Late Diastolic Peak Flow Velocity Research Articles

FIB-4 liver fibrosis index correlates with aortic valve sclerosis in non-alcoholic population.

Hepatic fibrosis, a progressive scarring of liver tissue, is commonly caused by non-alcoholic fatty liver disease (NAFLD), which increases the risk of cardiovascular disease. The Fibrosis-4 (FIB-4) index is a non-invasive tool used to assess liver fibrosis in patients with NAFLD. Aortic valve sclerosis (AVS), a degenerative disorder characterized by thickening and calcification of valve leaflets, is prevalent in the elderly and associated with increased cardiovascular morbidity and mortality. Recent studies have suggested that AVS may also be linked to other systemic diseases such as liver fibrosis. This study aimed to investigate the relationship between the FIB-4 index and AVS in a non-alcoholic population, with the hypothesis that the FIB-4 index could serve as a potential marker for AVS. A total of 92 patients were included in this study. AVS was detected using transthoracic echocardiography, and patients were divided into groups according to the presence of AVS. The FIB-4 index was calculated for all patients and compared between the groups. A total of 17 (18.4%) patients were diagnosed AVS. Patients with AVS had higher rates of diabetes mellitus, older age, hypertension, angiotensin-converting enzyme inhibitor use, higher systolic blood pressure (BP) and diastolic BP in the office, coronary artery disease prevalence, left atrial volume index (LAVI), left ventricular mass index (LVMI), and late diastolic peak flow velocity (A) compared to those without AVS. Moreover, AVS patients had significantly higher creatinine levels and lower estimated glomerular filtration rate. Remarkably, the FIB-4 index was significantly higher in patients with AVS. In univariate and multivariate analyses, higher systolic BP in the office (OR, 1.044; 95% CI 1.002-1.080, p=.024) and higher FIB-4 index (1.46±.6 vs. .91±.46, p<.001) were independently associated with AVS. Our findings suggest that the FIB-4 index is associated with AVS in non-alcoholic individuals. Our results highlight the potential utility of the FIB-4 index as a non-invasive tool for identifying individuals at an increased risk of developing AVS.

Diagnostic Value and Clinical Performance of Cardiac Ultrasound in Patients with Chronic Heart Failure with Hypertension.

Objective To assess the diagnostic value and clinical performance of cardiac ultrasound in patients with chronic heart failure and hypertension. Methods In this prospective study, between August 2017 and January 2020, 50 patients with chronic heart failure and hypertension were recruited and assigned to the study group and 50 healthy individuals during the same period after physical examinations were included in the control group. Cardiac ultrasound examinations were performed on the participants, and the results were compared and analyzed. Results The study group had a higher left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), and late diastolic peak flow velocity (A wave) and showed lower early diastolic peak flow velocity (E wave) and late diastolic peak flow velocity/lower early diastolic peak flow velocity (E/A) ratio levels than in the control group. The study group had 15 patients with grade I cardiac function (ultrasound detection rate of 100%), 18 patients with grade II cardiac function (ultrasound detection rate of 100%), and 17 patients with grade III cardiac function (ultrasound detection rate of 100%). Grade I cardiac function patients showed the lowest LVEDD, LVESD, and E/A and the highest LVEF than grade II patients, followed by grade III patients. The study group showed higher LVEF and echocardiographic estimation of the pulmonary arterial systolic pressure (PASP) and lower right ventricular lateral wall systolic excursion velocity and tricuspid annular plane systolic excursion (TAPSE) than the control group. Chronic heart failure with hypertension was associated with high levels of right atrial total emptying volume (RAVIt), right atrial passive emptying volume (RAVIp), right atrial active emptying volume (RAVIa), and right atrial active emptying fraction (RAVIaEF) and low levels of right atrial total emptying fraction (RAVItEF) and right atrial passive emptying fraction (RAVIpEF) versus the healthy status (all P < 0.05). Conclusion Cardiac ultrasound is a noninvasive operation with low cost, high repeatability, and accurate detection, which can identify right heart function impairment at an early stage, assist clinical treatment, and improve patient prognosis, so it is worthy of promotion and application.

Network Meta-analysis of oral blood-activating and stasis-removing Chinese patent medicines in treatment of hypertensive left ventricular hypertrophy

This study was designed to assess the clinical efficacy of oral blood-activating and stasis-removing Chinese patent medicines in treating hypertensive left ventricular hypertrophy(LVH) based on network Meta-analysis. The clinical randomized controlled trials(RCTs) concerning the treatment of hypertensive LVH with oral blood-activating and stasis-removing Chinese patent medicines were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and Cochrane Library from their inception to September 2021. Two researchers independently completed the literature screening, data extraction, and quality evaluation. The data were then analyzed by RevMan 5.3, Stata 15.1, and ADDIS 1.16.8. Finally, a total of 31 RCTs were included, involving 3 001 patients and four oral blood-activating and stasis-removing Chinese patent medicines. In terms of the alleviation of heart damage, the Chinese patent medicines combined with conventional western medicine groups were superior to the conventional western medicine groups in lo-wering the left ventricular mass index(LVMI). There was no significant difference in LVMI, left ventricular ejection fraction(LVEF), or the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity(E/A) between different Chinese patent medicines combined with conventional western medicine groups. Xinnao Shutong Capsules/Tablets combined with conventional western medicine had the best efficacy in reducing LVMI and elevating LVEF, while Xinkeshu Capsules/Tablets combined with conventional western medicine had the best effect in improving E/A. In the control of blood pressure, when all Chinese patent medicines except for Xinnao Shutong Capsules/Tablets were combined with conventional western medicine, the resulting systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower than those in the conventional western medicine group. Xinkeshu Capsules/Tablets combined with conventional western medicine produced the best effect in reducing SBP and DBP, followed by Xinnao Shutong Capsules/Tablets. In terms of safety, no serious adverse reactions occurred in all trials. The four oral blood-activating and stasis-removing Chinese patent medicines included in this study exhibited obvious advantages in the treatment of hypertensive LVH when they were combined with conventional western medicine, with the best effects observed in the Xinnao Shutong Capsules/Tablets combined with conventional western medicine group. However, due to the limitation of the quantity and quality of the included articles, the conclusion of this study still needs to be verified by more high-quality, multi-center, and large-sample RCTs.

Effects of long-term oral administration of β-blocker on septic myocardial injury and prognosis

To investigate the effect of long-term oral administration of β-blocker on septic myocardial injury and prognosis. A retrospective study was conducted. Patients who were admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2020 were enrolled. A total of 289 patients who met the criteria of myocardial injury induced by sepsis were included in the analysis. Among them, 187 patients who had never taken β-blocker within 3 months before diagnosis were divided in the non-β-blocker group, and 102 patients who took β-blocker daily for more than 3 months before diagnosis were in the β-blocker group. The physiological and biochemical characteristics were compared between the two groups, including heart rate, mean arterial pressure (MAP) at the time of diagnosis, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), MB isoenzyme of creatine kinase (CK-MB), blood lactic acid (Lac), central venous oxygen saturation (ScvO2), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score within 24 hours of diagnosis, left ventricular ejection fraction (LVEF), early and late mitral orifice diastolic peak flow velocity ratio (E/A), utilization rate of vasoactive drugs during hospitalization and 28-day mortality. The heart rate in the β-blocker group at the time of diagnosis was significantly lower than that in the non-β-blocker group (bpm: 107±8 vs. 110±7, P < 0.01), and the levels of cTnI and BNP within 24 hours of diagnosis were significantly lower than those in the non-β-blocker group [cTnI (μg/L): 0.191 (0.220) vs. 0.291 (0.300), BNP (ng/L): 627 (133) vs. 690 (201), both P < 0.05]. However, there were no significant differences in MAP, CK-MB, Lac, ScvO2, SOFA score, APACHE II score, LVEF, E/A, vasoactive drug utilization rate, and 28-day mortality between the β-blocker and non-β-blocker groups [MAP (mmHg, 1 mmHg = 0.133 kPa): 70.6±3.9 vs. 69.9±3.8, CK-MB (μg/L): 4.24 (3.33) vs. 4.32 (3.13), Lac (mmol/L): 3.50 (1.80) vs. 3.50 (1.90), ScvO2: 0.729±0.032 vs. 0.735±0.041, SOFA score: 7.74±2.34 vs. 7.25±2.23, APACHE II score: 17.19±5.13 vs. 18.27±6.12, LVEF: 0.567±0.058 vs. 0.557±0.051, E/A: 0.71 (0.20) vs. 0.69 (0.20), vasoactive drug utilization rate: 60.8% (62/102) vs. 56.7% (106/187), 28-day mortality: 23.5% (24/102) vs. 25.7% (48/187), all P > 0.05]. Long-term oral administration of β-blocker reduce myocardial injury in septic patients, and has no effect on disease severity and prognosis.

Longitudinal changes in maternal left atrial volume index and uterine artery pulsatility indices in uncomplicated pregnancy

Data on the relationship between longitudinal changes in maternal volume-dependent echocardiographic parameters and placentation in uncomplicated pregnancy are limited. This study aimed to evaluate changes in volume-dependent echocardiographic parameters in uncomplicated pregnancy to test the hypothesis of the existence of an association between volume-dependent echocardiographic parameters and Doppler ultrasound parameters of fetal circulation and the uterine artery in uncomplicated pregnancy and to establish which of the volume-dependent echocardiographic parameters best depicts volume changes and correlates best with Doppler ultrasound of fetal circulation and the uterine artery in healthy pregnancy. Data from 60 healthy pregnant women were analyzed. A complete echocardiographic study was performed at 11 to 13, 20 to 22, and 30 to 32 weeks' gestation: left ventricular end-diastolic volume, early diastolic peak flow velocity, late diastolic peak flow velocity, left atrial area, and left atrial volume index were assessed. Obstetrical assessment was performed including fetal growth and uterine artery pulsatility index. Fetal well-being was assessed by umbilical and middle cerebral artery blood flow. Serum pregnancy-associated plasma protein A and free β-human chorionic gonadotropin were assessed during the routine first-trimester scan (11-13 weeks' gestation). Left ventricular end-diastolic volume and left atrial area increased significantly between 11 to 13 and 20 to 22 weeks' gestation but not between 20 to 22 and 30 to 32 weeks' gestation. Left atrial volume index measured at 30 to 32 weeks' gestation correlated with uterine artery pulsatility indices in 3 trimesters. Changes in the left atrial volume index between the third and first trimesters correlated significantly with the uterine artery pulsatility index measured at 20 to 22 weeks' gestation (r=-0.345; P=.020) and at 30 to 32 weeks' gestation (r=-0.452; P=.002). Changes in the left atrial volume index between the second and first trimesters significantly correlated with the uterine artery pulsatility index measured in the first trimester (r=-0.316; P=.025). Our study showed that in an uncomplicated pregnancy, among volume-dependent echocardiographic parameters, left atrial volume index increased between both the first and second trimesters and the second and third trimesters and correlated with parameters of Doppler ultrasound of the fetal circulation and the uterine artery. Our results expand on the previous observation on the relationship between maternal cardiovascular adaptation and placentation in women with heart diseases to the population of healthy women with uncomplicated pregnancy.

PATTERN OF CHANGES OF CENTRAL BLOOD PRESSURE AND VOLUME DEPENDENT ECHOCARDIOGRAPHIC PARAMETERS IN MONITORING OF NORMOTENSIVE PREGNANCY

Objective: We investigated changes of brachial and central blood pressure (BP) as well as volume dependent echocardiographic parameters in different time points of pregnancy.Design and method: Data from 60 healthy pregnant women (mean age 31.4 ± 4.3 years) were analysed. Hypertensive women were excluded from the study. In all women complete echocardiographic study, brachial and central BP measurements were performed at 11–13, 20–22 and 30–32 weeks of pregnancy. Central and brachial BP was measured by Pulsecor (CardioScope) device. In echocardiography: left ventricle end diastolic volume (LVEDV), early diastolic peak flow velocity (E velocity), late diastolic peak flow velocity (A velocity), left atrium area (LAA) and left atrium volume index (LAVI) were assessed. Also E/A index was calculated. Results: Brachial systolic BP (SBP) was higher and brachial diastolic BP (DBP) was lower as compared to respectively central SBP and central DBP at all three time points (p < 0.0001- for each). Brachial and central SBP and DBP levels were higher at 11–13 as compared to 20–22 weeks, but no difference was found between 20–22 and 30–32 weeks (Table). There was a significant increase of LAVI between all three-time points. LVEDV and LAA increased between 11–13 and 20–22 weeks but not between 20–22 and 30–32 weeks. Significant decrease in E velocity between 20–22 and 30–32 weeks was observed. There were no differences in E/A between subsequent measurements (Table). There were no significant differences in heart rate between time points. Conclusions: Our results indicate that LAVI is the best echocardiographic parameter reflecting physiological changes in blood volume overload in normal uncomplicated pregnancy. We also observed that changes in brachial BP were consistent with changes in central BP. Brachial BP and LAVI are sufficient parameters in monitoring physiological pregnancy.

Assessment of subclinical cardiac damage in chronic plaque psoriasis patients: a case control study

IntroductionEpidemiological studies have suggested that patients with psoriasis are at an increased risk of developing cardiovascular diseases. Chronic inflammation may play a role in the pathogenesis of atherosclerosis in psoriasis patients. Recent studies have evaluated the expression of plasma endocan and homocysteine levels. Endocan is a marker of vascular endothelial damage, and homocysteine plays a role in the development of atherosclerosis. Plasma endocan and homocysteine levels, as well as echocardiographic parameters, were evaluated in patients with psoriasis to assess cardiovascular disease risk.Material and methodsThis was a prospective cohort analysis of 40 patients who were diagnosed with psoriasis and 40 healthy controls matched to the patient group according to demographic and biochemical parameters.ResultsSerum endocan and homocysteine concentrations were significantly higher in the psoriasis group than the control group (p < 0.001). Serum endocan concentrations correlated positively with disease duration (p < 0.001; r = 0.725). The Tei index (myocardial performance) was elevated in psoriasis patients (p < 0.001). Additionally, the E/A (mitral valve early diastolic peak flow velocity/mitral valve late diastolic peak flow velocity) and E/Em (early diastolic myocardial velocity) ratios were reduced in psoriasis patients (p < 0.001). Parameters indicative of left ventricular asynchrony were elevated significantly in the psoriasis group versus the control group (p < 0.001).ConclusionsWe observed a substantial increase in serum endocan and homocysteine concentrations, and significant differences in key parameters of cardiac function, in psoriasis patients relative to controls. These results are consistent with the hypothesis that subclinical cardiac damage is increased in patients with psoriasis and that psoriasis itself may be a cardiovascular risk factor.

Association between circulating fibroblast growth factor-23 and age-related cardiovascular-renal parameters in a healthy Chinese population.

Previous studies showed that circulating fibroblast growth factor-23 (FGF23) is a new biomarker linked to cardiovascular and kidney diseases. Here, we explored the association between serum FGF23 and aging-related cardiovascular-renal parameters in a healthy Chinese population. A total of 314 healthy participants aged 36-87 years were enrolled. Cardiovascular structure and function were assessed by the left ventricular ejection fraction, the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity at the mitral leaflet tips, carotid intima-media thickness, the diameter of the bilateral common carotid artery, blood systolic peak and end diastolic velocities, which were measured by M-mode ultrasonography. Glomerular filtration rate was evaluated using the Chronic Kidney Disease Epidemiology Collaboration equation and Chronic Kidney Disease Epidemiology Collaboration equation for Asians. Serum FGF23, 1, 25-dihydroxy vitamin D3 and parathyroid hormone were measured by enzyme-linked immunosorbent assay. For all participants, intima-media thickness/diameter of the bilateral common carotid artery gradually decreased with the progression from low to high FGF23 concentration (P < 0.05). After adjusting for all possible confounders, FGF23 remained significantly associated with intima-media thickness/diameter of the bilateral common carotid artery (P = 0.016). In women, serum FGF23 was significantly associated with serum creatinine, cystatin C and estimated glomerular filtration rate in the Spearman correlation analysis. FGF23 remained significantly associated with serum creatinine (P = 0.046) and estimated glomerular filtration rate (P = 0.034) after full adjustment. However, no such relationship was apparent in men. Serum FGF23 was correlated with aging-related cardiovascular-renal parameters even in healthy people. Measurement of serum FGF23 can provide valuable information to predict cardiovascular-renal function in healthy people, especially in older female adults. Geriatr Gerontol Int 2017; 17: 1221-1231.

The association of serum cathepsin B concentration with age-related cardiovascular-renal subclinical state in a healthy Chinese population

ContextCathepsin B (CTSB) is an important enzyme for many physiological and pathological processes, and its activity increases with age. Here, we explored the association between serum CTSB and aging-related subclinical cardiovascular and renal status in a healthy Chinese population. MethodsThe study included 369 healthy individuals aged 36–87 years. Cardiovascular structure and function were assessed by the left ventricular ejection fraction, the early-diastolic peak flow velocity to late-diastolic peak flow velocity ratio at the mitral leaflet tips, carotid intima-media thickness (IMT), the diameter of the bilateral common carotid artery (D), and blood systolic peak (SPV) and end diastolic velocities, which were measured by M-mode ultrasonography. Serum CTSB, insulin-like growth factor-1 (IGF-1), 1, 25-dihydroxy vitamin D3, and parathyroid hormone (PTH) were measured by enzyme-linked immunosorbent assay. ResultsIn men, serum CTSB was significantly related to IMT and IMT/D in the unadjusted model, and these associations were lost after age adjustment. In women, serum CTSB remained significantly associated with serum creatinine (SCr) (p=0.009), estimated glomerular filtration rate (p=0.048) and IMT/D (p=0.017) following full adjustment. PTH was independently associated with SCr. IGF-1 was significantly associated with SPV in women. CTSB was correlated with metabolic and endocrine biomarkers. ConclusionSerum CTSB was associated with aging-related cardiovascular-renal parameters even in healthy people. Measurement of serum CTSB alone or in combination with metabolic and endocrine biomarkers can provide valuable information for predicting cardiovascular-renal function in healthy people, especially in elderly women.

Nicorandil improves myocardial function by regulating plasma nitric oxide and endothelin-1 in coronary slow flow.

BackgroundCoronary slow flow (CSF) is a special coronary microvascular disorder. The pathogenesis and effective therapeutics of CSF remain unclear. This study aimed to evaluate the global and regional functions of the left ventricle (LV) and investigate the efficacy of nicorandil in patients with CSF.Patients and methodsThirty-six patients with CSF in the left anterior descending (LAD) branch and 20 patients with normal coronary arteries were included. Global and regional functions of the LV supplied by LAD were measured using conventional Doppler echocardiography and two-dimensional speckle tracking echocardiography, respectively, within 24 h after coronary angiography. Concentrations of plasma nitric oxide (NO) and endothelin-1 (ET-1) were detected using colorimetry and radioimmunoassay, respectively. The function of the LV and the levels of NO and ET-1 were also investigated before and 90 days after treatment with 15 mg/day of nicorandil.ResultsCompared with the control group, the early diastolic peak velocity (E), E/A ratio, and plasma NO levels were lower, whereas the late diastolic peak flow velocity (A) and plasma ET-1 levels were significantly higher in the CSF group (P<0.05). The longitudinal strain rate peak of the LV was reduced significantly in CSF patients (P<0.001). After treatment, 75% (27/36) of CSF patients were free of chest pain. The values of E peak, E/A ratio, longitudinal strain rate peak, and plasma NO level were increased (P<0.001), whereas the ET-1 level was decreased in CSF patients (P<0.001).ConclusionNicorandil may improve chest pain symptoms and the impaired function of the LV, possibly by increasing plasma NO and reducing ET-1 in CSF.

Use of Xinfeng capsule to treat abarticular pathologic changes in patients with rheumatoid arthritis

ObjectiveTo observe the influence of Xinfeng-capsule (XFC) on abarticular pathologic changes (APCs) and other indices of patients with rheumatoid arthritis (RA) and explore the mechanism of action of XFC in improving such changes. MethodsThree-hundred RA patients were divided randomly into a treatment group (n=150) and control group (n=150). A normal control (NC) group (n=90) was also created. Changes in cardiac function, pulmonary function, anemia indices and platelet parameters of RA patients were measured. Curative effects of the two groups were compared, and comparison carried out with the NC group. ResultsIn 300 RA patients, late diastolic peak flow velocity (A peak) was much higher (P<0.01) and early diastolic peak flow velocity (E peak), E/A, and left ventricular fraction shortening much lower (P<0.01) than those in the NC group. Vital capacity (VC), forced vital capacity in one second, forced vital capacity (FVC), maximal voluntary ventilation (MVV), maximal expiratory flow in 50% of VC (FEF50) and FEF75 were lowered remarkably (P< 0.05 or P<0.01). Platelet count (PLT), plateletcrit (PCT) and mean platelet volume (MPV) increased markedly (P<0.05 or P<0.01), and hemoglobin (Hb) level decreased significantly (P<0.05). After XFC treatment, the A peak and PLT and PCT were much lower (P<0.05), and E/A and the number of red blood cells as well as Hb level were much higher (P< 0.05), as were FVC, MVV and FEF50 (P<0.05 or P< 0.01), in the treatment group than those in the NC group. Total score of pain and swelling in joints, uric-acid level and high-sensitivity C-reactive protein level were much lower, and superoxide dismutase level as well as the number of CD4 + CD25 + regulation T cells (Treg) and CD4 + CD25 + CD127-Treg were much higher (P<0.05 or P<0.01) in the treatment group than those in the NC group. ConclusionRA patients with pathologic changes in joints also suffer from lower cardiac and pulmonary functions and from parameters of anemia and platelet factors. XFC can improve the symptoms of RA patients, ameliorate their cardiac and pulmonary functions and reduce the parameters of anemia and platelet factors. XFC lowers the immune inflammatory reaction to improve APCs in RA patients.

The Correlation between Peripheral Leukocyte Telomere Length and Indicators of Cardiovascular Aging

To investigate the relationship between telomere length in peripheral blood white cells and cardiovascular function in a healthy, aging Han Chinese population. In 2012, peripheral blood leukocytes were obtained from 139 healthy individuals in Beijing, China, and telomere restriction fragment (TRF) length was assayed using a digoxigenin-labeled hybridization probe in Southern blot assays. Indicators of cardiovascular function were also evaluated, including electrocardiograms (ECG), (RR, P, PR, QRS, ST and T intervals); blood pressure (BP), (SBP, DBP, PP, PPI); cardiovascular ultrasound (left ventricular ejection fraction, LVEF); mitral early and late diastolic peak flow velocity (MVE and MVA); and lipid indices (TC, TG, HDL, LDL, LCI). The relationships of these cardiovascular indictors to telomere length were evaluated. No correlations were found between telomere length and ECG, BP or lipid indices even after adjustment for age. Correlations were found between TFR length and some cardiovascular ultrasound indictors (D, MVEA, MVEDT, MVES, MVEL, MVEI, IMT), but these were not seen after adjusting for age. We did not find that leukocyte TFR length was associated with cardiovascular ultrasound indictors, ECG, BP, or lipid indices in this population of healthy Han Chinese individuals. Telomere length may serve as a genetic factor in biological aging.

GW24-e2951 Gender-Specific Relationship between Carotid Intema-media Thickness and Cardiac Diastolic function in a Healthy Chinese Population

ObjectivesTo identify gender difference in the associations between carotid intema-media thicknesss (CIMT) and cardiac diastolic function in healthy Chinese individuals.MethodsWe examined 852 healthy participants (aged 30-98 years, 46% men) in...

Gender Differences in the Relationship Between Age-Related Carotid Intima-media Thickness and Cardiac Diastolic Function in a Healthy Chinese Population

BackgroundVentricular-arterial coupling is a key determinant of cardiovascular performance. However, little is known about the gender differences in ventricular-arterial interactions in the healthy Chinese population. ObjectiveTo identify gender differences in the association between carotid intima-media thickness (CIMT) and cardiac diastolic function in healthy Chinese individuals. Methods and ResultsWe examined 852 healthy participants (aged 30–98 years, 46% men) in 3 northern China cities with the use of M-mode ultrasonography to analyze CIMT and cardiac structure and function. Cardiac function was measured by determining the ratio of early-diastolic peak flow velocity (E) and late-diastolic peak flow velocity (A), as well as the deceleration time of the early mitral velocity (MV-DT). Cardiac dysfunction was defined as E/A values <25th percentile (E/A <0.78 for men and <0.79 for women), left atrial volume (LAV) values >75th percentile (LAV >34.9 mL for men and >32.2 mL for women), and MV-DT values >75th percentile (MV-DT >210 ms for men and >195 ms for women). CIMT, E/A, LAV, and MV-DT were significantly correlated with age in both men (CIMT: r = 0.418, P < .01; E/A: r = −0.325, P < .01, LAV: r = 0.123, P < .05; MV-DT: r = 0.175, P < .01) and women (CIMT: r = 0.429, P < .01; E/A: r = −0.423, P < .01; LAV: r = 0.180, P < .01; MV-DT: r = 0.174, P < .01). Interestingly, left ventricular ejection fraction (LVEF) was not significantly correlated with age in either gender. CIMT was significantly associated with a lower E/A in an unadjusted model in tertiles II and III. The odds ratios (95% confidence interval [CI]) for men were 2.428 (1.36–4.335) and 3.017 (1.674–5.437), respectively. However, this association disappeared with age adjustment. The odds ratios (95% CI) for women were 3.298 (1.742–6.246) and 6.002 (3.202–11.251), respectively, and these were still significant after adjustments for all other variables, including age, blood pressure, blood lipid, and inflammatory markers (tertile II: 3.031, 95% CI 1.228–7.48; tertile III: 3.224, 95% CI 1.308–7.946). A higher MV-DT was significantly correlated with higher CIMT only in an unadjusted model for women, and this association was lost with age adjustment. There was no significant association between CIMT and higher LAV values. ConclusionsAge-related increases in CIMT were correlated with a decline in cardiac diastolic function only in women, which may contribute to the higher incidence of heart failure with preserved ejection fraction.

Features of left ventricular hypertrophy in patients with metabolic syndrome with or without comparable blood pressure: a meta-analysis

The prevalence of metabolic syndrome (MS) has been on the rise over the past few decades, and this is associated with an increased incidence of target organ damage such as left ventricular hypertrophy (LVH). This meta-analysis aims to evaluate the features of LVH in MS patients with or without high blood pressure (BP). PubMed, Cochrane Library, Embase, Science Citation Index, and China Biology Medicine Disc, WanFang data, China National Knowledge Infrastructure database, and VIP were searched. Cross-sectional studies which directly compared LVH in hypertensive patients with MS and those with hypertension alone were identified. The following parameters were analyzed: systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular mass (LVM), left ventricular mass index (LVMI), left ventricular mass/height(2.7) (LVM/h(2.7)), interventricular septum thickness (IVSt), left ventricular end-diastolic diameter (LVEDd), left ventricular posterior wall (LVPW), ratio of early to late diastolic peak flow velocity (E/A), and relative wall thickness (RWT). Data were extracted and analyzed by Cochrane Collaboration's RevMan 5.0 software. 14 studies involving 5,994 patients were included. In four studies, MS patients with comparable level of BP had higher SBP (mmHg) [Mean Difference (MD) = 2.28, 95 % confidence intervals (CI): -0.58 to 5.13], DBP (mmHg) (MD = 1.32, 95 % CI: -0.23 to 2.87), LVM (g) (MD = 42.10, 95 % CI: 6.92-77.28), LVMI (g/m(2)) (MD = 8.93, 95 % CI: 5.29-12.57), LVM/h(2.7) (g/m(2.7)) (MD = 5.40, 95 % CI: 2.51-8.29), IVSt (mm) (MD = 0.49, 95 % CI: 0.28-0.71), LVEDd (mm) (MD = 1.04, 95 % CI: -1.10 to 3.18), LVPW (mm) (MD = 0.75, 95 % CI: 0.13-1.37), RWT (MD = 0.06, 95 % CI: -0.00 to 0.12), and lower E/A (MD = -0.08, 95 % CI: -0.18 to 0.02) when compared to the patients with hypertension alone. In other ten studies, the hypertensive patients with MS exhibited higher levels of SBP (mmHg) (MD = 4.67, 95 % CI: 2.72-6.62), DBP (mmHg) (MD = 2.03,95 % CI: 1.40-2.65), LVM (g) (MD = 24.79, 95 % CI: 20.21-29.36), LVMI(g/m(2)) (MD = 9.22, 95 % CI: 2.81-15.64), LVM/h(2.7) (g/m(2.7)) (MD = 5.97, 95 % CI: 4.14-7.80), IVSt (mm) (MD = 0.63, 95 % CI: 0.58-0.69), LVEDd (mm) (MD = 1.11, 95 % CI: 0.42-1.80), LVPW (mm) (MD = 0.63, 95 % CI: 0.31-0.94), RWT (MD = 0.02, 95 % CI: 0.01-0.03), as compared to patients with hypertension alone (P < 0.05). In addition, the MS patients combining with hypertension showed a lower E/A (MD = -0.07, 95 % CI: -0.10 to -0.04) when compared to those with hypertension alone. This study suggests that MS plays an important role in the development of LVH. MS seems to amplify hypertension-related cardiac changes. Furthermore, MS combining with higher level of BP will aggravate LVH and damage the diastolic function of left ventricle.

Effect of Xinfeng Capsule (新风胶囊) on the cardiac function in patients with rheumatoid arthritis

To study the changes in cardiac function of rheumatoid arthritis (RA) patients and: to observe the effect of xinfeng capsule ( XFC) on them. Sixty-eight RA patients were: randomly assigned to two groups by a lottery: 38 patients in the treatment group treated orally with XFC, 3 capsules, thrice a day, and 30 in the control group treated with fengshi gutong capsule (FSGTC), 4 capsules, twice a day, 30 days as one course of treatment, and two courses were given for both groups. A normal control (NC) group including 20 healthy subjects was set up. The clinical efficacy was compared between the two treated groups. The changes in cardiac function, including early diastolic peak flow velocity (E), late diastolic peak flow velocity (A), left ventricular fraction shortening (FS), and E/A, as well as uric acid (UA), erythrocyte sedimentation rate (ESR), α-acid glycoprotein (α-AGP), and hypersensitive C-reaction protein (hs-CRP), were observed. The regulation T cell was determined with flow cytometry. (1) The total effective rate in the treatment group and the control group was 92.1%: (35/38) and 70.0% (21/30), respectively. Significant difference was shown between them (P<0.05). (2) <Compared with those of the NC group, E peak, E/A ratio, and FS of RA patients were lower (P<0.01), while <A peak was higher (P<0.01). Moreover, A peak of the treatment group after treatment was significantly lower <(P<0.05) and E/A ratio was significantly higher (<P<0.05) as compared with those of the control group. (3) The <improvement in the treatment group in reducing UA and hs-CRP was superior to those of the control group (P<0.05). In addition, the improvement in α-AGP, CD4 <CD4(+)CD25 CD25(+) Treg, and CD4 CD4(+)CD25 CD25(+)CD127 CD127(-)Treg of the treatment group was obvious as compared with the control group, although the difference was not statistically significant. The descendent of cardiac function exists in RA patients. XFC could improve cardiac: function of RA patients, which is superior to FSGTC. Its mechanism may be related to its effect on raising CD4 CD4(+)CD25 CD25(+)Treg and CD4 CD4(+)CD25 CD25(+)CD127(-) Treg cells, decreasing UA, α-AGP, and hs-CRP levels, reducing immune inflammation, adjusting the overall balance of immune response, and thus improving the cardiac function of RA patients.

An Echocardiographic Assessment of Cardiac Functions and Structure in Children on Dialysis

Background. Cardiovascular complications are the most important cause of mortality in end stage renal disease. The aim of this study is to evaluate systolic and diastolic functions of children with chronic renal disease. Methods. Twenty-five children on renal replacement therapy (16 on peritoneal dialysis, 9 on hemodialysis), 10 children in chronic renal insufficiency group, and 27 healthy subjects were examined by echocardiography. Results. No significant difference was observed in systolic functions between patients and controls. Left ventricular mass index was significantly higher in hemodialysis and peritoneal dialysis patients when compared with controls, where no significant difference was determined between chronic renal insufficiency group and controls. Although left ventricular mass index was tended to be higher in hemodialysis than peritoneal dialysis group, this was not significant. Peak late diastolic flow velocity (A) was significantly higher in dialysis groups when compared to controls. E/A ratios were significantly lower in dialysis groups than controls. Conclusion. The finding that the diastolic functions were impaired in both children on peritoneal dialysis and hemodialysis suggests that peritoneal dialysis is not superior to hemodialysis for preserving diastolic cardiac functions. Further studies with larger patient groups are needed to show long-term effects of peritoneal dialysis and hemodialysis on cardiac functions.

889 Hypoplastic left heart syndrome: the role of cardiac STIC in prenatal diagnosis

889 Hypoplastic left heart syndrome: the role of cardiac STIC in prenatal diagnosis

Thalassemia Heart Disease: A Comparative Evaluation of Thalassemia Major and Thalassemia Intermedia

Heart disease represents the main determinant of survival in beta-thalassemia, but its particular features in the two clinical forms of the disease, thalassemia major (TM) and thalassemia intermedia (TI), are not completely clarified.We compared clinical and echocardiographic global parameters in 131 TM patients who received regular chelation transfusions and were highly compliant with treatment (mean age, 28 +/- 6 years [+/- SD]), and 74 age-matched, TI patients who did not receive chelation transfusions.Congestive heart failure was encountered in five patients with TM (3.8%; age range, 25 to 29 years) and in two patients with TI (2.7%; age range, 37 to 40 years). Systolic left ventricular (LV) dysfunction (ejection fraction < 55% or shortening fraction < 35%) was only encountered in patients with TM (8.4%). Considerable pulmonary hypertension (systolic tricuspid gradient > 35 mm Hg) was only present in TI (23.0%). In the remaining patients without evident heart disease, cardiac dimensions, LV mass, LV shortening and ejection fractions, and cardiac output were significantly higher in patients with TI. LV afterload was higher in patients with TM. LV diastolic early transmitral diastolic peak flow velocity (E)/late transmitral diastolic peak flow velocity (A) ratio was also higher in TM. Systolic and mean pulmonary artery pressures and total pulmonary resistance were higher in both young and old TI patients.Regular lifelong transfusion and chelation therapy in TM prevented premature heart disease and pulmonary hypertension, although LV dysfunction still occurred and led to heart failure. The absence of regular therapy in TI, in contrast, preserved systolic LV function but allowed pulmonary hypertension development, which also led to heart failure, starting within the fourth decade of life, a decade later compared to TM.

Adiponectin, insulin resistance, and left ventricular structure in dipper and nondipper essential hypertensive patients

Adiponectin is an adipocyte-derived protein with insulin-sensitizing and antiatherogenic properties. Failure to decrease blood pressure (BP) normally during night in hypertensive patients has been independently associated with left ventricular hypertrophy. We examined the relationship between adiponectin levels, insulin sensitivity, and left ventricular structure in 40 newly diagnosed never-treated patients with essential hypertension, including 20 patients with a normal night-time pressure decrease (ie, dippers) and 20 patients with BP persistently elevated throughout the 24-h period (ie, nondippers). All subjects had grade 1-2 hypertension, aged 18 to 65 years, no diabetes mellitus, no obesity, no hyperlipidemia, and no cardiopulmonary, renal, or hepatic disease. The two groups of patients were similar for age, sex, body mass index, and had no differences for clinic, 24-h, and diurnal BP, and 24-h, diurnal, and nocturnal heart rate, as well as glucose, total cholesterol, and triglyceride levels. Plasma insulin and homeostasis model assessment (HOMA index) were higher (P < .01), and adiponectin levels were lower (P < .005) in nondippers than in dippers. Adiponectin correlated inversely with HOMA index and insulin levels (r = -0.58, and r = -0.62, respectively, P < .001) in the entire population. Nondippers showed left ventricular mass, relative wall thickness, and measure of early and late diastolic peak flow velocity ratio similar to those of dippers. In the absence of major cardiovascular risk factors, nondipper essential hypertensive patients show more prominent insulin resistance and lower adiponectin compared to dippers. Therapeutic modulation of adiponectin or insulin resistance might provide additional benefit to the conventional antihypertensive treatment.