首页 > 文献资料
-
超声诊断双腔左心室1例
双腔左心室(double-chambered left ventricle,DCLV)是罕见的先天性心脏畸形,是指左心室被异常的肥厚肌束或大的呈脊状突起的肌性纤维组织分隔为主、副两个心腔,通常其主腔位于近端,二尖瓣口与主动脉瓣口常在主腔内,而副腔位于远端的心尖部或主腔的侧壁[1,2,4].
-
心力衰竭家兔左心室瞬间外向钾通道重构及氯沙坦干预研究
本研究应用膜片钳全细胞记录方法记录左心室心肌瞬间外向钾电流(Ito);应用半定量-聚合酶链反应(RT-PCR)法检测左心室瞬间外向钾通道a亚单位KV1.4、KV4.2和KV4.3 mRNA表达,观察心力衰竭家兔左心室瞬间外向钾通道重构情况以及氯沙坦的干预作用,进一步探讨血管紧张素受体拮抗剂(ARBs)降低心力衰竭心律失常的机制.
-
组织多普勒指导心脏再同步治疗中左心室电极导线的植入
心脏再同步化治疗(CRT)作为慢性充血性心力衰竭治疗的有效方法之一,已逐渐被人们接受,在多数病人中,它能改善临床症状,逆转或终止慢性心脏重构.然而,仍有约20%~30%的患者起搏后症状未改善甚至恶化.究其原因可能与患者入选不合适以及左心室电极导线位置不恰当有关,但目前国内外对于如何指导左心室电极导线的放置还没有理想的方法.
-
高龄左右冠状动脉-左心室瘘一例
患者女性,77岁,因"活动后胸闷、胸痛1年余,加重3天"于2008年4月入院.近1年活动耐力下降,快步行走后即感胸闷、气促.患者有心律失常(频发房性早搏、窒性早搏)史10余年.
-
多发巨大右冠状动脉瘤合并左心室瘘一例
患者男性,45岁.因活动后心悸气促1年,加重1周入院.查体:心尖搏动位于左第6肋锁骨中线外1.5 cm,心率62次/min,心律不齐,胸骨左缘3~4肋间可闻及2/6级舒张期杂音,无震颤.
-
中国心脏瓣膜外科的发展与现状
Heart valve surgery in China dates back to 4 to 5 decades ago. In 1954, the first closed mitral commissurotomy was successfully performed in a patient with mitral stenosis. In 1960, with the advent of transventricular dilator and by the route of left ventricle, the efficacy of mitral commissurotomy was improved. The procedure was rapidly adopted by many centers in this country[1]. In 1958, the first open heart surgery using cardiopulmonary bypass was performed in China. This was an epoch-making event, which opened up a new era in the field of cardiac surgery in China. Thereafter, in cities like Beijing and Shanghai, direct repairs of mitral lesions under CPB were made with good results. In 1965, the development of the first totally home-made ball valve prosthesis and its successful application in mitral valve replacement was another landmark in the history of heart valve surgery in China. In 1976, aortic valve replacement with glutaraldehyde-preserved bovine pericardial valve prosthesis was carried out successfully. The next year, the first porcine aortic valve prosthesis was produced and introduced to clinical use, which greatly accelerated the progress of heart valve surgery in China. During the last 2 decades, heart valve surgery and its techniques have been widely applied throughout China.
-
左室心肌致密化不全——一种可以辨认的先天性心肌疾病
左室心肌致密化不全(non-compaction of left ventricle,NCLV)是近10余年得到确认的一种先天性心肌疾病,早于1990年由Chin报道,1995年被WHO/ISFC(国际心脏病学联盟)专题工作组分类为"性质未定心肌病"[1].一般认为,本病是少见病,Ritter等[2]回顾Mayo临床中心10年间37 555例成年人超声心动图,仅发现17例(男性14例)NCLV.但是Texas儿童医院回顾6年间26 000例患儿超声心动图,其中36例诊断为NCLV,占同期心肌病的9.5%.因此,NCLV被认为可能是一种相对常见的小儿心肌疾病[3].
-
心室肌致密化不全的研究进展
心室肌致密化不全(noncompaction of ventricular myocardium,NVM)是由于正常心室内膜在胚胎发育时受到抑制导致发育中的心肌小梁致密化失败,以持续存在无数粗大突起的肌小梁和小梁间深陷的隐窝[1]为特征的一种罕见的先天性心肌病,可孤立存在(isolated noncompaction of the ventricular myocardium,INVM)或与其他先天畸形并存.多见于左心室(noncompaction of left ventricle,NCLV),也可见于右心室[2].近年来学者们对其病因、发病机制、诊断和治疗等方面进行了比较深入的研究,本文就目前研究的新进展综述如下.
-
原发性高血压患者心功能特征100例分析
背景:高血压患者心功能常有不同程度损害,不同分期高血压患者心功能损害程度有何差异?目的:观察高血压不同分期患者的心功能,并与健康者相应指标进行对照.设计:病例-对照,对比观察.单位:解放军沈阳军区总医院特诊科.对象:选择2002-10/2003-05解放军沈阳军区总医院内科住院原发性高血压患者100例.其中高血压Ⅰ期30例,高血压Ⅱ期40例,高血压Ⅲ期30例.选择同期本院健康体检者30人为对照.纳入对象均知情同意.方法:纳入对象心功能测定采用XJS-Ⅰ型心功能检测仪.患者取仰卧位,按四电极法放置电极.于呼气末屏气,同步描记Ⅰ导联心电图、心音图、心导纳微分图、颈动脉搏动图.通过微机处理显示各种指标.检测指标为:心率,排血前时间,左室排血时间,排血前时间/左室排血时间,电机械延迟时间,等容收缩时间,等容收缩时间/左室排血时间,脉搏波传递时间,每搏量,心排血量,心脏指数,心肌收缩强度指数,总外周阻力,血管顺应性.主要观察指标:不同分期高血压患者与健康者心功能状况比较.结果:原发性高血压患者100例和健康者30人均进入结果分析.[1]排血前时间、等容收缩时间、总外周阻力、排血前时间/左室排血时间和等容收缩时间/左室排血时间:高血压患者明显大于或长于健康者(P<0.01),Ⅱ,Ⅲ期高血压患者明显高于或长于Ⅰ期高血压患者(P<0.01).[2]每搏量、心排血量、心肌收缩强度指数、血管顺应性、脉搏波传递时间、心脏指数:高血压患者明显低于或短于健康者(P<0.01),Ⅱ,Ⅲ期高血压患者明显低于或短于Ⅰ期高血压患者(P<0.01).在上述指标中,Ⅲ期高血压患者血管总外周阻力明显高于Ⅱ期高血压患者(P<0.05),血管顺应性明显低于Ⅱ期高血压患者(P<0.05).结论:高血压患者心功能较健康者明显下降,随着高血压病情发展,心功能进一步下降.
-
老年高血压患者动脉重塑与脉压及左室结构和功能的关系
原发性高血压的危害是其对重要靶器官的结构和功能的损害.研究证实高血压通过损害血管的结构和功能导致心脑肾等重要器官并发症的发生.颈动脉内膜中层厚度(intimal-medial thickness,IMT)增加常被视为全身动脉硬化的一个窗口,是心脑血管事件的独立危险因子[1,2].本文通过颈动脉超声检查,探讨反映血管重塑替代指标的颈动脉IMT与脉压及左室结构和功能的关系.
-
Localization of premature ventric-ular contractions from ventricular outflow tract
Premature ventricular contractions (PVCs)may arise from the endocardial,midmyocardial,or epicardial surfaces in either the right or left ventricle.While the right ventricular outflow tract(RVOT)is the most common site for idiopathic PVC origin,other potential locations include the left ventricular outflow tract (LVOT),fascicles,papillary muscles,aortic valve cusps,aorto-mitral continuity,mitral valve annulus,or epicardium.In addition,sleeves of ventricular myocardium extending beyond the semilunar valves and into the proximal portion of the great arteries have also been established as sites of ventricular ectopy.The myocardial sleeves tend to extend in a circumferential pattern above the pulmonic valve,while myocardial extension above the aortic valve tends to occur along the right coronary cusp and the anterior aspect of the left coronary cusp.Premature ventricular contractions (PVCs)may arise from the endocardial,midmyocardial,or epicardial surfaces in either the right or left ventricle.While the right ventricular outflow tract(RVOT)is the most common site for idiopathic PVC origin,other potential locations include the left ventricular outflow tract (LVOT),fascicles,papillary muscles,aortic valve cusps,aorto-mitral continuity,mitral valve annulus,or epicardium.In addition,sleeves of ventricular myocardium extending beyond the semilunar valves and into the proximal portion of the great arteries have also been established as sites of ventricular ectopy.The myocardial sleeves tend to extend in a circumferential pattern above the pulmonic valve,while myocardial extension above the aortic valve tends to occur along the right coronary cusp and the anterior aspect of the left coronary cusp.
-
Lesson Thirty-Six Ventricular Pump Function and Pacing-Physiological and Clinical Integration
Optimal cardiac pump function depends on ordered mechanical events that are orchestrated by electrical timing. This electromechanical coupling occurs at multiple anatomic levels: within atria, between atria and ventricles, between ventricles, and especially within the left ventricle (LV ).
-
超声心动图评价左心室整体与节段舒张功能的新进展
长期以来,对于左心室收缩功能的评价,左室射血分数(EF值)是公认的指标.EF值评价左室收缩功能,并进行治疗前后的对比,对心功能不全的诊断及治疗效果评价有确切的指导意义.
-
新生儿左心室巨大横纹肌瘤1例
患儿,男性,1 d,因呼吸急促、口周发绀2 h入院.患儿为第1胎第1产,足月顺产出生,Apgar评分1 min、5 min均为10分,羊水清亮,无脐带绕颈,胎盘无异常.出生体重3 650 g.其母孕期未行系统产科检查,否认结节性硬化症及心脏肿瘤、心脏病家族史.
-
AIM: To investigate the role of catecholamine, angiotensin converting enzyme(ACE) and adenosine triphosphatase in ischemic preconditioning in isolated rat hearts. METHODS: Isolated perfused rat heart was subjected to global ischemia for 40 min followed by reperfusion for 10 min (I/R). Preconditioning (PC) was induced by 5 min of ischemia and 10 min of reperfusion. The tissue concentrations in NE, and ACE, ATPase activities were determined in left ventricle in the PC and I/R groups by fluorometry and spectrophotometry. RESULTS: There were no significant difference in NE and ACE between PC and I/R groups. PC hearts showed improved recovery of the contractile function after 40 min ischemia/10 min reperfusion, but activities of the myocardial total ATPase, Mg2+-ATPase, Na+K+-ATPase were inhibited markedly compared with I/R group. CONCLUSION: The inhibited myocardial ATPase may be involved in the mechanism of ischemic preconditioning protection in the isolated rat heart. Endogenous myocardial norepinephrine and ACE activation are not essential for ischemic preconditioning in the isolated rat heart.
-
Exosomes secreted by mesenchymal stem cells have shown great therapeutic potential in regenerative medicine .In this study, we performed meta-analysis to assess the clinical effectiveness of using exosomes in ischemia /reperfusion injury based on the reports pub-lished between January 2000 and September 2015 and indexed in the PubMed and Web of Science databases .The effect of exosomes on heart function was evaluated according to the following parameters:the area at risk as a percentage of the left ventricle , infarct size as a percentage of the area at risk , infarct size as a percentage of the left ventricle , left ventricular ejection fraction , left ventricular frac-tion shortening , end-diastolic volume , and end-systolic volume .Our analysis indicated that the currently available evidence confirmed the therapeutic potential of mesenchymal stem cell-secreted exosomes in the improvement of heart function .However , further mechanis-tic studies, therapeutic safety and clinical trials are required for optimization and validation of this approach to cardiac regeneration after ischemia/reperfusion injury .