Thrombosis remains a significant cause of morbidity and mortality in many cardiovascular and cerebrovascular diseases, and thrombolysis stands out as a promising treatment method. However, the slow diffusion of thrombolytic agents within thrombi leads to delayed recanalisation. Additionally, these agents face limitations in clinical application due to their short circulation time and the risk of hemorrhagic side effects. To address these challenges, we have developed an innovative thrombolytic drug delivery platform for integrated diagnosis and treatment. This platform utilises microbubbles (MB) conjugated with RGDS (Arg-Glytem targets thrombi through interaction with alpha IIb/3 3 in activated platelets, ensuring accurate thrombus site diagnosis. These thrombus-targeted MB serve as promising carriers for efficient drug delivery, offering a potential platform for the development of thrombolytic nanomedicines with prospects for clinical translation.

Abstract Living bacterial therapy offers strong tumor‐targeting and deep penetration into hypoxic regions, but its therapeutic potential is hindered by biosafety risks from bacterial proliferation after treatment. Herein, we designed a trigger‐destructive bacterial system that combines precise tumor targeting with controllable bacterial elimination to ensure safety. Specially, sonosensitizer barium titanate nanoparticles (BTO NPs) grafted by amino silane coupling agent (γ‐aminopropyltriethoxysilane, KH550) were electrostatically anchored onto Salmonella VNP20009 to construct a nano‐biohybrid delivery system (KBTO‐VNP). Upon systemic administration, the inherent hypoxia‐targeting capability of the bacteria enabled efficient accumulation and deep penetration of the sonosensitizer into tumor tissues. In vitro studies demonstrated that, the nano‐biohybrid exhibited markedly enhanced penetration in 3D tumor spheroid models, achieving over a 100 μm increase in penetration depth compared to free nanoparticles. In vivo experiments revealed that bacterial surface modification improved the tumor‐targeting efficiency of KBTO NPs by 7‐fold. Importantly, no bacteria were recovered from normal organs after US irradiation, confirming the controllable proliferation and efficient clearance of bacteria from off‐target tissues. Therapeutic evaluations on the B16F10 subcutaneous tumor model further confirmed that KBTO‐VNP achieved remarkable tumor suppression, with an inhibition rate exceeding 96%. Moreover, immunological mechanism analysis revealed that the ultrasound‐triggered cell apoptosis released abundant tumor‐associated and bacterial antigens, which subsequently promoted robust immune cell infiltration, leading to approximately a 3‐fold increase in the intratumoral infiltration of dendritic cells and T cells. This nano‐biohybrid system offers valuable theoretical support for the advancement of sonodynamic therapy and holds great potential for future cancer treatments.

This study evaluates the association between baseline left ventricular (LV) peak strain dispersion (PSD) and 3-to-5-year cardiovascular outcomes in patients undergoing maintenance hemodialysis (MHD). This single-center retrospective cohort study screened 586 adult patients undergoing MHD at a tertiary renal unit between January 2018 and December 2020, with follow-up through June 2024. Patients were stratified by baseline PSD at the prespecified cutoff of ≥65 ms. One-to-one propensity score matching (nearest neighbor, caliper: 0.02) using 24 covariates was applied to minimize confounding. The primary outcome was major adverse cardiovascular events (MACE)-a composite of cardiovascular death, nonfatal myocardial infarction, hospitalization for heart failure, nonfatal stroke and sustained ventricular arrhythmia. Secondary outcomes included cardiovascular and all-cause mortality. Survival was analyzed using Kaplan-Meier curves, matched-pair robust Cox proportional hazards models and competing-risk sensitivity analyses. After matching, 336 patients (168 per group) were analyzed, with excellent covariate balance (all standardized mean differences <0.10). Over a median follow-up of 46.8 months, MACE occurred in 64 patients (38.1%) with high PSD and 34 patients (20.2%) with low PSD. High PSD was associated with a higher hazard of MACE (adjusted hazard ratio [aHR]: 2.05, 95% confidence interval [CI]: 1.48-2.84; p < 0.001), cardiovascular mortality (aHR: 2.18, 95% CI: 1.08-4.40; p = 0.030) and all-cause mortality (aHR: 1.58, 95% CI: 1.02-2.45; p = 0.041). Subgroup analyses demonstrated directionally consistent associations, with a stronger association in patients with impaired global longitudinal strain (interaction p = 0.03). Baseline LV PSD was associated with adverse cardiovascular outcomes in patients receiving MHD. Incorporating PSD into echocardiographic risk stratification may refine risk assessment, but multicenter prospective validation is required before threshold-based clinical implementation.

To establish an ultrasound-based radiomics model to differentiate fibro adipose vascular anomaly (FAVA) and intramuscular venous malformation (VM). The clinical data of 65 patients with VM and 31 patients with FAVA who were treated and pathologically confirmed were retrospectively analyzed. Dimensionality reduction was performed on these features using the least absolute shrinkage and selection operator (LASSO). An ultrasound-based radiomics model was established using support vector machine (SVM) and random forest (RF) models. The diagnostic efficiency of this model was evaluated using the receiver operating characteristic. A total of 851 features were obtained by feature extraction, and 311 features were screened out using the t-test and Mann-Whitney U test. The dimensionality reduction was performed on the remaining features using LASSO. Finally, seven features were included to establish the diagnostic prediction model. In the testing group, the AUC, accuracy and specificity of the SVM model were higher than those of the RF model (0.841 [0.815-0.867] vs. 0.791 [0.759-0.824], 96.6% vs. 93.1%, and 100.0% vs. 90.5%, respectively). However, the sensitivity of the SVM model was lower than that of the RF model (88.9% vs. 100.0%). In this study, a prediction model based on ultrasound radiomics was developed to distinguish FAVA from VM. The study achieved high classification accuracy, sensitivity, and specificity. SVM model is superior to RF model and provides a new perspective and tool for clinical diagnosis.

Atherosclerosis (AS), a chronic inflammatory disease and a leading cause of cardiovascular morbidity and mortality worldwide, is a significant contributor to disability. Neutrophil extracellular traps (NETs) have been closely associated with the progression of AS and plaque vulnerability. However, developing a treatment strategy that specifically targets neutrophils and effectively reduces NET release at the lesion site remains a major challenge. In this study, a biomimetic nanosystem with neutrophil-targeting properties is engineered. Coating Prussian blue nanoparticles with bacterial biomimetic membranes (MPB NPs) enables specific recognition and internalization by neutrophils. By hitching onto neutrophils, the MPB NPs scavenge intracellular reactive oxygen species (ROS) and suppress NET formation at the lesion site. Importantly, MPB NPs reduce the size of atherosclerotic plaques by 3.29-fold, from 22.53% to 6.85%, stabilize the plaques, and halt their progression in atherosclerotic mouse models. These findings suggest that MPB NPs offer a promising therapeutic strategy for atherosclerosis, and provide a versatile platform for the treatment of NET-associated diseases.

Obesity is a global epidemic and a major risk factor for cardiovascular diseases. Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric surgery, but its effect on cardiac functions remains unclear. This study aims to investigate the impact of weight loss after LSG on the left ventricular myocardial work (LVMW) in obese patients and explore the clinical value of the left ventricular pressure - strain loop (LV - PSL). Thirty - eight obese patients (body mass index ≥ 30 kg/m2) were enrolled preoperatively, and 31 patients completed the study after six months of follow - up. Clinical information, parameters from left ventricular myocardial work and traditional two - dimensional strain echocardiography were collected and analyzed. After LSG, significant reductions in body mass index (BMI), diastolic blood pressure (DBP) and weight were observed. Cardiac output (CO), stroke volume (SV), left ventricular end - diastolic volume (LVEDV), left ventricular end - systolic volume (LVESV), left ventricular ejection fraction (LVEF), Peak E, e', and a' decreased, while left ventricular mass index increased. Myocardial work parameters also showed significant changes after LSG, with global longitudinal strain (GLS) and global work efficiency (GWE) increasing and global work index (GWI), global constructive work (GCW), and global wasted work (GWW) decreasing. Significant correlations were observed between the differences in GWW and left ventricular end - diastolic diameter (LVDd), as well as between the differences in GWI and LVEDV. The differences in left ventricular mass and its index were both significantly negatively correlated with the difference in GWW. LV - PSL can effectively evaluate left ventricular myocardial work in obese patients. Weight loss after LSG can improve left ventricular myocardial work efficiency, and the associated parameter changes are related to cardiac structure, offering new clinical references.

Carotid intima thickness (CIT) and hardness coefficient (HC) are sensitive indicators of structural and functional changes in the carotid arteries in the subclinical stage of atherosclerosis. The monocyte to high-density lipoprotein cholesterol ratio (MHR), which is a biomarker of inflammation, has been shown to correlate with cardiovascular disease. The aim of this study was to assess the predictive value of CIT and HC with MHR in determining the severity of coronary artery stenosis in patients with premature coronary artery disease (PCAD). This prospective study included 85 PCAD patients who underwent coronary angiography. Patients were categorized into high-score (42 cases) and low-score (43 cases) groups based on the median Gensini score. Additionally, 41 volunteers matched by body mass index (BMI), age, and gender served as a control group. CIT, carotid media thickness (CMT) and carotid intima-media thickness (CIMT) were measured using a 24 MHz ultra-high frequency ultrasound probe. Diameter (Diam), distance (Dist), pulse wave velocity (PWV), and HC were evaluated through RF-data based quantitative analysis on vessel stiffness. Binary logistic regression identified risk factors influencing the severity of coronary artery stenosis. Receiver operating characteristic curves were plotted to evaluate the diagnostic performance of CIT, HC, and MHR, both individually and in combination, for predicting coronary artery stenosis severity in PCAD patients. CIT, HC and MHR were significantly higher in the high group than in the low and control groups. CIT (AUC = 0.731, 95

ObjectiveThis study aims to explore the value of layer-specific strain in evaluating the differences in left ventricular 18-segment myocardial function between female hypothyroidism patients and healthy controls.MethodsThirty-two female hypothyroidism patients (hypothyroidism group, HG) with normal left ventricular global systolic function and 30 healthy female volunteers (control group, CG) underwent two-dimensional echocardiography. Offline analysis using EchoPAC113 software measured peak systolic circumferential strain (PCS) and peak systolic longitudinal strain (PLS). Layer-specific strain values (endocardium, mid-myocardium, epicardium) were compared between groups.ResultsPLS of the endocardium (PLS-endo) of the posterior wall in the middle segments of the left ventricle in HG was lower than that in CG. PCS of the mid-myocardium (PCS-mid) and epicardium (PCS-epi) of all walls in the apical segments of the left ventricle in HG were lower than those in CG. In the middle segments of the left ventricle in HG, the PCS-epi of the anterior septum, PCS-mid and PCS-epi of the anterior wall, PCS-mid and PCS-epi of the inferior wall, and PCS-endo, PCS-mid, and PCS-epi of the lateral and posterior walls were lower than those in CG. In the basal segments of the left ventricle in HG, the PCS-mid and PCS-epi of the anterior wall, PCS-mid and PCS-epi of the posterior wall, PCS-epi of the inferior wall, and PCS-endo, PCS-mid, and PCS-epi of the lateral wall were lower than those in CG. The global circumferential strain (GCS) of the mid-myocardium and epicardium in the basal and apical segments, as well as all layers in the middle segment, was significantly lower in HG.ConclusionsThe layer-specific strain values in the left ventricle in female patients with hypothyroidism differed from those of healthy female controls. When evaluating the left ventricular regional myocardial function in female patients with hypothyroidism, circumferential strain was, to a certain extent, more affected by thyroid hormone abnormalities than longitudinal strain.

An adequate amount of theoretical knowledge is a prerequisite for developing hands-on competency in contrast-enhanced ultrasound (CEUS), particularly for novices. Despite the increasing adoption CEUS for liver examinations, there is currently no standardized tool to assess the competency of trainees in terms of both theoretical knowledge and practical cognitive skills, which hinders the objective evaluation of training effectiveness.The purpose of this study is to develop and validate a CEUS competency assessment for the liver (CCAL) and address the critical gap in current training paradigms. To develop and validate a CEUS competency assessment for the liver (CCAL) and address the critical gap in current training paradigms. A four-stage process was conducted as follows: ① Item Generation: The initial items were derived from a literature review and clinical guidelines. ② Qualitative Refinement: The items underwent three rounds of Delphi expert consultation (n=21 experts) and cognitive testing (n=10 trainees) for content validity and clarity. ③ Internal Validation: Psychometric properties (reliability: Cronbach’s αand Guttman split-half; validity: exploratory factor analysis and item difficulty/discrimination) were analyzed using responses from trainees (n=100). ④ External Validation: Generalizability was assessed using data from trainees (n=579) across 25 multicenter sites. The final CCAL was comprised of 66 items across three domains (demographics, self-evaluations, and objective questions), demonstrating high reliability (Cronbach’s α=0.916) and discriminant validity and revealing significant competency gaps in scanning procedures (65.6% pass rate) and image-guided intervention (38.3% pass rate), with objective questions showing balanced difficulty (63.2% easy and 3.5% difficult) and strong discrimination (61.4% good). The CCAL represents the first validated instrument designed for the objective assessment of operator competency in liver CEUS and thereby addresses an essential unmet need in current training paradigms. Furthermore, its implementation holds significant potential to standardize competency-based assessments and improve quality assurance protocols within hepatic imaging programs. Chinese Clinical Trial Registry; ChiCTR2000035750.

OBJECTIVES:To investigate the added value of strain elastography (SE) by recategorizing ultrasound (US) breast imaging reporting and data system (BI-RADS) 3 and 4a lesions. METHODS:A total of 4371 patients underwent US and SE with BI-RADS 2-5 categories solid breast lesions were included from 32 hospitals. We evaluated the elastographic images according to elasticity scores (ES) and strain ratios (SR). Three combined methods (BI-RADS + ES, BI-RADS + SR, BI-RADS + ES + SR) and two reclassified methods were used (method one: upgrading BI-RADS 3 and downgrading BI-RADS 4a, method two: downgrading BI-RADS 4a alone). The diagnostic performance and the potential reduction of unnecessary biopsies were evaluated. RESULTS:Combining BI-RADS with SE had a higher area under the curve (AUC) than BI-RADS alone (0.822-0.898 vs 0.794, P < .01). For reclassified method one, the sensitivity, specificity, and accuracy were 99.36%, 66.70%, 78.36% for BI-RADS + ES and 98.01%, 66.45%, 77.72% for BI-RADS + SR, and 99.42%, 66.70%, 78.38% for BI-RADS + ES + SR, respectively. For reclassified method two, the sensitivity, specificity, and accuracy were 99.17%, 70.72%, 80.87% for BI-RADS + ES and 97.76%, 81.75%, 87.46% for BI-RADS + SR, and 99.23%, 69.83%, 80.32% for BI-RADS + ES + SR, respectively. Downgrading BI-RADS 4a alone had higher AUC, specificity, and accuracy (P < .01) and similar sensitivity (P > .05) to upgrading BI-RADS 3 and downgrading BI-RADS 4a. Combining SE with BI-RADS could help reduce unnecessary biopsies by 17.64%-55.20%. CONCLUSIONS:Combining BI-RADS with SE improved the diagnostic performance in distinguishing benign from malignant lesions and could decrease false-positive breast biopsy rates. Downgrading BI-RADS 4a lesions alone might be sufficient for achieving good diagnostic performance. ADVANCES IN KNOWLEDGE:Downgrading BI-RADS category 4a lesions alone had higher AUC, specificity, and accuracy, and similar sensitivity to upgrading or downgrading BI-RADS category 3 and 4a lesions.

BackgroundNormal hepatic functional reserve is the key to avoiding liver failure after liver surgery. This study investigated the assessment of hepatic functional reserve using liver shear wave velocity (LSWV) combined with biochemical indicators, tumor volume, and portal vein diameter.MethodsIn this single-center prospective study, a total of 123 patients with hepatocellular carcinoma (HCC) were divided into a test group (n=92) and a validation group (n=31). All patients were Child-Pugh grade A. The indocyanine green retention rate at 15 min (ICG-R15), liver shear wave velocity (LSWV), portal vein diameter (Dpv), alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GGT), albumin (ALB), prothrombin time (PT), and also liver tumor volume (maximum diameter ≤5 cm) were measured. In the test group, multiple parameters were used to evaluate hepatic functional reserve, and the multiparametric model was established. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the multiparametric model. In the validation group, the predictive effectiveness of the multiparametric model was analyzed using consistency tests.ResultsIt was revealed that LSWV, ALB, and PT were statistically significant in evaluation of the hepatic functional reserve (P<0.05). The multiparametric model was formulated as follows: Y= -18.954 + 9.726*LSWV-0.397*ALB+2.063*PT. The value of the area under the curve (AUC) for the multiparametric model was 0.913 (95% confidence interval (CI): 0.835-0.962, P< 0.01), with a cutoff value of 16.656 (sensitivity, 0.763; specificity, 0.926). The Kappa value of consistency testing was 0.655 (P<0.01).ConclusionLSWV combined with ALB and PT exhibited a high predictive effectiveness for the assessment of hepatic functional reserve, assisting the clinical diagnosis and management of liver diseases.

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor with high morbidity and mortality. The aim of this study was to evaluate ultrasonographic findings associated with KHE.The clinical and ultrasonographic findings of a cohort of 64 cases with pathologically proven KHE were retrospectively reviewed and analyzed between November 2014 and February 2021. Two subtypes were divided according to the presence or absence of the Kasabach-Merritt phenomenon (KMP). The KMP risk factors in patients with KHE were analyzed statistically.Among the 64 cases of KHE, 43 (67.2%) were accompanied by KMP. There was a positive correlation between the appearance of KMP and tumor size. KHEs had an increased risk of developing KMP if the lesions measured were >6 cm and if they belonged to the deep or mixed subtype. On ultrasonography, all KHE lesions were heterogeneous, and 81.3% were hypoechoic; 93.8% of KHEs exhibited ill-defined margins, 68.7% had strands branching into the adjacent tissue, and 84.4% presented marked hypervascularity. Elastography showed that central hypoechogenic lesion areas were hard, and surrounding hyperechogenic lesion areas were soft.KHEs can occur in different parts of childrens' bodies. On ultrasonography, the main findings are heterogeneous low erosions, indistinct margins, branching strangulation into adjacent tissues, and obvious hypervascularity. Patients with lesions larger than 6 cm or belonging to deep or mixed subtypes (musculoskeletal infiltrates) are at risk for developing KMP, and clinicians should be vigilant.

Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional (3D) echocardiography for different ethnic groups. This study was designed to establish the normal values of 3D-left ventricular (LV) and left atrial (LA) volume and function in a nationwide, population-based cohort of healthy Han Chinese adults. A total of 1117 healthy volunteers aged 18–89 years were enrolled from 28 collaborating laboratories in China. Two sets of 3D echocardiographic instruments were used, and full-volume echocardiographic images were recorded and transmitted to a core laboratory for image analysis with a vendor-independent off-line workstation. Finally, 866 volunteers (mean age of 48.4 years, 402 men) were qualified for final analysis. Most parameters exhibited substantial differences between different sex and age groups, even after indexation by body surface area. The normal ranges of 3D-LV and 3D-LA volume and function differed from those recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging guidelines, presented by the World Alliance Societies of Echocardiography (WASE) study, and from the 2D values in the EMINCA study. The normal reference values of 3D echocardiography-derived LV and LA volume and function were established for the first time in healthy Han Chinese adults. Normal ranges of 3D-LV and 3D-LA echocardiographic measurements stratified with sex, age, and race should be recommended for clinical applications.

Three-dimensional (3D) echocardiography is an emerging technique for assessing right ventricular (RV) volume and function, but 3D-RV normal values from a large Chinese population are still lacking. The aim of the present study was to establish normal values of 3D-RV volume and function in healthy Chinese volunteers. A total of 1117 Han Chinese volunteers from 28 laboratories in 20 provinces of China were enrolled, and 3D-RV images of 747 volunteers with optimal image quality were ultimately analyzed by a core laboratory. Both vendor-dependent and vendor-independent software platforms were used to analyze the 3D-RV images. We found that men had larger RV volumes than women did in the whole population, even after indexing to body surface area, and older individuals had smaller RV volumes. The normal RV volume was significantly smaller than that recommended by the American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines in both sexes. There were significant differences in 3D-RV measurements between the two vendor ultrasound systems and the different software platforms. The echocardiographic measurements in normal Chinese adults II study revealed normal 3D-RV volume and function in a large Chinese population, and there were significant differences between the sexes, ages, races, and vendor groups. Thus, normal 3D-RV values should be stratified by sex, age, race, and vendor.

Introduction Parameters, such as left ventricular ejection fraction, peak strain dispersion, global longitudinal strain, etc. are influential and clinically interpretable for detection of cardiac disease, while manual detection requires laborious steps and expertise. In this study, we evaluated a video-based deep learning method that merely depends on echocardiographic videos from four apical chamber views of hypertensive cardiomyopathy detection. Methods One hundred eighty-five hypertensive cardiomyopathy (HTCM) patients and 112 healthy normal controls (N) were enrolled in this diagnostic study. We collected 297 de-identified subjects’ echo videos for training and testing of an end-to-end video-based pipeline of snippet proposal, snippet feature extraction by a three-dimensional (3-D) convolutional neural network (CNN), a weakly-supervised temporally correlated feature ensemble, and a final classification module. The snippet proposal step requires a preliminarily trained end-systole and end-diastole timing detection model to produce snippets that begin at end-diastole, and involve contraction and dilatation for a complete cardiac cycle. A domain adversarial neural network was introduced to systematically address the appearance variability of echo videos in terms of noise, blur, transducer depth, contrast, etc. to improve the generalization of deep learning algorithms. In contrast to previous image-based cardiac disease detection architectures, video-based approaches integrate spatial and temporal information better with a more powerful 3D convolutional operator. Results Our proposed model achieved accuracy (ACC) of 92%, area under receiver operating characteristic (ROC) curve (AUC) of 0.90, sensitivity(SEN) of 97%, and specificity (SPE) of 84% with respect to subjects for hypertensive cardiomyopathy detection in the test data set, and outperformed the corresponding 3D CNN (vanilla I3D: ACC (0.90), AUC (0.89), SEN (0.94), and SPE (0.84)). On the whole, the video-based methods remarkably appeared superior to the image-based methods, while few evaluation metrics of image-based methods exhibited to be more compelling (sensitivity of 93% and negative predictive value of 100% for the image-based methods (ES/ED and random)). Conclusion The results supported the possibility of using end-to-end video-based deep learning method for the automated diagnosis of hypertensive cardiomyopathy in the field of echocardiography to augment and assist clinicians. Trial registration Current Controlled Trials ChiCTR1900025325, Aug, 24, 2019. Retrospectively registered.

目的 应用经胸超声心动图测量中原地区常驻汉族健康青年左心室乳头肌最大径,观察左心室乳头肌形态,探讨其最大径正常参考值.方法 2021年1月-2023年5月河南省人民医院体检健康汉族青年1 194例,均行经胸超声心动图检查,于胸骨旁左心室乳头肌水平短轴切面观察乳头肌形态.选择左心室单头状乳头肌青年,于舒张末期测量左心室前外侧乳头肌(APM)、后内侧乳头肌(PPM)中段前后径、左右径,以APM或PPM前后径或左右径的最大值为左心室乳头肌最大径,采用95％医学参考值范围公式计算男、女性左心室乳头肌最大径参考值范围;采用Pearson相关法分析左心室乳头肌最大径与体质量指数(BMI)的相关性.选择同期30例健康体检者,由2名经验丰富的超声科医师行经胸超声心动图检查,测量并计算左心室乳头肌最大径,间隔1 h进行重复测量,采用组内相关系数(ICC)分析观察者间及观察者内测量的一致性.结果(1)1 194例中左心室乳头肌形态为单头状者1 106例.1 106例单头状者中,男545例,BMI为(21.31±1.67)kg/m2;女561例,BMI为(21.39±1.44)kg/m2.男性左心室APM横断面呈椭圆形366例(67.16％)、圆形179例(32.84％),PPM横断面呈椭圆形386例(70.83％)、圆形159例(29.17％).女性左心室APM横断面呈椭圆形386例(68.81％)、圆形175例(31.19％),PPM横断面呈椭圆形417例(74.34％)、圆形144例(25.66％).(2)男性青年左心室APM前后径、左右径[(8.25±1.10)、(8.29±1.13)mm]与PPM前后径、左右径[(8.29±1.03)、(8.28±1.08)mm]比较差异均无统计学意义(t=-0.538,P=0.591;t=0.231,P=0.817).女性青年左心室 APM 前后径、左右径[(7.43±1.01)、(7.46±1.06)mm]与 PPM 前后径、左右径[(7.47±1.07)、(7.43± 1.06)mm]比较差异均无统计学意义(t=-0.685,P=0.494;t=0.395,P=0.693).(3)男性青年左心室乳头肌最大径为(9.11±1.14)mm,女性青年为(8.10±1.01)mm.男性青年左心室乳头肌最大径参考值为6.87～11.34 mm,女性青年为6.12～10.07 mm.(4)男、女性青年左心室乳头肌最大径与BMI均无相关性(r=0.065,P=0.128;r=0.010,P=0.795).(5)左心室APM、PPM前后径及左右径在观察者间、观察者内测量的一致性均较好(ICC均＞0.75).结论 中原地区1 194例汉族健康青年左心室乳头肌形态以单头状、椭圆形多见,男、女性青年左心室单头状乳头肌最大径与BMI无关,男性青年左心室乳头肌最大径参考值为6.87～11.34 mm,女性青年为6.12～10.07 mm.

BackgroundLiver cirrhosis is closely associated with cardiac dysfunction. The aims of this study were to evaluate left ventricular systolic function in patients with hepatitis B cirrhosis by non-invasive left ventricular pressure-strain loop (LVPSL) technique, and to explore the correlation between myocardial work indices and liver function classification. MethodsAccording to the Child-Pugh classification, 90 patients with hepatitis B cirrhosis were further divided into three groups: Child-Pugh A group (n = 32), Child-Pugh B group (n = 31), and Child-Pugh C group (n = 27). During the same period, 30 healthy volunteers were recruited as the control (CON) group. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were derived from the LVPSL and compared among the four groups. The correlation between myocardial work parameters and Child-Pugh liver function classification was evaluated, and the independent risk factors affecting left ventricular myocardial work in patients with cirrhosis were investigated by univariable and multivariable linear regression analysis. ResultsGWI, GCW and GWE of Child-Pugh B and C groups were lower than those of CON group, while GWW was higher than that of CON group, and the changes were more obvious in Child-Pugh C group (P < 0.05). Correlation analysis revealed that GWI, GCW, and GWE were negatively correlated with liver function classification to various degrees (r = -0.54, -0.57, and -0.83, respectively, all P < 0.001), while GWW was positively correlated with liver function classification (r = 0.76, P < 0.001). Multivariable linear regression analysis showed that GWE was positively correlated with ALB (beta = 0.17, P < 0.001), and negatively correlated with GLS (beta = -0.24, P < 0.001). ConclusionsThe changes in the left ventricular systolic function in patients with hepatitis B cirrhosis were identified using non-invasive LVPSL technology, and myocardial work parameters are significantly correlated with liver function classification. This technique may provide a new method for the evaluation of cardiac function in patients with cirrhosis.