简介：BackgroundStatinsreduceadversecardiovascularoutcomesandslowtheprogressionofcoronaryatherosclerosisinproportiontotheirabilitytoreducelow-densitylipoprotein(LDL)cholesterol.However,fewstudieshaveeitherassessedtheabilityofintensivestatintreatmentstoachievediseaseregressionorcomparedalternativeapproachestomaximalstatinadministration.MethodsWeperformedserialintravascularultrasonographyin1039patientswithcoronarydisease,atbaselineandafter104weeksoftreatmentwitheitheratorvastatin,80mgdaily,orrosuvastatin,40mgdaily,tocomparetheeffectofthesetwointensivestatinregimensontheprogressionofcoronaryatherosclerosis,aswellastoassesstheirsafetyandside-effectprofiles.ResultsAfter104weeksoftherapy,therosuvastatingrouphadlowerlevelsofLDLcholesterolthantheatorvastatingroup(62.6vs.70.2mgperdeciliter[1.62vs.1.82mmolperliter],P<0.001),andhigherlevelsofhigh-densitylipoprotein(HDL)cholesterol(50.4vs.48.6mgperdeciliter[1.30vs.1.26mmolperliter],P=0.01).Theprimaryefficacyendpoint,percentatheromavolume(PAV),decreasedby0.99%(95%confidenceinterval[CI],1.19to-0.63)withatorvastatinandby1.22%(95%CI,-1.52to-0.90)withrosuvastatin(P=0.17).Theeffectonthesecondaryefficacyendpoint,normalizedtotalatheromavolume(TAV),wasmorefavorablewithrosuvastatinthanwithatorvastatin:-6.39mm3(95%CI,-7.52to-5.12),ascomparedwith?4.42mm3(95%CI,-5.98to-3.26)(P=0.01).Bothagentsinducedregressioninthemajorityofpatients:63.2%withatorvastatinand68.5%withrosuvastatinforPAV(P=0.07)and64.7%and71.3%,respectively,forTAV(P=0.02).Bothagentshadacceptableside-effectprofiles,withalowincidenceoflaboratoryabnor-malitiesandcardiovascularevents.ConclusionsMaximaldosesofrosuvastatinandatorvastatinresultedinsignificantregressionofcoronaryatherosclerosis.DespitethelowerlevelofLDLcholesterolandthehi

简介：BackgroundAcuteinferiorandanteriormyocardialinfarctionoftenleadstorightventricular(RV)functiondecrease.EstimationofRVfunctionischallengingduetothecomplexRVgeometry.Fewstudieshavebeenconductedtoinvestiogatetheeffectsofacutemyocardialinfarction(AMI)onrightventricularfunctions(RVFs).Two-dimensionSpeckleTrackingImaging(STI)isanovelmethodthatallowsforasegmentbasedmeasurementofmyocardialdeformationandmayhavethepotentialtoquantifyRVdysfunctionmorepreciselythantheconventionalparametersofRVfunction.Therefore,inthisstudyweanalyzedtheRVfunctioninAMIpatientsbyusingthisnoveltechnique.MethodsThirty-fourpatientswithacuteinferiormyocardialinfarction(AIMI),31patientswithacuteanteriormyocardialinfarction(AAMIand30agematchedhealthyindividualswereenrolledforthestudy.2Dspeckletrackingimaging(STI)wasusedtoobtain2Dimagingattheapicalfour-chamberviewunderrestcondition.Peaksystolicstrainsandstrainratesofallsegmentsinrightventricularfreewallwereanalyzed.ResultsComparedtothenormalcontrolgroup,longitudinalpeaksystolicstrain(ε),strainrate(SRs),earlydiastolicstrainrate(SRe)andlatediastolicstrainrate(SRa)inallsegmentsofrightventricularfreewallweresignificantlylowerinAMIpatients.ε,SRs,SReandSRaofeachsegmentofRVintheAIMIgroupweredecreasedsignificantlythanthoseofthenormalcontrolgroup(P<0.05).ε,SRs,SReandSRaofeachsegmentofRVintheAAMIgroupwerelowerthantheseinthecontrolgroup.ExceptforbasalsegmentalSRa,thereweresignificantdifferencesamongotherparameters(P<0.05).ConclusionsRVFsareimpairedinAMIpatients.RVFscouldbeaccuratelyandsensitivelyassessedwithSTI.

简介：BackgroundTwo-dimensionalspeckletrackingimaging(2D-STI)andreal-timethree-dimensionalechocardiography(RT-3DE)havemoreadvantagesinevaluatingleftventricular(LV)systolicdyssynchronythantraditionalechocardiographictechniques.ThestudyaimedtoevaluateLVdyssynchronyparametersbyboth2D-STIandRT-3DE,andthecorrelationbetweenthesetwotechniques.MethodsAtotalof43chronicheartfailure(CHF)patientsand27healthyvolunteerswereenrolled.Therewere23dyssynchronyparametersselectedtoevaluateleftventricularsystolicsynchronization,involving15from2D-STIand8fromRT-3DE.ResultsFewofthedyssynchronyparametersshowednegativecorrelationswithLVejectionfraction(LVEF)intheCHFgroup.Thedifferencebetweentimetopeak-systolicradialstrainoftheanteroseptalandposteriorsegmentsatthelevelofpapillarymuscles[AS-P(RS)]from2D-STIshowedpositivecorrelationswithpartsoftheparametersfromRT-3DE(P<0.05).ConclusionsLVsystolicdysfunctiondoesnotcorrelatewithdyssynchrony.Moreover,thereisaweakassociationbetween2D-STIandRT-3DEinassessmentofleftventriculardyssynchrony.