ABSTRACT
Objective To study the changes and their value of ultrasonic myocardial integrated backscatter (IBS)in normal control and patients with super-acute phase of myocardial infarction. Methods There were 38 cases of acute myocardial infarction(AMI)patients in the super-acute phase(time ＜ 2 h infarction)and the acute phase(infarction time ＞ 2 h,typical ECG changes)for myocardial ultrasonic backscatter parameters detection,an additional 25 cases as healthy control group. The myocardial infarction region and non-infracted myocardial tissue region average duration of cardiac cycle of integrated backscatter(IBS)were measured,and IBS adjusted value (IBS%)was calculated as the ratio of myocardial IBS to the pericardium,the difference of IBS at end-diastolic and late systolic was used as cyclic variation of IBS(CVIB). The ratio of IBS to pericardial CVIB was used as its adjusted value(CVIB%). Over the same period for the electrocardiogram,myocardial enzymes and cardiac troponin I were measured. Results When ECG was not typically changed in patients with super-acute phase AMI,the IBS values significantly increased in the myocardial infarction region than the normal control group (43. 7 ± 10. 8)dB vs.(22. 6 ± 4. 6)dB,P ＜0.01),and CVIB was significantly lower than that in the normal control group(10. 2 ±2. 6)dB vs.(13. 2 ± 3.8)dB,P ＜ 0.01]. The IBS in the acute phase in patients was significantly higher than that in the normal control group and those non-infarcted areas,and CVIB was significantly lower than that in the normal control group and those in the non-infarcted areas. The changes were consistent with the ECG changes. Conclusions Ultrasonic backscatter parameters might be helpful for diagnosis of hyperacute period of AMI,and the determination of the scope and extent of AMI.
ABSTRACT
BACKGROUND: The inflammatory reaction occurs following implantation of cardiovascular stent with manifestations of the activation of blood coagulation system and dramatically increasing of inflammatory markers serum C-reactive protein. OBJECTIVE: To explore the changes of inflammatory reaction and C-reactive protein in coronary artery disease patients following cardiovascular stent implantation.METHODS: A computer-based online search of CNKI (1990/2009) and PubMed databases (1990/2009) was performed for related articles with the key words "cardiovascular stent, C-reactive protein" in Chinese and "cardiovascular stent on plasma, C-reactive protein" in English.RESULTS AND CONCLUSION: Based on the metal stents, drug-eluting stents can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis, Main drugs of anti-inflammatory drug-eluting stent include dexamethasone and methylprednisolone. Main drugs of anti-migratory and anti-proliferative drug-eluting stent includerapamycin, paclitaxel and actinomycin D. Main drugs of supporting intima concrescence stent include estradiol. Coronary artery stents implantation can induce and aggravate local inflammation reaction, which have important infection for vascular endodermis hyperplasia and restenosis occurrence. Some impressible index for inflammation reaction, such as levels of C-reactive protein,have predictive value for vascular events following the coronary artery stents implantation. A significant increase in plasma C-reactive protein after coronary stenting has been observed following stent implantation. Therefore, understanding of inflammatory reaction and C-reactive protein, as well as cytokine changes is important for preventing restenosis, early treatment of restenosis, as well as improving treatment effect.