, when the scar had matured. Cardiac function and left ventricular remodeling were assessed by such as echocardiography, BNP (brain natriuretic peptide) and the heart weight/body weight ratio (HW/BW). Myocardial hypertrophy and fibrosis were examined by WGA (wheat germ agglutinin) staining, HE (hematoxylin-eosin staining) staining and Sirius Red staining. The results showed that the nilotinib-loaded microneedles patch could effectively attenuate fibrosis expansion in the peri-infarct zone and myocardial hypertrophy, prevent adverse ventricular remodeling and finally improve cardiac function. This treatment strategy is a beneficial attempt to correct the cardiac dysfunction after myocardial infarction, which is expected to become a new strategy to correct the cardiac dysfunction after MI. This is of great clinical significance for improving the long-term prognosis of MI patients.

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