Left ventricular function in male patients with secondary hypogonadism

BACKGROUND: In addition to the effects on ventricular repolarization, testosterone could also affect left ventricular performance. The enhancement of left ventricular contractility in testosterone-deficient rats following testosterone replacement implies to the possible testosterone effect. OBJECTIVES: The aim of the current study is to reveal the alterations of left ventricular functions, if any, in secondary hypogonadal male patients. METHODS: Thirty-four males with secondary hypogonadism comprised the study group. The control group consisted of 30 healthy subjects. Echocardiographic measurements including left ventricular dimensions, ejection fraction, mitral inflow, and left ventricular outflow parameters were obtained from all subjects. Tissue Doppler parameters were also measured from left ventricular lateral wall and interventricular septum. RESULTS: Left ventricular diameters, wall thicknesses, and performance parameters were similar in both groups. Mitral inflow parameters showed a statistically insignificant difference. Pulse-wave tissue Doppler interpretation of hypogonadal and healthy subjects were similar in terms of lateral and septal basal segment Sm, Em, and Am wave velocities. CONCLUSIONS: Regarding the findings of previous studies that showed impaired myocardial contractility and lusitropy in testosterone deficient rats and our study results, further studies are needed for better understanding of testosterone's effects on human myocardium.     

经食道超声观察心肺复苏时胸外心脏按压的血流动力学变化

目的　探讨心肺复苏时胸外心脏按压的血流动力学机制。方法　 6例心搏骤停患者均为2 0 0 0～ 2 0 0 1年心内科患者 ,男性 5例 ,女性 1例。在心肺复苏胸外按压时用变频多平面食道超声及彩色多普勒观察心脏改变。结果　所有 6例病人 ,在胸外按压阶段 ,二尖瓣关闭 ,主动脉瓣开放。主动脉瓣峰值血流速度为 (5 9 0± 13 0 )cm/s。在放松阶段 ,二尖瓣开放 ,主动脉瓣关闭 ,二尖瓣峰值血流速度平均为(6 0 0± 2 0 0 )cm/s。在按压末左室内径明显减小为 (32 1± 7 1)mm ,放松末增大为 (42 1± 12 9)mm (P<0 0 5 )。按压末左室容积为 (39 0± 8 9)ml,放松末 (6 8 8± 2 1 7)ml (P <0 0 5 )。按压频率为 10 0次 /min ,心排血量为 (2 8± 0 8)L/min。按压时有创血压为 6 0～ 80 / 10～ 30mmHg,指端血氧饱和度可达 98%～99 %。结论　在实行心肺复苏胸外心脏按压的过程中 ,食道超声可清楚地显示二尖瓣关闭、主动脉瓣开放 ,左室容积减小 ,产生前向血流 ,支持心泵机制     

老年原发性高血压患者左心房/左心室容量比值的变化

目的本文旨在探讨老年原发性高血压患者左心房容量／左心室容量比值变化的临床意义。方法老年正常对照组32例。老年原发性高血压无室壁肥厚患者35例，老年原发性高血压患者伴室壁肥厚者33例。应用实时三维三平面显像方式测量左房、左室容量，对3组病人的左房容量，左房内径，左房容量指数和左心房容量／左心室容量比值进行分析。结果左房容量，左房内径，左房容量指数和左心房容量／左心室容量比值在高血压室壁肥厚组与对照组之间均存在极显著差异（P〈0．01），但左房内径在原发高血压无室壁肥厚组与对照组之间无显著差异（P〉0．05）。左房容量、左房容量指数在原发高血压无室壁肥厚组与对照组之间差异有显著性（P〈0．05），左心房容量／左心室容量比值在原发高血压无室壁肥厚组与对照组之间差异更为显著（P〈0．01）且变异性最小。结论左心房容量／左心室容量比值是一种新的参数，能够灵敏地反映老年原发性高血压患者舒张功能减低的血流动力学改变。     

右心系统感染性心内膜炎的超声诊断

分析经手术证实的１２例先天性心脏畸形并发右心系统感染性心内膜炎的临床及超声资料，认为该种无创性检查可作为感染性心内膜炎的主要诊断方法。讨论了误诊和漏诊的原因以及如何提高右心系统感染性心内膜炎的检出率。     

超声心动图对中老年房间隔缺损封堵术后左心房收缩功能的研究

目的探讨中老年房间隔缺损（ASD）封堵术后左心房功能变化的特征。方法选择33例ASD患者分别于封堵术前、术后48h及术后3个月分别从机械运动、血流变化、压力变化及组织运动来研究左心房收缩功能。结果封堵术后3个月左心房充盈分数、左房收缩分数及左房射血力较术前明显增高（P〈0．05）,左房射血分数、左房动能明显减低（P〈0．05）,但心房收缩期心肌组织运动峰速,左房电机械时间。左房压术前术后无明显变化（P〉0．05）。结论中老年房间隔缺损封堵术后3个月左房收缩功能各指标较术前有明显改变。