Electrocardiographic Examination Research Articles

Calculation of left ventricular volumes and systolic indices in monitoring the therapeutic effect of levothyroxine replacement therapy in subclinical hypothyroidism.

Subclinical hypothyroidism (SCH) is defined as high thyroid-stimulating hormone (TSH) and normal thyroxine (T4) levels. Data on the effects of early substitution with levothyroxine on psychophysical health in SCH are not consistent enough to support its general administration. The aim of this study was to examine the effect of 3-months levothyroxine (LT4) treatment on cardiovascular function in symptomatic SCH with TSH <10mIU/L. Anthropometric, biochemical, electro- and echocardiographic indices were measured in 35 patients with persistent symptomatic SCH (4mIU/L < TSH <10mIU/L; mean±SD: 7.0±2.1mIU/L) and 40healthy controls at baseline and three months after the euthyroid state had been achieved on LT4 for SCH group, or 3months of follow-up for controls. The analyses showed a significant reduction in body weight (P=.030), systolic and diastolic blood pressure (P=.024, P=.019), TSH (P<.001) and thyroid peroxidase antibodies (TPOAb) (P<.001) on LT4 in the SCH group. There was a statistically significant decrease in end-systolic (ESV) and end-diastolic volumes (EDV) (P<.001, P<.001, respectively) after LT4 treatment. LT4 therapy significantly increased values of ejection fraction (EF), global longitudinal, circumferential and radial strains (P<.001, P<.001, P<.001, respectively). Our study confirmed an echocardiographic improvement of cardiac structure and function in treated individuals. Findings suggest the role of electrocardiographic and echocardiographic examination in objective monitoring for LT4 therapeutic effects.

Effects of Mongolian medicine Shaosha-7 on myocardial ischemia/ reperfusion injury of rats

Objective: To investigate the effects of Shaosha-7 in rats with myocardial ischemia-reperfusion injury and its mechanisms. Methods: male SD rats were divided into sham operation group (n=10), myocardial ischemia-reperfusion injury group (n=10), low, medium and high dose of Shaosha-7 groups (n=10), and positive drug group (n=10). The rats of Shaosha-7 (low, medium and high dose) groups were treated with Shaosha-7 at the doses of 0.4, 0.8 and 1.6 g/kg respectively, once a day for 15 days. The rats of positive drug group were treated with 0.3 g/kg Danshen, once a day for 15 days. The rats of the sham operation group and myocardial ischemia-reperfusion injury were treated with 2 ml/100 g distilled water, once a day for 15 days. After 15 days, the rats of the model group and the treatment group underwent thoracotomy and ligation of coronary artery for 30 minutes, then thoracic cavity was closed after reperfusion. Rats in six groups were executed electrocardiographic examination and their hearts were taken for Hematoxylin-Eosin (HE) staining and 2, 3, 5-triphenyltetrazolium chloride (TTC) staining to observe infarct area and myocardial pathological changes. The contents of cTnI, CK-MB, LDH, MDA, SOD, GSH-Px, TNF-α, IL-18, IL-6 and IL-1 β in serum were detected by ELISA. The expression of NF-кB was detected by immunohistochemistry. Results: Compared with the sham operation group, the infarct size, the levels of cTnI, CK-MB, CK-MB, LDH, MDA, GSH-Px, TNF-α, IL-18, IL-6, IL-1β and NF-кB were increased and the content of SOD were decreased in rats with myocardial ischemia-reperfusion injury. Compared with the rats with myocardial ischemia-reperfusion injury, Shaosha-7 improved the arrhythmia and pathological changes, reduced the infarct area, decreased the contents of cTnI, CK-MB, LDH, MDA, GSH-Px, TNF-α, IL-18, IL-6, IL-1 β, increased the content of SOD, decreased the expression of NF-кB. Conclusion: Mongolian medicine Shaosha-7 can effectively alleviate myocardial ischemia-reperfusion injury in rats. This study provides a theoretical basis for the treatment of myocardial ischemia-reperfusion (I/R) injury with Shaosha-7.

Pengelolaan Anestesi pada Pasien yang dilakukan Eksisi Tumor Medula Spinalis Servikal 2-3 dengan Ventrikel Ekstra Sistole

Compression of the spinal cord can cause irritation to the autonomic nervous system. Hyperinervation of sympathetic nerves at high risk for arrhythmias characterized by electrocardiographic results in changes in P-wave duration, QRS duration, ST-segment depression, T-wave peak interval, and ventricular extrasystole. A 52-year-old male with an intra-extramedullar tumor in cervical 2-3, tetraparesis, dysrhythmias, and ventricular extrasystole bigemini. Wide excision of tumor and posterior stabilization would be performed. The pulse was 90x/minute palpable irregularly. Electrocardiography examination revealed irregular rhythm 82 x/minute and ventricular extrasystole 10 x/minute. Echocardiography showed grade 3 diastolic dysfunction with preserved LV function. Before the procedure, the patient was given management for the dysrhythmia and ventricular extrasystole with analgetics and amiodaron 150mg (10ml) in the first 10 minutes followed by 360mg (200mg) for the next 6 hours, 540mg for the next 18 hours and analgetics. General anesthesia carried out with midazolam 3mg, fentanyl 200mcg, lidocaine 60mg, propofol 100mg, and atricurium 30mg, with manual intubation in-line. After arterial line and central venous catheter insertion, the patient was placed in the prone position. Surgery lasted for approximately 6 hours. The patient was treated in the ICU for 2 days before moving to the usual ward. Amiodarone can be considered in ventricular extrasystole requiring immediate treatment with stable hemodynamic.

Expert consensus document on automated diagnosis of the electrocardiogram: The task force on automated diagnosis of the electrocardiogram in Japan. Part 1: Nomenclature for diagnosis and abnormal findings.

As these terms should accurately represent the abnormal findings and conditions as much as possible, we propose to unify these terms into terminologies that are not confusing and easy to understand for everyone.

Clinicopathological features of pulmonary artery and vein intimal sarcomas: case series of rare pulmonary vessel intimal sarcoma.

BackgroundPulmonary vessel intimal sarcoma (IS) is rare.MethodsWe studied gross pathology, microscopic images and immunohistochemistry of 2 pulmonary artery ISs (PAISs) and 2 pulmonary vein ISs (PVISs), followed up the prognosis. The clinical manifestations of IS, imaging examination, electrocardiographic examination and serological examination were also studied.ResultsGrossly, the tumors were grayish yellow or grayish-white accompanied by local bleeding, and were manifested as sticky and slippery nodules. PAISs were located in the lumen of the pulmonary trunk or right ventricular outflow tract, and 1 of them had pedicle. PVISs were mainly located in the left atrium. Microscopically, the heteromorphic spindle cells were arranged in lobules and bundles, partially epithelioid, with visible mitotic figures. There were interstitial mucoid degeneration and local hemorrhage and necrosis/infarction. Immunohistochemistry showed that vimentin, h-caldesmon and MDM2 were all positive, SATB2 (+, 3/4); Ki67 proliferation rate was 30–60%; smooth muscle actin, desmin and CD56 were partially positive; cytokeratin and CD34 were locally positive; CD31, FLI-1, and ERG vascular markers were negative; and S-100 was negative. Case 4 showed MDM2 (12q15) amplification. Tumor markers were negative in venous blood; and lactate dehydrogenase increased in 2 cases. 3 patients died after surgery, 1 still survives after 14 months with lung and chest metastases for immunotherapy and 9 courses of chemotherapy.ConclusionsIS is rare. Microscopically, it is mainly composed of spindle cells (or local epithelioid), along with interstitial mucoid degeneration. IS can differentiate into tumor of fibroblasts, bone, cartilage and smooth muscle, etc. The prognosis is poor.

Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy

BackgroundLimb–girdle muscular dystrophy (LGMD) is a genetically and clinically heterogeneous group of rare muscular dystrophies. Subtype 2A (LGMD2A) also known as “calpainopathy” is an inherited autosomal recessive gene defect. Cardiac dysfunction is common in several forms of LGMD. Cardiac involvement in LGMD2A, however, is not clear. The aim of this study was to perform cardiac magnetic resonance (CMR)-based strain analysis in LGMD2A patients, as this is a diagnostic parameter of subclinical cardiac involvement and a powerful independent predictor of mortality. We conducted the largest prospective cardiac magnetic resonance study to date, including 11 genetically verified LGMD2A patients and 11 age- and sex-matched control subjects and performed CMR-based strain analysis of the left and right ventricles.ResultsLeft and right global longitudinal strain (GLS) were not significantly different between the two groups and within normal reference ranges (left ventricle: control − 21.8 (5.1) % vs. patients − 22.3 (3.2) %, p = 0.38; right ventricle: control − 26.3 (7.2) % vs. patients − 26.8 (5.8) %, p = 0.85). Also, global circumferential and radial strains did not significantly differ between the two groups (p = 0.95 and p = 0.86, respectively). LGMD2A patients did not show relevant amounts of late gadolinium enhancement (LGE) or malignant ventricular arrhythmias.ConclusionsNo evidence of even subtle cardiac dysfunction is evident form CMR-based strain analysis in LGMD2A patients. Malignant ventricular arrhythmias were not detected. Thus, in case of non-pathological initial echocardiographic and electrocardiographic examination, a less frequent or even no cardiac follow-up may be acceptable in these patients. However, if there are signs and symptoms that suggest an underlying cardiac condition (e.g. palpitations, angina, shortness of breath), this approach needs to be individualized to account for the unknown.

Perinatal Cardiovascular Evaluation in Dorper Sheep Echocardiographic Description and Behavior of the Heart Rate Variability on the Field

The heart is innervated by the autonomic nervous system, with a predominance of sympathetic and parasympathetic activity associated, respectively, with increases and decreases in the heart rate, as illustrated by the Heart Rate Variability (HRV). Pregnancy induces significant changes in the maternal cardiovascular and hemodynamic systems. This study aimed at evaluating changes in the clinical and echocardiographic parameters of pregnant sheep, as well as the HRV indexes due to the physiological alterations that happen at this stage implicating in high maternal metabolic demands. For this purpose, the study evaluated 10 Dorper sheep through their pregnancy, starting from the second month until the day after delivery (24 h after birth), being evaluated clinical parameters, some of the echocardiographic measurements and electrocardiographic examinations focused on the HRV. The HRV indexes were obtained through the Televet 100® system. There were increases in the thickness of the interventricular septum during diastole starting from the third month and in the internal diameter of the left ventricle during systole and diastole at the second and third months, that diverged across the moments studied, while the ejection fraction increased as the pregnancy progressed. There were increases in the LVFWs values in the 2nd and 5th months. The size of the left atrium increased starting at the second month. The SDNN, RMSSD and PNN 50 HRV indexes were higher at the fifth month of pregnancy and after delivery. There were no significant differences in the frequency-domain HRV indexes during pregnancy. As pregnancy progresses, there is an increase in some echocardiographic parameters as well as a predominance of parasympathetic autonomic nervous system activity. The gestation leads to alterations in the clinical parameters and the activity of the autonomic nervous system.

Development of ECG measurement and processing system in LabVIEW environment

Abstract In this project an ECG measurement and wave identification system was made. The measuring system hardware is based on a Texas Instruments ADS1298ECG amplifier and analog-to-digital converter board. The measurement and processing software was created in LabVIEW environment using the built-in functions of the Biomedical toolkit. Initially, the theory behind heartbeat and its effect on the skin surface potential are presented. Then the measurement techniques of these are described. The research group provide information on the mathematical background of how the ECG curve is processed and the waves are identified. The HRV analysis, the statistical analysis of identified R waves are described. Subsequently, publications dealing with electrocardiographic examinations in various fields will be presented. Then an overview of the specifications of the amplifiers used in this work and the capabilities of their original software are given. The final device structure is presented. The system validation process and the properties of the reference devices are illustrated.

Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction

BackgroundPericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplastic diseases, lymphatic dysfunctions, or idiopathic pericardial disease. Pericardial tamponade can develop after cardiac surgical procedures or as a complication of myocardial infarction. Collection of blood inside the pericardial sack can be the result of pericardial or cardiac trauma. It is exceedingly rare for the injury to be caused by a migrating foreign body. Although a typical picture of pericardial tamponade has been previously described, the disorder may clinically resemble an acute myocardial infarction.Case presentationWe report the case of a 58-year-old female patient complaining of new onset thoracic pain and shortness of breath. Electrocardiographic examination results were suggestive of an acute inferior myocardial infarction. However, echocardiography revealed significant pericardial tamponade. The cause was found to be a needle which remained inside the pelvis following a previous cesarean delivery, which the patient had undergone 18 years prior. In emergency setting, the needle was removed and the pericardial tamponade was resolved. Due to the prompt and efficient management, the patient had an uneventful postoperative recovery and presented no recurrence at the follow-up examinations.ConclusionsThe migration of foreign bodies through tissues is exceedingly rare. If present, it may cause life-threatening complications. Since the aetiology of pericardial tamponade is vast, a thorough assessment is highly important. Therefore, echocardiography is the imaging modality of choice. We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions.

THE ROLE OF VASODILATION FACTORS IN THE PATHOGENESIS OF CHRONIC HEART FAILURE OF ISCHEMIC ORIGIN IN ATRIAL FIBRILLATION

The purpose of the study is to study the possible role of vasodilation factors in the pathogenesis of chronic heart failure (CHF) in persistent atrial fibrillation (AF) in patients with stable coronary heart disease. Materials and methods. A survey of 86 patients with stable coronary heart disease complicated by CHF II-III FC according to the NYHA classification. There was 1 group - 22 patients with CHF with reduced LV EF ≤ 40.0% and AF; I (comparative group) - 20 patients with CHF with reduced LV EF without AF; 2-nd group - 24 patients with preserved LV EF ≥ 40.1% and AF and II (comparative group) - 20 patients with CHF with preserved LV EF without AF. The content of endothelial nitric oxide synthase (eNOS), nitrites (NO2-) and nitrates (NO3-) was determined. All patients underwent electrocardiographic examination (ECG) for the initial screening of arrhythmias and conduction, diagnosis of focal changes in the ventricular myocardium. Structural and hemodynamic characteristics of the heart muscle were determined by echocardiography.Results. In the examined patients of the 1st group with CHF of ischemic origin and reduced LV EF ≤ 40.0% and AF in comparison with the 2nd group of patients with CHF with preserved LV EF and AF, a significant increase in the values of ICO, ICD, IMML, the size of LA and a decrease in LV EF (p &lt;0.01), indicating the development of LVH (remodeling) and a decrease in isotropic heart function. When comparing the levels of vasodilation factors in patients with CHF with low LV EF and AF and data from the CHF comparison group without AF, a significant decrease in eNOS by 96.8% (almost twice) and a significant decrease in serum nitrite and nitrate levels (p &lt; 0.01), indicating the development of endothelial dysfunction. Conclusions. In patients with CHF of ischemic origin in the development of persistent forms of AF pathogenetic role is played by a significant decrease in vasodilating factors (content of eNOS, nitrites and nitrates). At decrease in EF of LV ≤ 40,0% there is a significant decrease in vasodilating factors, as a result of disturbance of endothelial function that testifies to need of correction of the revealed changes directed on slowing down of disease progression.

Complete Heart Block In Pregnancy : A Case Report

Background: Complete heart block occurs due to various pathological conditions that cause an infiltration, fibrosis, or lose the connection from a part of the cardiac conduction system. Complete heart block in pregnancy is often caused by congenital anomalies. Around 30% cases, complete heart block remain asymptomatic and not detected until adulthood and may present in pregnancy state and puerperium. When the reversible cause of the AV Block cannot be found, the permanent pacemaker or temporary pacemaker may be indicated when the patients show the symptoms.&#x0D; Case Illusration: A-21 year old female, G2P0A1 preterm pregnancy (27-28 weeks) with bradycardia. From electrocardiograph examination revealed Total AV Block with junctional escape rhytym. Transthoracic echocardiogram shows massive tricuspid regurgitation, early phase of peripartum cardiomyopathy and ejection fraction 36-40%. Caesarean section was peformed due to PPROM. A male baby was born with birth weight of 1100 grams, 32 centimeters of body length and APGAR score of 7/9. The baby was died in NICU on day care 4th, with suspected respiratory problem.&#x0D; Conclusion: Complete heart block in pregnancy is a rare condition. This condition could remain asymptomatic and not detected until pregnancy. Multidisciplinary approach, close monitoring of the symptoms and cardiac functions are needed for patients with CHB.

P-Wave Terminal Force in Dogs With Myxomatous Mitral Valve Disease

P-wave terminal force (PTF) is accepted as an electrocardiographic criteria to assess left atrial abnormalities in humans. In this study, the applicability of PTF in dogs with myxomatous mitral valve disease (MMVD) was evaluated, and compared its ability to identify left atrial dilatation with 4 other P-wave derived parameters. Seventy-four dogs with echocardiographically diagnosed MMVD were recruited for this prospective cross-sectional study. Also, 47 healthy dogs were included to serve as controls. All dogs underwent physical, electrocardiographic and standard echocardiographic examinations prior to enrollment. Electrocardiographic measurements were obtained from simultaneous recordings at three different locations for precordial lead V1. PTF was defined as the deflection following the second half of the P-wave, and was best documented at the first and third right intercostal spaces. In those locations, the P-wave was negative and P-wave terminal force was recognized as a positive undulation in baseline following P-wave. P-wave terminal force and P-wave duration measured from recordings obtained at either the first or third right intercostal spaces had poor to weak correlations (P < .05) with echocardiographic surrogates of cardiac remodeling and congestion. In dogs with MMVD, only P-wave duration and P-wave area distinguished normal and dilated left atria (P < .05). In conclusion, PTF had positive polarity and was best recorded when precordial lead V1 electrode was placed at the most cranial right intercostal locations. PTF failed to reliably identify left atrial enlargement in dogs with MMVD.

Neurostimulator-induced ECG artefacts: A systematic analysis

ObjectivesDeep brain stimulation (DBS) is known to interfere with electrocardiographic (ECG) examinations. In emergency situations, such electrical interferences can not only thwart ECG diagnostics, but even induce an ECG pattern that causes the emergency medical service to initiate inadequate or even harmful therapy. Aim of this prospective study was to evaluate factors influencing ECG interpretation in DBS and to evaluate the susceptibility of ECG criteria ‘frequency’, ‘rhythm’, ‘regularity’, ‘QRS-configuration’, and ‘ST-segment’ on neurostimulation. Patients and methodsIn 33 DBS patients (17 male, 16 female, mean age 64 years), limb-, 12 channel-, Nehb, and adhesive paddle-lead ECG were performed in activated (n = 33) and deactivated (n = 31) stimulation mode during outpatient follow-up examinations. The examinations were carried out using three different ECG devices (two portable emergency ECG-monitor/defibrillation/pacer-devices, one stationary hospital device), resulting in 4096 ECG leads. Statistics have been based on regression analyses and on a maximum likelihood estimation regression model. ResultsMonopolar settings were found to be a relevant factor interfering significantly more often with ECG recording than bipolar parameters (p < 0.0001). Due to recurring movement artefacts, deactivation of bipolar stimulation might even significantly worsen ECG quality (p < 0.0001). Interpretability of ‘rhythm’ (β = −0.088, p = 0.03) and ‘frequency’ (β = −0.110, p = 0.02) revealed significant negative correlation to the applied neurostimulation voltage. Nehb lead yielded in highest ECG interpretability. ConclusionBipolar neurostimulation mode barely affected the ECGs; furthermore, the suppression of motion artefacts by neurostimulation can improve ECG quality. If monopolar neurostimulation is required, at least, stimulation voltage should be as low as possible to obtain good stimulation results.

Cardiotoxic Effects of Micrurus surinamensis (Cuvier, 1817) Snake Venom

Micrurus surinamensis is a coral snake from the Elapidae family of wide distribution in Amazonia Forest. Its venom contains neurotoxins that induce muscular and respiratory paralysis; however, its cardiovascular action is not yet characterized. The aim of this study was to investigate the cardiotoxic effects caused by M. surinamensis poisoning in rodents. Twelve guinea pigs (Cavia porcellus) were distributed in two groups (n = 6) named as control and envenomed. The control group received 0.2ml of PBS/BSA via intramuscular injection (IM), while envenomed animals received 0.75µg of venom per g of body weight, also via IM. Electrocardiographic examination (ECG) and biochemical serum tests were conducted before and 2h after inoculation. ECG of the envenomed animals revealed severe progressive arrhythmias including atrioventricular block, supraventricular, and ventricular extrasystoles. Serum biochemistry showed significant increase in CK, CK-MB, and LDH enzymes corroborating the skeletal and cardiac muscle damage. Myonecrosis and degeneration were observed in both skeletal and heart muscle; nevertheless, transmission electron microscopy revealed cardiac muscle fibers fragmentation. In conclusion, M. surinamensis venom has a potent cardiotoxic activity eliciting arrhythmogenic effects and heart damage after only 2h of envenomation.

Examination of Electrocardiography and 24-Hour Holter Electrocardiography Data of Children Presenting With the Complaint of Palpitation.

Examination of Electrocardiography and 24-Hour Holter Electrocardiography Data of Children Presenting With the Complaint of Palpitation.

Analysis of normal electrocardiographic patterns in mandarin ducks (Aix galericulata).

Background:Electrocardiographic (ECG) examination in birds is considered an inexpensive and noninvasive diagnostic aid for the recognition of infectious and metabolic diseases. Contrary to other bird species, studies describing normal ECG patterns for mandarin ducks (Aix galericulata) are lacking.Aim:The aim of this study was to describe and evaluate normal ECG patterns in A. galericulata.Methods:Ten clinically healthy mandarin ducks of both sexes, aged between 1 and 2 years and with body weight between 0.8 and 1.2 kg were included. Electrocardiograms were performed in a quiet room with animals conscious and manually restrained. All electrocardiographic parameters were recorded using standard (I, II, and III) and augmented (aVR, aVL, and aVF) limb leads. The paper speed was set at 50 mm/second. The amplitude was 1 mV = 20 mm. Morphological patterns of P, QRS, and T deflections were evaluated in all limb leads. The amplitude and the duration of waves and, their intervals were determined in lead II. The mean electrical axis (MEA) in the frontal plane was calculated using the Bailey hexaxial system.Results:In all birds examined, a regular sinus rhythm was observed. P waves were mainly positive in I, II, III, and aVF. A negative P wave was identified in aVR, while in aVL a great variability was present. The QRS complex was mainly isoelectric in lead I, while it was negative with rS or QS morphology in leads II, III, and aVF. A positive polarity of QRS was detected in aVL with R pattern, while it was negative or positive with QS or R morphology, respectively, in aVF. T waves were mostly positive in leads II, III, and aVF and, isoelectric in lead I. ST slurring and Ta wave were observed in 2/10 and 8/10, respectively. The mean heart rate was 246 ± 90 beats per minute and the MEA was −88.8° ± 9.57°.Conclusion:The ECG tracings of mandarin ducks show similarities and some differences with other avian species. The electrocardiographic values provided here can be used to assist in the interpretation of ECG in A. galericulata.

Study of Electrocardiographic and Two-Dimensional Echocardiography Changes in Patients of Intracerebral Hemorrhage and its Outcome in Terms of Mortality

Aims of the Study: The aim was to study the electrocardiographic and two-dimensional echocardiography (2D ECHO) changes in patients of intracerebral hemorrhage and its outcome in terms of mortality. Materials and Methods: Patients admitted to medicine ward and intensive care unit selected for the study. Their electrocardiography (ECG), 2D ECHO, and outcome noted. Results: Mortality was higher in patients of intracerebral bleed having ECG and 2D ECHO changes than those with normal ECGs and 2D ECHO. Conclusion: ECG and 2D ECHO abnormalities are common in patients of intracerebral hemorrhage, and these have prognostic significance in predicting mortality in patients of intracerebral hemorrhage. Thus, every patient of intracerebral hemorrhage should undergo ECG and 2D ECHO examination for the evaluation of cardiac dysfunction occurring in these patients.

Deriving a parsimonious cardiac endpoint for use in epidemiological studies of Chagas disease: results from the Retrovirus Epidemiology Donor Study-II (REDS-II) cohort.

ABSTRACTChagas cardiomyopathy (ChCM) is a severe consequence of Trypanosoma cruzi infection and has a range of electrocardiographic (ECG) and echocardiographic (ECHO) manifestations. There is a need for a standard and parsimonious research cardiac end point that does not rely on expert panel adjudication, and it is not intended to change the ChCM definition. We use data from the REDS-II cohort to propose a simplified cardiac endpoint. A total of 499 T. cruzi-seropositive blood donors were included. All participants underwent a 12-lead ECG, echocardiogram and clinical examination, and those with abnormal findings were reviewed by a panel of cardiologists who classified cases as having Chagas cardiomyopathy or not. We created an exhaustive set of ECG and ECHO finding combinations and compared these with the panel’s classification. We selected the simplest combination that most accurately reproduced the panel’s results. Individual ECG and ECHO variables had low sensitivity for panel-defined cardiomyopathy. The best performing combination was right bundle branch block and/or ECHO evidence of left ventricular hypocontractility. This combination had 98% specificity and 85% sensitivity for panel-defined ChCM. It was not possible to improve the overall accuracy by addition of any other ECG or ECHO variable. Substituting right bundle branch block for the more inclusive finding of QRS interval > 120 ms produced similar results. The combination of prolonged QRS interval and/or left ventricular hypocontractility closely reproduced the REDS-II expert panel classification of Chagas ChCM. In conclusion, the simple and reproducible research endpoint proposed here captures most of the spectrum of cardiac abnormalities in Chagas disease.

Research on Applications of Shenmai Injection on Hypertensive ICH Combined with Cerebrocardiac Syndromes

Objective: This study is to observe the therapeutic effects of Shenmai injection on patients with hypertensive ICH and cerebrocardiac syndromes as well as its effects on prognosis. Methods: A total of 72 patients with severe hypertensive ICH and cerebrocardiac syndromes were selected and divided into the control group and the experimental group (Shenmai injection group) randomly, 36 patients in each group. The control group was treated by conventional therapy, while the experimental group was administrated by intravenous drip of the mixture of 50 ml Shenmai injection and 250 ml 5% glucose injection based on the treatment of the control group, once everyday, 2 weeks continuously. Results: Myocardial enzyme indexes of two groups at 3d, 7d and 14d were observed (Table 1). Myocardial enzyme index of the experimental group was improved quickly and significantly. Myocardial enzyme data of two groups at 3d, 7d and 14d were P < 0.05. According to the electrocardiographic examinations results, ECG anomalies of the experimental group at 7d and 14d were also improved quickly (P < 0.05). There are no evident anomalies in GCS scores of two groups at 7d, but GCS score of the experimental group at 14d of the medication was significantly higher than that of the control group (P < 0.05). Conclusions: Shenmai injection has some therapeutic effects on cerebral injuries and myocardial damages. It can treat brain and heart simultaneously, realize the goal of addressing both symptoms and root causes, and improve prognosis of patients with severe hypertensive ICH.

Исследование некоторых параметров электрокардиографии лыжников-гонщиков

Very high results, the achievement of which is possible only with long systematic train-ing with the use of large and sometimes excessive physical activity characterizes modern sports. The preparation process from beginner to master of sports takes an average of 5–10 years. During this time, the athlete must develop and improve special physical and mental qualities, as well as master certain motor skills specific to this sport. Therefore, children's and youth's organisms of athletes are subject to increased loads, especially in classes that develop endurance. But not always physical activity contributes to the strengthening of the body, sometimes excessive loads, especially with the wrong approach, lead to complications from the cardiovascular system, in particular, to changes in heart rate. Therefore, the issue of adapting the functions of the heart of young athletes to muscle loads becomes increasingly important. The purpose of the work was to study the activities of the cardiovascular system of skiers-riders in the preparatory period of the one-year cycle. Currently, various methods of functional diagnosis of the cardiovascular system are used. We considered the results obtained during electrocardiographic examination of skiers-riders. We investigated electrical activity of the heart and presented model characteristics according to the considered indicators.