115 results on '"Cuizhen Pan"'
Search Results
2. FBXL4 protects against HFpEF through Drp1-Mediated regulation of mitochondrial dynamics and the downstream SERCA2a
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Miyesaier Abudureyimu, Xuanming Luo, Lingling Jiang, Xuejuan Jin, Cuizhen Pan, Wei Yu, Junbo Ge, Yingmei Zhang, and Jun Ren
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HFpEF ,FBXL4 ,Mitochondrial dynamics ,Drp1 ,Intracellular Ca2+ ,Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Aims: Heart failure with preserved ejection fraction (HFpEF) is a devastating health issue although limited knowledge is available for its pathogenesis and therapeutics. Given the perceived involvement of mitochondrial dysfunction in HFpEF, this study was designed to examine the role of mitochondrial dynamics in the etiology of HFpEF. Method and results: Adult mice were placed on a high fat diet plus l-NAME in drinking water (‘two-hit’ challenge to mimic obesity and hypertension) for 15 consecutive weeks. Mass spectrometry revealed pronounced changes in mitochondrial fission protein Drp1 and E3 ligase FBXL4 in ‘two-hit’ mouse hearts. Transfection of FBXL4 rescued against HFpEF-compromised diastolic function, cardiac geometry, and mitochondrial integrity without affecting systolic performance, in conjunction with altered mitochondrial dynamics and integrity (hyperactivation of Drp1 and unchecked fission). Mass spectrometry and co-IP analyses unveiled an interaction between FBXL4 and Drp1 to foster ubiquitination and degradation of Drp1. Truncated mutants of FBXL4 (Delta-Fbox) disengaged interaction between FBXL4 and Drp1. Metabolomic and proteomics findings identified deranged fatty acid and glucose metabolism in HFpEF patients and mice. A cellular model was established with concurrent exposure of high glucose and palmitic acid as a ‘double-damage’ insult to mimic diastolic anomalies in HFpEF. Transfection of FBXL4 mitigated ‘double-damage’-induced cardiomyocyte diastolic dysfunction and mitochondrial injury, the effects were abolished and mimicked by Drp1 knock-in and knock-out, respectively. HFpEF downregulated sarco(endo)plasmic reticulum (SR) Ca2+ uptake protein SERCA2a while upregulating phospholamban, RYR1, IP3R1, IP3R3 and Na+-Ca2+ exchanger with unaltered SR Ca2+ load. FBXL4 ablated ‘two-hit’ or ‘double-damage’-induced changes in SERCA2a, phospholamban and mitochondrial injury. Conclusion: FBXL4 rescued against HFpEF-induced cardiac remodeling, diastolic dysfunction, and mitochondrial injury through reverting hyperactivation of Drp1-mediated mitochondrial fission, underscoring the therapeutic promises of FBXL4 in HFpEF.
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- 2024
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3. Echocardiographic characteristics of PRKAG2 syndrome: a research using three-dimensional speckle tracking echocardiography compared with sarcomeric hypertrophic cardiomyopathy
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Lu Tang, Xuejie Li, Nianwei Zhou, Yingying Jiang, Cuizhen Pan, and Xianhong Shu
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PRKAG2 syndrome ,Hypertrophic cardiomyopathy ,3D STE ,Strain ,GLS ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background PRKAG2 syndrome is a rare disease characterized as left ventricular hypertrophy (LVH), ventricular preexcitation syndrome, and sudden cardiac death. Its natural course, treatment, and prognosis were significantly different from sarcomeric hypertrophic cardiomyopathy (HCM). However, it is often clinically misdiagnosed as sarcomeric HCM. PRKAG2 patients tend to experience delayed treatment. The delay may lead to adverse outcomes. This study aimed to identify the echocardiographic parameters which can differentiate PRKAG2 syndrome from sarcomeric HCM. Methods Nine PRKAG2 patients with LVH, 41 HCM patients with sarcomere gene mutations, and 202 healthy volunteers were enrolled. Clinical characteristics, conventional echocardiography, and three-dimensional images were recorded, and reviewed by an attending cardiologist. We evaluated the parameters of left ventricular strains from three-dimensional speckle tracking echocardiography (3D STE) by TomTec software. Receiver operating characteristic (ROC) curves analysis was used to assess clinical and echocardiographic parameters’ differential diagnosis potential. Results The heart rate (HR) of the PRKAG2 group was significantly lower than both the healthy group (53.11 ± 10.14 vs. 69.22 ± 10.48 bpm, P 0.05). The absolute value of GLS in the PRKAG2 group was significantly higher than HCM patients (-18.92 ± 4.98 vs. -13.43 ± 4.30%, P = 0.004). SV calculated from EDV and ESV in PRKAG2 syndrome showed a higher value than sarcomeric HCM (61.83 ± 13.52 vs. 44.96 ± 17.53%, P = 0.020). The area under the ROC curve (AUC) for HR + GLS was 0.911 (0.803 -1). For HR + GLS, the sensitivity and specificity of the best cut-off value (0.114) were 69.0% and 100%, respectively. Conclusions PRKAG2 patients present deteriorated LV diastolic function and preserved LV systolic function. Bradycardia and preserved GLS are useful to identify PRKAG2 syndrome from sarcomeric HCM, which may be beneficial for clinical decision-making.
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- 2022
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4. Three-dimensional transthoracic echocardiographic evaluation of tricuspid regurgitation severity using proximal isovelocity surface area: comparison with volumetric method
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Beiqi Chen, Yu Liu, Wuxu Zuo, Quan Li, Dehong Kong, Cuizhen Pan, Lili Dong, Xianhong Shu, and Junbo Ge
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Three-dimensional echocardiography ,Tricuspid regurgitation ,Proximal isovelocity surface area ,Effective regurgitant orifice area ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The quantification of tricuspid regurgitation(TR) using three-dimensional(3D) proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) is feasible in functional TR. The aim of our study was to explore the diagnostic accuracy and utility of 3D PISA EROA in a larger population of different etiologies. Methods One hundred and seven patients with confirmed TR underwent 2D and 3D transthoracic echocardiography (TTE). 3D PISA EROA was calculated and EROA derived from 3D regurgitant volume (Rvol) was used as the reference. Results 3D PISA EROA showed better correlation in primary TR than in functional TR(r = 0.897, P
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- 2020
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5. Assessment of left ventricular diastolic function after Transcatheter aortic valve implantation in aortic stenosis patients by echocardiographic according to different guidelines
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Yao Guo, Minmin Sun, Haiyan Chen, Dehong Kong, Xianhong Shu, and Cuizhen Pan
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Transcatheter aortic valve implantation ,Diastolic function ,Transthoracic echocardiography ,Doppler imaging ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background To evaluate the detailed dynamic change of left ventricular diastolic function (LVDF) by echocardiography in aortic stenosis (AS) patients receiving transcatheter aortic valve implantation (TAVI) and compare LVDF classification according to 2009 ASE/EAE and 2016 ASE/EACVI recommendations. Methods Thirty-five AS patients receiving TAVI underwent echocardiography the day before operation (PRE), on the third day (3D), in the first-month (1 M) and the six-month (6 M) after TAVI. LVDF was analyzed using 2D and doppler imaging to get parameters including E/A, E/e’, isovolumic relaxation time (IVRT), deceleration time, LA area, LA volume index (LAVI) and systolic tricuspid regurgitation velocity (TR). LVDF classification was evaluated four times for each patient according to 2009 and 2016 recommendations respectively and the results were compared. Results The decrease of IVRT and TR occurred immediately post surgery up to 1-month. Improvement of E/e’ occurred late from 3-day to 1-month. LA area and LAVI decreased continuously shortly after operation till 6-month. Forty-four percent (62/140) by 2009 recommendations were reclassified with different grades when using 2016 guidelines. Comparing PRE and 6 M, with 2009 guidelines, 19 patients improved 1 grade, 8 patients improved 2 grades; with 2016 guidelines, 9 patients improved 1 grade, 13 patients improved 2 grades, 1 patient improved 3 grades. Conclusions The conventional 2D echocardiography could effectively reflect variation process of LVDF in AS patients after TAVI. For LVDD classification, obvious differences resulted by the 2009 and updated recommendations were found, and more patients can be regarded as benefiting from TAVI by 2016. recommendations.
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- 2020
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6. Real-Time Monitoring and Step-by-Step Guidance for Transcatheter Tricuspid Annuloplasty Using Transesophageal Echocardiography
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Yu Liu, Wei Li, Daxin Zhou, Xiaochun Zhang, Dehong Kong, Zhenyi Ge, Haiyan Chen, Xianhong Shu, Cuizhen Pan, and Junbo Ge
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tricuspid regurgitation ,tricuspid annuloplasty ,transesophageal echocardiography ,tricuspid valve intervention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Transcatheter tricuspid valve intervention (TTVI) is a novel alternative to functional tricuspid regurgitation (FTR) for patients with prohibitive surgical risk. Devices have been designed according to different pathophysiological mechanisms of FTR, including ones to achieve an edge-to-edge repair and others aiming at direct annuloplasty. Recently, a transcatheter tricuspid valve repair system mimicking a surgical Kay procedure (K-Clip™ system, Huihe Medical Technology, Shanghai, China) completed its salvage-use trial. The system, which clips the posterior annulus to achieve bicuspidization of the TV, demonstrated acceptable procedural safety and efficacy. Each TTVI system has distinct characteristics for echocardiographic imaging and special consideration for intraoperative guidance. This review focuses on elaborating how two-dimensional and three-dimensional transesophageal echocardiography (TEE) are used in clinical practice to guide K-Clip™ implantation in comparison to other direct annular reduction devices. A limited number of TEE work planes are proposed for the procedure with the aim to provide a steeper learning curve for the echocardiographer and interventionalist while simplifying the implantation steps.
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- 2022
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7. Right ventricular systolic function and cardiac resynchronization therapy
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Lu Tang, Nianwei Zhou, Xue Gong, Shengmei Qin, Zhaohua Yang, Zhenning Nie, Shimo Dai, Quan Li, Yangang Su, Cuizhen Pan, and Xianhong Shu
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Cardiac resynchronization therapy ,response ,right ventricular function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: The aim of this study was to investigate the influence of right ventricular (RV) dysfunction on the response to cardiac resynchronization therapy (CRT) and the impact of CRT on RV function in a beagle model of heart failure (HF). Methods: Twenty-one beagles were implanted with transvenous cardiac pacemakers and underwent rapid RV pacing for 2 weeks at 260 bpm to induce HF. Dogs were subsequently divided into three groups that were either treated with bi-ventricular pacing (CRT group) or untreated (control group and HF group). Echocardiographic images were acquired at baseline, before CRT, and 4 weeks after CRT. Results: Left ventricular systolic function and synchrony (left ventricular internal dimensions, left ventricular end systolic volume [LVESV], left ventricular ejection fraction [LVEF], septal-to-posterior wall motion delay [SPWMD], and aorta pre-ejection interval and the pulmonary artery pre-ejection interval [|APEI-PPEI|]) were significantly improved in the CRT group compared with the HF group. RV myocardial performance index (MPI) and pulmonary artery systolic pressure deteriorated with left ventricular dysfunction and improved after CRT. RV outflow ESV, standard deviation of time to minimum systolic volume (Tmsv), and Tmsv% decreased in the CRT group compared with the HF group. LVESV, LVEF, SPWMD, and |APEI-PPEI| were significantly different between responders and nonresponders, while there was no difference about RV functional parameters. Conclusions: RV function deteriorated with left ventricular dysfunction and improved after CRT. RV function did not significantly influence the response to CRT.
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- 2019
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8. Impact of Thrombocytopenia in Patients With Atrial Fibrillation Undergoing Left Atrial Appendage Occlusion: A Propensity-Matched Comparison of 190 Consecutive Watchman Implantations
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Xiaochun Zhang, Qinchun Jin, Jialu Hu, Dehong Kong, Cuizhen Pan, Dandan Chen, Shasha Chen, MIngfei Li, Daxin Zhou, and Junbo Ge
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atrial fi ,left atrial appendage occlusion ,thrombocytopenia ,bleeding ,stroke ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: The purpose of this study was to provide data on the long-term efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) and chronic thrombocytopenia (cTCP).Methods: Between January 2016 and December 2018, a total of 32 AF patients with thrombocytopenia (platelet count 0.9) and device-related thrombus (DRT) (3.13 vs. 2.50%, p > 0.9). Major (12.50 vs. 3.75%, p = 0.065) and minor bleeding (15.63 vs. 1.25%, p = 0.002) was more frequent in cTCP patients but no statistical difference was reached in major bleeding. Moreover, thrombocytopenia was also identified as an independent predictor of any bleeding events (OR: 8.150, 95% CI: 2.579–25.757, p < 0.001), while an inverse relationship between higher absolute platelet count and stroke events was revealed (OR: 1.015; 95% CI: 1.002~1.029, p = 0.022). However, in both groups we saw a significant reduction in observed annualized rates of non-procedural complications compared with the predicted values. In the cTCP and control groups, clinical thromboembolism was reduced by 100 and 74.32%, and major bleeding by 42.47 and 71.67%, respectively.Conclusion: Our preliminary results indicate that LAAO using the Watchman device could be a safe and effective means of preventing stroke in AF patients with or without thrombocytopenia, but bleeding complications should be monitored intensively in cTCP patients.
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- 2021
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9. Impact of Leaflet Tethering on Residual Regurgitation in Patients With Degenerative Mitral Disease After Interventional Edge-to-Edge Repair
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Zhenyi Ge, Wenzhi Pan, Wei Li, Lai Wei, Dehong Kong, Cuizhen Pan, Daxin Zhou, Xianhong Shu, and Junbo Ge
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3D transesophageal echocardiography ,degenerative mitral regurgitation ,mitral valve geometry ,interventional edge-to-edge repair ,minimally invasive surgery ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Grade 2+ residual mitral regurgitation (MR 2+) is associated with the recurrence of MR and a lower survival rate in interventional mitral valve (MV) edge-to-edge (EE) repair. We sought to determine the MV anatomic factors affecting residual MR 2+ during interventional EE repair with the ValveClamp system in patients with degenerative MR (DMR).Methods: In this multicenter study, 62 patients with significant (grade 3+ to 4+) DMR underwent ValveClamp implantation across eight centers from July 2018 to December 2019. Patient clinical, anatomical, and procedural characteristics were prospectively collected and retrospectively analyzed.Results: A single clamp was implanted in 59 patients, and two clamps were implanted in three patients. Residual MR 2+ was found in 14 patients (22.6%) immediately after the ValveClamp procedure. Patients with residual MR 2+ showed significantly larger preoperative tenting sizes and annular dimensions than the residual MR ≤1+ group. Multivariate analysis identified tenting volume as the major determinant of residual MR 2+ after ValveClamp procedures (odds ratio, 1.410 per 0.1-mL/m2 increase; 95% confidence interval, 1.167–1.705; P < 0.001). Receiver operating characteristic curves identified a tenting volume index ≥0.82 mL/m2 as the optimal cutoff point to predict residual MR 2+ (area under curve, 0.84). Patients with a tenting volume index ≥0.82 mL/m2 were more likely to develop recurrent 3+ MR or undergo MV surgery during short-term follow-up (P < 0.001).Conclusions: Preoperative assessment of the tenting volume index will help to predict intraoperative residual MR 2+ in patients with DMR receiving EE-based interventional repair. Improvements in the interventional strategy are warranted for sustained MR reduction in patients with DMR with unfavorable anatomy.
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- 2021
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10. Real-Time Monitoring and Step-by-Step Guidance for Transapical Mitral Valve Edge-to-Edge Repair Using Transesophageal Echocardiography
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Zhenyi Ge, Cuizhen Pan, Wei Li, Daxin Zhou, Wenzhi Pan, Lai Wei, Haiyan Chen, Xianhong Shu, and Junbo Ge
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
MitraClip edge-to-edge (E2E) repair system is the only transcatheter device recommended in the current guidelines for treating mitral regurgitation (MR). The percutaneous femoral venous transseptal access of MitraClip requires a complex steerable delivery system and may thus be technically complex to optimally position and deploy the clip onto the mitral valve. A transapical approach for E2E repair has been devised to treat MR for the ease of operation (ValveClamp system, Hanyu Medical Technology, Shanghai). The first-in-human study of ValveClamp has demonstrated its early feasibility and effectiveness for the treatment of patients with degenerative MR. Transesophageal echocardiography (TEE) is the only imaging modality required for intraoperative guidance of ValveClamp implantation. Successful implantation depends on accurate localization and orientation of the clamp and efficient intraoperative communication between the echocardiographer and the intervention team. Thus, the focus of this review is on elaborating how two-dimensional (2D) and three-dimensional (3D) TEE are used in clinical practice to guide ValveClamp implantation and it may facilitate the understanding of simplicity and safety of this novel procedure. We also describe the implementation of several novel advancements in 3D TEE imaging, which improve the confidence of image interpretation for intraoperative guidance and expedite implantation times.
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- 2021
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11. Role of three-dimensional transesophageal echocardiography in transcatheter aortic valve implantation of bicuspid aortic valve stenosis: A controlled study and comparison with tricuspid aortic valve stenosis
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Nianwei Zhou, Cuizhen Pan, Weipeng Zhao, Daxin Zhou, Wenzhi Pan, Xiaochun Zhang, Kefang Guo, Xianhong Shu, Xiaolin Wang, and Junbo Ge
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Aortic stenosis ,bicuspid ,transcatheter aortic valve replacement ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Aims: This study aims to investigate the application of three-dimensional transesophageal echocardiography in aortic valve stenosis for the assessment of aortic valve ring size, to monitor the procedure of transcatheter aortic valve implantation (TAVI), and perform postoperative follow-up. Methods: Eighteen patients with bicuspid valve malformation and severe aortic stenosis bicuspid aortic valve (Group BAV-AS) and 23 patients with a tricuspid valve and severe aortic stenosis trileaflet aortic valve (Group TAV-AS) were enrolled in this study. Preoperative routine transthoracic echocardiographic (TTE) examination and two- and three-dimensional transesophageal echocardiography (2D and 3DTEE) were performed, followed by perioperative 2D and 3D TEE monitoring and postoperative routine TTE at 6-month follow-up. Results: Both BAV-AS and TAV-AS patient groups were successfully implanted with bioprosthetic valves under 3DTEE guidance. Parameters at 6-month postoperatively, including prosthetic valve orifice area, mean aortic transvalvular pressure gradient, and left ventricular ejection fraction, showed significant improvement compared with baseline measures (P < 0.0001) in both the groups. No differences were observed between the groups. The maximum diameter of the aortic annulus and eccentricity index were larger in the BAV-AS group than in the TAV-AS group, whereas the minimum diameter of the aortic annulus was larger in the latter (both P < 0.0001) after TAVI. Moreover, the values of maximum and minimum diameters on 3DTEE were strongly correlated with those on multidetector computed tomography. Conclusions: TEE is capable of clearly displaying the morphology of aortic valves and valve rings and precisely quantifying the size of the aortic annulus, thereby playing an essential role during preoperative and perioperative periods. The postoperative shape of the prosthetic valve ring was more oval (larger than normal eccentricity index) in the BAV-AS group and more circular (smaller than normal eccentricity index) in the TAV-AS group.
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- 2018
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12. Assessment of subclinical left ventricular changes in essential hypertensive patients with hyperuricemia: A three-dimensional speckle-tracking echocardiography study
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Xiaoyan Fang, Cuizhen Pan, Yongle Chen, Minmin Sun, Zhuojun Zhang, Lindi Jiang, Xiaolin Wang, and Xianhong Shu
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hypertension ,hyperuricemia ,left ventricular ,speckle-tracking ,three-dimensional ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: To evaluate the effect of hyperuricemia (HU) on subclinical changes of left ventricle (LV) function and structure in patients with hypertension (HT) using three-dimensional speckle-tracking echocardiography (3DSTE) and to explore the relationships between serum uric acid (SUA) levels and three-dimensional speckle tracking echocardiography (3DSTE) parameters in hypertensive and nonhypertensive patients with HU. Methods: Four age- and sex-matched groups were studied: I: healthy controls, HT– HU– (n = 40); II: HT– HU+ (n = 40); III: HT+ HU– (n = 40); IV: HT+ HU+ (n = 44). Conventional echocardiography and 3DSTE were recorded. Relative wall thickness (RWT) and left ventricular mass index assessed by M-mode echocardiography (LVMi-M) were calculated. 3DSTE parameters including LV volumes and ejection fraction (EF), LVMi-3D, global longitudinal strain (GLS), and global circumferential strain (GCS) were compared. The relationships between SUA levels and 3DSTE parameters were investigated. Results: Despite LV diameters, LV volumes and EF were similar among groups (all p > 0.05), GLS decreased and LVMi-3D increased from controls (group I) to patients with HU or HT alone (group II or III), and patients with both HU and HT (group IV) (all p < 0.05). SUA levels were significantly correlated with the absolute value of GLS (r = −0.461, p < 0.05) and LVMi-3D (r = 0.504, p < 0.05) in hypertensive and nonhypertensive patients with HU. Conclusions: HU may exacerbate LV systolic dysfunction and remodeling in hypertensive patients, which can be detected by 3DSTE. Early uric acid lowing treatment may be beneficial for hypertensive patients with HU.
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- 2017
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13. Whole-exome sequencing identified a novel desmoglein-2 gene mutation associated with familial arrhythmogenic right ventricular cardiomyopathy
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Nianwei Zhou, Yili Liu, Shengmei Qin, Weipeng Zhao, Lu Tang, Cuizhen Pan, Zilong Qiu, Xiaolin Wang, and Xianhong Shu
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Arrhythmogenic right ventricular cardiomyopathy ,desmoglein-2 ,whole-exome sequencing ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: The objective of this study is to evaluate novel variations in a Chinese family of Han ethnicity, with arrhythmogenic right ventricular cardiomyopathy (ARVC) by the powerful technology of whole-exome sequencing (WES). Methods: Genomic DNA from representative family members was extracted and processed for WES via standardized methods. The exome sequence data were analyzed by Genome Analysis Toolkit software. Sanger sequencing was performed on DNA from the proband for genotype confirmation and from the other family members for familial co-segregation analysis. Results: A rare single nucleotide variant c.1592T>G (p.Phe531Cys) in exon 10 of desmoglein-2 (DSG2) was identified by WES in the affected individuals but not in the healthy control, which was confirmed by Sanger sequencing, suggesting that the mutation probably was a causal mutation for the familial disorder of ARVC. Conclusion: We identified a rare disease-causing mutation of the DSG2 gene associated with familial ARVC. The results might contribute to the early genetic analysis in inherited cardiomyopathies.
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- 2017
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14. Anomalous left coronary artery with single ostium (Shared with Right Coronary Artery) detected by echocardiography: Two case reports
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Yingjie Zhao, Yang Liu, Mengruo Zhu, Haiyan Chen, Cuizhen Pan, and Xianhong Shu
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Computed tomography angiography ,coronary artery ,echocardiography ,invasive coronary angiography ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Anomalous aortic origin of a coronary artery (AAOCA) from the inappropriate sinus of Valsalva has received increasing attention due to its association with malignant cardiac events in otherwise healthy and asymptomatic individuals. Despite this, we still face tremendous challenges in detecting the anomalies in a timely fashion to prevent sudden cardiac death. Here, we present two cases of anomalous left coronary artery with single ostium (shared with right coronary artery); in patients with normal cardiac function. The diagnosis of AAOCA in both cases was first suspected on transthoracic echocardiography and was later established using either coronary computed tomography angiography or invasive coronary angiography. Although angiography is the gold standard for diagnosing AAOCA, echocardiography is a more frequently used imaging modality in the workup of cardiac patients.
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- 2018
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15. Tricuspid valve dysfunction due to incarcerated right ventricular lead
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Lili Xu, Cuizhen Pan, Xianhong Shu, and Junbo Ge
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Heart failure ,pacemaker ,tricuspid valve dysfunction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Here we report a case of severe tricuspid regurgitation related to the pacemaker lead incarcerated in the chordae tendinae, resulting in significantly reduced systolic function of right ventricular and right sided heart failure. The necessity of echocardiography is ignored in the follow-ups after pacemaker implantation, which may be useful for optimal lead placement.
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- 2019
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16. The myocardial ischemia evaluated by real-time contrast echocardiography may predict the response to cardiac resynchronization therapy: a large animal study.
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Yongle Chen, Leilei Cheng, Haohua Yao, Haiyan Chen, Yongshi Wang, Weipeng Zhao, Cuizhen Pan, and Xianhong Shu
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Medicine ,Science - Abstract
Evidence-based criteria for applying cardiac resynchronization therapy (CRT) in patients with ischemic cardiomyopathy are still scarce. The aim of the present study was to evaluate the predictive value of real-time myocardial contrast echocardiography (RT-MCE) in a preclinical canine model of ischemic cardiomyopathy who received CRT. Ischemic cardiomyopathy was produced by ligating the first diagonal branch in 20 beagles. Dogs were subsequently divided into two groups that were either treated with bi-ventricular pacing (CRT group) or left untreated (control group). RT-MCE was performed at baseline, before CRT, and 4 weeks after CRT. Two-dimensional speckle tracking imaging was used to evaluate the standard deviation of circumferential (Cir12SD), radial (R12SD), and longitudinal (L12SD) strains of left ventricular segments at basal as well as middle levels. Four weeks later, the Cir12SD, R12SD, and myocardial blood flow (MBF) of the treated group were significantly improved compared to their non-CRT counterparts. Furthermore, MBF values measured before CRT were significantly higher in responders than in non-responders to bi-ventricular pacing. Meanwhile, no significant differences were observed between the responder and non-responder groups in terms of Cir12SD, R12SD, and L12SD. A high degree of correlation was found between MBF values before CRT and LVEF after CRT. When MBF value>24.9 dB/s was defined as a cut-off point before CRT, the sensitivity and specificity of RT-MCE in predicting the response to CRT were 83.3% and 100%, respectively. Besides, MBF values increased significantly in the CRT group compared with the control group after 4 weeks of pacing (49.8±15.5 dB/s vs. 28.5±4.6 dB/s, p
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- 2014
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17. Mitral Regurgitation Quantification from Multi-channel Ultrasound Images via Deep Learning.
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Keming Tang, Zhenyi Ge, Rongbo Ling, Jun Cheng 0006, Wufeng Xue, Cuizhen Pan, Xianhong Shu, and Dong Ni 0001
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- 2023
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18. Transcatheter edge to edge repair using the ease-of-use valve clamp system for functional mitral regurgitation: a primary report
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Wei, Li, Yuliang, Long, Wenzhi, Pan, Lai, Wei, Cuizhen, Pan, Lihua, Guan, Daxin, Zhou, and Junbo, Ge
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Surgery ,General Medicine - Abstract
The ValveClamp system is a novel edge-to-edge mitral valve repair system designed for the ease of operation. We report the outcomes of our initial experience of treating functional mitral regurgitation (MR) with the ValveClamp system.The subjects of this study were patients with symptomatic functional MR despite standard medical therapy, who were treated with transapical ValveClamp implantation. The patients were divided into an atrial functional mitral regurgitation (AFMR) group and a ventricular functional mitral regurgitation (VFMR) group. Clinical and echocardiographic outcomes were evaluated at baseline and then at the 3-month follow up.Twelve patients, with a median age of 71 years (range 65-78 years), were assigned to the AFMR group (n = 5) or the VFMR group (n = 7). The device implantation rate was 100%, and 10 (83.3%) patients required implantation of only one clamp. The catheter time was less than 10 min in half of the patients, the fastest time being 5 min. There were no procedure-related complications. At the 3-month follow up, all patients were free from all-cause mortality, surgery, and rehospitalization. MR improved to ≤ 2 + in all 12 patients with MR grade 3 + or 4 + at baseline, (100%) and to ≤ 1 + in 9 of these patients (75%), with a low-pressure gradient. The left atrial diameter and the left ventricular end diastolic diameter decreased significantly in both the AFMR and VFMR groups. The left ventricular eject fraction at the 3-month follow up showed a rising trend in both the AFMR and VFMR groups, whereas PASP decreased remarkably. All 12 patients with baseline NYHA functional class III/IV (100%) showed improvement of at least 1 class, and 2 of these patients (16.7%) showed improvement of at least 2 classes.The ValveClamp system is simple and effective for transapical transcatheter edge to edge repair in patients with functional MR.
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- 2022
19. Feasibility Study of a Novel Transcatheter Tricuspid Annuloplasty System in a Porcine Model
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Wenzhi Pan, Yuliang Long, Xiaochun Zhang, Shasha Chen, Wei Li, Cuizhen Pan, Yingqiang Guo, Daxin Zhou, and Junbo Ge
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Cardiology and Cardiovascular Medicine - Abstract
Gradually, more attention has been paid to tricuspid regurgitation. Formerly the "forgotten valvular heart disease," it has been recognized as having high incidence and adverse prognosis if untreated. However, isolated tricuspid valve surgery carries substantial risk and is thus not recommended. The K-Clip transcatheter tricuspid annuloplasty system has recently emerged as a minimally invasive therapeutic option that may help address these unmet clinical needs. The K-Clip technology simulates the Kay's procedure, which reduces the dimensions of the tricuspid annulus by folding and clamping the tricuspid annulus issue with a rigid clamping device. The feasibility of the K-Clip technology was investigated in this study, and annulus area reduction and declining tricuspid regurgitation grades were noted following the procedure. The findings of this study suggest that the K-Clip system may potentially be applicable as a novel transcatheter tricuspid annuloplasty device for the treatment of severe tricuspid in humans.
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- 2022
20. Secondary Leaflet Tethering in Patients with degenerative mitral regurgitation and its Association with the Severity of Mitral Regurgitation
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Zhenyi Ge, Chunqiang Hu, Fangyan Tian, Yingjie Zhao, Yongshi Wang, Dehong Kong, Wei Li, Yashu Xie, Zhengdan Ge, zibire fulati, Yufei Cheng, Yao Guo, Yingying Jiang, Cuizhen Pan, and Xianhong Shu
- Abstract
Background The purpose of the study was to determine the association between vena contracta area (VCA) and secondary leaflet tethering among mitral valve prolapse (MVP) patients, and thus to further identify and characterize an MVP with pathological leaflet tethering (MVPt+) phenotype. Methods We prospectively evaluated 94 consecutive MVP patients with significant mitral regurgitation (MR) and 20 healthy controls. MVPt+ group was defined as tenting volume index (TVi) > 0.7 ml/m . The three-dimensional (3D) geometry of mitral valve apparatus and VCA was measured with dedicated quantification software. Results Of the 94 patients with MVP and significant MR, 31 patients showed a TVi > 0.7 ml/m and entered the MVP with leaflet tethering (MVPt+) group. In stepwise multivariate analysis, only prolapse volume index and TVi was independently associated with 3D VCA. Apart from marked left ventricular and annular enlargement, MVPt+ group presented significantly higher frequency of leaflet flail, greater VCA, elevated plasma levels of NT-proBNP and sPAP. ROC curve revealed that occurrence of leaflet tethering is associated with a VCA ≥0.55 cm in MVP patients. Conclusions Secondary leaflet tethering is a significant mechanism behind severe degenerative mitral regurgitation, resulting an MVPt+ phenotype featuring more advanced morphological and hemodynamical characteristics .
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- 2023
21. Identification of CHMP4C as a new risk gene for inherited dilated cardiomyopathy
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Zilong Qiu, Shengmei Qin, Junbo Ge, Xuejie Li, Bo Yuan, Xianhong Shu, Nianwei Zhou, Shifang Shan, Cuizhen Pan, Xiaolin Wang, Yingying Jiang, and Lu Tang
- Subjects
Cardiomyopathy, Dilated ,Genetics ,MEDLINE ,medicine ,Humans ,Risk gene ,Identification (biology) ,Dilated cardiomyopathy ,Biology ,Bioinformatics ,medicine.disease ,Molecular Biology ,HeLa Cells - Published
- 2022
22. A case report of transcatheter repair of severe functional mitral regurgitation in cardiac amyloidosis
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Fangmin, Meng, primary, Shaohua, Lu, additional, Lai, Wei, additional, and Cuizhen, Pan, additional
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- 2022
- Full Text
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23. Preliminary Implantation of a Novel TAVR Device With Polymeric Leaflets for Symptomatic Calcific Aortic Disease
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Junbo Ge, Daxin Zhou, Xiaochun Zhang, Shiqiang Hou, Shasha Chen, Qinchun Jin, Wenzhi Pan, Wei Li, Cuizhen Pan, and Juying Qian
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Cardiology and Cardiovascular Medicine - Published
- 2023
24. Left atrial dysfunction in patients with obstructive sleep apnea: a combined assessment by speckle tracking and real-time three-dimensional echocardiography
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Quan Wan, Guiling Xiang, Xianhong Shu, Cuizhen Pan, Yumeng Xing, Shengyu Hao, and Shanqun Li
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medicine.medical_specialty ,Echocardiography, Three-Dimensional ,Diastole ,Speckle tracking echocardiography ,030204 cardiovascular system & hematology ,Left ventricular hypertrophy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Heart Atria ,cardiovascular diseases ,030212 general & internal medicine ,Systole ,Subclinical infection ,Advanced and Specialized Nursing ,Sleep Apnea, Obstructive ,business.industry ,medicine.disease ,respiratory tract diseases ,Obstructive sleep apnea ,Anesthesiology and Pain Medicine ,Apnea–hypopnea index ,Cardiology ,Atrial Function, Left ,business ,Cohort study - Abstract
BACKGROUND At present, little research concerning the assessment of left atrial (LA) dysfunction in patients with obstructive sleep apnea (OSA) using a combined assessment by speckle tracking (STE) and real-time three-dimensional echocardiography (RT3DE) is available. The objective of this study was to evaluate the LA volume and function by STE and RT3DE in patients with OSA. METHODS In our cohort study, ninety-two OSA patients and 50 healthy individuals were enrolled. According to the apnea hypopnea index (AHI), patients (AHI >15/h) classified as having moderate and severe OSA were included. The patients were divided into 2 subgroups according to the left ventricular mass index (LVMI): the left ventricular hypertrophy (LVH) group in which patients had LVH (n=30), and the nonLVH group in which patients did not have LVH (n=62). All subjects underwent LA function assessment by conventional techniques and the combination of STE and RT3DE. RESULTS OSA patients showed impaired LA global longitudinal strain during early diastole (LA S-E) and systole (LA S-S) but increased LA global longitudinal strain during late diastole (LA S-A) compared with controls (all P
- Published
- 2021
25. Comparison of fluoroscopy and transesophageal echocardiogram for intra-procedure device surveillance assessment during implantation of Watchman
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Yingying Jiang, Dandan Chen, Lei Zhang, Daxin Zhou, Shasha Chen, Cuizhen Pan, Junbo Ge, Qinchun Jin, Dehong Kong, Cody R. Hou, and Xiaochun Zhang
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Cardiac Catheterization ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Transesophageal echocardiogram ,Left atrial appendage occlusion ,03 medical and health sciences ,0302 clinical medicine ,Atrial Fibrillation ,medicine ,Humans ,Fluoroscopy ,Atrial Appendage ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Adverse effect ,Contraindication ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Retrospective cohort study ,medicine.disease ,Treatment Outcome ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Transesophageal - Abstract
Objectives To evaluate intraprocedural assessments using transesophageal echocardiography (TEE) and fluoroscopy during left atrial appendage occlusion (LAAO) with the WATCHMAN device. Method A total of 208 patients with non-valvular atrial fibrillation (AF) undergoing LAAO were included in this study[101 standard procedures (retrospective cohort) and 107 with fluoroscopy-alone approach (prospective cohort). Individual device position, anchoring, compression and peri-device leak (PDL) were successively analyzed based on TEE and fluoroscopy in the retrospective cohort to summarize detailed fluoroscopic assessments for prospective application. Clinical outcomes were assessed between two cohorts. Results For retrospective cohort, TEE and fluoroscopy agreed on device position and anchoring. Compression upon fluoroscopy was well correlated with 2D-TEE (r = 0.908) and the difference in overall detection of PDL was not statistically significant between two imaging modalities (p = 0.304). For the prospective cohort with fluoroscopy-guidance alone, implantation success was similar to that of the retrospective cohort (98.13% vs 100%, p = 0.498). The incidence rate of major clinical adverse events was relatively higher in prospective cohort during hospitalization and follow-up but did not reach significant difference (5.61% vs 1.98%; 0.99% vs 0.93%, p > 0.05). Moreover, the prospective group presented with shorter procedural duration, shorter in-hospital stay and lower total hospitalization cost than retrospective group. Conclusion LAAO performed by experienced operators in large volume centers is feasible under fluoroscopy guidance. However, there is still a trend in favor of TEE for greater procedural safety and more complete LAA seal. We suggest that this minimalist approach could be proposed in cases with contraindication to general anesthesia and/or TEE.
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- 2021
26. Real‐time echocardiographic guidance for transcatheter repair noncentral mitral regurgitation using the novel ValveClamp system
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Cuizhen Pan, Wenzhi Pan, Junbo Ge, Daxin Zhou, Long Yuliang, and Wei Li
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Heart Valve Prosthesis Implantation ,Pulmonary and Respiratory Medicine ,Cardiac Catheterization ,medicine.medical_specialty ,Mitral regurgitation ,business.industry ,Mitral Valve Insufficiency ,Treatment Outcome ,Echocardiography ,Internal medicine ,medicine ,Cardiology ,Humans ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
27. Differential diagnosis of PRKAG2 Cardiac syndrome in hypertrophic cardiomyopathy patients of han nationality
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Hui-Lin Xie, Wen Liu, Xianhong Shu, Xuejie Li, Cuizhen Pan, and Nianwei Zhou
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medicine.medical_specialty ,business.industry ,Sinus bradycardia ,Hypertrophic cardiomyopathy ,Autosomal dominant trait ,Atrial fibrillation ,medicine.disease ,Left ventricular hypertrophy ,Ventricular hypertrophy ,Internal medicine ,Heart failure ,RC666-701 ,hypertrophic cardiomyopathy ,prkag2 protein ,whole-exome sequencing ,medicine ,Cardiology ,cardiovascular system ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,medicine.symptom ,business ,Exome sequencing - Abstract
Objectives: This study aimed to diversify the spectrum of PRKAG2 variants and explore its clinical features in a Chinese Han population with hypertrophic cardiomyopathy (HCM). Methods: Whole-exome sequencing was performed on 200 patients diagnosed with HCM, and four causative PRKAG2 variants were identified in the probands and their relatives using Sanger sequencing. Their clinical manifestations, laboratory examinations, therapeutic methods, and outcomes were documented and analyzed. Results: Four variants were identified in six probands and seven of their relatives. Left ventricular hypertrophy was present in all probands. Five probands had sinus bradycardia, three had implanted pacemakers (PM), one developed heart failure, two had ventricular preexcitation, and one had atrial fibrillation. Conclusions: PRKAG2 cardiac syndrome (PCS) is a rare autosomal dominant disease characterized by ventricular hypertrophy, preexcitation, and progressive conduction defects, resulting in a high incidence of PM implantation. Genetic testing provides robust information for distinguishing PCS from sarcomeric HCM, which will be beneficial in guiding therapy and improving prognosis.
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- 2021
28. Reference value of perimeter‐derived diameter assessed by three‐dimensional transesophageal echocardiography in left atrial appendage occluder size selection
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Cuizhen Pan, Xiaochun Zhang, Lili Dong, Qinchun Jin, Xianhong Shu, Yingying Jiang, Dehong Kong, and Daxin Zhou
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Cardiac Catheterization ,Septal Occluder Device ,Echocardiography, Three-Dimensional ,030204 cardiovascular system & hematology ,Perimeter ,03 medical and health sciences ,0302 clinical medicine ,Reference Values ,Left atrial ,Atrial Fibrillation ,medicine ,Humans ,Atrial Appendage ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Retrospective Studies ,Appendage ,medicine.diagnostic_test ,business.industry ,Digital subtraction angiography ,Treatment Outcome ,Landing zone ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,Echocardiography, Transesophageal - Abstract
The aim of this study was to investigate the utility of perimeter-derived diameter (PDD) measured by three-dimensional (3D) transesophageal echocardiography (TEE) in predicting the size of left atrial appendage (LAA) occluder.Left atrial appendage landing zone diameter (LZD) was measured by two-dimensional (2D) TEE, 3DTEE, and digital subtraction angiography (DSA) as LZD-2Dmax, LZD-2Dmean, LZD-3Dmax, LZD-3Dmean, LZD-PDD, LZD-DSAmax, respectively, before and during transcatheter LAA closure with Watchman devices in 100 patients. A difference of one or more device size intervals between the predicted size and the size actually implanted was defined as mismatching. Seventy-eight patients were followed up by TEE to obtain occluder compression ratio. The correlation between LZD and the final implanted occluder size was 0.559, 0.641, 0.754, 0.760, 0.782, and 0.848 for LZD-2Dmax, LZD-2Dmean, LZD-3Dmax, LZD-3Dmean, LZD-PDD and LZD-DSAmax, respectively (P .001). Matching ratio between the size predicted by retrospective measurements of LZD and the device size actually implanted was 65%, 57%, 66%, 63%, 70%, and 83% for LZD-2Dmax, LZD-2Dmean, LZD-3Dmax, LZD-3Dmean, LZD-PDD and LZD-DSAmax, respectively. There was no significant difference in LZD value, matching ratio, and compression ratio between the patients with eccentric and noneccentric LAA landing zone (P .05). Compression ratio of the mismatching subjects was higher than that in the matching subjects when evaluated by LZD-2Dmean, LZD-3Dmean, and LZD-PDD (P .05).Landing zone diameter derived from LAA perimeter measured by preprocedure 3DTEE showed reference value for LAA occluder size selection, providing superior correlation and matching ratio with the final implanted size and indicating the adjustment of oversizing.
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- 2020
29. Assessment of left ventricular diastolic function after Transcatheter aortic valve implantation in aortic stenosis patients by echocardiographic according to different guidelines
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Cuizhen Pan, Yao Guo, Xianhong Shu, Minmin Sun, Haiyan Chen, and Dehong Kong
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Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Diastolic function ,Transcatheter aortic ,Transthoracic echocardiography ,Guidelines as Topic ,Regurgitation (circulation) ,Doppler imaging ,Ventricular Function, Left ,Transcatheter Aortic Valve Replacement ,Diastole ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Angiology ,Aged, 80 and over ,Transcatheter aortic valve implantation ,business.industry ,Research ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Deceleration time ,Stenosis ,Echocardiography ,lcsh:RC666-701 ,Aortic Valve ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Isovolumic relaxation time ,business - Abstract
Background To evaluate the detailed dynamic change of left ventricular diastolic function (LVDF) by echocardiography in aortic stenosis (AS) patients receiving transcatheter aortic valve implantation (TAVI) and compare LVDF classification according to 2009 ASE/EAE and 2016 ASE/EACVI recommendations. Methods Thirty-five AS patients receiving TAVI underwent echocardiography the day before operation (PRE), on the third day (3D), in the first-month (1 M) and the six-month (6 M) after TAVI. LVDF was analyzed using 2D and doppler imaging to get parameters including E/A, E/e’, isovolumic relaxation time (IVRT), deceleration time, LA area, LA volume index (LAVI) and systolic tricuspid regurgitation velocity (TR). LVDF classification was evaluated four times for each patient according to 2009 and 2016 recommendations respectively and the results were compared. Results The decrease of IVRT and TR occurred immediately post surgery up to 1-month. Improvement of E/e’ occurred late from 3-day to 1-month. LA area and LAVI decreased continuously shortly after operation till 6-month. Forty-four percent (62/140) by 2009 recommendations were reclassified with different grades when using 2016 guidelines. Comparing PRE and 6 M, with 2009 guidelines, 19 patients improved 1 grade, 8 patients improved 2 grades; with 2016 guidelines, 9 patients improved 1 grade, 13 patients improved 2 grades, 1 patient improved 3 grades. Conclusions The conventional 2D echocardiography could effectively reflect variation process of LVDF in AS patients after TAVI. For LVDD classification, obvious differences resulted by the 2009 and updated recommendations were found, and more patients can be regarded as benefiting from TAVI by 2016. recommendations.
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- 2020
30. Transcatheter Mitral Valve Edge-to-Edge Repair with a Novel System
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Yuliang, Long, Wenzhi, Pan, Cuizhen, Pan, Wei, Li, Lai, Wei, Yongjian, Wu, Yingqiang, Guo, Daxin, Zhou, and Junbo, Ge
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Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Male ,Cardiac Catheterization ,Time Factors ,Mitral Valve Insufficiency ,Middle Aged ,Treatment Outcome ,Echocardiography ,Heart Valve Prosthesis ,Feasibility Studies ,Humans ,Female ,Prospective Studies ,Aged - Abstract
The ValveClamp system is a novel edge-to-edge mitral valve repair system that is designed for ease of operation. We aimed to report the 1-year outcomes of the early feasibility study of this system.Patients with severe degenerative mitral regurgitation (MR) at higher surgical risk and who received transapical ValveClamp implantation were followed for 1 year for clinical and echocardiographic outcomes.Twelve patients (mean age, 76.5 ± 6.3 years; mean Society of Thoracic Surgery score, 6.9 ± 1.9%) were enrolled at three sites in China. At 1 year, no patient died, received reoperation, or had long-term complications. Of the 12 patients with MR of 3+ or 4+ at baseline, 11 patients (91.67%) remained with MR ≤ 2+ at 1 year, and no patient had mitral stenosis. Significant reductions in maximum MR area (from 15.1 ± 6.51 cm
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- 2022
31. A case report of transcatheter repair of severe functional mitral regurgitation in cardiac amyloidosis.
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Fangmin, Meng, Shaohua, Lu, Lai, Wei, and Cuizhen, Pan
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MITRAL valve insufficiency ,CARDIAC amyloidosis ,BRAIN natriuretic factor ,LEFT heart atrium ,HEART failure ,HOSPITAL admission & discharge - Abstract
Background Transcatheter therapy has become an alternative for functional mitral regurgitation (FMR) in patients at high surgical risk. However, the intervention of FMR in cardiac amyloidosis (CA) with transcatheter edge-to-edge repair (TEER) is controversial due to the potential risk of left atrial pressure (LAP) elevation. Case summary An 83-year-old woman with repeated heart failure (HF) and severe mitral regurgitation (MR) was referred to our centre for TEER. Pre-procedural transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) confirmed the degree of MR and a functional aetiology. A peculiar LAP increase in this patient occurred immediately after successful TEER clip implantation and her n -terminal prohormone of brain natriuretic peptide significantly increased post-operatively. The diagnosis of CA was suspected and was subsequently established through endomyocardial biopsy. Aggressive anti-HF therapy was initiated and the patient was discharged after her HF symptoms were relieved. At 6-month follow-up, the patient was still alive and no episode of acute HF was experienced. Discussion Severe functional MR in CA treated with TEER has the potential risk of increasing LAP. During the short-term follow-up, TEER appears beneficial for left heart function (reduction of MR) but harmful for right heart function (increase of LAP). CA patients with severe FMR should be carefully evaluated about the benefits and potential harm of TEER intervention. [ABSTRACT FROM AUTHOR]
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- 2023
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32. Early Assessment of Left Ventricular Function by Layer-Specific Strain and Its Relationship to Pulsatile Arterial Load in Patients with Coronary Slow Flow
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Jing Shi, Yumeng Xing, Juying Qian, Hongbo Yang, Dehong Kong, Xianhong Shu, Cuizhen Pan, Qing Li, Limin Luo, and Yan Yan
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Adult ,Male ,medicine.medical_specialty ,Heart Ventricles ,medicine.medical_treatment ,Pulsatile flow ,Strain (injury) ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Endocardium ,Aged ,business.industry ,Angiocardiography ,General Medicine ,Thrombolysis ,Middle Aged ,medicine.disease ,Coronary Vessels ,Pathophysiology ,Coronary arteries ,Compliance (physiology) ,medicine.anatomical_structure ,ROC Curve ,Echocardiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Previous studies reported a controversial left ventricular (LV) function impairment and pathophysiology in patients with coronary slow flow (CSF). Greater arterial load has been shown to increase aortic impedance and endothelial shear stress, potentially affecting coronary anatomy and function. We investigated LV systolic function by a new layer-specific strain technology and assessed the association between pulsatile arterial load and contractility.A total of 70 patients with CSF and 50 controls with normal coronary angiography were included in the study. Layer-specific longitudinal and circumferential strains were assessed from endocardium, mid-myocardium, and epicardium (global longitudinal strain (GLS)-endo, GLS-mid, GLS-epi and GCS-endo, GCS-mid, GCS-epi) by two-dimensional speckle tracking imaging (2D-STI). Pulsatile arterial load was estimated by indexed arterial compliance (ACI). Layer-specific GLS showed a decreasing gradient from the endocardium to the epicardium in both the controls and CSF group. GLS-endo and GLS-mid in the CSF group were significantly lower than the control group (all P < 0.05). Layer-specific longitudinal strain showed a good correlation with the number of affected coronary arteries (all P < 0.05) and the mean thrombolysis in the myocardial infarction frame count (TFC) (all P < 0.05). ACI was lower in patients with CSF (P = 0.005), and ACI was correlated negatively with layer-specific GLS (all P < 0.05).Layer-specific evaluation of the LV provides an understanding of the layer-specific properties of the LV wall and the possible process of the LV impairment in patients with CSF. Greater pulsatile arterial load, as manifested by a lower ACI, is coupled with worse LV longitudinal function in patients with CSF.
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- 2019
33. Right Ventricular Systolic Function and Cardiac Resynchronization Therapy
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Shengmei Qin, Zhenning Nie, Xianhong Shu, Nianwei Zhou, Quan Li, Cuizhen Pan, Xue Gong, Zhaohua Yang, Yangang Su, Lu Tang, and Shimo Dai
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lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Systolic function ,medicine.artery ,Internal medicine ,medicine ,cardiovascular diseases ,End-systolic volume ,Aorta ,response ,Ejection fraction ,business.industry ,medicine.disease ,right ventricular function ,Blood pressure ,lcsh:RC666-701 ,Heart failure ,Pulmonary artery ,cardiovascular system ,Cardiology ,business ,circulatory and respiratory physiology - Abstract
Objectives: The aim of this study was to investigate the influence of right ventricular (RV) dysfunction on the response to cardiac resynchronization therapy (CRT) and the impact of CRT on RV function in a beagle model of heart failure (HF). Methods: Twenty-one beagles were implanted with transvenous cardiac pacemakers and underwent rapid RV pacing for 2 weeks at 260 bpm to induce HF. Dogs were subsequently divided into three groups that were either treated with bi-ventricular pacing (CRT group) or untreated (control group and HF group). Echocardiographic images were acquired at baseline, before CRT, and 4 weeks after CRT. Results: Left ventricular systolic function and synchrony (left ventricular internal dimensions, left ventricular end systolic volume [LVESV], left ventricular ejection fraction [LVEF], septal-to-posterior wall motion delay [SPWMD], and aorta pre-ejection interval and the pulmonary artery pre-ejection interval [|APEI-PPEI|]) were significantly improved in the CRT group compared with the HF group. RV myocardial performance index (MPI) and pulmonary artery systolic pressure deteriorated with left ventricular dysfunction and improved after CRT. RV outflow ESV, standard deviation of time to minimum systolic volume (Tmsv), and Tmsv% decreased in the CRT group compared with the HF group. LVESV, LVEF, SPWMD, and |APEI-PPEI| were significantly different between responders and nonresponders, while there was no difference about RV functional parameters. Conclusions: RV function deteriorated with left ventricular dysfunction and improved after CRT. RV function did not significantly influence the response to CRT.
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- 2019
34. A novel user-friendly transcatheter edge-to-edge mitral valve repair device in a porcine model
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Junbo Ge, Daxin Zhou, Wenzhi Pan, Cuizhen Pan, Hasan Jilaihawi, Yue Tang, and Lai Wei
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Male ,Cardiac Catheterization ,medicine.medical_specialty ,medicine.medical_treatment ,Sus scrofa ,030204 cardiovascular system & hematology ,Prosthesis Design ,03 medical and health sciences ,0302 clinical medicine ,Epicardial echocardiography ,Mitral valve ,Materials Testing ,medicine ,Animals ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Heart Valve Prosthesis Implantation ,Mitral valve repair ,Mitral regurgitation ,business.industry ,Hemodynamics ,Mitral Valve Insufficiency ,General Medicine ,medicine.disease ,Thrombosis ,Surgery ,Disease Models, Animal ,medicine.anatomical_structure ,Clamp ,Heart Valve Prosthesis ,Infective endocarditis ,Feasibility Studies ,Mitral Valve ,Cardiology and Cardiovascular Medicine ,business ,Transapical approach - Abstract
Objectives The present study was performed to evaluate the feasibility and safety of the ValveClamp system for transcatheter edge-to-edge mitral valve repair in a porcine model. Background The ValveClamp system is a novel, transapically delivered edge-to-edge mitral valve repair system designed for ease of operation. Methods Thirteen young adult swine were enrolled in the study. The procedure was performed via the transapical approach under epicardial echocardiography guidance. Results The acute procedure success rate was 92.3% (12/13). The catheter manipulation time was just 18.5 ± 8.2 min. Four pigs were explanted on the 14th day after the procedure. One pig died at the 20th day because of pneumonia. The other eight pigs lived to the study endpoint (140 days). No pig had severe mitral valve dysfunction. The gross observation showed that the clamp device was securely attached and created a double-orifice mitral valve in all pigs except the failed one. In the eight pigs living to the endpoint, the clamp device was noted to be completely endothelialized. None of the 13 pigs developed infective endocarditis, thrombosis, thromboembolism, or valve impairment. In two pigs for which mitral regurgitation (MR) was created, the degree of MR was reduced from severe to trace after the device implantation. Conclusions It was feasible and safe to use ValveClamp to perform a catheter-mediated edge-to-edge mitral valve repair in a porcine model. This system is potentially applicable as a novel user-friendly system for the treatment of MR.
- Published
- 2018
35. Clinical outcomes of bivalirudin versus heparin in atrial fibrillation patients undergoing percutaneous left atrial appendage occlusion
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Junbo Ge, Xiaochun Zhang, Daxin Zhou, Zhiyun Shen, Qinchun Jin, Dan Zhou, Cuizhen Pan, Xian Zhang, and Dehong Kong
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medicine.medical_specialty ,medicine.drug_class ,business.industry ,medicine.medical_treatment ,Anticoagulant ,Atrial fibrillation ,General Medicine ,Heparin ,030204 cardiovascular system & hematology ,medicine.disease ,Left atrial appendage occlusion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Cardiology ,Bivalirudin ,Original Article ,030212 general & internal medicine ,Thrombus ,business ,Stroke ,Mace ,medicine.drug - Abstract
Background Prior studies have suggested that patients with atrial fibrillation (AF) referred for left atrial appendage occlusion (LAAO) are confronted with considerable risk of periprocedural thromboembolism and hemmorhagic events. The purpose of this study was to evaluate the safety and feasibility of bivalirudin during LAAO. Methods This retrospective, observational study included 420 AF patients who were evaluated as being at high risk of stroke or bleeding and indicated for LAAO at our center between June 2018 and June 2019 (158 with bivalirudin and 262 with heparin). The primary outcome was the incidence of any bleeding within 48 hours of LAAO. Secondary outcomes were major adverse cardiac events (MACE) between 48 hours and 60 days post-procedure and overall bleeding events during follow up. Results No significant difference was observed between bivalirudin and heparin for major periprocedural bleeding (1.27% for bivalirudin vs. 2.29% for heparin, P=0.716) or minor bleeding (1.27% vs. 1.15%, P>0.9). At 48 hours post-procedure, strokes occurred at a rate of 0.63% in the bivalirudin group and 1.15% in the heparin group (P>0.9), and one case treated with bivalirudin developed systemic embolization. At 60 days, the rates of MACE (1.90% vs. 2.29%, P>0.9), a device-related thrombus (DRT) (1.27% vs. 1.52%, P>0.9), and overall bleeding events (5.06% vs. 4.96%, P=0.963) were comparable between the 2 cohorts. Upon Kaplan-Meier survival analysis, early safety during the 60-day follow-up was 93.67% in the bivalirudin group and 91.60% in the heparin group (P=0.570). Conclusions Bivalirudin has a comparable safety and efficacy profile to heparin as an intraprocedural anticoagulant, but currently, it should still be reserved for patients in which heparin is contraindicated.
- Published
- 2021
36. Real-Time Monitoring and Step-by-Step Guidance for Transapical Mitral Valve Edge-to-Edge Repair Using Transesophageal Echocardiography
- Author
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Wei Li, Junbo Ge, Daxin Zhou, Cuizhen Pan, Wenzhi Pan, Xianhong Shu, Haiyan Chen, Lai Wei, and Zhenyi Ge
- Subjects
medicine.medical_specialty ,Percutaneous ,Echocardiography, Three-Dimensional ,Review Article ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Mitral valve ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Intraoperative guidance ,Heart Valve Prosthesis Implantation ,Mitral regurgitation ,business.industry ,MitraClip ,Mitral Valve Insufficiency ,Clinical Practice ,medicine.anatomical_structure ,Surgery, Computer-Assisted ,RC666-701 ,Mitral Valve ,Delivery system ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Transapical approach ,Echocardiography, Transesophageal - Abstract
MitraClip edge-to-edge (E2E) repair system is the only transcatheter device recommended in the current guidelines for treating mitral regurgitation (MR). The percutaneous femoral venous transseptal access of MitraClip requires a complex steerable delivery system and may thus be technically complex to optimally position and deploy the clip onto the mitral valve. A transapical approach for E2E repair has been devised to treat MR for the ease of operation (ValveClamp system, Hanyu Medical Technology, Shanghai). The first-in-human study of ValveClamp has demonstrated its early feasibility and effectiveness for the treatment of patients with degenerative MR. Transesophageal echocardiography (TEE) is the only imaging modality required for intraoperative guidance of ValveClamp implantation. Successful implantation depends on accurate localization and orientation of the clamp and efficient intraoperative communication between the echocardiographer and the intervention team. Thus, the focus of this review is on elaborating how two-dimensional (2D) and three-dimensional (3D) TEE are used in clinical practice to guide ValveClamp implantation and it may facilitate the understanding of simplicity and safety of this novel procedure. We also describe the implementation of several novel advancements in 3D TEE imaging, which improve the confidence of image interpretation for intraoperative guidance and expedite implantation times.
- Published
- 2021
37. Impact of Leaflet Tethering on Residual Regurgitation in Patients With Degenerative Mitral Disease After Interventional Edge-to-Edge Repair
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Zhenyi Ge, Wenzhi Pan, Wei Li, Lai Wei, Dehong Kong, Cuizhen Pan, Daxin Zhou, Xianhong Shu, and Junbo Ge
- Subjects
degenerative mitral regurgitation ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,03 medical and health sciences ,0302 clinical medicine ,Mitral valve ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,030212 general & internal medicine ,Survival rate ,minimally invasive surgery ,Original Research ,Mitral regurgitation ,Receiver operating characteristic ,business.industry ,mitral valve geometry ,Odds ratio ,Confidence interval ,Clamp ,medicine.anatomical_structure ,interventional edge-to-edge repair ,RC666-701 ,3D transesophageal echocardiography ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine - Abstract
Background: Grade 2+ residual mitral regurgitation (MR 2+) is associated with the recurrence of MR and a lower survival rate in interventional mitral valve (MV) edge-to-edge (EE) repair. We sought to determine the MV anatomic factors affecting residual MR 2+ during interventional EE repair with the ValveClamp system in patients with degenerative MR (DMR).Methods: In this multicenter study, 62 patients with significant (grade 3+ to 4+) DMR underwent ValveClamp implantation across eight centers from July 2018 to December 2019. Patient clinical, anatomical, and procedural characteristics were prospectively collected and retrospectively analyzed.Results: A single clamp was implanted in 59 patients, and two clamps were implanted in three patients. Residual MR 2+ was found in 14 patients (22.6%) immediately after the ValveClamp procedure. Patients with residual MR 2+ showed significantly larger preoperative tenting sizes and annular dimensions than the residual MR ≤1+ group. Multivariate analysis identified tenting volume as the major determinant of residual MR 2+ after ValveClamp procedures (odds ratio, 1.410 per 0.1-mL/m2 increase; 95% confidence interval, 1.167–1.705; P < 0.001). Receiver operating characteristic curves identified a tenting volume index ≥0.82 mL/m2 as the optimal cutoff point to predict residual MR 2+ (area under curve, 0.84). Patients with a tenting volume index ≥0.82 mL/m2 were more likely to develop recurrent 3+ MR or undergo MV surgery during short-term follow-up (P < 0.001).Conclusions: Preoperative assessment of the tenting volume index will help to predict intraoperative residual MR 2+ in patients with DMR receiving EE-based interventional repair. Improvements in the interventional strategy are warranted for sustained MR reduction in patients with DMR with unfavorable anatomy.
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- 2020
38. The Effect of a Novel Transcatheter Edge-to-Edge Mitral Valve Repair Device in a Porcine Model of Mitral Regurgitation
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Zhenyi, Ge, Wenzhi, Pan, Cuizhen, Pan, Daxin, Zhou, Wei, Li, Lai, Wei, Xianhong, Shu, and Junbo, Ge
- Subjects
Original Article - Abstract
BACKGROUND: A new technique has been developed for treating mitral regurgitation (MR) via a transapical approach, which encompasses an easy-to-use leaflet clamp and a smaller-sized delivery system (14F-16F). OBJECTIVES: We aimed to evaluate the effectiveness of this device in a porcine model of acute MR. METHODS: Acute MR was induced in 36 anesthetized porcine subjects by severing the chordae supporting the corresponding segment of the leaflet. The ValveClamp system was then transapically implanted on the prolapsing segment under epicardial echocardiographic guidance. Echocardiographic assessments were performed before and after the transapical interventions. All of the animals were killed 30 days after the procedure to verify the proper location of the implanted devices. RESULTS: Epicardial echocardiography revealed severe MR (n = 26) or moderate to severe MR (n = 10) in the pig model of acute MR. Overt MR reduction was observed following the procedure through echocardiography; residual MR was absent in 10 cases, mild in 17 cases, and moderate in 9 cases. There was no evidence of mitral stenosis at the end of the procedure in terms of mitral valve area and mitral valve pressure gradient. Autopsy demonstrated that all ValveClamp devices were precisely placed to clamp the prolapsing segment of the mitral valve. CONCLUSIONS: Transapical implantation of the ValveClamp device under epicardial echocardiographic guidance was effective and safe in reducing acutely induced MR in this pig model. It is potentially applicable as a novel user-friendly transcatheter edge-to-edge mitral valve repair device for the treatment of MR in humans.
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- 2020
39. Mutations in CHMP4C cause dilated cardiomyopathy via dysregulation of autophagy
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Cuizhen Pan, Weipeng Zhao, Zilong Qiu, Nianwei Zhou, Xianhong Shu, Xiaolin Wang, Yixuan Jiang, J.B. Ge, Lu Tang, and Xuejie Li
- Subjects
business.industry ,Autophagy ,Cancer research ,Medicine ,Dilated cardiomyopathy ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Abstract
Background Gene mutations have been implicated in DCM. However, due to the difficulty of clinical genetic diagnosis, more causal genes potentially related to DCM remain to be discovered. Methods We screened for gene mutations in more than 400 cases from families with hereditary cardiovascular disease using whole-exome sequencing. Then we validated biological functions of CHMP4C mutations in zebrafish models. To further assess the mechanism of CHMP4C mutations, we evaluated the potential signaling pathway in the cells. Results We identification of CHMP4C variants that segregated with DCM variants in four families from a total of 411 families via whole-exome sequencing. We further validate the function of CHMP4C in heart function in zebrafish models and found that over-expression of CHMP4C variants in zebrafish resulted in cardiac malformation, pericardial edema and increased heart rate, consistent with CHMP4C mutation-associated findings in DCM patients. Furthermore, we found that mutations in CHMP4C impaired autophagy and activated apoptosis in HEK293T cells, suggesting that the molecular mechanism of CHMP4C is involved in heart development. Conclusions CHMP4C is a novel candidate gene for DCM and may play a critical role in cardiac development by regulating autophagy. Funding Acknowledgement Type of funding source: None
- Published
- 2020
40. Three-Dimensional Transthoracic Echocardiographic Evaluation of Tricuspid Regurgitation Severity Using Proximal Isovelocity Surface Area: Comparison with Volumetric Method
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Lili Dong, Wuxu Zuo, Junbo Ge, Yu Liu, Xianhong Shu, Cuizhen Pan, Dehong Kong, Beiqi Chen, and Quan Li
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Proximal isovelocity surface area ,Population ,Echocardiography, Three-Dimensional ,Regurgitant volume ,Diagnostic accuracy ,Tricuspid regurgitation ,Regurgitation (circulation) ,Three-dimensional echocardiography ,Effective Regurgitant Orifice Area ,Sensitivity and Specificity ,Severity of Illness Index ,Internal medicine ,Image Interpretation, Computer-Assisted ,Effective regurgitant orifice area ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Prospective Studies ,education ,Aged ,Angiology ,education.field_of_study ,business.industry ,Research ,Reproducibility of Results ,General Medicine ,Middle Aged ,Tricuspid Valve Insufficiency ,lcsh:RC666-701 ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The quantification of tricuspid regurgitation(TR) using three-dimensional(3D) proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) is feasible in functional TR. The aim of our study was to explore the diagnostic accuracy and utility of 3D PISA EROA in a larger population of different etiologies. Methods One hundred and seven patients with confirmed TR underwent 2D and 3D transthoracic echocardiography (TTE). 3D PISA EROA was calculated and EROA derived from 3D regurgitant volume (Rvol) was used as the reference. Results 3D PISA EROA showed better correlation in primary TR than in functional TR(r = 0.897, P 2 vs. 0.41 cm2). The chi-square value for incorporated clinical symptoms, positive echocardiographic results and 3D PISA EROA to grade severe TR was higher than only included clinical symptoms or incorporated clinical symptoms and positive echocardiographic results (chi-square value 137.233, P Conclusion TR quantification using 3D PISA EROA is feasible and accurate under different etiologies. It has incremental diagnostic value for evaluating severe TR.
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- 2020
41. Effect of a novel transcatheter edge-to-edge repair device on the three-dimensional geometry of mitral valve in degenerative mitral regurgitation
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Daxin Zhou, Wei Li, Zhenyi Ge, Junbo Ge, Cuizhen Pan, Xianbao Liu, Xianhong Shu, Lai Wei, Wenzhi Pan, and Zhaoxia Pu
- Subjects
medicine.medical_specialty ,Echocardiography, Three-Dimensional ,Acute effect ,030204 cardiovascular system & hematology ,Transoesophageal echocardiography ,Three dimensional geometry ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Mitral valve ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Mitral regurgitation ,business.industry ,Volumetric data ,Mitral Valve Insufficiency ,General Medicine ,medicine.anatomical_structure ,Treatment Outcome ,Cardiology ,Mitral Valve ,Transcatheter mitral valve repair ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Transesophageal - Abstract
OBJECTIVES We sought to assess the acute intraprocedural effects of the ValveClamp system in DMR patients on the mitral valve (MV) three-dimensional (3D) geometry and the association of these effects with mitral regurgitation (MR) reduction. BACKGROUND Few data are available about the specific impact of transcatheter edge-to-edge repair in patients with degenerative mitral regurgitation (DMR). METHODS Thirty-five symptomatic patients (age 74.26 ± 6.61 years) with Grade 3 to 4+ degenerative MR underwent 3D transoesophageal echocardiography (TEE) during ValveClamp implantation. Volumetric data sets were retrospectively analyzed using mitral valve quantitative 3D modeling software. RESULTS Mitral valve annular anterior-posterior (AP) diameter decreased from 33.24 ± 4.03 to 31.12 ± 3.66 mm (p
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- 2020
42. Sources of Variability in Vena Contracta Area Measurement for Tricuspid Regurgitation Severity Grading: Comparison of Technical Settings and Vendors
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Junbo Ge, Lili Dong, Xianhong Shu, Dehong Kong, Wuxu Zuo, Ling Jin, Cuizhen Pan, Quan Li, Yu Liu, Yue Zhang, and Beiqi Chen
- Subjects
Echocardiography, Three-Dimensional ,Severity grading ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Area measurement ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,otorhinolaryngologic diseases ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Reproducibility ,Vena contracta ,business.industry ,Limits of agreement ,Color doppler ,Tricuspid Valve Insufficiency ,Echocardiography, Doppler, Color ,Research studies ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,Laboratories - Abstract
Background Previous studies found different cutoffs of vena contracta area (VCA) to define severe tricuspid regurgitation (TR). The aim of this study was to investigate the factors associated with such variability by comparing technical variables and vendors. Methods Sixty-nine patients with scheduled tricuspid surgery were included in this prospective study. For each patient, TR data sets were obtained on three-dimensional color Doppler transthoracic echocardiography on at least two of three systems: GE Vivid E95 (n = 39), Siemens SC2000 Prime (n = 64), and Philips EPIQ 7C (n = 60). VCA was measured using default settings or with color baseline shifted on all three platforms and with minimal color gain (10%–20%) on the GE platform. Results Color gain reduction and baseline shift caused significant change sin VCA measurement (−46% and 10%, respectively). Intervendor comparison exhibited wide limits of agreement (narrowest range, −74% to 167%), with either default or optimized settings. Different technical settings, platforms, and reference methods all produced different VCA cutoffs for severe TR. Conclusions VCA measurement in TR is sensitive to technical factors and demonstrates intervendor variability. Technical variables in VCA measurement should be reported in detail to allow comparison among research studies. The same vendor and settings should be used for longitudinal analysis of TR VCA in the same patient in multivendor echocardiography laboratories.
- Published
- 2020
43. Mutations in CHMP4C Cause Dilated Cardiomyopathy via Dysregulation of Autophagy
- Author
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Jie Cui, Nianwei Zhou, Haiyan Chen, Bo Yuan, Xiaolin Wang, Shengmei Qin, Shifang Shan, Zilong Qiu, Yingying Jiang, Junbo Ge, Cuizhen Pan, Wenqing Zhu, Xuejie Li, Minmin Sun, Xianhong Shu, and Lu Tang
- Subjects
Candidate gene ,biology ,Mechanism (biology) ,business.industry ,Autophagy ,Dilated cardiomyopathy ,Disease ,Gene mutation ,Bioinformatics ,medicine.disease ,biology.organism_classification ,medicine ,business ,Gene ,Zebrafish - Abstract
Background: Gene mutations have been implicated in DCM. However, due to the difficulty of clinical genetic diagnosis, additional causal genes potentially related to DCM remain to be discovered. Methods: We screened for gene mutations in more than 400 cases from families with hereditary cardiovascular disease using whole-exome sequencing and then validated the biological functions of CHMP4C mutations in zebrafish models. To further assess the mechanism of CHMP4C mutations, we determined the potential signaling pathway in a cell line. Results: We identified via whole-exome sequencing CHMP4C variants that segregated with DCM in four families among a total of 411 families. We further validated the function of CHMP4C in heart function in zebrafish models and found that overexpression of CHMP4C variants resulted in cardiac malformation, pericardial edema and an increased heart rate, consistent with CHMP4C mutation-associated findings in DCM patients. Furthermore, mutations in CHMP4C impaired autophagy and activated apoptosis in HEK293T cells, suggesting that the molecular mechanism of CHMP4C is involved in heart development. Conclusions: CHMP4C is a novel candidate gene causing DCM and may play a critical role in cardiac development by regulating autophagy. Funding Statement: This work was supported by NSFC Grants (# 81671685, #31625013, and #91732302); Shanghai Science and Technology Committee Foundation (#17411954400); Shanghai Brain-Intelligence Project from STCSM (16JC1420501); Strategic Priority Research Program of the Chinese Academy of Sciences (XDBS01060200); Program of Shanghai Academic Research Leader, the Open Large Infrastructure Research of Chinese Academy of Sciences; and the Shanghai Municipal Science and Technology Major Project (#2018SHZDZX05). Declaration of Interests: None. Ethics Approval Statement: The study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University (No. B2016-016(2)R).
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- 2020
44. Mechanisms, features, and significance of diastolic mitral regurgitation: a case series
- Author
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Lili Dong, Quan Li, Xianhong Shu, Cuizhen Pan, Weipeng Zhao, Wuxu Zuo, Yu Liu, and Haiyan Chen
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medicine.medical_specialty ,Diastole ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Mitral valve ,medicine ,Mechanisms ,Case Series ,AcademicSubjects/MED00200 ,cardiovascular diseases ,Mitral regurgitation ,Cardiac Imaging (Echocardiography / Cardiac MRI / Nuclear Cardiology) ,Left bundle branch block ,business.industry ,Dilated cardiomyopathy ,Atrial fibrillation ,medicine.disease ,Diastolic mitral regurgitation ,medicine.anatomical_structure ,Functional mitral regurgitation ,Cardiology ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,030217 neurology & neurosurgery - Abstract
Background Diastolic mitral regurgitation (DMR) is a type of functional mitral regurgitation. Its occurrence in the diastolic phase of cardiac cycle renders DMR an easily ignored entity. Confusing it with systolic mitral regurgitation occasionally happens. The reversal of left atrioventricular pressure gradient during diastole and the incomplete closure of mitral valve are the essential conditions for DMR. Diastolic mitral regurgitation develops under various situations, where the mechanisms of diastolic reversal of left atrioventricular pressure gradient differ. Case summary Patient 1 was a 50-year-old man diagnosed with 2:1 second-degree atrioventricular block (AVB). Patient 2 was a 70-year-old man diagnosed with first-degree AVB. Patient 3 was a 66-year-old man diagnosed with atrial fibrillation with long intermission and occasional atrial flutter with unequal conduction. Patient 4 was a 54-year-old woman diagnosed with dilated cardiomyopathy with complete left bundle branch block. Patient 5 was a 36-year-old man diagnosed with severe acute aortic regurgitation secondary to subacute bacterial endocarditis. Discussion Although the degree of DMR is relatively mild, its appearance generally prompts further clinical considerations. The appreciation of DMR has an incremental value for diagnosing and evaluating the underlying cardiovascular disease.
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- 2019
45. Role of three-dimensional transesophageal echocardiography in transcatheter aortic valve implantation of bicuspid aortic valve stenosis: A controlled study and comparison with tricuspid aortic valve stenosis
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Daxin Zhou, Xiaolin Wang, Junbo Ge, Wenzhi Pan, Nianwei Zhou, Xianhong Shu, Kefang Guo, Xiaochun Zhang, Cuizhen Pan, and Weipeng Zhao
- Subjects
Aortic valve ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Tricuspid valve ,Ejection fraction ,business.industry ,Aortic stenosis ,Perioperative ,medicine.disease ,Stenosis ,medicine.anatomical_structure ,Bicuspid aortic valve ,bicuspid ,Bicuspid valve ,lcsh:RC666-701 ,Aortic valve stenosis ,Internal medicine ,medicine ,Cardiology ,cardiovascular system ,transcatheter aortic valve replacement ,business - Abstract
Aims: This study aims to investigate the application of three-dimensional transesophageal echocardiography in aortic valve stenosis for the assessment of aortic valve ring size, to monitor the procedure of transcatheter aortic valve implantation (TAVI), and perform postoperative follow-up. Methods: Eighteen patients with bicuspid valve malformation and severe aortic stenosis bicuspid aortic valve (Group BAV-AS) and 23 patients with a tricuspid valve and severe aortic stenosis trileaflet aortic valve (Group TAV-AS) were enrolled in this study. Preoperative routine transthoracic echocardiographic (TTE) examination and two- and three-dimensional transesophageal echocardiography (2D and 3DTEE) were performed, followed by perioperative 2D and 3D TEE monitoring and postoperative routine TTE at 6-month follow-up. Results: Both BAV-AS and TAV-AS patient groups were successfully implanted with bioprosthetic valves under 3DTEE guidance. Parameters at 6-month postoperatively, including prosthetic valve orifice area, mean aortic transvalvular pressure gradient, and left ventricular ejection fraction, showed significant improvement compared with baseline measures (P < 0.0001) in both the groups. No differences were observed between the groups. The maximum diameter of the aortic annulus and eccentricity index were larger in the BAV-AS group than in the TAV-AS group, whereas the minimum diameter of the aortic annulus was larger in the latter (both P < 0.0001) after TAVI. Moreover, the values of maximum and minimum diameters on 3DTEE were strongly correlated with those on multidetector computed tomography. Conclusions: TEE is capable of clearly displaying the morphology of aortic valves and valve rings and precisely quantifying the size of the aortic annulus, thereby playing an essential role during preoperative and perioperative periods. The postoperative shape of the prosthetic valve ring was more oval (larger than normal eccentricity index) in the BAV-AS group and more circular (smaller than normal eccentricity index) in the TAV-AS group.
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- 2018
46. GW24-e1764 Speckle Tracking Imaging Combined with High Sensitive Cardiac Troponin T in Early Detection and Prediction of Cardiotoxicity during Anthracycline-based Chemotherapy
- Author
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Yu, Kang, Leilei, Cheng, Lin, Li, Haiyan, Chen, Minmin, Sun, Cuizhen, Pan, and Xianhong, Shu
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- 2013
- Full Text
- View/download PDF
47. GW24-e1771 Clinical studies of predicting response to cardiac resynchronisation therapy
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Yu, Kang, Lin, Li, Haiyan, Chen, Minmin, Sun, Yangang, Su, Shengmei, Qin, Cuizhen, Pan, and Xianhong, Shu
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- 2013
- Full Text
- View/download PDF
48. Whole-Exome Sequencing Identified a Novel Desmoglein-2 Gene Mutation Associated with Familial Arrhythmogenic Right Ventricular Cardiomyopathy
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Lu Tao, Shengmei Qin, Yili Liu Liu, Cuizhen Pan, Weipeng Zhao, Nianwei Zhou, Qiu Zilong, Shu Xianhong, and Wang Xiaolin
- Subjects
Proband ,Genetics ,Sanger sequencing ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Biology ,Gene mutation ,Genetic analysis ,symbols.namesake ,lcsh:RC666-701 ,Genotype ,Mutation (genetic algorithm) ,symbols ,whole-exome sequencing ,Arrhythmogenic right ventricular cardiomyopathy ,desmoglein-2 ,Exome ,Exome sequencing - Abstract
Objective: The objective of this study is to evaluate novel variations in a Chinese family of Han ethnicity, with arrhythmogenic right ventricular cardiomyopathy (ARVC) by the powerful technology of whole-exome sequencing (WES). Methods: Genomic DNA from representative family members was extracted and processed for WES via standardized methods. The exome sequence data were analyzed by Genome Analysis Toolkit software. Sanger sequencing was performed on DNA from the proband for genotype confirmation and from the other family members for familial co-segregation analysis. Results: A rare single nucleotide variant c.1592T>G (p.Phe531Cys) in exon 10 of desmoglein-2 (DSG2) was identified by WES in the affected individuals but not in the healthy control, which was confirmed by Sanger sequencing, suggesting that the mutation probably was a causal mutation for the familial disorder of ARVC. Conclusion: We identified a rare disease-causing mutation of the DSG2 gene associated with familial ARVC. The results might contribute to the early genetic analysis in inherited cardiomyopathies.
- Published
- 2017
49. Assessment of subclinical left ventricular changes in essential hypertensive patients with hyperuricemia: A three-dimensional speckle-tracking echocardiography study
- Author
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Xianhong Shu, Yongle Chen, Cuizhen Pan, Xiaolin Wang, Lindi Jiang, Xiao-yan Fang, Zhuojun Zhang, and Minmin Sun
- Subjects
Male ,medicine.medical_specialty ,Longitudinal strain ,Physiology ,Heart Ventricles ,Echocardiography, Three-Dimensional ,Speckle tracking echocardiography ,Hyperuricemia ,030204 cardiovascular system & hematology ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Circumferential strain ,In patient ,030212 general & internal medicine ,Aged ,Subclinical infection ,Ejection fraction ,business.industry ,Reproducibility of Results ,Stroke Volume ,Organ Size ,General Medicine ,Middle Aged ,medicine.disease ,Uric Acid ,medicine.anatomical_structure ,Echocardiography ,Ventricle ,Hypertension ,Cardiology ,Female ,Essential Hypertension ,business - Abstract
To evaluate the effect of hyperuricemia (HU) on subclinical changes of left ventricle (LV) function and structure in patients with hypertension (HT) using three-dimensional speckle-tracking echocardiography (3DSTE) and to explore the relationships between serum uric acid (SUA) levels and three-dimensional speckle tracking echocardiography (3DSTE) parameters in hypertensive and nonhypertensive patients with HU.Four age- and sex-matched groups were studied: I: healthy controls, HT- HU- (n = 40); II: HT- HU+ (n = 40); III: HT+ HU- (n = 40); IV: HT+ HU+ (n = 44). Conventional echocardiography and 3DSTE were recorded. Relative wall thickness (RWT) and left ventricular mass index assessed by M-mode echocardiography (LVMi-M) were calculated. 3DSTE parameters including LV volumes and ejection fraction (EF), LVMi-3D, global longitudinal strain (GLS), and global circumferential strain (GCS) were compared. The relationships between SUA levels and 3DSTE parameters were investigated.Despite LV diameters, LV volumes and EF were similar among groups (all p0.05), GLS decreased and LVMi-3D increased from controls (group I) to patients with HU or HT alone (group II or III), and patients with both HU and HT (group IV) (all p0.05). SUA levels were significantly correlated with the absolute value of GLS (r = -0.461, p0.05) and LVMi-3D (r = 0.504, p0.05) in hypertensive and nonhypertensive patients with HU.HU may exacerbate LV systolic dysfunction and remodeling in hypertensive patients, which can be detected by 3DSTE. Early uric acid lowing treatment may be beneficial for hypertensive patients with HU.
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- 2017
50. Anomalous Left Coronary Artery with Single Ostium (Shared with Right Coronary Artery) Detected by Echocardiography: Two Case Reports
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Cuizhen Pan, Xianhong Shu, Yingjie Zhao, Yang Liu, Haiyan Chen, and Mengruo Zhu
- Subjects
Cardiac function curve ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,coronary artery ,medicine.diagnostic_test ,business.industry ,invasive coronary angiography ,medicine.disease ,Sudden cardiac death ,Ostium ,Left coronary artery ,lcsh:RC666-701 ,Internal medicine ,Right coronary artery ,medicine.artery ,Anomalous aortic origin of a coronary artery ,Angiography ,cardiovascular system ,medicine ,Cardiology ,echocardiography ,Computed tomography angiography ,business - Abstract
Anomalous aortic origin of a coronary artery (AAOCA) from the inappropriate sinus of Valsalva has received increasing attention due to its association with malignant cardiac events in otherwise healthy and asymptomatic individuals. Despite this, we still face tremendous challenges in detecting the anomalies in a timely fashion to prevent sudden cardiac death. Here, we present two cases of anomalous left coronary artery with single ostium (shared with right coronary artery); in patients with normal cardiac function. The diagnosis of AAOCA in both cases was first suspected on transthoracic echocardiography and was later established using either coronary computed tomography angiography or invasive coronary angiography. Although angiography is the gold standard for diagnosing AAOCA, echocardiography is a more frequently used imaging modality in the workup of cardiac patients.
- Published
- 2018
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