Objective To investigate the clinical efficacy of mitral valve repair technique in the treatment of rheumatic mitral valve lesions. Methods The clinical data of patients diagnosed with rheumatic mitral valve lesions and undergoing mitral valve repair under extracorporeal circulation in our department from 2021 to 2022 were retrospectively analyzed. Results A total of 100 patients were collected, including 78 females and 22 males with an average age of 52 years. There were no secondary open heart or death in the whole group. Extracorporeal circulation time was 136.3±33.1 min, aortic cross-clamping time was 107.6±27.5 min, ventilator use time was 12.9±5.9 h, ICU stay was 2.6±1.4 d, and vasoactive medication use was 823.4±584.4 mg. Before and after the surgery, there were statistical differences in the left ventricular end diastolic diameter, left atrial end systolic diameter, effective mitral valve orifice area, shortening rate of left ventricular short axis, mitral E-peak blood flow velocity, mean mitral transvalvular pressure difference, mitral pressure half-time, and cardiac function graded by New York Heart Association (P＜0.05). While there was no statistical difference in left ventricular ejection fraction or left ventricular end-diastolic volume (P>0.05). Conclusion Overall repair of rheumatic mitral valve lesions can significantly improve the cardiac function and hemodynamics of the patients, and is a good choice for patients with rheumatic mitral valve lesions.
OBJECTIVE :To investigate ocular vessel flow velocity in normal eyes by color Doppler imaging(CDI). METHODS: Ninety people (180 normal eyes)had flow velocity measured by CDI in three vessels,ophthalmic artery (OA),central retinal artery(CRA) and posterior ciliary artery (PCA),and the relations between velocity and affecting factors were analysed. RESULT: The diastolic and systolic velocity of OA,CRA and PCA were (31.7plusmn;10.9)cm/s, (7.2plusmn;2.6)cm/,s, (10.2plusmn;3.4)cm/s, (2.8plusmn;1.2)cm/s and (11.3plusmn;3.6)cm/s, (3.2plusmn;1.4)cm/s respectively. The velocity of OA had possitive correl-ativity with RBC,HCT and negative correlativity with age,while it revealed no relationship with sex, laterality of right or left eye,and normal IOP. CDI of ocular vessels in normal eyes is a triangle with three peaks and double sunkens in its frenquency spectum, revealed highly resistant,and both the pulsatility and resistive indexes were relatively high. The width of each frequency band basically was the same,and there was no obvious frequency window. CONCLUSION: The ocular application of CDI might lay the foundation of a comparatively comprehensive knowledge of the ocular hemodynamics. （Chin J Ocul Fundus Dis,1997,13: 99-101）
Ｈｅｍｏｄｙｎａｍｉｃ ｃｈａｎｇｅｓ ｏｆ ｓｙｓｔｅｍｉｃ ａｎｄ ｐｏｒｔａｌ ｖｅｉｎ ｆｌｏｗ ａｎｄ ｒｅｇｕｌａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ ｈａｖｅ ｂｅｅｎ ｓｔｕｄｉｅｄ ｉｎ ７３ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ（ｇｒｏｕｐ Ａ）ａｎｄ ３９ ｃａｓｅｓ ｗｉｔｈ ｓｉｍｐｌｅ ｇａｌｌｂｌａｄｄｅｒ ｓｔｏｎｅｓ（ｇｕｏｕｐ Ｂ）．Ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｗａｓ ｓｕｂｇｒｏｕｐｅｄ ｉｎｔｏ ｇｒｏｕｐ Ａ１（ｎｏｉｎｄｏｍｅｔｈａｃｉｎ ａｄｍｉｎｉｓｔｒａｔｉｏｎ），ｇｒｏｕｐ Ａ２（ｐｒｅｏｐｅｒａｔｉｖｅ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ），ｇｒｏｕｐ Ａ３（ｐｏｓｔｏｐｅｒａｔｉｖｅ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ），ａｎｄ ｇｒｏｕｐ Ａ６（ｓｅｎｉｌｅ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ）．Ｏｆ ｔｈｅｍ ｇｒｏｕｐ Ａ１ ｗａｓ ｓｕｂｇｒｏｕｐｅｄ ｉｎｔｏ ｇｒｏｕｐ Ａ４（ｍａｌｉｇｎａｎｔ ｏｂｓｔｒｕｃｔｉｏｎ）ａｎｄ ｇｒｏｕｐ Ａ５（ｂｅｎｉｇｎ ｏｂｓｔｒｕｃｔｉｏｎ）ａｇａｉｎ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｔｈｅ ｓｔｒｏｋｅ ｖｏｌｕｍ（ＳＶ），ｃａｒｄｉａｃ ｏｕｔｐｕｔ（ＣＯ）ａｎｄ ｃａｒｄｉａｃ ｉｎｄｅｘ （ＣＩ）ｗｅｒｅ ｈｉｇｈｅｒ ｉｎ ｅａｃｈ ｇｒｏｕｐ ｏｆ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｇｒｏｕｐ Ｂ（Ｐ＜０．０１），ａｎｄ ｔｈｅ ｍｅａｎ ａｒｔｅｒｙ ｐｒｅｓｓｕｒｅ （ＭＡＰ），ｓｔｒｏｋｅ ｖｅｓｓｅｌ ｒｅｓｉｓｔａｎｃｅ （ＳＶＲ）ａｎｄ ｐｏｒｔａｌ ｖｅｉｎ ｂｌｏｏｄ ｆｌｏｗ（ＰＶＦ）ｗｅｒｅ ｌｏｗｅｒ ｉｎ ｅａｃｈ ｇｒｏｕｐ ｏｆ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｇｒｏｕｐ Ｂ（Ｐ＜０．０１）．Ｔｈｅ ＭＡＰ，ＳＶＲ ａｎｄ ＰＶＦ ｉｎ ｇｒｏｕｐ Ａ２ ａｎｄ ｇｒｏｕｐ Ａ３ ｓｈｏｗｅｄ ｂｅｔｔｅｒ ｉｍｐｒｏｖｅｍｅｎｔ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｏｔｈｅｒ ｓｕｂｇｒｏｕｐｓ，ｂｕｔ ａｓ ｃｏｍｐａｒｅｄ ｗｉｔｈ ｇｒｏｕｐ Ｂ ｔｈｅｒｅ ｗｅｒｅ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅｓ （Ｐ＜０．０１）．Ｔｈｅ ａｕｔｈｏｒｓ ｃｏｎｓｉｄｅｒ ｔｈａｔ ｉｎｄｏｍｅｔｈａｃｉｎ ｃａｎ ｉｍｐｒｏｖｅ ｔｈｅ ｃｉｒｃｕｌａｔｉｏｎ ｆｕｎｃｔｉｏｎ，ＰＶＦ ａｎｄ ｌｉｖｅｒ ｆｕｎｃｔｉｏｎ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ．
OBJECTIVE: To investigate the hemodynamic changes of the end-to-end anastomosed arteries with nitinol clips. METHODS: Fifteen New Zealand rabbits were divided into anastomosis clip group, suture group and control group randomly. The carotid arteries were resected and end-to-end anastomosis were carried out with nitinol clips in anastomosis clip group and with traditional suture in suture group. The carotid arteries remained undamaged in control group. On the days of 3, 9, 21 and 30 postoperatively, mean blood velocity (Vm), pulsatility index (PI) and resistance index (RI) of anastomosed arteries were determined by Ultrasonography Doppler. RESULTS: On the days of 8 and 9 postoperatively, there were no significant differences of VM, PI and RI between two experimental groups (P gt; 0.05). On the days of 20 and 30 postoperatively, the differences of Vm and RI were significant (Vm: P lt; 0.01, P lt; 0.05: RI: P lt; 0.01, P lt; 0.05). The hemodynamic restoration of the anastomosis clip group was better than that of the suture group. CONCLUSION: The hemodynamics of arteries anastomosed with nitinol clips is better than that with traditional suture. This technique has practical value clinically.
Objective To introduce the clinical significance and pathophysiologic aspects of the circulatory and cardiac complications in terminal stage cirrhosis. Methods Recently relevant literatures were reviewed and summarized. Results Haemodynamic changes in cirrhosis arose on the basis of combined humoral and nervous dysregulation, with abnormalities in cardiovascular regulation, volume distribution and cardiac performance. Conclusion Comprehending the mechanisms of cardiovascular complications will contribute a lot for the treatment of terminal stage cirrhosis.
Objective To investigate the effect of prone position ventilation (PPV) on hemodynamics in patients with interstitial lung disease (ILD) concurrent with acute respiratory distress syndrome (ARDS) or not. Methods Severe ARDS patients received PPV treatment in intensive care unit from 2013 to 2015 were retrospectively analyzed. Pulse index continuous cardiac output (PiCCO) monitoring indices were compared 2h before PPV (PPV-2), in-PPV (PPVmean) and 2h after turn back to supine position (PPV+2), including mean arterial pressure (MAP), cardiac index (CI), intrathoracic blood volume index (ITBVI), etc. Heart function, liver function, renal function, coagulative function were compared before and after all the PPV treatment. Results Thirty-six severe pulmonary ARDS patients were recruited. Norepinephrine (NE) dose was (0.14±0.10) μg·kg-1·min-1 and lactate concentration was (1.70±0.57) mmol/L before PPV. CI in all the patients was increased [(4.06±0.95) L·min-1·m-2 vs. (3.98±1.05) L·min-1·m-2, P > 0.05) and central venous oxygen saturation, ITBVI [(76.94±8.94)% vs. (70.67±8.23)%, (982.17±245.87) mL/m2 vs. (912.97±177.65) mL/m2, P < 0.05)] were significantly increased compared with PPV-2, while heart rate (HR), MAP, urine volume were decreased (P > 0.05). The patients were divided into an ILD group (n=17) andanon-ILD group (n=19),and no significant differences were found in baseline data between two groups. Compared with PPV-2, MAP was significant decreased at PPV+2 [(85.44±10.84) mm Hg vs. (89.21±10.92) mm Hg, P < 0.05) in the ILD group. Compared with PPVmean, CI was obviously declined at PPV+2 in the ILD group. Activated partial thromboplastin time was increased [(67.04±97.52)s vs. (41.24±8.72) s, P < 0.05] and BUN was higher [(10.64±4.95) μmol/L vs. (8.18±3.88) μmol/L, P < 0.05] in the ILD group, while no significant difference was found in the non-ILD group. Conclusion PPV will not affect cardiac output in severe ARDS patients with ILD. It can increase venous return and improve tissue perfusion, but the perfusion of the abdomen organ need to be monitored cautiously.
ObjectiveTo investigate the expression of tumor necrosis factor α(TNF-α ) in isolated rat heart at different time points after myocardial hypoxia/reoxygenation. MethodsThe isolated langendorff perfused rat heart model was established. Forty-eight SD rats were randomly divided into four groups: a sham group, hypoxia/reoxygenation groups including a H/R 0.5 h group, a 1 h group and a 2 h group. The heart rate(HR), the 1eft ventricular development pressure(LVDP), maximal rates of increase/decrease of the left ventricular pressure(±dp/dtmax) were continuously recorded. The concentrations of TNF-α and creatine kinase-MB(CK-MB) in myocardium, mRNA expression of TNF-α in myocardium were tested. Ultra structure of myocardium was observed under electron microscope. ResultsThe levels of LVDP, ±dp/dtmax, and HR of hypoxia/reoxygenation group were significantly lower than those in the sham group(P<0.05).The levels of TNF-α and CK-MB and the expressions of TNF-α at mRNA level in the hypoxia/reoxygenation group were higher than those in the sham group(P<0.05).There were significant differences in the above parameters among the H/R 0.5 h group, the 1 h group, the 2 h group(P<0.05).The concentrations of TNF-α and CK-MB, the mRNA expression of TNF-α were higher in the I/R 2 h group than those in the other two groups. ConclusionThe high expression of TNF-α in myocardium after myocardial hypoxia/reoxygenation in rats is related to the degree of myocardium damage and may lead to myocardial injury.
To visualize and quantify the hemodynamics in the aortic arch in normal individuals, we used velocity distribution, retrograde flow, vortex formation, and mean energy loss (mEL) at different cardiac cycles in our study. We performed Vector flow mapping (VFM) analysis by using echocardiography in 87 healthy volunteers. The results showed that ① in different sections of the aortic arch, a skewed peak flow velocity (Vp) always appeared in the period of rapid ejection but in different distribution. The systolic flow in the entire aortic arch rose rapidly from near-zero at the point of iso-volumetric contraction to the peak velocity at the period of rapid ejection, and then decreased gradually; ② In the period of iso-volumetric relaxation, retrograde flow and vortex were observed in all subjects in the inner wall of the entire aortic arch; and ③ The change rule of mEL in the entire aortic arch was similar to that of flow velocity. VFM can provide insights into the intra-aortic arch flow patterns, and offer essential fundamentals about flow features associated with common aortic diseases.