[Safety and efficacy of dual guiding catheter kissing technique in the treatment of stent partially dislodgement in coronary artery].

Objective: To investigate the safety and efficacy of dual guiding catheter kissing technique (DCK) in the treatment of stent partly dislodgement in coronary artery. Methods: The study retrospectively involved 6 hospitalized patients with coronary artery stent partly dislodgement during PCI at The First Affiliated Hospital of Zhengzhou University from February 2016 to June 2019, DCK was used in these patients. We observe the success rate of stent retrieval, success rate of PCI, incidence of complications and major adverse cardiovascular events in 1 year follow up. Results: 6 patients were involved, of which 3 are male, ages range 49 to 68 years old, 4 patients are diagnosed with unstable angina, the other two are stable angina. All the partially disloged stents in the 6 patients were successfully removed from coronary artery. Except for 1 patient who refused coronary artery stenting again, the other 5 patients were successfully implanted coronary artery stenting. No serious complications occurred, no patients died and no major adverse cardiovascular events happened during 1 year follow up. Conclusions: DCK is safe and effective to remove partially dislodged stent in coronary artery.

[Outcomes of patients treated with drug-coated balloons for de novo large coronary vessels].

Objective: To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels. Methods: One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure. Results: Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up. Conclusion: DCB treatment for de novo large coronary vessels is effective and safe.

[Efficacy and safety of three-dimensional electroanatomical mapping system for catheter ablation of paroxysmal supraventricular tachycardia in children].

Objective: To evaluate the efficacy and safety of three-dimensional electroanatomical mapping system for catheter ablation of paroxysmal supraventricular tachycardiain (PSVT) children. Methods: Clinical data from 187 children with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation in our department between January 2012 and April 2016 were analyzed. Among the patients, 91 cases were treated with traditional two-dimensional X-ray radiofrequency ablation, 96 cases were treated with radiofrequency ablation guided by three-dimensional electroanatomical mapping system. Postoperative electrocardiogram and echocardiography follow-up was performed at 1, 3, 6, 12, and 24 months. The success rate, recurrence rate, complication rate, operation time and amount of X-ray exposure were compared between the two groups. Kaplan-Meier survival curve was used to analyze the PSVT-free survival rate of the patients between the 2 groups. Results: The mean follow-up time was (739±92) days. The success rate (95.8%(92/96) vs. 94.5%(86/91), P=0.912), recurrence rate (5.4%(5/92) vs. 4.7%(4/86), P=0.807), complication rate (4.2%(4/96) vs. 5.5%(5/91), P=0.379), operation time ((73±31)min vs. (79±36)min, P=0.124) were similar between the two groups. However, X-ray exposure time ((8.1±2.9)min vs. (21.3±8.4)min, P=0.026), amount of X-ray ((23±11)mGy vs. (58±23)mGy, P=0.013) were significantly lower in the three-dimensional electroanatomical mapping system group than in the traditional two-dimensional X-ray radio frequency ablation group. PSVT-free survival rate was similar between the two groups (χ(2)=0.060, P=0.807) . Conclusion: Three-dimensional electroanatomical mapping system is safe and effective for radiofrequency ablation of paroxysmal supraventricular tachycardia in children, and can significantly reduce the amount of radiation as compared to the traditional two-dimensional X-ray radiofrequency ablation.

HOTAIR promotes myocardial fibrosis through regulating URI1 expression via Wnt pathway.

OBJECTIVE: To investigate whether HOX transcript antisense RNA (HOTAIR) regulates myocardial fibrosis via promoting proliferation of cardiac fibroblasts (CFs) and upregulating the expression levels of fibrotic proteins through activating Wnt signaling pathway. MATERIALS AND METHODS: The expression level of HOTAIR in Ang II-induced cardiac fibroblasts was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). Overexpression or knockdown of HOTAIR expression was achieved by lentivirus transfection. The effects of HOTAIR on regulating cell proliferation, migration and apoptosis were measured by cell counting kit-8 (CCK-8) test, transwell assay and flow cytometry, respectively. Western blot and qRT-PCR experiments were performed to detect expressions of fibrosis-related genes and Wnt pathway-related genes. Target gene of HOTAIR was predicted by bioinformatics analysis. Rescue assays were conducted to assess whether HOTAIR could regulate cell proliferation and fibrosis by activating Wnt signaling pathway via URI1. RESULTS: QRT-PCR results showed that HOTAIR expression in Ang II-induced CF cells was significantly higher than that in control. HOTAIR overexpression in CF cells can promote cell proliferation and migration, inhibit apoptosis, and promote the expressions of fibrosis-related genes. Western blot results indicated that HOTAIR could upregulate URI1 expression and activate Wnt signaling pathway. In addition, rescue assay demonstrated that overexpression of URI1 reversed the inhibitory effect of HOTAIR knockdown on Wnt pathway. CONCLUSIONS: Highly expressed HOTAIR promoted proliferation and migration of cardiac fibroblasts. HOTAIR remarkably upregulated fibrosis-related genes in CF cells. The mechanism of HOTAIR in regulating myocardial fibrosis might be related to the activation of Wnt signaling pathway through targeting URI1 expression.

MiR-93 inhibition ameliorates OGD/R induced cardiomyocyte apoptosis by targeting Nrf2.

OBJECTIVE: To identify the expression changes of microRNA 93 (miR-93) in oxygen-glucose deprivation/reoxygenation (OGD/R) injury in cardiomyocytes and its mechanism of mediating OGD/R and inducing apoptosis. MATERIALS AND METHODS: Primary cardiomyocytes were extracted and OGD/R model in cardiomyocytes was established in vitro. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expressions of miR-93, and Western blot assay was applied to measure the protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and caspase-3. Flow cytometry was utilized to examine the cardiomyocyte apoptosis rate. RESULTS: The apoptosis rate was increased after OGD/R in cardiomyocytes, accompanied by remarkable rise of miR-93 expression. After transfection of miR-93 antagomir, the apoptosis rate of cardiomyocyte induced by OGD/R was down-regulated, and the expression of cleaved caspase-3 was decreased. Meanwhile, the results of qRT-PCR and Western blot showed that the levels of Nrf2 mRNA and protein expression were up-regulated after the miR-93 level was inhibited, and luciferase reporter assay affirmed that Nrf2 was a target molecule for OGD/R-induced apoptosis mediated by miR-93. CONCLUSIONS: miR-93 mediates OGD/R-induced hypoxia/reoxygenation injury apoptosis in cells by targeting Nrf2.

Analysis on the relationship and mechanism of high blood pressure and vascular aging on the condition that the gender and age matches.

OBJECTIVE: The relationship between hypertension and the mechanism of the expression of T-lymphocyte Kv1.3 channels in vascular aging has been analyzed in this study based on the gender and age matches' principle. PATIENTS AND METHODS: Thirty patients have been consecutively chosen with vascular aging caused by hypertension (group A), while 30 cases of high blood pressure not merged with vascular aging (group B) were chosen, and 30 cases of healthy volunteers (group C), conforming to gender and age 1:1 and the closest matching principle, were studied. The aim of this study was to separate the peripheral blood mononuclear cells and give intervention of 0.2 nmol/L ANGII to CD4 + T-lymphocytes, and store them in the incubator 48 h. The difference of Kv1.3 channel current of CD4 + T-lymphocyte, mRNA, angiotensin receptor (AT1R) protein mRNA, and IFN-γ density has also been compared. RESULTS: The membrane capacitance, peak current, and current density of group A, are higher than those of the other two groups, and the differences have statistical significance (p<0.05). After adding ANGII intervention to group A, the expression levels of T-lymphocyte Kv1.3 potassium channels mRNA, AT1R mRNA, and IFN-γ are significantly increased, so that the difference has statistical significance p<0.05, while the other two groups have no significant change (p>0.05). The levels of Kv1.3 potassium channels, AT1R mRNA, and IFN-γ of group A before and after the intervention are significantly higher than those of the other two groups, and the differences are statistically significant (p<0.05). CONCLUSIONS: Vascular aging caused by hypertension may be linked to the increase of Kv1.3 potassium channel activity of T-lymphocyte, while ANGII can improve the high expression of Kv1.3 potassium channel and AT1R, to stimulate lymph cells to secrete IFN-γ.

[Studies on electrophysiology of lysophosphatidylcholine and evaluation of its clinical significance].

The cellular electrophysiological effects of lysosphatidylcholine (LPC) were investigated by using patch-clamp whole cell recording and conventional microelectrode technique, LPC(10 microns) suppressed the sodium, background potassium and calcium current and the effect of LPC on activity of ionic channels was nonselective. Resting potential, action potential amplitude and maximal rate of rise of phase of action potential were decreased with LPC (50 microns) perfusing. The incidence of abnormal automaticity, early after depolarization (EAD) and delayed after depolarization (DAD) was higher. It is clearly shown that LPC accumulates at early time of myocardial ischemia and thus may induce ischemic arrhythmias.