简介：ObjectivesToevaluateretrospectivelythepotentialbenefitsofcombinedutilizationofvariousassistedcirculationdevicesincardiacarrestpatientswhodidnotrespondtoconventionalcardiopulmonarycerebralresuscitation(CPCR).MethodsAssistedcirculationdevices,includingemergencycardiopulmonarybypass(ECPB),intra-aorticballoonpump(IABP),andleftventricularassistdevice(LVAD),wereappliedto16adultpatientswhohadcardiacarrest82min-56hafteropenheartsurgeryanddidnotrespondto20minorlongerconventionalCPCR.ECPBwasappliedto2patients,ECPBplusIABPto8patients,ECPBplusIABPandLVADto6patients.ResultsOnepatientrecoveredfullyandonepatientdied.Oftheother14patients,13resumedspontaneouscardiacrhythmandonedidnot;noneofthemcouldbeweanedfromECPB.Furthertreatmentofthe14patientswithcombinationsofassistedcirculationdevicesenabled6patientstorecover.Oneofthe7recoveredpatientsdiedofreoccurringcardiacarrestafter11days;theother6weredischargedingoodconditionandwerefollowedupfor3-49months(mean=22months).Ofthe6dischargedpatientsonesufferedcerebralembolismduringLVADtreatment,resultinginmildlimitationofmobilityoftherightlimbs;theother5nevermanifestedanycentralnervoussystemcomplications.Therewasnolatedeathsgivinga37.5%(6/16)long-termsurvivalrate.ConclusionsECPBcouldeffectivelyreestablishbloodcirculationandoxygensupply,rectifyacidosis,andimproveinternalmilieu.ThecombinedutilizationofECPB,IABP,andLVADreducesthedurationofECPB,improvestheincidenceofrecovery,andoffersbeneficialalternativestorefractorycardiacarrestpatients.

简介：Toanalyzetheclinicalcharacteristicsof216patientswithnon-STsegmentelevationmyocardialinfarction(NSTEMI).MethodsAretrospectiveanalysiswasused.TwohundredandsixteenNSTEMIpatientsweredividedintotwogroups:①accordingtotheage:age<65yearsgroupandage≥65yearsgroup;②accordingtothrombolysisinmyocardialischemiatrial(TIMI)IIBriskstratificationscoringsystem:score<4groupand≥4group;③accordingtoserumcreatinine(sCr)level:sCrlevel≤178μmol·L-1groupand>178μmol·L-1group.Sevenhundredandeightysixacutemyocardialinfarction(AMI)patientsduringthesameperiodweredividedintoSTsegmentelevationmyocardialinfarction(STEMI)groupandNSTEMIgroup.Clinicalcharacteristicsofthepatientsinthetwogroupswerecompared.Results①ThenumberofNSTEMIpatientsinage≥65yearsgroupissignificantlygreaterthanthatinage<65yearsgroup.Studyrevealedthatthepatientsinage≥65yearsgroupwerewithoutchestpain,hadhypertension,dyslipidemia,atrialfibrillation,cardiacandrenaldysfunction(sCr>178μmol·L-1)andtriplevesseldisease.Fewerpatientsinthisgroupreceivedcoronaryarteryangiography(CAG),percutaneouscoronaryintervention(PCI)andcoronaryarterybypassgraft(CABG).Morenumberofdeathsinthisgroupcomparedwiththeage<65yearsgroup.②ThenumberofNSTEMIpatientsinTIMIscore>4groupissignificantlygreaterthanthatinTIMIscore<4group.Fourmajorcomplicationssuchasacuteleftventricularfailure,cardiogenicshock,seriousarrhythmiaanddeaths,increasedsignificantlyinTIMIscore>4groupcomparingwithTIMIscore≤4group.③Obviously,morenumberofelderlypatients,non-insulindependantdiabetesmellitus(NIDDM),patientswithcardiactroponinT(CTnT)>3.0ng·L-1anddeathsoccurredinsCr>178μmol·L-1group.④STEMIandNSTEMIpatientswerecomparedinsametimeframeasfollows:fewerNSTEMIpatientsandmoreelderlypatientshadnochestpain,NIDDM,hypert

简介：Amlodipine/valsartan(Aml/Val)single-pillcombination(SPC)therapyhasbeenwidelyusedandstudiedinclinicalpracticeinrecentyears.ThisarticlereviewstheChineseandEnglishliteratureontheclinicaluseofAml/ValSPCtherapyinChinesehypertensivepatients.Accordingtofivestudiesconcerningtheefficacyandsafetyofthistreatment,Aml/ValSPCtherapywasmoreefficaciousthanmonotherapywithvalsartan,amlodipine,orthenifedipinegastrointestinaltherapeuticsystem.Thistreatmentshowedgreaterbloodpressure-loweringeffects,ahigherbloodpressurecontrolrate,andahigherresponserate.Aml/ValSPCtreatmentwaswelltolerated,withadverseeventratessimilartothoseofmonotherapywithvalsartanoramlodipineandsignificantlyrareradverseeventscomparedwiththenifedipinegastrointestinaltherapeuticsystem.Aml/ValSPCisahighlyefficaciousandwell-toleratedantihypertensivetreatmentinChinesehypertensivepatients.

简介：ObjectivesTostudywhetherchangeofBNPlevelsreflectthechangeofcardiacfunctionandtoinvestigatetheshort-termprognosticpotentialofBNPandQOLinpatientswithCHF.Methods96consecutivepatientsadmittedwithCHFbetweenSeptember2002andJanuary2003werestudied,uponentrythestudy,BNPlevelsweremeasured,Patientsadministeredthedisease-specificqualityoflifequestionnaireMinnesotalivingwithheartfailurequestionnaire(LiHFe)within1day.BNPlevelsandadministeringLiHFewererepeatedthreemonthslater.ResultsBNPlevelswereincreasedproportionaltotheseverityofcardiacfunction.PhysicaldomainandtotalscoreofLiHFeweresignificantlycorrelatedtotheseverityofCHF(p＜0.05).BNPlevelsweredecreasedinimprovinggroup(p=0.032).IndeterioratinggroupBNPlevelsincreased(P=0.043).Kaplan-meieranalysisaccordingtoBNPlevelcutoffpoint150ng/l,thelifecurveofhigherBNPlevelgroupwassignificantlylowerthanthelowergroup(p=0.001).Inunivariatelogisticregression,NYHAclass,BNP,LVEF,LVEDD,heartsize,totalscoreofLiHFe,physicaldomainofLiHFeandtheemotionaldomainofLiHFewereallsignificantprognosticfactorsofCHF(p＜0.05forall).Whileinmultipleregression,onlyBNPlevel(p=0.036)andtheemotionaldomainofLiHFe(p=0.025)wereindependentprognosticfactors.ConclusionsChangeofBNPreflectsthetreatmentefficacyofCHF.BNPandQOLarethetwomajorshort-timeprognosticfactorsofthechronicheartfailurepatients.

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简介：Formanyyears,cardiovascularclinicianshavebeenmakingtheargumentthatcompleterevascularizationisthewaytoproceedinpatientswithanyformofischemicheartdisease.Ibelievethatcardiovascularsurgeonsagreewiththisapproachandtrytheirbesttocompletelyrevascularizepatientsatthetimeofcoronaryarterybypassgraftsurgery.AttheUniversityofFlorida,we,likemanyothersintheworld,treatanacutemyocardialinfarctionasanemergency,and,ifthereisSTsegmentelevation,thepatientistransportedimmediatelytothecardiaccatheterizationlaboratoryfromtheemergencydepartment,forrecanalizationoftheculpritartery.

简介：ObjectivesToinvestigatetheassociationofsolubleFasligand(sFasL)andsolubleFasreceptor(sFas)withhumanchroniccongestiveheartfailure(CHF).MethodsTheserumlevelofsFasLandsFasin33patientswithCHF(13incardiacfunctionclassⅡ,17inclassⅢ,3inclassⅣ,NYHA)wasassessedwithenzyme-linkedimmunosorbentassay,andwascomparedwiththatof18age-,bloodpressure-matchedpatientswithcardiacfunctionclassⅠ(NYHA).ResultsTherewasnodifferenceinthelevelofsFasLbetweenthetwogroups[CHFgroup:231.50+/-84.50(cardiacfunctionclassⅡ216.50+/-96.00,classⅢ226.80+/-85.70,classⅣ244.00+/-73.00)vs.cardiacfunctionclassIgroup:217.50+/-89.00pg/mL,P>0.05].However,thelevelofsFaswassignificantlyhigherinthepatientswithCHFthanthoseofcardiacfunctionclassIgroup[CHFgroup:1353.30+/-507.71(cardiacfunctionclassⅡ1154.85+/-371.20,classⅢ1412.88+/-493.62,classⅣ1875.67+/-806.

简介：BackgroundPreviousstudieshaveimplicatedastronglinkbetweencirculatingplasmaresistinandcoronaryarterydisease(CAD).Theaimofthisstudywastoinvestigatewhetherresistinelevationpredictsworseoutcomeofstent-placementinacutecoronarysyndrome(ACS)patients.MethodsTotally126ACSparticipantswhowereeligibleforstent-placementwereenrolledfor2years'follow-upbymonitoringclinicalendpointsoccurringviaoutpatientvisitsor/andtelephonecall.Baselinecharacteristicswerecollected.Allparticipantsweredividedintolowresistingroup(<3.464μg/mL)andhighresistingroup(>3.464μg/mL).Clinicalendpointsintermsofmajoradversecardiovascularevents(MACE),cardiovasculardeath,non-fatalmyocardialinfarction,ischemicstroke,andcoronaryrevascularization(CR)werecompared.ResultsPatientswithstenosisinthreevesselspresentedmorefrequentlyinhighresistingroupthaninlowresistingroup(35.6%vs.48.3%,P=0.001).IncidencesofMACEandCRweresignificantlyhigherinhighresistingroupthanthoseinlowresistingroup(31.6%vs.18.8%,P=0.018);15%vs.7.58%,P=0.006).ConclusionsInpatientswithbaselineresistinelevation,theincidenceofMACEissignificantlyincreasedafterstent-placement.

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简介：Thisstudyinvestigatedtheeffectofcatheter-basedrenalsympatheticdenervation(RD)onleftventricularhypertrophy(LVH)andsystolicanddiastolicfunctioninpatientswithresistanthypertension.LVHanddiastolicdysfunctionareassociatedwithelevatedsympatheticactivityandincreasedmorbidityandmortality.TheeffectofRDonLVHandLVfunctionisunclear.MethodsandResultsForty-sixpatientsunderwentbilateralRD,and18patientsservedascontrols.Transthoracicechocardiographywasperformedatbaseline,andafter1monthand6months.Besidesreductionofsystolicanddiastolicbloodpressure(-22.5/-7.2mmHgat1monthand-27.8/-8.8mmHgat6months,P<0.001ateachtimepoint),RDsignificantlyreducedmeaninterventricularseptumthicknessfrom14.1±1.9mmto13.4±2.1mmand12.5±1.4mm(P=0.007),andLVmassindexfrom53.9±15.6g/m(2.7)(112.4±33.9g/m(2))to47.0±14.2g/m(2.7)(103.6±30.5g/m(2))and44.7±14.9g/m(2.7)(94.9±29.8g/m(2))(P<0.001)at1monthand6months,respectively.ThemitralvalvelateralE/E'decreasedafterRDfrom9.9±4.0to7.9±2.2at1monthand7.4±2.7at6months(P<0.001),indicatingreductionofLVfillingpressures.Isovolumicrelaxationtimeshortened(baseline109.1±21.7msvs.85.6±24.4msat6months,P=0.006),whereasejectionfractionsignificantlyincreasedafterRD(baseline:63.1±8.1%vs.70.1±11.5%at6months,P<0.001).Nosignificantchangeswereobtainedincontrolpatients.ConslusionsBesidestheknowneffectonbloodpressure,ourstudyshowedforthefirsttimethatRDsignificantlyreducesLVmassandimprovesdiastolicfunction,whichmighthaveimportantprognosticimplicationsinpatientswithresistanthypertensionathighcardiovascularrisk.

简介：ObjectivesTostudyclinicalandcoronaryangiographicfindingsinpatientswithbothcoronaryheartdiseases(CHD)andtype2diabetesmellitus(T2DM).Methods215patientswithCHDconfirmedbycoronaryangiographywereinvolvedinthisstudy.Thepatientsweredividedintotwogroups:74CHDpatientswithT2DM(meanage64.7±8.2years,male/female47/27),and141CHDpatientswithoutT2DM(meanage66.2±9.2years,male/female100/41).Theclinicalfeaturesandthedatafromselectivecoronaryangiographieswerecomparedbetweentype2diabeticandnon-diabeticCHDpatients.ResultsComparedtonon-diabeticCHDpatients,thepatientswithbothCHDandT2DMsufferedmorefromacutemyocardialinfarction,silentischemiaandseverearrhythmias(P＜0.01,P＜0.05),andhadhigherserumtriglyceridesandapo-lipoproteinB,alongwithincreasedserumuricacid(P＜0.01,P＜0.05),increasedleftventricularenddiastolicdiameter(P＜0.01),anddecreasedleftventricularejectionfraction(P＜0.001).Comparedtonon-diabeticCHDpatients,thepatientswithbothCHDandT2DMsufferedmorefromtriplevesseldisease(P＜0.01),severecoronaryarterystenosis,completeocclusionsanddiffuselesions(P＜0.001).ConclusionsSevereclinicalmanifestation,leftventriculardysfunction,diffuseorcomplicatedlesionsofcoronaryarteriesweremorecommoninpatientswithbothCHDandT2DM,itsuggeststhatthetype2diabeticCHDpatientshavepoorprognosis.

简介：BackgroundDataarelimitedregardingtheriskofcontrast-inducednephropathy(CIN)forpatientsafterthesecondcontrastexposure.ObjectiveToexaminetheriskofCINafterthesecondcontrastexposureinpatientsofacutecoronarysyndrome(ACS)withchronickidneydisease(CKD).MethodsPatientsofACSscheduledforasecondelectivePCI.Patientswererequiredtohaveanestimatedcreatinineclearance(CrCl)between15and60ml/min.Thevalueofserumcreatinin(sCr)priortothesecondcontrastexposuremustnotbe≥25%or≥88.4μmol/Lcomparedtobaseline.CINwasdefinedasanincreaseofsCr≥25%frombaselinewithin48-72hafterthesecondcontrastexposure.Theprimaryend-pointwasriskofdevelopingCIN.ResultsThirty-ninepatientscompletedthestudy.Theaverageofintervalbetweencontrastexposureswas116±64h,contrastvolumewas266±100mLandlengthofhospitalizationwas8.3±4.7days.TheincidenceofCINintheoverallstudypopulationwas10.3%.TherewasnotchangesignificantlyinaveragesCrandCrClafterthesecondcontrastexposure(sCr1.52±0.62vs.1.54±0.60mg/dLbaseline,P=0.75;CrCl(40.68±14.46vs.39.16±12.10mL/minbaseline,P=0.26).Noneofthepatientwasdeathin30days.One(2.6%)ofthepatientswhodevelopedCINrequireddialysisin-hospital.ConclusionOurfindingssuggestthatpatientswithpriorrenaldysfunctionarenotincreasedriskofdevelopingCINafterthesecondcontrastexposure.Thiscohortmaybebenefitfromsufficientprophylaxis.

简介：ObjectivesToanalyzethechangesofvasoactivesubstancesoriginatedfromendotheliuminpatientswithunstableanginapectoristreatedbymodifiedthrombolytictherapyandexplorethemechanismsofthedrugtotreatunstableanginapectoris.Methods120patientswithunstableanginapectoriswhowerenotwellresponsedtocommonmedicationwerestudied.TheirECGstresstestswereabnormalandtherewereischemicchangesinHolter.Urokinase300,000Uwasaddedin100mlnormalsalineandinjectedwithin30minonceadayfor3days.300mgaspirinwasadministratedadaybeforeandduringurokinaseapplications.Beforeandafterurokinasetreatments,endothelin-1,plasmatissueplasminogenactivatoranditsinhibitor-1weredetermined.ResultsComparedwithpretreatments,aftertreatments,theactivitiesoftissueplasminogenactivatorincreased,endothelin-1andtheinhibitor-1decreased.Thechangesweresignificant.ConclusionsModifiedthrombolytictherapycanregulatethevasoactivesubstancesoriginatedendotheliuminpatientswithunstableanginapectoris.Themajorsubstancesincludeendothelin-1,plasmatissueplasminogenactivatorandinhibitor-1.Thismechanismmaysuggestthaturokinasecantreatcoronaryheartdiseaseeffectively.

简介：BackgroundHospital-acquiredpneumonia(HAP)isthemostcommonandmostseriousnosocomialinfectionforcardiacsurgerypatients,withhighincidenceandfatalityrate1.ItisimportantforcardiacsurgeonstocorrectlyidentifyHAP,assesstheseverity,andthenadjustanti-infectionmethod,whichcanreducethemortalityrate,shortenhospitalizationtime,andreducethewasteofmedicalresources.ThepurposeofthisresearchistoevaluatetheapplicationvalueoflungCTindiagnosisandtreatmentofHAPaftercardiacsurgery.MethodsAretrospectiveanalysiswasconductedforclinicaldataabout76cardiacsurgerypatientswhowerediagnosedwithHAPduringJanuarytoDecember2013.Theclinicaldatamainlyincludedsymptoms,physicalsigns,laboratoryexaminations(suchasroutinebloodtestsandserumprocalcitonin),andlungCTandX-raydata.OurfocusisonthecomparisonbetweenlungCTandX-raydata.ResultsThepositivediagnosticrate,falsenegativerate,andfalsepositiverateoflungCTwere71/76(93.4%),5/76(6.6%),and1/76(1.3%)respectively.ThecoincidencerateofX-rayandCTwas45/76(59.2%),andthefalsenegativerateofX-raywas23/76(30.3%).ConclusionLungCTisbetterthanX-rayindiagnosisofHAPaftercardiacsurgeryandassessmentofseverity,andhasgreatersignificanceforguidingtherationaluseofantibiotics.Therefore,lungCTisworthyofapplicationandpopularization.

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：BackgroundThiazolidinediones(TZDs)notonlyimproveinsulinresistance,loweringbloodsugar,alsohasanti-atheroscleroticeffect.However,whethertheprotectiveeffectoncardiovascularpioglitazoneisstillcontroversial.MethodsTotally98patientswithcoronarydiseaseanddiabetesmellituswererandomlydividedintopioglitazonegroup(n=48)receivingconventionaltherapyandpioglitazone(15mg/day),andcontrolgroup(n=50)merelyreceivingconventionaltherapy.Thepatientswerefollowedupfor12months.TheplasmalevelofPlasminogenactivatorInhibitor1(PAI-1)andP-selectinweredetectedatbaselineandaftertreatmentfor12monthsbyELISA,andmajoradversecardiacevents(MACE)werestudied.ResultsPioglitazonetherapyfor12monthswasassociatedwithasignificantdecreaseofPAI-1[(7.9±1.4vs4.2±0.5)ng/mL,P<0.05]andP-selectin[(16.6±6.8vs12.4±3.6)ng/mL,P<0.05],MACEwassignificantlylowerinthepioglitazonegroupthaninthecontrolgroup[acutecoronarysyndrome(ACS):32.0%vs10.4%,P<0.05;targetvesselrevascularization:22.0%vs6.3%,P<0.05].ConclusionsPioglitazonecaneffectivelyreducetheplasmalevelofPAI-1,P-selectinandtheoccurrenceofMACEinpatientswithcoronaryheartdiseaseanddiabetesmellitus.

简介：ObjectivesToinvestigatethegeneexpressionofcalcium-handlingproteinsinpatientswithrheumaticheartdisease(RHD)andatrialfibrillation(AF).MethodsAtotalof50patientswithrheumaticmitralvalvediseasewereincluded.AccordingtocardiacrhythmanddurationofepisodeofAF,patientsweredividedintofourgroups:sinusrhythmgroup,oaroxvsmalAFre'our,persistentAFforlessthan6monthsgroupandpersistentAFformorethan6monthsgroup.Atrialtissuewasobtainedfromtherightatrialappendage,therightatrialfreewallandtheleftatrialappendagerespectivelyduringopenheartsurgery.TotalRNAwasisolatedandreverslytran-scribedintocDNA.Inasemi-quantitativepolymerasechainreactionthecDNAofinterestandofglyceralde-hyde3-phosphatedehydrogenase(GAPDH)weream-plifiedandseparatedbyethidiumbromide-stainedgelelectrophoresis.MultiplelinerregresswasusedforcorrelationbetweenthemRNAamountandage,sex,rightatrialdiameter(RAd)andleftatrialdiameter(LAd)ResultsThemRNAofL-typecalciumchannelα1osubunit,ofCa^2+-ATPaseandofryanodinereceptorinpatientswithpersistentAFformorethan6monthsweresignificantlydecreased(Pall<0.01)ButnoalterationsofthemRNAlevelsforSRphos-pholambanandcalsequestrinwereobservedinpatientswithpersistentAFformorethan6monthscomparedwithpatientswithsinusrhythm,paroxysmalAFandpersistentAFforlessthan6months(Pall>0.05)Therewasnodifferenceofthegeneexpressionamongthethreeatrialtissuesamplingsites(Pall>0.05).Age,gender,RAdandLAdhadnosignificanteffectsonthegeneexpressionofcalcium-handlingproteins(Pall>0.05).ConclusionsThemRNAexpressionofcalcium-handlingproteinsisdown-regulatedonlyinpatientswithRHDandlong-termpersistentAF.Suchabnormalitiesmayberelatedtotheinitiationand/orperpetuationofAFinthepatientswithRHD.

简介：BackgroundThecoronarycollateralcirculationhasapositiveeffectontheischemicmyocardium.Butitislimitedforpatientsmissingthetimewindowoftotalocclusionofthecoronaryarteryelectivepercutaneouscoronaryintervention(PCI).Theeffectofcollateralcirculationonleftcardiacfunctionhasbeenlessstudied.MethodsAtotalof34patientswithoneormorecoronaryarteryocclusionwhounderwentcoronaryangiographyandRentrop'smethodweredividedinto2groups:Goodcollateralcirculation(Agroups,Rentropscore2-3,n=19)and(Bgroups,Rentropscore1-2,n=15).Theimprovementofleftventricularenddiastolicvolume(LVEDV)andleftventricularejectionfraction(LVEF)werecomparedbetweenthetwogroupsbeforeandafterPCI.ResultsIngoodcollateralcirculationgroup,leftventricularejectionfraction(LVEF)wassignificantlyhigherafterPCI(P<0.05).Inpoorcollateralcirculationgroup,leftventricularenddiastolicvolumeindex(LVEDV)wassignificantlyincreasedafterPCI(P<0.05).ConclusionsGoodcollateralcirculationhasasignificantprotectiveeffectonleftventricularfunction.PCIoperationcansignificantlyimprovetheprognosisofpatientswithgoodcollateralcirculationofcoronaryarteryocclusion.

简介：ObjectivesToinvestigatetherelationshipofserumleptinconcentrationwiththelipidsandbodymassindex(BMI)inpatientswithchroniccongestiveheartfailure(CHF).MethodsTheserumconcentrationofleptinin39patientswithCHF(14incardiacfunctionclassⅡ,21inclassⅢ,4inclassⅣ,NYHA)andin46patientswithcardiacfunctionclassⅠ(NYHA)wereassessedbyradioimmunoassay.ResultsTheserumconcentrationofleptinwere9.018±4.519μg/linCHFgroup(cardiacfunctionclassⅡ11.492±5.649μg/l,classⅢ7.763±3.321μg/l,classⅣ6.100±2.657μg/l);11.674±6.911μg/linclassⅠgroup.TheserumconcentrationsofleptinweresignificantlylowerinCHFgroup,ascomparedwithclassⅠgroup(P<0.05).Moreover,thedecreaseofserumleptinconcentrationwassignificantlycorrelatedwiththedecreasedserumconcentrationsoftotalcholesterol,triglyceride,bodymassindexandleftventricularejectionfractioninCHFgroup,respectively(P<0.05).ConclusionsThesignificanceofthedecreaseinserumleptininCHFpatientsneedsfurtherstudy.

简介：BackgroundHypertensionassociatedwithhyperhomocysteinemia(HHcy)isdefinedasH-typehypertension.HypertensionandHHcyhasastrongsynergythatcouldleadtotheriskofvasculardisease,suchascarotidremodeling.However,therelationofinflammatoryfactorsandadhesionmoleculewithcarotidremodelinginH-typehypertensionisunknown.MethodsFifty-sixpatientswithH-typehypertensionand52withouthyperhomocysteinemiahypertensionwereenrolledinthisstudy,with42healthyvolunteersasthecontrolgroup.AllthesubjectsunderwentcolorDopplerultrasoundexaminationofcarotidartery.TheexpressionofICAM-1inperipheralbloodmonocyteswasmeasuredbydirectimmunofluorescencetechniqueincombinationwithflowcytometry.ThelevelsofhighsensitivityC-reactiveprotein(hs-CRP),Monocytechemoattractantprotein-1(MCP-1)andsICAM-1weremeasured.Thecorrelationsbetweencarotidvascularremodelingandthesebiomarkerswereanalyzed.ResultsTheintima-mediathickness(IMT),circulatinglevelsofhs-CRPandMCP-1,andmonocyteICAM-1weresignificantlyincreasedinH-typehypertensiongroup(P<0.05).Therewerenosignificantdifferenceinthosemeasurementsbetweenthesimplehypertensiongroupandthecontrolgroup(P>0.05).ThelevelsofsICAM-1showednosignificanceamongthethreegroups(P>0.05).Correlationanalysesrevealedapositivecorrelationofcarotidplaqueindexwithhomocysteine,hs-CRPandMCP-1,andtheexpressionofICAM-1inthemonocytesintheH-typehypertensiongroup.MultivariatelogisticregressionanalysisrevealedthatHcyandhs-CRPweretheindependentriskfactorsofIMTintheH-typehypertensiongroup.ConclusionThepatientswithH-typehypertensionaremorelikelytohavecarotidvascularremodelingwithhigherlevelsofinflammationandadhesionmoleculeswhichmightleadtothedevelopmentofatherosclerosis.