| Objectives The study was conducted to investigate the application of self-expandable occluder for transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PH) in adults, and the immediate and short-term results were assessed as well. Background Surgical closure of PDA with severe PH in adults carries higher risk than in children. Methods 29 adult patients (6 males, 23 females) underwent attempted transcatheter closure of PDA at a mean age of 31.1±11.4 years (18～58 years) and a mean weight of 54.1±7.1 kg (42～71 kg). Based on haemodynamic and clinical data that obtained before and after trial occlusion, the final duct occlusion was determined and carried out. Chest x-ray, electrocardiogram and echocardiography were used for follow-up evaluation of the treatment within 1 day, 1 month and 3 to 6 months after successful closure. Results 20 of the 29 patients had successful occlusion (named groupl), and 9 patients failed (named group2). In the groupl which occlusion was taken, mean pulmonary arterial pressures decreased significantly after trial occlusion: 78±19.3 mm Hg (50～125 mm Hg) before occlusion and 41±13.8mmHg (23～77mm Hg) after occlusion. Systemic artery oxygen saturation (SAsat) was higher than 90% in 19 patients and was lower than 90% in the other case before oxygen inhalation, and＞95% during oxygen inhalation or after occlusion in all these 20 patients. In the group2 which occlusion was given up, 2 patients were due to unavailable device, and another 2 patients were due to worsening of symptoms. The other 5 patients resulted from elevated pulmonary arterial pressures after trial closure, and their mean pulmonary arterial pressures increased by 10.3±6 mm Hg (4～16mm Hg) after trial occlusion, and SAsat was 85.5±2.6% (82.6～88%) before oxygen inhalation and 94.7±1.7% (90.7～99.1%) during oxygen inhalation. In groupl, the dimensions of left atrium, left ventricle and pulmonary artery attenuated significantly in 3 to 6 month follow-up compared with those of preocclusion. Conclusions Transcatheter closure is an effective therapy for adults with PDA associated with reversible severe PH. Further research is needed for the evaluation of long-term results. Objectives The present study was carried out to collect and analyze the clinical data of hypertrophic cardiomyopathy (HCM) in Northern China. Methods All patients were imaged with Cardiac magnetic resonance imaging (CMR), and the clinical findings were collected, including signs and symptoms, electrocardiogram, echocardiography and so on. Results 225 patients (163 males, 62 females) were defined as HCM by CMR. The age was 50.4±14.5(13～79) years. 197 patients were symptomatic, and 11 patients were associated syncope. 28 patients were asymptomatic and were found by physical exermation and anomly of electrocardiogram. Abnormal findings of electrocardiogram occurred in 216 patients. Systolic murmurs can be found in 126 patients. Echocardiography showed that left ventricular outflow obstruction occurred in 95 patients. Mitral regurgence occurred in 32 patients. 50 patients were associated with hypertension, 14 patients with coronary artery disease and 5 patients with diabetes mellitus. Conclusions Hypertrophic cardiomyopathy in Chinese patients is characterized by late onset of presentation, and the ratio of sex and clinical findings are different from those of other areas. and analyzed the distribuation and extent of hypertrophic segments. Methods All patients were imaged with CMR. The left ventricle was divided into 9 segments to describe the location, extent and function of the hypertrophic segments. Results 2025 segments of 225 patients (163 males, 62 females) were analyzed, and 650 segments were affected, which accounted for 32.1%. Asymmetrical hypertrophy was found in 222 patients, and ventricular septal hypertrophy presented in 198 patients. 67 patients presented apical hypertrophy. The thickness of hpertrophic ventricular septum was 23±5.2mm(14mm～42mm). In the patients with left ventricular outflow obstruction, the thickness of hpertrophic ventricular septum was higher than that in patients without left ventricular outflow obstruction (24.3±5.3mm vs 21.6±4.6mm, P＜0.05). The thickness of hpertrophic apex was 15.6±3.4mm(10mm～24mm). In addition, the left atrial dimension was 39.4±8.3mm(20mm～70mm) and the end diastolic left ventricular dimension was 47.8±5.5mm(29mm～70mm). CMR confirmed that left ventricular outflow obstruction occurred in 95 patients and the ventricular septum of all patients was hypertrophic. Conclusions CMR is capable of identifying regions of left ventricular hypertrophy and assessing regional contractile function of hypertrophic cardiomyopathy.Objectives The present study was carried out to collect the cardiac magnetic resonance imaging (CMR) of hypertrophic cardiomyopathy (HCM) in Northern China, and analyze the segments of delayed enhancement. Methods All patients were diagnosed with CMR. The delayed contrast-enhanced images were acquired after 5～15-min delayed. The left ventricle was divided into 9 segments to describe the location, extent and function of the hypertrophic segments. Results 154 patients (male, 107; female, 47) with contrast CMR were involved in the study. The age was 49.7±14.8 years (14～77years), height were 167.7±7.5cm (150～185cm) and weight was 70.7±11.8kg (35～101kg). Delayed enhancement was found in 95 patients (male, 71; female, 24), and no enhancement occurred in the other 59 patients(male, 36; female, 23). The thickness and number of hypertrophic segments in delayed enhancement group were higher than those in non-delayed enhancement group (24.8±5.5mm vs 20.4±3.8mm, P＜0.05; 3.3±1.9 vs 2.4±1.7, P＜0.05), and the ages were reverse (46±15.2 yr vs 55±11.9 yr, P＜0.05). The diffuse enhancement was found in 62 patients, and confluent enhancement in 33 patients. Septal alcohol ablation was performed in 14 patients, and confluent enhancement can be found in all patients.Conclusions CMR is capable of identifying regions of left ventricular hypertrophy and assessing regional contractile function. |
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