简介:Heartfailure(HF)isacomplexclinicalsyndromethatresultsfromanystructuralorfunctionalimpairmentofventricularfillingorejectionofblood.HFisoneofthemostimportantandsevereendstagesofmanycardiovasculardiseases.EpidemiologicalstudiesofHFhavefocusedmainlyontheprevalence,incidence,mortality,fatality,anddistributionandtemporaltrendsoftheseindicatorsamongdifferentpopulations.ThisreviewhighlightsimportantepidemiologicalstudiesofHFinChina.
简介:BackgroundMyocardialbloodflow(MBF)canbequantifiedwithmyocardialcontrastechocardiography(MCE)duringavenousinfusionofmicrobubble.AminimalMBFisrequiredtomaintaincellmembraneintegrityandmyocardialviabilityinischemiccondition.Thus,wehypothesizedthatMCEcouldbeusedtoassessmyocardialviabilitybythedeterminationofMBF.MethodsandResultsMCEwasperformedat4hoursafterligationofproximalleftanteriordescendingcoronaryarteryin7dogswithconstantvenousinfusionsofmicrobubbles.Thevideointensityversuspulsingintervalplotsderivedfromeachmyocardialpixelwerefittedtoanexponentialfunction:y=A(1-e-βt),whereyisⅥatpulsingintervalt,Areflectsmicrovascularcross-sectionalarea(ormyocardialbloodvolume),and(3reflectsmeanmyocardialmicrobubblevelocity.TheproductofA·β representsMBF.MBFwasalsoobtainedbyra-diolabeledmicrospheremethodserveredasreference.MBFderivedbyradiolabeledmicrosphere-methodinthere
简介:ObjectivesIschemiainducedarrhythmia(ventriculartachycardia/ventricularfibrillation)isoneofthemajorcausesofdeath.Potassiumchannelschangearelikelytoberesponsiblefortheischemia-relatedarrhythmias.Cardiacpotassiumcurrentisthemajoroutwardcurrentinvolvedincardiacrepolarization.Thepropertiesofpotassiumchannelshavebeenintensivelystudied.Here,weinvestigatedtheassociationbetweenischemiainducedarrhythmiaandpotassiumchannelsgeneticvariations.Methods23patientswithventriculartachycardia/ventricularfibrillationinducedbyischemiawereselectedasobjects.5MLperipheralbloodweretakenfromeachperson,fromwhichDNAwasextractedus-ingastandardenzymaticphenol-chloroformmethod.Candidategenes(HERG、KCNJ2、KCNQ1、Mink、Mirp1、Kir2.1、KV4.3、Kir3.1、KV1.5、Kir6.1、Kir6.2、Kir2.1)Werescreenedforpotassiumchannelsgenemutationswithdirectsequencingmethods.ResultsHere4potassiumchannelsgenemutationshavebeendiscovered.InthegenecodingfortheATP-sensitiveK~+channelssubunitKir6.2,thereisachangefromvalinetoisoleucineatthepositionof326(V326I).Attheposition448,argininesubstitutesproline(P448R)intheKC-NQ1gene.InthegeneKCNJ2twomutationshavebeenfound(P156L,Q193H).ConclusionsThisstudyimplicatedthatthereisahighrelationshipbetweenischemiainducedarrhythmiaandthemutationofpotassiumchannels.Inordertoidentifythepreciselyrelationshipthereisneedfunctionalanalysis.
简介:BackgroundMicroRNAshaverecentlybeenconsideredasbiomarkersinseveraldifferentcardiovasculardiseases,however,sofartherearenocirculatingmiRNAsdataabouthypertension.Therefore,theaimofthepresentpilotstudywastoidentifycirculatingmiRNAsforhypertensionbiomarkers.MethodsUsinganAgilentmicroarray,plasmamiRNAswereprofiledfromplasmasamplesof10patientswithuntreatedessentialhypertensionand10healthycontrols.CandidatebiomarkersidentifiedintheprofilesweresubjectedtovalidationbyusingquantitativePCRinanindependentsamplesetof20patientswithuntreatedessentialhypertensionand20healthycontrols.Then,weassessedtheselectedmiRNAsforthedetectionanddiagnosisofhypertensionfromplasmasamplesof70patientswithuntreatedessentialhypertensionand20healthycontrols.TheSpearmancorrelationcoefficientwasusedtoassessedtheselectedmiRNAscorrelationswithbloodpressure.Theareaunderthereceiveroperatingcharacteristiccurve(AUC)wasusedtoevaluatediagnosticaccuracy.ResultsTheexpressionsofselected8miRNAswereinvestigatedindependentlyinplasmasamplesfrom10hypertensionpatientsand10healthysubjects.ThelevelsofcirculatingmiR-30c-5p,miR-133b,miR-29b-3p,miR-29a-3p,miR-29c-3p,miR-30a-3p,miR-let7b-3pexpressionweresignificantlydownregulatedinhypertensiongroupcomparedwithhealthygroupandthelevelofhsa-miR-92b-3pwassignificantlyunregulatedbetweenthegroups.WeusedqRT-PCRassaytoconfirmtheexpressionof8candidatemiRNAs,miR-30c-5p(P<0.001),miR-29b-3p(P<0.001),miR-29a-3p(P=0.027),miR-29c-3p(P<0.001),miR-92b-3p(P=0.003),miR-30a-3p(P=0.704),miR-133b(P=0.346),andmiR-let7b(P=0.161).ThediagnosticaccuracyofmiR-30c-5p,miR-29b-3p,miR-29a-3p,miR-29c-3pandmiR-92b-3p,asmeasuredbyAUC,were0.897,0.90,0.829,0.825and0.832,respectively,withallP<0.001.ConclusionsTheplasmalevelsofmiR-30c-5p,miR-29b-3p,miR-29a-3p,miR-29c-3pandmiR-92b-3passociatedwithhypertensionwhichprovideanimp
简介:ObjectivesToevaluatethechangesoftheplasmaendothelinlevelinpatientswithdilatedcardiomyopathy,andtoinvestigatetherelationshipbetweentheplasmaendothelinlevelandtheseverityofheartfailure,heartsize,leftventricularfunctionandwithornotwithpulmonaryarterialhypertension;thechangesoftheplasmaendothelinlevelbeforeandaftertreatment.MethodsTheplasmaendothelinlevelof30patientswithDCM,30healthycontrolsubjects,andtheirLVEF,PAP,heartsize,plasmaendothelinlevelbeforeandaftertreatmentweredetermined.ResultsTheplasmaendothelinlevelinDCMgroupwassignificantlyhigherthanthatincontrolgroup(135.93±70.65pg/mL)vs(43.65±12.07pg/mL),P<0.05;therewasacorrelationbetweenETlevelandheartsize(r=0.4580,P=0.0109);therewasasignificantnegativecorrelationbetweenLVEFofDCMandETlevel(r=-0.6922,P=0.0021);anditwasasignificantpositivecorrelationbetweenETlevelandpulmonaryarterialhypertension(r=0.8974,P<0.0005).Aftertreatment,theETleveldecreasedsignificantlythanbeforeinDCMgroup(129.15±43.93pg/mL)vs(63.12±22.20pg/mL),P<0.05.ConclusionsPlasmaETlevelmaybeanewparameterofevaluatingseverityofheartfailure,efficacyoftherapyandprognosis.
简介:ObjectivesToinvestigateserumconcentrationofprocollagentypeIcarboxyterminalpeptide(PIP),typeⅢaminopeptide(PⅢP)andtypeIcollagentelopeptide(ICTP)inessentialhypertension(EH).MethodsSerumlevelsofPIP,PⅢPandICTPin42EHpatientsand30healthycontrolweremeasuredbyradioimmunoassays.ResultsInEHpatients,serumconcentrationofPIP,PⅢPwassignificantlyhigherthanthatin30healthycontrol.AlthoughEHpatientsdidtendtoexhibitahigherserumICTPconcentrationthannormalcontrolsubjects,thedifferencewasnotstatisticallysignificant.EHpatientswithleftventricularhypertrophyexhibitedhighervaluesofPIP(P<0.05)andlowervaluesofICTP(P<0.05)thanEHpatientswithoutleftventricularhypertrophy.NosignificantdifferencewasnotedbetweentheserumPⅢPoftheEHpatientswithandwithoutleftventricularhypertrophy(P>0.05).ConclusionsTheresultssuggestthatPIPandPⅢParesensitiveserummarkersofmyocardialcollagensynthesis.Myocardialfibrosismaybeduetotheexcessivesynthesisandinsufficientdegradationofcollagen.PIP,PⅢPandICTPmaybeindirectmarkersofmyocardialfibrosis.
简介:BackgroundClinicalapplicationofimplantablecardioverterdefibrillator(ICD)cansignificantlyreducetheincidenceofsuddencardiacdeath(SCD).However,ICDcannotpreventventriculartachycardia(VT)orventricularfibrillation(VF).PreviousstudiesindicatedthatICDcombinedwithreasonableanti-arrhythmicdrugtherapycanimproveanti-arrhythmiceffect.EMIAT,CAMIAandOPTICtrialsreportedthatcombinedtreatmentofAmiodaroneandβreceptorblockerswassuperiortotheirtreatmentalone.Therefore,itisnecessarytogiveanti-arrhythmictreatmentafterICDimplantation.MethodsTotally180ICDimplantationrecipientsenrolledinourhospitalfromJan2011toMarch2014.Amongthem,39recipientsweretreatedwithAmiodarone(GroupA),89recipientsweretreatedwithβblocker(GroupB),and52recipientsweretreatedwithAmiodaronecombinedwithβblocker(GroupC)afterICDimplantation.Patientswerefollowedupfor3to40monthsbymonitoringtheheartrate,LVEFValueandrapidventriculararrhythmiasevents.ResultsTherewerenosignificantdifferencesonheartratebeforeandafterICDimplantationamongthethreegroups(P=1.28,P=0.85),butthechangeofheartratewasstatisticallyhigher(P=0.04)inGroupBcomparedwithGroupAandGroupC.TherewerenostatisticalsignificanceinLVEFvaluebeforeICDimplantationandafterICDimplantationandthechangeofLVEFvalue(P=0.56,P=0.50,P=0.99).TheoccurrencerateofrapidventriculararrhythmiasinGroupA(10.26%)andGroupB(10.11%)wassignificantlyhigher(P=0.04)thaninGroupC(1.92%).whichwaeslightlyincreasedbyAmiodaroneinGroupAandGroupC.Therewere2casesofthyroiddysfunctioninGroupA,1caseinGroupCandnocaseinGroupB.Nopulmonaryinterstitialfibrosiscaseswerefoundinthisstudy.ConclusionsCombinedtreatmentwithAmiodaroneandβreceptorblockerscouldsignificantlyreducerapidventriculararrhythmiaswhencomparedwithtreatmentofAmiodaroneorβblockeralone.
简介:ObjectivesToinvestigatetheanti-apoptoticeffectsofmesenchymalstemcells(MSCs)onhypoxicinjuredcardiacmyocytesinvitro.MethodsMSCswereisolatedfrombonemarrowofSprague-Dawley(SD)rats,andcardiacmyocytesfromneonatalrats.Theratcardiacmyocyteswereco-culturedwithMSCsorMSC-conditionedmediainanoxia(95%N2+5%CO2)for72hours.CellapoptosiswasmeasuredbyHoechst33258staining.TheexpressionofBcl-2andBaxincardiacmyocyteswastestedbyWesternBlot.ResultsTheapoptoticratewas51.6%±2.4%whencardiacmyocyteswereculturedincontinuoushypoxiaandwassignificantlydecreasedwhencardiacmyocyteswerecoculturedwithMSCsorMSC-conditionedmedia(15.1%±5.4%and24.0%±4.2%respectively,P<0.001).ThedecreasedexpressionofBaxinthecardiacmyocyteswasgreatlyrelatedtothedecreasingofapoptosis,buttherewasnodifferenceinBcl-2expressionamongthesegroups.ConclusionsCo-culturedMSCsshowedsignificantanti-apoptoticeffectsoncardiacmyocytesincontinuoushypoxia.ThemechanismmaybetheinteractofcelltocellandparacrineofcytokineswhicheffectedtheexpressionofBaxinthecardiacmyocytes.
简介:ObjectivesTodetectionofchlamydiapneumoniae(Cpn)DNAinthecirculatingmononuclearcellfractionsofcoronaryheartdiseaseandtoinvestigatetheassociationbetweeninfectionwithchlamydiapneumoniaeandcoronaryheartdisease(CHD)andprospectivelywhetherblood-basednestedpolymerasechainreaction(nPCR)isusefulinidentifyingCpninfection.MethodsTheperipheralbloodmononuclearcell(PBMC)CpnDNAwasexaminedusingnPCRtechniqueandconfirmedbyelectrophoresisin150patientswithCHD.Select55patientswithclinicalsuspectedCHDbutangiographyresultarenormalascontrolgroup(CG).Thenweconductedaprospective,randomized,double-blind,placebo-controlledstudyof6monthsofazithromycinandplacebotreatmentinCHDgroup.PatientswithCpnDNApositivewerethenrandomizedtoreceiveazithromycinorplacebo.Aftertreatmentbloodsamplewerecollectedforrepeatedmeasurement.ResultsChlamydiapneumoniaeDNAwasdetectedin49(32.7%)of150personswithCHDandin1(1.8%)of55personswithcontrolgroup,oddsratio26.2,95%confidenceinterva13.52-194.98.ThepositivityratesofnPCRinCHDgroupswerehigherthanthoseincontrolgroup.16cases(29.1%)inlatentcoronaryheartdiseases(LCHD)group,19cases(39.6%)inunstableangina(UAP)group,and14cases(29.9%)inacutemyocardialinfarction(AMI)groupwereCpnpositivebynPCR.TherewerenosignificantdifferenceamonginAMIUAPandLCHDgroup.ThereweresignificiantdifferenceinCpnDNAnegativeratesaftertheazithromycinandtheplacebotreatment.ConclusionsChlamydiapneumoniaeispresentinPBMCofasignificantproportionofpersonswithCHD.Thepotentialroleofchlamydiapneumoniaeincoronaryatherosclerosismaythereforebemorerelatedtoaccelerationofdiseaseorsystemiceffectsbypersistentinfectionthantosuddeninitiationofprogressivecoronaryarterydiseasebyacuteinfection.ThedetectionofCpnDNAinPBMCwithnPCRmaybeofgreatvalueforidentifyingCpncarriersandfo
简介:ObjectivesToassesstherelationshipbetweenpeakoxygenconsumption(PVO2)andtheambulationdistanceinsix-minutewalktest(6MWT)amongthehealthysubjects.MethodsThe51healthysubjectswererecruitedforthesix-minutewalktest.Dataofpulmonarygasexchangebreathbybreath,suchasVO2,VCO2werereal-timemeasuredwithwirelessremotesensingK4B2,sotostudytherelationshipbetweenpeakoxygenuptakeandtheambulationdistance.ResultsItwasnoticedthattherewasapositivelinearcorrelationbetweentheambulationdistanceandPVO2(r=0.619,P<0.001)insix-minutewalktest.Theregressionequationwassetup(VO2/kg=0.05D-6.331,P<0.001).PVO2>PVCO2,R<1werefound,whichsuggestedthat6MWTwasatestbelowanaerobicthreshold.ConclusionsTherewasacloselypositivelinearcorrelationbetweentheambulationdistanceandPVO2,whichissafety,convenientandvaluablefortheevaluationofcardiopulmonaryfunctionandthetreatmentofcardiopulmonaryrehabilitation.
简介:Useagenesutureimmersedrecombinanttissue-typeplasminogenactivator(r-tPA)expressionplasmidtotransducemyocardiatopreventthethrombosisaftermechanicaltricuspidvalvereplacementinpigs.MethodsAr-tPAgeneplasmidwasconstructedandconjugatedtoanovelcationicphosphonolipidandar-tPAgenesuturewasmade.Eighteenpigswereselectedanddividedintotwogroupsatrandomization.Therewere9pigsintheexperimentalgroupand9inthecontrolgroup,allthe18pigs'tricuspidswerereplacedwithmechanicalvalves.Thegenethreadsweresuturedintotherightventricularwallsnearmechanicalvalvesandanultrasoundwasusedonthesurfacesoftherightventricularwallsforthegenetransferintheexperimentalgroup.Coagulativefunction,D-dimerlevelofthebloodandthethrombosisonthesurfacesofthevalveswereobserved.Resultsr-tPAgeneplasmidwassuccessfullyconstructedandr-tPAproteinwasexpressedintheventricularcellsaroundthegenesutures.D-dimerreacheditspeaklevel(1.67±0.79)μg·mL-1in1weekafteroperationintwogroups,butitdecreasedtopreoperationlevelthereafterincontrolgroupandkeptonthehighlevelandreincreasedtoanewhighlevel(1.89±0.79)μg·mL-1untiltheendoftheexperimentinexperimentalgroup.Thethrombosesaroundthevalveswerefoundinallthecontrolgroup(100%)butonly1(11.11%)caseinexperimentalgroup.Therewerenochangesinprothrombintimepreandpostoperationintwogroups.ConclusionsUsinggenesutureimmersedr-tPAexpressionplasmidtotransducemyocardiamightbeabestsubstitutionforlifelonganti-coagulationtherapyforthepatients,whounderwentoperation.
简介:ObjectivesThepurposeofthisstudywastodetermineiftheultrasonicintegratedbackscatterandechointensitycouldbeusedinclinicaldiagnosisofacutemyocardialinfarction.MethodsandResultsWithin2weeksafteracutemyocardialinfarction,35patientsunderwentultrasonictissuecharacterizationfromthepapillaryshort-axisview.Thecyclicvariationofintegratedbackscatterandechointensityofthreedifferentmyocardialregionsperfusedbyleftanteriordescendingcoronaryartery,leftcircumflexcoronaryandrightcoronaryweremeasured.Thevalueofcyclicvariationofintegratedbackscatterandintegratedbackscatterandechointensity≤halfofthehighestvalueofthreedifferentmyocardialregionsonasameviewweredefineasthecriteriafordiagnosingacutemyocardialinfarction,andtheresultswerecomparedwithcoronaryangiography.ThesensitivityofdiagnosingacutemyocardialinfarctionbybothUltrasonictissuecharacterizationwithintegratedbackscatterandechointens
简介:BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.
简介:BackgroundAnimalmodelsofhyperlipidemiawereestablishedbyfeedingrabbitswithhigh-cholesteroldiet,andthechangesinstructureandfunctionofcellmembraneinrabbitswerealsoreducedbyhyperlipidemia.Thus,thealternationsinerythrocytemembranelipidperoxidation(EMLP)andfluidityinrabbitsinducedbyhigh-cholesteroldietwereresearchedbyus.MethodsFourteenrabbitsweresubjectedtohigh-cholesteroldiet(cholesterol2g/d)andtheother14rabbitstocommondieteverydayforconsecutivetwomonths,plasmatotalcholesterol(TC),andbloodlipidsaswellasEMLPandfluidityweremeasuredbeforeandafterthefeeding.ResultsComparedwiththefeedingbefore,levelsofTCandlowdensitylipoproteincholesterol(LDL-C)weresignificantlyraised,thoseoferythrocytemembranelowdensitylipoproteincholesterol(MLDL-C),membraneconjugateddiene(MCD),erythrocytemalonaldehyde(RMDA)weresignificantlyincreased,whilethoseoferythrocytesuperoxidedismutase(R-SOD),membranefluidity(M-Flu)andmembranehighdensitylipoprotein-cholesterol(MHDL-C)weresignificantlydecreasedinexperimentalgroup,andtherewerenochangesincontrolgroup.ConclusionsHigh-cholesteroldietinduceslipidperoxidationandlowerfluidityoferythrocytemembrane.
简介:ObjectivesTostudythestatusoffibrinolyticinhibitioninpatientsofacutecoronarysyndrome(ACS)complicatedwithtypeⅡdiabetesmellitus(NIDDM)andtoevaluatetheeffectoffibrinolyticinhibitiontotheclinicalprognosis.MethodsTypeⅡdiabetesmellituswasdefinedbyADA1997/WH01998criteria.Thesubjectsweredividedintotreatmentgroupsthatincluded39patientsofACSwith20casesofacutemyocardiacinfarction(AMI),36patientsofACS+NIDOMwith20casesofAMI.Twentycasesofhealthypeoplewererandomizedtocontrolgroup.Theplasmaleveloftissuetypeplasminogenactivator(t-PA),plasminogenactivatorin-hibitortype-1(PAI-1)andplasmaD-dimerweredetectedbyusingelisatechnique.TheindexofstatueinfibrinolysiswasdetectedwiththeplasmalevelofD-dimerandtherateofPAI-1/D-dimerinpercentage.ThisindexwasusedtoevaluatethefibrinolyticinhibitionandtheclinicaloutcomeinallthepatientswithAMIintreatmentgroups.TheclinicaloutcomeinpatientswithAMIconsistedoftherateofreperfusion,theincidencesofreinfarction,severi-ousarrhythmia,pumpfailureanddeathintheearlyperiodofAMI.ResultsTheplasmalevelofPAI-1andD-dimerwashigherinthetwotreatmentgroupsthanthatinthecontrolgroup(P<0.01).TheplasmalevelofPAI-1significantlyhigherinACS+NIDDMpatientsthanthatinACS(P<0.05),buttheplasmalevelofD-dimerraisedfrombasiclevelwassignificanflylowerinACS+NIDDMthanthatinACS(P<0.05).TherateofPAI-1/D-dimerinpercentagewassignificantlyhigherinACS+NIDDMthanthatinACSorincontrolgroup(P<0.01).ForAMIpatientsintwotreatmentgroups,therateofreperfusionafterthethrorabolytictherapywassignifi-candylowerinACS+NIDDMthanthatinACS(P<0.01).TherateofincidencesinpumpfailurewassignificantlyhigherinACS+NIDDMthanthatinACStoo(P<0.05).Themorbidityofseveriousarrhythmia,re-infarctionandthemortalitywerealsohigherinACS+NI
简介:BackgroundAsforthepatientswithcoronaryarteriosclerosis,thepresenceofischemicmyocardialsurvivalissignificantforthetreatmentandprognosis.Gated13N-NH3and18F-FDGPET/CTimagingprovidesmyocardialperfusion,metabolismandcardiacfunctionwhichcanvaluatemyocardialviabilityaccuratelyandnoninvasively.MethodsFourpigsweresubjectedtobilateralinternalmammaryarteryY-bypassoperationinoperatingroom.ThepigsundertheanesthetizedstateweresenttoPETcenterwhentheoperationfinished.Then13N-NH3gated-PET/CTand18F-FDGgated-PET/CTwereperformed.ResultsThemyocardialperfusionandmyocardialmetabolismiswell-distributedofleftventricularwall.Themotionofthewallwasnormal.Theejectionfunctionwasgreaterthan50%.ConclusionGated-PET/CTcanbeusedfornoninvasiveevaluationofmyocardialperfusion,myocardialmetabolismandleftventriclefunction.