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Objectives: The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through the graft vessels to improve left atrium (LA) function of patients with previous myocardial infarction and chronic heart failure using echocardiography., Methods: Forty-two patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: coronary artery bypass graft (CABG) only (18 in CABG group) or CABG with BMMNC transplantation (24 in CABG + BMMNC group). Echocardiographic parameters were measured on two-dimensional (2D) imaging, three-dimensional imaging, 2D strain, and strain rate imaging, eight parameters were measured totally., Results: Postoperative LA global strain (LAGS) versus Preoperative LAGS were 24.875 ± 1.588% versus 14.250 ± 1.281% (P < 0.05) in CABG + BMMMNC group and 17.556 ± 1.834% versus 13.111 ± 1.479% (P < 0.05) in CABG group, LVEF was 49.083 ± 1.914% versus 36.042 ± 1.185% (P < 0.05) in CABG + BMMMNC group and 41.389 ± 2.210% versus 34.667 ± 1.369% (P < 0.05) in CABG group, and LA volume (LAV) was 15.651 ± 0.631 mL versus 23.894 ± 0.831 mL (P < 0.05) in CABG + BMMMNC group and 21.429 ± 0.707 mL versus 22.379 ± 0.959 mL (P < 0.05) in CABG group. LAGS, LVEF, and LAV were significantly improved postoperatively in both groups. The degree of the improvement was significantly different between the two groups with the CABG + BMMNC group improved more versus the group of CABG only (P < 0.05). Postoperative LVEDV and LVESV were significantly improved compared with those obtained prior to operation in CABG + BMMNC group (P < 0.05)., Conclusions: The improvement of LA function in CABG + BMMNC group is better than CABG group. 2D strain imaging is a more sensitive tool to evaluate LA function., (© 2015, Wiley Periodicals, Inc.)

Objectives: The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through graft vessels to improve left ventricular function of patients with previous myocardial infarction and chronic heart failure using echocardiography., Methods: Forty-two patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: CABG only (18 in CABG group), or CABG with BMMNC transplantation (24 in CABG + BMMNC group). Echocardiographic parameters of systolic function were measured on B-mode imaging, tissue Doppler imaging (TDI), two-dimensional (2D) strain imaging, and 8 parameters were measured totally. Echocardiographic parameters of diastolic function were measured on pulsed-wave Doppler imaging, TDI, and 2D strain rate imaging; 17 parameters were measured totally., Results: Postoperative left ventricular ejection fraction (LVEF) versus preoperative LVEF were 49.083 ± 1.914% versus 36.042 ± 1.185% (P < 0.05) in CABG + BMMMNC group and 41.389 ± 2.210% versus 34.667 ± 1.369% (P < 0.05) in CABG group, global longitudinal strain were -12.542 ± 0.512% versus -7.083 ± 0.583% (P < 0.05) in CABG + BMMMNC group and -9.278 ± 0.591% versus -7.000 ± 0.673% (P < 0.05) in CABG group, mLsr1 were -0.108 ± 0.018/sec versus -0.039 ± 0.017/sec (P < 0.05) in CABG+BMMMNC group and -0.048 ± 0.021/sec versus 0.004 ± 0.020/sec (P < 0.05) in CABG group, mLsr2 were -0.055 ± 0.013/sec versus -0.009 ± 0.015/sec (P < 0.05) in CABG + BMMMNC group and 0.004 ± 0.015/sec versus 0.024 ± 0.017/sec (P < 0.05) in CABG group, and Aa1 were 7.303 ± 0.479 cm/sec versus 5.131 ± 0.381 cm/sec (P < 0.05) in CABG + BMMMNC group and 7.908 ± 0.553 cm/sec versus 6.764 ± 0.440 cm/sec (P < 0.05) in CABG group. Parameters above were significantly improved postoperatively in both groups. The degree of the improvement was significantly different between the two groups with the CABG + BMMNC group improved more versus the group of CABG only (P < 0.05)., Conclusions: The improvement of left ventricular function in CABG + BMMNC group is better than CABG group. 2D strain and strain rate imaging is a more sensitive tool to evaluate left ventricular function., (© 2014, Wiley Periodicals, Inc.)

Background: Impaired left ventricular (LV) diastolic function is a common pathophysiological feature of patients with hypertrophic cardiomyopathy (HCM). The noninvasive evaluation of diastolic function in these patients remains a challenge. Speckle tracking echocardiography (STE) provides direct information on intrinsic myocardial function and may improve the diagnostic of diastolic dysfunction in HCM patients., Methods and Results: We retrospectively analyzed 51 patients with obstructive HCM (HOCM). Strain rate (SR) curves were obtained for 18 different segments of the LV myocardium. The peak SR during the isovolumic relaxation period (SRIVR ) and the peak early diastolic strain rate (SRE ) were measured for each segment. Cardiac catheterization was performed within 24 hours after echocardiographic analysis. LV end-diastolic pressure (LVEDP) was measured and time constant of myocardial relaxation (τ) was calculated. We therefore correlated STE-derived with invasive indices and compared it with flow and tissue Doppler measurements. SRIVR and SRE were significantly reduced in all 51 HOCM patients (0.16 ± 0.09%/sec and 0.71 ± 0.25%/sec).The ratio of peak early mitral inflow velocities to SRIVR and SRE (E/SRIVR and E/SRE ) correlated well with LVEDP (r = 0.760, P < 0.001; r = 0.401, P = 0.004). Receiver operating characteristic analysis shown E/SRE ratio had the largest under curve area in predicting HOCM patients with seriously elevated LVEDP. In addition, SRIVR and SRE significantly related with τ (r = -0.611, P < 0.001; r = -0.369, P = 0.008)., Conclusions: Diastolic function was seriously impaired in HOCM patients. The E/SRE ratio can be used to predict LVEDP with acceptable accurate in HOCM patients. In addition, SRIVR is a reliable parameter to assess LV relaxation in patients with HOCM., (© 2013, Wiley Periodicals, Inc.)

Background: Percutaneous transluminal septal myocardial ablation (PTSMA) is an alternative therapy for patients with hypertrophic obstructive cardiomyopathy (HOCM) that results in sustained improvement in the global diastolic dysfunction. Regional diastolic abnormalities and diastolic asynchrony are very common and closely related to global diastolic dysfunction. The aim of this study was to examine the effect of PTSMA on regional diastolic dysfunction and diastolic asynchrony in HOCM patients using speckle tracking echocardiography., Methods: Strain rate curves were obtained for 18 different segments of the left ventricular (LV) myocardium in 30 HOCM patients 24 hours before and 1 year after PTSMA. The peak strain rate during the isovolumic relaxation period (SRIVR ), the peak early diastolic strain rate (SRE ), and the time from the onset of the QRS-wave to SRE (TSRE ) were measured for each segment. The left atrial volume indexed to the body surface area (LAVI) was measured as a global diastolic index., Results: At 1 year after PTSMA, there was significant improvement of the global SRIVR (0.14 ± 0.06-0.22 ± 0.07%/sec, P < 0.001) and SRE (0.67 ± 0.24-0.82 ± 0.23%/sec, P = 0.001). The coefficient of variation in TSRE (CVTSRE ) decreased significantly. The changes in the regional myocardial diastolic deformation and CVTSRE correlated well with the reduction in the LAVI., Conclusions: Percutaneous transluminal septal myocardial ablation has a favorable effect on regional diastolic abnormalities and diastolic asynchrony, which may partly account for the persistent improvement in global LV diastolic function in HOCM patients after PTSMA., (© 2013, Wiley Periodicals, Inc.)