Echocardiography for Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy. The prevalence of phenotypic expression, in the absence of another systemic or cardiac disease causing increased left ventricular (LV) wall thickness, is estimated to be 1:500. The frequency of clinical presentation is far less, highlighting the need for a non-invasive diagnostic imaging tool. Echocardiography is readily available and allows for structural characterization and hemodynamic assessment of the hypertrophic heart and to screen patients at-risk for HCM, such as first degree relatives of affected individuals, and differentiate HCM from the athletic heart. Echocardiography can also be used to assess for anatomic abnormalities of the mitral valve apparatus that may exacerbate LV outflow track obstruction and to further risk stratify patients during exercise. Finally, echocardiography plays an integral role in guiding alcohol septal ablation procedures.     

舒肝解郁胶囊联合稳心颗粒治疗心脏神经症的疗效观察

目的 探讨舒肝解郁胶囊联合稳心颗粒治疗心脏神经症的临床疗效。方法 选取2017年8月-2018年8月商洛市中心医院90例心脏神经症患者为研究对象,按照随机数字表法分成对照组及观察组两组,每组45例。对照组口服稳心颗粒治疗,观察组患者在对照组的基础上口服舒肝解郁胶囊治疗,治疗2个月后,比较两组患者的临床疗效、治疗前后两组患者各症状评分、24 h动态心电图结果及症状自评量表（SCL-90）评分变化。结果 治疗后,观察组患者治疗总有效率显著高于对照组（P<0.05）。治疗后,两组患者的各症状评分较治疗前均显著降低（P<0.05）,且观察组显著低于对照组（P<0.05）。治疗后,经24 h动态心电图检查两组患者早搏、心动过速、心动过缓、非特异性STT改变的发生率较治疗前均显著降低（P<0.05）,且观察组显著低于对照组（P<0.05）。治疗后,两组患者的SCL-90量表总分较治疗前均显著降低（P<0.05）,且观察组显著低于对照组（P<0.05）。结论 舒肝解郁胶囊联合稳心颗粒可有效改善心脏神经症患者的临床症状及心电图检查结果,对提高治疗效果、改善心理健康状态具有积极意义。     

Decreases in cardiac catheter laboratory workload during the COVID‐19 level 4 lockdown in New Zealand

An increase in coronavirus disease (COVID‐19) infections prompted Level 4 lockdown throughout New Zealand from 25 March 2020. We have investigated trends in coronary and electrophysiology (EP) procedures before and during this lockdown. The number of acute procedures for ST elevation myocardial infarction remained stable. In contrast, the number of in‐patient angiograms and percutaneous intervention procedures fell by 53% compared with the previous 4 weeks in 2020 and by 56% compared with the corresponding period in 2019. Further study is required to determine the reasons for these trends.     

Surgical incision in complete video-assisted mitral valve replacement

Background Prosthetic mitral valve replacement is a common surgical treatment of mitral valve disease.Complete video-assisted mitral valve replacement represents the contemporary minimally invasive cardiac surgery in valve disease surgical therapy. In the field of minimally invasive cardiac surgery, the success of the operation is largely depending on surgical incision, it also reflects the surgeon's technique level. Method From February 2010 to February 2013, 80 cases of cardiac patients with mitral valve pathological changes in our department who had received surgical treatment of complete video-assisted mitral valve replacement were recruited, they were divided into two groups according to the surgical incision: midclavicular group(M group,n = 50) and parasternal group(P group, n = 30). The clinical data were recorded including: cardiopulmonary bypass time, aortic clamping time, volume of thoracic drainage after operation, ICU tracheal intubation time,postoperative days of hospital stay and time for observing the postoperative complications. The comparison between two groups was performed using t-test analysis. Result Both M Group and P Group had favorable surgical view, there were no emergency situation of redo median sternotomy during initial operative period or intraoperative death, no pericardial tamponade, no infection, and no other serious postoperative complications.Whereas, there were 2 cases of redo operation for stanch bleeding in M Group and 1 case of perivalvular leakage in P Group. Nevertheless, 3 months later, the result of reexamine showed that the perivalvular leakage had vanished. The clinical data was shown as follow(M Group vs. P Group): cardiopulmonary bypass time(90.2 ± 28.7 vs. 87.3 ± 24.5 min, P 0.05), aortic clamping time(65.2 ± 17.4 vs. 68.6 ± 21.9 min, P 0.05),1st day volume of thoracic drainage after operation 1(75.8 ± 35.6 vs. 53.2 ± 25.6 mL, P 0.05), ICU tracheal intubation time(9.6 ± 3.4 vs. 8.4 ± 4.5 hours, P 0.05), postoperative days of hospital stay(7.3 ± 2.2 vs. 6.9± 3.2 days, P 0.05). T-test analysis of the data of each groups showed that there were no significant statistically difference. Conclusions Appropriate surgical incisions guarantee a favorable surgical view and the success of the whole process during intraoperative period. In both midclavicular and parasternal approaches, the complete video-assisted mitral valve replacement is able to be accomplished safely and successfully. Due to the current development level of thoracoscopic instruments and equipment, the surgical incision and approach for video-assisted mitral valve replacement are diversified. As a result, diversified surgical incisions can be customized according to the variegated pathological changes of cardiac patients.