Oscillometric 24-h ambulatory blood pressure reference values in Hong Kong Chinese children and adolescents.

Objectives: We aimed to establish community-based normal reference values of 24-h ambulatory blood pressure monitoring (ABPM) for Chinese children and adolescents. Furthermore, we investigated how excluding overweight children affects BP percentiles and compared them with German references.

Methods: In this territory-wide cross-sectional prospective cohort study, 1445 Hong Kong Chinese children and adolescents aged 8-17 years with body height between 119 and 185 cm were recruited.

Early time-dependent dynamic changes of TBET and GATA3 mRNA expressions in patients with acute coronary syndrome.

Background: T-box expressed in T cells (TBET) and guanine adenine thymine adenine sequence-binding protein 3 (GATA3) play important roles in the differentiation of Th1 and Th2 subsets, which contributes to the progression of acute coronary syndrome (ACS).

Objective: This study aimed to investigate the temporal change of TBET/GATA3 mRNA ratio in ACS.

Methods: Thirty-three patients suspected of ACS with symptom onset within 24 hours were recruited.

The association between in utero hyperinsulinemia and adolescent arterial stiffness.

Aim: To determine the relationship between in utero hyperinsulinemia and children's arterial stiffness at adolescence.

Methods: Indices of arterial stiffness were measured using the SphygmoCor apparatus in 129 adolescents (42 offsprings of mother with gestational diabetes and 87 offsprings of mother with normal glucose tolerance during pregnancy) at 15 years of age.

Results: Adolescent of mothers with gestational diabetes had similar central aortic blood pressure, augmentation pressure (AP), augmentation index (AI), and carotid-femoral pulse wave velocity (PWV) as that of controls.

Atrial dysfunction and interatrial dyssynchrony predict atrial high rate episodes: insight into the distinct effects of right atrial appendage pacing.

Introduction: Right atrial (RA) appendage pacing may prolong atrial conduction time (ACT). This study aimed to investigate if RA appendage pacing can induce intra- and interatrial dyssynchrony and if atrial dysfunction and dyssynchrony can predict atrial high rate episodes (AHREs) in the first year after pacing.

Methods And Results: Patients implanted with dual-chamber pacemakers for symptomatic bradycardia were enrolled.

Left atrial appendage closure with AMPLATZER cardiac plug for stroke prevention in atrial fibrillation: initial Asia-Pacific experience.

Background: Left atrial appendage (LAA) is the main source of left atrial thrombus that causes stroke in patients with non-valvular atrial fibrillation (NVAF). This study reported the initial safety, feasibility, and 1-yr clinical outcomes following AMPLATZER cardiac plug (ACP) implantation in Asia-Pacific region.

Methods: Twenty NVAF patients (16 males, age 68 ± 9 yr) with high risk for developing cardioembolic stroke (CHADS(2) score: 2.

Deleterious effect of right ventricular apical pacing on left ventricular diastolic function and the impact of pre-existing diastolic disease.

Aims: Right ventricular apex (RVA) pacing may have deleterious effects on left ventricular (LV) systolic function, but its impact on LV diastolic function has not been explored.

Methods And Results: Ninety-seven patients with sinus node dysfunction and ejection fraction (EF) ≥ 50% with permanent RVA pacing were randomly programmed to V-sense and V-pace modes and examined by echocardiography. Tissue Doppler imaging was employed to assess myocardial systolic velocity (S') and early diastolic velocity (E') at the mitral annulus.

Rho-kinase inhibition: a novel therapeutic target for the treatment of cardiovascular diseases.

The Rho/rho-kinase (ROCK) pathway has an important role in the pathogenesis of several cardiovascular diseases. The activation of ROCK is involved in the regulation of vascular tone, endothelial dysfunction, inflammation and remodeling. The inhibition of ROCK has a beneficial effect in a variety of cardiovascular disorders.

Impact of cardiac contractility modulation on left ventricular global and regional function and remodeling.

Objectives: This study aimed to evaluate the impact of cardiac contractility modulation (CCM) on left ventricular (LV) size and myocardial function.

Background: CCM is a device-based therapy for patients with advanced heart failure. Previous studies showed that CCM improved symptoms and exercise capacity; however, comprehensive assessment of LV structure, function, and reverse remodeling is not available.

A novel method for assessing arterial stiffness by a hydrostatic approach.

Arterial stiffness is an important index for cardiovascular events. The objective of this study is to examine possible parameters related to arterial stiffness that can be estimated during simple arm movements. An experiment was conducted on 32 subjects divided into two groups, one with an age of 26+/-4 years old, and the other 61+/-9.

Incremental prognostic value of combining left ventricular lead position and systolic dyssynchrony in predicting long-term survival after cardiac resynchronization therapy.

The efficacy of CRT (cardiac resynchronization therapy) can be affected by a number of factors; however, the prognostic significance of the LV (left ventricular) lead position has not been explored. The aim of the present study was to examine whether a PL (posterolateral) lead position has an additional value to systolic dyssynchrony in predicting a better survival after CRT. Patients (n=134) who received CRT were followed-up for 39+/-24 months.

Effect of left ventricular lead concordance to the delayed contraction segment on echocardiographic and clinical outcomes after cardiac resynchronization therapy.

Introduction: The optimal left ventricular (LV) pacing site for cardiac resynchronization therapy (CRT) is unclear. The current study aims to explore the clinical significance of LV lead concordance to delayed contraction segment in CRT.

Methods And Results: Concordant LV lead position was defined as the lead tip located by fluoroscopy at or immediately adjacent to the LV segment with latest contraction determined by tissue Doppler imaging.

Improvement of left atrial function is associated with lower incidence of atrial fibrillation and mortality after cardiac resynchronization therapy.

Background: Left atrial (LA) volume is a predictor of cardiovascular events in patients with heart failure. Improvement of LA function and reverse remodeling was observed after cardiac resynchronization therapy (CRT).

Objective: The purpose of this study was to explore the clinical significance of improvement in LA function after CRT.

Reversible left ventricular dyssynchrony and heart failure induced by right ventricular pacing.

Right ventricular (RV) pacing related heart failure is reported in some patients after long term pacing. The exact mechanism is not yet clear but may be related to left ventricular (LV) dyssynchrony induced by RV apical pacing. We report one case with baseline normal LV ejection fraction but complicated by heart failure and ventricular tachycardia after 4 months of pacing for complete heart block together with illustration of LV dyssynchrony demonstrated by tissue Doppler imaging.

Impact of atrial fibrillation in heart failure with normal ejection fraction: a clinical and echocardiographic study.

Background: The clinical significance of atrial fibrillation (AF) in heart failure with normal ejection fraction (HFNEF) remains undetermined.

Methods And Results: We compared the clinical and echocardiographic characteristics among 238 patients hospitalized for HF. Using the cutoff of left ventricular EF of 50%, there were 146 patients with HFNEF (AF = 42) and 92 with systolic HF (AF = 30).

Improvement of atrial function and atrial reverse remodeling after cardiac resynchronization therapy for heart failure.

Objectives: We sought to examine whether cardiac resynchronization therapy (CRT) improves atrial function and induces atrial reverse remodeling.

Background: Cardiac resynchronization therapy is an established therapy for advanced heart failure with prolonged QRS duration, which improves left ventricle (LV) function and is associated with LV reverse remodeling.

Methods: A total of 107 heart failure patients (66 +/- 11 years) who received CRT and were followed up for 3 months were studied.

Effect of left ventricular endocardial activation pattern on echocardiographic and clinical response to cardiac resynchronization therapy.

Objective: To explore the left ventricular (LV) electrical activation pattern in heart failure (HF) and its implication to cardiac resynchronization therapy (CRT).

Design And Setting: Observational study at the University Teaching Hospital.

Patients: 23 optimally treated patients with HF with New York Heart Association class III, QRS duration >120 ms and LV ejection fraction <35%.

Diastolic and systolic asynchrony in patients with diastolic heart failure: a common but ignored condition.

Objectives: The present study aimed to examine whether diastolic and systolic asynchrony exist in diastolic heart failure (DHF) and their prevalence and relationship to systolic heart failure (SHF) patients.

Background: Few data exist on mechanical asynchrony in DHF.

Methods: Tissue Doppler echocardiography was performed in 373 heart failure patients (281 with SHF and 92 with DHF) and 100 normal subjects.

Prognostic value of renal function in patients with cardiac resynchronization therapy.

Background: Renal insufficiency is prevalent in patients with heart failure and indicates poor prognosis. We examine (i) the relationship between left ventricular (LV) reverse remodeling (RR) and renal function and (ii) the prognostic value of renal function in patients receiving cardiac resynchronization therapy (CRT).

Methods: The relationship between LV-RR, defined as a 10% reduction in LV end-systolic volume, and renal function was examined in 85 consecutive patients receiving CRT.

Benefits of cardiac resynchronization therapy for heart failure patients with narrow QRS complexes and coexisting systolic asynchrony by echocardiography.

Objectives: This study was designed to evaluate the role of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with narrow QRS complexes (<120 ms) and echocardiographic evidence of mechanical asynchrony.

Background: Cardiac resynchronization therapy is currently recommended to advanced HF patients with prolonged QRS duration. Echocardiographic assessment of systolic mechanical asynchrony has been proven useful to predict a favorable response after CRT.

Effect of cardiac resynchronization therapy in patients with moderate left ventricular systolic dysfunction and wide QRS complex: a prospective study.

Background: We sought to investigate the effect of cardiac resynchronization therapy (CRT) on disease progression in patients with moderate left ventricular (LV) systolic dysfunction.

Methods And Results: This is a prospective study to explore the effect of CRT in 15 optimally treated patients (age: 66.1 +/- 12.

Atrial strain rate echocardiography can predict success or failure of cardioversion for atrial fibrillation: a combined transthoracic tissue Doppler and transoesophageal imaging study.

Aims: The purpose of this study was to assess the feasibility of measuring left atrial dysfunction with tissue Doppler imaging derived strain rate and to explore its role in predicting the maintenance of sinus rhythm after cardioversion for atrial fibrillation.

Methods And Results: Strain rate (SR) and tissue Doppler imaging (TDI) were performed with offline analysis of the basal left atrial wall (LA). SR detected a systolic (Ssr) and early diastolic (Esr) deformation induced by ventricular motion.