Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-cham...Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.展开更多
Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardio...Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardiography in 125 patients with one vessel disease before and 48 hours after selective coronary angioplasty. The following parameters of left ventricular diastolic function were evaluated: peak early (VE, m/s) and peak late diastolic (VA, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (DT, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular function. Results All of the patients were initially successful treated with coronary angioplasty (residual stenosis <40% ). In 98 patients( 78.4% ) stents were used to improve an inadequate result after coronary angioplasty. Both patient groups (27 patients with coronary angioplasty and 98 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after revascularisation. Surprisingly there was no significant short term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.Conclusions We suppose that stent implantation might normalize coronary blood flow faster than that of coronary balloon angioplasty.展开更多
Left ventricular assist device( LVAD) in this study is a mechanical tool that is used to support blood flow in the patient with heart disease. It supports left ventricle by building up the pressure to the pump outlet ...Left ventricular assist device( LVAD) in this study is a mechanical tool that is used to support blood flow in the patient with heart disease. It supports left ventricle by building up the pressure to the pump outlet connected to the aorta. This pump was designed based on the magnetic driven centrifugal pump with a unique small washout hole constructed inside the impeller to generate the washout flow passage to prevent the stagnation at the region underneath and around the rotor. Computational fluid dynamics( CFD) was adopted in this study to assess the performance and optimize the design to avoid recirculation and high shear stress which is the main cause of stagnation and blood damage. Transient simulation was used for this study due to the asymmetric design of the washout hole and the complication of the bottom support of the impeller that has a risk of thrombosis,also,it was used to predict the variation of hydraulic performance caused by the rotation of the impeller and pulsed flow at the pump inlet. The simulation results show no excessive stress and no recirculation observed within the computational domain; in addition,the research result also provides information for further optimization and development to the pump.展开更多
Background It’s essential to prevent from thrombosis on device without increasing the risk of bleeding complications after successfully implanted left atrial appendage device.At present,no guidelines recommend about ...Background It’s essential to prevent from thrombosis on device without increasing the risk of bleeding complications after successfully implanted left atrial appendage device.At present,no guidelines recommend about postoperative antithrombotic therapy of left atrial appendage closure(LAAC).The purpose of this study is to investigate the safety and efficacy of different antithrombotic therapies after LAAC.展开更多
Background Left ventricular dilatation and a decreased ejection fraction is one of the most serious complications in patients with Takayasu arteritis(TA).We aim to describe the prevalence,clinical features,treatment,a...Background Left ventricular dilatation and a decreased ejection fraction is one of the most serious complications in patients with Takayasu arteritis(TA).We aim to describe the prevalence,clinical features,treatment,and long-term prognosis of TA patients with this complication.展开更多
Background In an effort to avoid x-ray and contrast agents for patients of atrial fibrillation(AF)with chronic kidney disease,we developed a method for transcatheter closure of left atrial appendage(LAA)under the guid...Background In an effort to avoid x-ray and contrast agents for patients of atrial fibrillation(AF)with chronic kidney disease,we developed a method for transcatheter closure of left atrial appendage(LAA)under the guidance of transesophageal echocardiography(TEE)without fluoroscopy.展开更多
Background Cryoballoon ablation has been demonstrated to be an effective way for the treatment of atrial fibrilation(AF).However,in the population with high risk of thromboembolism,long-term oral anticoagulants are st...Background Cryoballoon ablation has been demonstrated to be an effective way for the treatment of atrial fibrilation(AF).However,in the population with high risk of thromboembolism,long-term oral anticoagulants are still in need,which lead to the odds of hemorrhage.As previous studies confirmed,left atrial appendage closure(LAAC)could decrease the risk of thromboembolism in AF patients,and may substitute for the long term anticoagulation.Therefore,we attempted to combine both these operations for AF.展开更多
Background The goal of this study was to explore the significance of left ventricular(LV)ejection/filling parameters in assessing severity and prognosis of pulmonary arterial hypertension(PAH).Methods Newly diagnosed ...Background The goal of this study was to explore the significance of left ventricular(LV)ejection/filling parameters in assessing severity and prognosis of pulmonary arterial hypertension(PAH).Methods Newly diagnosed PAH patients were recruited between July 2011 and December 2013 prospectively.Cardiopulmonary hemodynamics derived from right heart catheterization,and LV ejection/filling parameters derived from CMR were collected.Follow-up data were collected periodically using a specifically-designed network database until April 30,2016.展开更多
A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department.Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius...A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department.Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor.Chest contrast computed tomography revealed the tumor invaded right pulmonary artery,superior vena cava,and the persistant left superior vena cava flowed into the coronary sinus.The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava(SVC)utilizing ringed polytetrafluoroethylene graft.To the best of our knowledge,this was the first report of complete resection of locally advanced lung cancer involving superior vena cava,right pulmonary artery trunk and main bronchus with persistant left superior vena cava.展开更多
The problem of left-behind children appears under the background of China’s industrialization,urbanization and modernization with the deepening of its reform and opening up. From 1980s,literature began to give attent...The problem of left-behind children appears under the background of China’s industrialization,urbanization and modernization with the deepening of its reform and opening up. From 1980s,literature began to give attention to this special phenomenon.Many writers wrote about children’s psychological trauma in alienated families and social environment,and also gave suggestions on the healing of left-behind children’ psychological trauma in their works. This paper argues that the weakening of family education,the deficiency of schooling and the low social coordination are essential factors that lead to the psychological trauma of left-behind children in rural China. Joint effort from family,school and society contribute to the healing of the trauma,among which,love,writings and speeches are effective ways.展开更多
OBJECTIVE To investigate the effects of total flavonoids of bugloss(TFB) on left ventricular(LV) remodeling after myocardial infarction(MI),LV size and function was compared in mice subjected to left anterior descendi...OBJECTIVE To investigate the effects of total flavonoids of bugloss(TFB) on left ventricular(LV) remodeling after myocardial infarction(MI),LV size and function was compared in mice subjected to left anterior descending coronary artery ligation.METHODS 28 d after MI,the infarcted fraction of the LV and LV mass,systolic and diastolic function were measured.Capillary density and myocyte width in the nonischemic portion of the LV were also determined.RESULTS 28 d after MI,both groups had dilated LVs with decreased fractional shortening and lower ejection fractions.Although the infarcted size of the LV was similar in both groups,LV end-diastolic internal diameter,end-diastolic volume,and mass were lower,but fractional shortening,ejection fraction,and the maximum rate of developed LV pressure(dp/dtmax) were greater in TFB treated mice than in control mice.Impairment of diastolic func.tion,as measured by the time constant of isovolumic relaxation(t) and the maximum rate of LV pres.sure decay(dp/dtmin),was more marked in control mice than in TFB treated mice.Mortality after MI was greater in control mice than in TFB treated mice.In control mice,capillary density and myocyte width in the nonischemic portion of the LV did not differ before and 28 days after MI,whereas in TFB treated mice,capillary density increased and myocyte width declined after MI.CONCLUSION These results suggest that the presence of TFB limits LV dysfunction and remodeling in a murine model of MI in part by decreasing myocyte hypertrophy in the remote myocardium.展开更多
Finite-difference time-domain(FDTD) method is used to simulate the propagation of electromagnetic wave in left-handed material slab(LHMs) with cold plasma model The effects of optical propagation in the left-handed ma...Finite-difference time-domain(FDTD) method is used to simulate the propagation of electromagnetic wave in left-handed material slab(LHMs) with cold plasma model The effects of optical propagation in the left-handed material compared to convex lens are discussed.The wider the LHMs is,the stronger electric field of focusing image in left-handed material slab is confirmed by the simulation with various slab length.However,the outer image point location would slightly moves to the LHMs side when the length of LHMs is reduced.展开更多
【目的】为了探讨应用4D左心房自动定量分析(4D Auto LAQ)软件测定的左房容积和应变值对鉴别毛细血管前肺动脉高压和毛细血管后肺动脉高压的价值,并与肺-左心房应变偶联指数(ePLAGS)的鉴别能力进行比较。【方法】本研究为回顾性研究,共...【目的】为了探讨应用4D左心房自动定量分析(4D Auto LAQ)软件测定的左房容积和应变值对鉴别毛细血管前肺动脉高压和毛细血管后肺动脉高压的价值,并与肺-左心房应变偶联指数(ePLAGS)的鉴别能力进行比较。【方法】本研究为回顾性研究,共纳入了自2021年7月至2022年4月就诊于中山大学附属第一医院门诊或住院部的98例高概率肺动脉高压(PH)患者,收集所有患者的临床病史及实验室资料。根据肺动脉楔压(PAWP)将所有患者分为2组:毛细血管前PH组(PAWP≤15 mmHg)及毛细血管后PH组(PAWP>15 mmHg)。所纳入的患者均接受了经胸超声心动图检查,并应用4D Auto LAQ软件自动测量左房容积和应变参数。【结果】根据PAWP的数值,入选患者分为两组:毛细血管前PH组[n=39,年龄(53±24)岁]和毛细血管后PH组[n=59,年龄(57±18)岁]。与毛细血管前PH组相比,毛细血管后PH组的最大左心房容量指数(LAVImax)、最小左心房容量指数(LAVImin)和左心房射血前的容量指数(LAVIpreA)显著增加,而左心房储备期纵向应变值(LASr)和左心房导管期纵向应变值(LAScd)明显降低。多元逻辑回归分析显示,LAVImax[OR:1.40;95%CI:(1.052,1.872);P=0.021]和LAScd[OR:1.76;95%CI:(1.183,2.489);P=0.004]是检测毛细血管后PH的强大独立预测因子。ROC曲线分析表明,LAVImax(AUC=0.82,P<0.001)和LAScd(AUC=0.78,P<0.001)在预测毛细血管后PH组方面具有很高的辨别力,其临界值分别为35.69 mL/m^(2)(敏感性86%,特异性74%)和-9%(敏感性80%,特异性70%)。【结论】:应用4D auto LAQ测量的LAVImax和LAScd是区分毛细血管前和毛细血管后PH患者有价值的参数,且其鉴别能力优于肺-左心房应变偶联指数(ePLAGS)。展开更多
文摘Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.
文摘Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardiography in 125 patients with one vessel disease before and 48 hours after selective coronary angioplasty. The following parameters of left ventricular diastolic function were evaluated: peak early (VE, m/s) and peak late diastolic (VA, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (DT, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular function. Results All of the patients were initially successful treated with coronary angioplasty (residual stenosis <40% ). In 98 patients( 78.4% ) stents were used to improve an inadequate result after coronary angioplasty. Both patient groups (27 patients with coronary angioplasty and 98 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after revascularisation. Surprisingly there was no significant short term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.Conclusions We suppose that stent implantation might normalize coronary blood flow faster than that of coronary balloon angioplasty.
文摘Left ventricular assist device( LVAD) in this study is a mechanical tool that is used to support blood flow in the patient with heart disease. It supports left ventricle by building up the pressure to the pump outlet connected to the aorta. This pump was designed based on the magnetic driven centrifugal pump with a unique small washout hole constructed inside the impeller to generate the washout flow passage to prevent the stagnation at the region underneath and around the rotor. Computational fluid dynamics( CFD) was adopted in this study to assess the performance and optimize the design to avoid recirculation and high shear stress which is the main cause of stagnation and blood damage. Transient simulation was used for this study due to the asymmetric design of the washout hole and the complication of the bottom support of the impeller that has a risk of thrombosis,also,it was used to predict the variation of hydraulic performance caused by the rotation of the impeller and pulsed flow at the pump inlet. The simulation results show no excessive stress and no recirculation observed within the computational domain; in addition,the research result also provides information for further optimization and development to the pump.
文摘Background It’s essential to prevent from thrombosis on device without increasing the risk of bleeding complications after successfully implanted left atrial appendage device.At present,no guidelines recommend about postoperative antithrombotic therapy of left atrial appendage closure(LAAC).The purpose of this study is to investigate the safety and efficacy of different antithrombotic therapies after LAAC.
文摘Background Left ventricular dilatation and a decreased ejection fraction is one of the most serious complications in patients with Takayasu arteritis(TA).We aim to describe the prevalence,clinical features,treatment,and long-term prognosis of TA patients with this complication.
文摘Background In an effort to avoid x-ray and contrast agents for patients of atrial fibrillation(AF)with chronic kidney disease,we developed a method for transcatheter closure of left atrial appendage(LAA)under the guidance of transesophageal echocardiography(TEE)without fluoroscopy.
文摘Background Cryoballoon ablation has been demonstrated to be an effective way for the treatment of atrial fibrilation(AF).However,in the population with high risk of thromboembolism,long-term oral anticoagulants are still in need,which lead to the odds of hemorrhage.As previous studies confirmed,left atrial appendage closure(LAAC)could decrease the risk of thromboembolism in AF patients,and may substitute for the long term anticoagulation.Therefore,we attempted to combine both these operations for AF.
文摘Background The goal of this study was to explore the significance of left ventricular(LV)ejection/filling parameters in assessing severity and prognosis of pulmonary arterial hypertension(PAH).Methods Newly diagnosed PAH patients were recruited between July 2011 and December 2013 prospectively.Cardiopulmonary hemodynamics derived from right heart catheterization,and LV ejection/filling parameters derived from CMR were collected.Follow-up data were collected periodically using a specifically-designed network database until April 30,2016.
文摘A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department.Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor.Chest contrast computed tomography revealed the tumor invaded right pulmonary artery,superior vena cava,and the persistant left superior vena cava flowed into the coronary sinus.The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava(SVC)utilizing ringed polytetrafluoroethylene graft.To the best of our knowledge,this was the first report of complete resection of locally advanced lung cancer involving superior vena cava,right pulmonary artery trunk and main bronchus with persistant left superior vena cava.
基金Social Science Achievement Appraisal Committee Project in Hunan Province:The Revelation of Morrison’s Traumatic Thought to the Psychological Trauma’s Healing of Modern Left-behind Children(XSP17YBZZ001)Scientific Research Project of Education Department of Hunan Province:A study of Female Trauma in Toni Morrison’s novels(16C0237)
文摘The problem of left-behind children appears under the background of China’s industrialization,urbanization and modernization with the deepening of its reform and opening up. From 1980s,literature began to give attention to this special phenomenon.Many writers wrote about children’s psychological trauma in alienated families and social environment,and also gave suggestions on the healing of left-behind children’ psychological trauma in their works. This paper argues that the weakening of family education,the deficiency of schooling and the low social coordination are essential factors that lead to the psychological trauma of left-behind children in rural China. Joint effort from family,school and society contribute to the healing of the trauma,among which,love,writings and speeches are effective ways.
基金supported by National Natural Science Foundation of China (8167342 81573645) and CAMS Innovation Fund for Medical Sciences (2016-12M-3-007)
文摘OBJECTIVE To investigate the effects of total flavonoids of bugloss(TFB) on left ventricular(LV) remodeling after myocardial infarction(MI),LV size and function was compared in mice subjected to left anterior descending coronary artery ligation.METHODS 28 d after MI,the infarcted fraction of the LV and LV mass,systolic and diastolic function were measured.Capillary density and myocyte width in the nonischemic portion of the LV were also determined.RESULTS 28 d after MI,both groups had dilated LVs with decreased fractional shortening and lower ejection fractions.Although the infarcted size of the LV was similar in both groups,LV end-diastolic internal diameter,end-diastolic volume,and mass were lower,but fractional shortening,ejection fraction,and the maximum rate of developed LV pressure(dp/dtmax) were greater in TFB treated mice than in control mice.Impairment of diastolic func.tion,as measured by the time constant of isovolumic relaxation(t) and the maximum rate of LV pres.sure decay(dp/dtmin),was more marked in control mice than in TFB treated mice.Mortality after MI was greater in control mice than in TFB treated mice.In control mice,capillary density and myocyte width in the nonischemic portion of the LV did not differ before and 28 days after MI,whereas in TFB treated mice,capillary density increased and myocyte width declined after MI.CONCLUSION These results suggest that the presence of TFB limits LV dysfunction and remodeling in a murine model of MI in part by decreasing myocyte hypertrophy in the remote myocardium.
基金Supported by the National Natural Science Foundation of China(60601028)
文摘Finite-difference time-domain(FDTD) method is used to simulate the propagation of electromagnetic wave in left-handed material slab(LHMs) with cold plasma model The effects of optical propagation in the left-handed material compared to convex lens are discussed.The wider the LHMs is,the stronger electric field of focusing image in left-handed material slab is confirmed by the simulation with various slab length.However,the outer image point location would slightly moves to the LHMs side when the length of LHMs is reduced.
文摘【目的】为了探讨应用4D左心房自动定量分析(4D Auto LAQ)软件测定的左房容积和应变值对鉴别毛细血管前肺动脉高压和毛细血管后肺动脉高压的价值,并与肺-左心房应变偶联指数(ePLAGS)的鉴别能力进行比较。【方法】本研究为回顾性研究,共纳入了自2021年7月至2022年4月就诊于中山大学附属第一医院门诊或住院部的98例高概率肺动脉高压(PH)患者,收集所有患者的临床病史及实验室资料。根据肺动脉楔压(PAWP)将所有患者分为2组:毛细血管前PH组(PAWP≤15 mmHg)及毛细血管后PH组(PAWP>15 mmHg)。所纳入的患者均接受了经胸超声心动图检查,并应用4D Auto LAQ软件自动测量左房容积和应变参数。【结果】根据PAWP的数值,入选患者分为两组:毛细血管前PH组[n=39,年龄(53±24)岁]和毛细血管后PH组[n=59,年龄(57±18)岁]。与毛细血管前PH组相比,毛细血管后PH组的最大左心房容量指数(LAVImax)、最小左心房容量指数(LAVImin)和左心房射血前的容量指数(LAVIpreA)显著增加,而左心房储备期纵向应变值(LASr)和左心房导管期纵向应变值(LAScd)明显降低。多元逻辑回归分析显示,LAVImax[OR:1.40;95%CI:(1.052,1.872);P=0.021]和LAScd[OR:1.76;95%CI:(1.183,2.489);P=0.004]是检测毛细血管后PH的强大独立预测因子。ROC曲线分析表明,LAVImax(AUC=0.82,P<0.001)和LAScd(AUC=0.78,P<0.001)在预测毛细血管后PH组方面具有很高的辨别力,其临界值分别为35.69 mL/m^(2)(敏感性86%,特异性74%)和-9%(敏感性80%,特异性70%)。【结论】:应用4D auto LAQ测量的LAVImax和LAScd是区分毛细血管前和毛细血管后PH患者有价值的参数,且其鉴别能力优于肺-左心房应变偶联指数(ePLAGS)。
