简介:目的采用12导联动态心电图监测分析阵发性心房纤颤(PAF)的触发方式、发生部位和发生频率,以了解阵发性房颤自行发作的机理.方法对31例自行发生PAF的病人采用12导联24h动态心电图系统进行监测,并对记录到的287次PAF的触发方式、房性早搏的发生部位、频率和心率进行分析.结果264次PAF发作(92%)是由房性早搏触发,20次PAF发作(7%)是由典型心房扑动进展形成,3次PAF发作(1%)由房性心动过速转变形成.根据12导联心电图标准,触发PAF的房性早搏中有217次(82%)起源于左房,5次(2%)起源于右房,42次(16%)起源部位不明确.在22例(71%)反复PAF发作的病人中,有15例病人是由同一形态的房性早搏触发.在PAF发作前120s和前30s期间内,房性早搏发生频率由0.8次/min分别增加到4.0次/分和6.1次/min(P=0.029和P=0.016).有224次PAF(78%)是在正常窦性频率(60~100次/min)下发生的.结论大多数PAF自行发作是在正常窦性频率下,由起源于左房并且发生频率增加的房性早搏所触发.
简介:ObjectivesToexploretheprotectiveeffectofirbesartan(Irb)undertheinterferencewithangiotensinⅡ(AngⅡ)onABCA1.MethodsElectronmicroscopywasusedtodetectthemorphousoffoamcells.TheexpressionofABCA1mRNAanditsproteinweredeterminedbyRT-PCRandWesternblotting,respectively.Thevarianceofcellularcholesterolcontentwasmeasuredbyzymochemistryvia-fluorospectrophotometer.ResultsApositivefacilitativeeffectofAngⅡontheformationoffoamcellswasobserved.TotalcholesterolwasincreasedsignificantlybyAngⅡ,theexpressionofABCA1wasdown-regulatedobviouslybyAngⅡ;IrbcouldprotectABCA1againstthelesionofAngⅡ;TotalcellularcholesterolcontentwasreducedsignificantlyinIrb+AngⅡgroup;However,considerablealterationaboutthecholesterolcontentandtheexpressionofABCA1werenotobservedinIrbgroupwithoutincubationwithAngⅡ.ConclusionsIrbcouldprotectABCA1againstthelesionofAngⅡ,whichmaycontributetoitsanti-atheroscleroticproperties.
简介:目的评价12导联同步Holter(简称DCG)诊断缺血型ST段改变的敏感性。方法选择22倒接受过冠状动脉造影(CAG)、12导联Holter检查的住院者,统计其CAG结果和DCG栓查结果中各导联缺血型ST段改变。结果①22例中,3例CAG未见异常DCG存在缺血型ST—T改变(占13.64%);1例CAG异常DCG未发生心肌缺血(占4.55%);②DCG示各导联缺血型ST段改变的发生率,以V6导联最高,占86.36%(19/22);其次为V6导联,aVL导联未发生;③DCG示ST段下降程度最重的是V6导联(-37mm),其次为V5导联(-32.3mm)。结论DCG无创、费用低,对心肌缺血的诊断具有较高的敏感性.可作为诊断心肌缺血的重要无创性检查技术。
简介:BackgroundComparedtoclopidogrel,Ticagrelorsignificantlyreducestheriskofcardiovasculareventsinpatientswithacutemyocardialinfarction(AMI)howeverincreasestheincidenceofbleedingandtheriskoffatalintracranialhemorrhage.Inthisstudy,wescreenedtheAMIpatientswithclopidogrelresistence,anddeterminedwhetherticagrelorsequentialtherapycouldreducetheriskofcardiovasculareventsandbleedingrisk.MethodsAtotalof319AMIpatientswereenrolledinthisprospectiveclinicalstudy.Theplateletinhibitionratesinadenosine5'-diphosphate(ADP)pathwaysweremeasuredbyathrombelastography(TEG)system.ThepatientswithclopidogrelresistanceweredividedintoTicagrelorsequentialtherapygroup(ticagrelorfor3monthsandclopidogrelfor9months,n=143)andClopidogrelgroup(clopidogrelfor12months,n=176).Theriskofmajoradversecardiacevents(MACE)andthesafetyendpointsat1-yearfollow-upwereanalyzed.ResultsTheratesofstentthrombosis(ST)(2.1%vs.8.0%,P=0.017)orMI(2.8%vs.10.2%,P=0.009)werelowerintheticagrelorsequentialtherapygroupthanintheclopidogrelgroup.Dyspneawasmoreoftenintheticagrelorsequentialtherapygroupthanintheclopidogrelgroup(17.5%vs.4.5%,P<0.001).Nosignificantdifferenceintherateofmajorbleedingwasfoundbetweenthegroups(3.4%vs.3.9%,P=0.528).ConclusionsInAMIpatientswithhyporesponsivenesstoclobidogrelticagrelorsequentialtherapygroupsignificantlydecreasedtheratesofSTandMIwithoutincreasedriskofmajorbleedingascomparedwithclopidolgrel.
简介:T1mappingusingcardiovascularmagneticresonance(CMR)introducesnoveltechniquesformyocardialtissuecharacterizationtodetectandquantifydiseaseprocessesoccurringatthemicroscopiclevel.EventhoughT1mappinghaslimitedspatialresolution,cellularandmolecularchangesoccurringwithineachvoxelcanaffecttheaggregateT1signalrenderingthemquantifiable.TheestimatedT1-basedparametersquantifiedona“map”demonstratethespatiallocalizationofthesechangeswherebyeachpixelexpressesthequantitativevalueofthatparameter.Thisquantificationpermitsdetectionofdiffusediseaseevenifitisnotdirectlyvisible.Ratherthanrelyingonnonspecificfunctionalmeasures,T1mappingfocusesonintrinsicchangesofmyocardialcompositionthatadvancesunderstandingaboutspecificdiseasepathways.Thesechangesinmyocardialtissuecompositioninformdiagnosisandprognosis.T1mappingencompassestwokeyparameters:native(i.e.,precontrast)T1andextracellularvolumefraction(ECV)derivedfromadditionalpostcontrastT1andbloodT1measurements.Theseadvancesintroducenewtoolstodetectfocalanddiffusemyocardialderangementsoccurringincardiacdiseasethatcanbeotherwisedifficulttodetect.T1andECVmappingfosterprecisionmedicineandpersonalizedcare,promisingtoimprovepatientoutcomesthroughtargetedtherapy.CapitalizingontheopportunitiesintroducedbyT1mappingandECVrequiresfurtherinvestigation.
简介:BackgroundCoronarymicroembolization(CME)ischaracterizedbydistalmicrovascularocclusion.However,theinflammatorymechanismsandtherapeutictargetsofCMEarelargelyunknown.MethodsAtotalof11GuangxiBamaminiatureswinesweredividedintotwogroups:sham(n=5)andCME(n=6).MicrosphereswereinjectedintotheleftanteriordescendingarteryoftheCMEgrouptomakeananimalmodelofCME.TheexpressionsofmicroRNA-146a(miR-146a)andIRAK1,TRAF6,andAUF1inthemyocardiumweredetectedbyqPCR.ResultsIntheCMEgroup,microspheres,microinfarction,andinflammatorycellinfiltrationwerefoundunderanopticalmicroscope.TheexpressionlevelsofmiR-146awerelowinbothgroups.AfterCME,theexpressionlevelsofIRAK1,TRAF6,andAUF1intheCMEgroupwereupregulatedcomparedwiththoseintheshamgroup(P<0.01;P<0.05;P<0.05,respectively).ConclusionsAUF1,IRAK1andTRAF6,butnotmiR-146a,couldbeinvolved,inmyocardiuminflammationfollowingCME.
简介:BackgroundEssentialhypertension(EH)hasbecomethemostcommonchronicnon-infectiousepidemicandisoneofthemostcommonriskfactorsforthedamagetoheart,brain,kidneyandotherorgans.TheserumlevelsofICAM-1,IGF-1andIL-8playimportantrolesinthepathogenesisofEH.MethodsInthemedicalcheck-upcenteroftheAffiliatedHospitalofQingdaoUniversityMedicalCollege,sixtynormaloffspringwithafamilyhistoryofEHwererandomlyrecruitedintotwogroups:30offspringwithafatherormothersufferingfromEHassingle-parentgroup,and30offspringwithbothparentssufferingfromEHasdouble-parentgroup,andanother30normaloffspringwhoseparentsdidnotsufferfromEHascontrolgroup.TheserumlevelsofICAM-1,IGF-1andIL-8weredeterminedbyenzyme-linkedimmunosorbentassay(ELISA).ResultTheserumlevelsofICAM-1,IGF-1andIL-8weresignificantlyhigherinbothsingle-parentgroupanddouble-parentgroupthaninthecontrolgroup(P<0.05),andtheserumlevelsofICAM-1,IGF-1andIL-8werehigherinthedouble-parentgroupthaninthesingle-parentgroup(P<0.05).TheserumlevelsofICAM-1,IGF-1andIL-8werepositivelycorrelatedwiththeseverityofbloodpressureelevation(r=0.375,r=0.465,r=0.326,P<0.05,P<0.01,P<0.05respectively).ConclusionsDuetotheinfluenceofheredity,theseruminflammatoryfactorcontentsinnormaloffspringwithEHfamilyhistorymayincreasebeforebloodpressurerise.DetectionofseruminflammatoryfactorsinhealthyoffspringwithafamilyhistoryofEHcouldpredictoccurrenceofhypertension,andprovideamorereliablebasisfortheprimarypreventionofhypertension.
简介:目的:探讨血清转化生长因子(TGF-β1)和胰岛素样生长因子(IGF-1)水平对冠心病患者心功能的影响.方法:选择因胸痛住院患者88例分为急性心肌梗死(AMI)组、心绞痛(AP)组和对照组,填调查表,入院择日行选择性冠状动脉造影术,术前采股动脉血,以ABC双抗体夹心ELISA法检测血清TGF-β1和IGF-1浓度,入院2周内完成超声心动图,所有资料用SPSS10.0软件处理.结果:AMI患者与AP患者相比,血清TGF-β1浓度较低(P<0.05),IGF-1血清浓度较低(P<0.001);冠心病患者血清IGF-1水平与EF(P<0.05)和FS(P<0.02)正相关.结论:TGF-β1和IGF-1对冠心病患者具有某种保护作用,其中IGF-1能保护冠心病患者的心功能.