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Objective To investigate the changes and clinical significance of the plasma growth differentiation factor-15 (GDF-15) in patients with chronic congestive heart failure (CHF). Methods A total of 100 patients with CHF were in?cluded in this study (CHF group), and 30 healthy persons were used as control group. CHF group was divided into heart func? tionⅡgrade (n=35),Ⅲgrade (n=32),Ⅳgrade (n=33) groups in accordance with New York Heart Association (NYHA). And CHF group was also divided into left ventricular ejection fraction (LVEF)<0.4 grade (n=52) and LVEF≥0.4 grade (n=48) groups in accordance with LVEF of patients. The plasma GDF-15 and brain natriuretic peptide (BNP) levels were detected by ELISA. The values of LVEF, left ventricular end-diastolic diameter (LVDd), left ventricular systolic diameter (LVDs) and left ventricular fractional shortening (LVFS) were detected by echocardiography. The correlation of GDF-15, NYHA classifi?cation, BNP and index of echocardiography was analyzed between groups. Results Compared with control group, the levels of BNP, GDF-15, LVDd and LVDs were significantly higher in heart failure group, and values of LVEF and LVFS were sig?nificantly lower (P<0.05). The plasma levels of BNP, GDF-15, LVDd and LVDs were in turn increased in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group. The plasma levels of LVFS were in turn decreased, in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group (P<0.05). There were positive correlations between the plasma levels of GDF-15 and BNP, NYHA, LVDd and LVDs (r=0.524, 0.286, 0.453 and 0.531, P<0.05). The plasma level of GDF-15 was negatively correlated with LVEF and LVFS (r=-0.592,-0.587,P<0.05). Conclusion The plasma level of GDF-15 can be used as a new marker for diagnosis, treatment and prognosis in patients with chronic congestive heart failure.
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Objective To assess under different vessel diameter ,the effect of the aspiration thrombectomy catheter in improving the myocardial reperfusion and clinical prognosis in patients with acute myocardial infarction (AMI)who were undergone primary percutaneous coronary intervention(PCI) .Methods 205 patients with AMI immediate implant stents after thrombus suction ,the TIMI flow grade(myocardial infarction thrombolysis treatment test flow classification ) ,postoperative ecg evolution ,incidence of no-reflow MACE in 30 days and MACE in 6 months were compared between conventional thrombus suction group and suction again group(blood vessels of <3 .0 mm and ≥3 .0 mm) .Results The level 3 blood flow rate ,MACE in 6 months in suction again group with blood vessels of ≥3 .0 mm had improved significantly ,but had no beneficial effects in blood vessels of ≥3 .0 mm .Conclusion In AMI patients treated with primary PCI ,application of aspiration thrombectomy catheter with blood vessels of ≥3 .0 mm may im-prove the flow condition before infarction related blood vessels ,reduce MACE .
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Objective: To investigate the protection roll of rosuvastatin on chronic heart failure (CHF) in rats with its effect on asymmetric dimethylarginine (ADMA) metabolic pathway. Methods: A total of 36 male SD rats were randomly divided into 3 groups, n=12 in each group. Isoproterenol (ISO) group, the rats received ISO subcutaneous injection (5mg·kg·d) for 7 days to establish CHF model, and then received normal saline gavage administration for 7 days. Rosuvastatin (ROS) treatment group, the rats received ISO with ROS for 7 days, then continuously receiving ROS until 14 days. Normal control group, the rats received saline gavage administration for 7 days. The related serum index and haemodynamic parameters were examined, myocardial pathological changes were observed and the relevant protein expression was measured by Western blot analysis. Results: Compared with Normal control group, ISO group had obviously increased troponin (cTn I), serum ADMA,-LVdP/dtmin, all P0.05. Conclusion: Rosuvastatin has the protective roll on ISO induced CHF in rats, which might be related to decreased serum levels of cTn I, BNP and ADMA metabolic pathway regulation.
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Objective To investigate the change of serum CD62p of coronary heart disease (CHD) patients after different doses of clopidogrel administration.Methods One hundred and ninety-one patients with CHD were selected as our subjects.Of which,95 cases were with SAP and 66 cases were with non ST segment elevation acute coronary syndrome (NST-ACS).SAP patients were randomly given clopidogrel at dose of 75 mg/d or 150 mg/d and served as A and B groups.NST-ACS patients were randomly given 300 mg clopidogrel,then randomly divided into C and D groups with sequentially taking clopidogrel at dose of 75 mg/d or 150 mg/d respectively.Thirty healthy peoples were served as E group without drug intervention.Concentrations of serum CD62p were detected by Elisa before taking clopidogrel,24 h and the fifty day of after taking clopidogrel.Results (1) Before taking clopidogrel,the serum concentrations of CD62p in CHD patients were higher (A group:(7.62 ± 2.99) ng/L,B group:(8.48 ± 3.13) ng/L,C group:(9.50 ± 3.32) ng/L,D group:(10.22 ± 5.14) ng/L than that of healthy control group ((5.49 ± 1.99) ng/L,P ＜ 0.05).The Serum CD62p levels in SAP patients were lower than that of NST-ACS patients (P ＜ 0.05).(2)The serum concentrations of CD62p in A and B groups at before taking clopidogrel were (7.62 ±2.99) ng/L and (8.48 ±3.13) ng/L respectively,higher than that four days after taking clopidogrel ((6.79 ± 2.51) ng/L,(6.37 ± 1.80) ng/L;t =2.390,4.520;P ＜0.05 or P ＜0.01).There was no statistical significant difference between A and B groups(P ＞0.05).(3) In C and D groups,the serum CD62p at before taking clopidogrel were (9.50 ±3.32) ng/L and (10.22 ±5.14) ng/L,higher than that after taking clopidogrel for four days ((8.21 ± 2.62) ng/L,(8.17 ± 2.37) ng/L; t =2.084,2.157 ; P ＜ 0.05).No significant difference was seen between C and D groups (P ＞ 0.05).Conclusion The serum CD62p in patients with CHD was higher than that in the healthy control.Clopidogrel administration can decrease serum CD62p in CHD patients.
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Objective To evaluate the changes of platelet activity before and after anti-platelet treatment in pa?tients with coronary heart disease, and their responsiveness to clopidogrel through detecting the phosphorylation levels of va?sodilator stimulated phosphoprotein (VASP). Methods Twenty-eight cases of healthy people were selected as control group . Patients with chronic stable angina pectoris (CSA, n=95) were randomly divided into A (48 cases) group and B (47 cases) group,and were given clopidogrel 75 mg/d or 150 mg/d respectively;Patients with non ST segment elevation acute coronary syndrome (NST-ACS, n=67) were all given 300 mg loading dose of clopidogrel at the first time, then randomly divid?ed into C (33 cases) group and D (34 cases) group, and given clopidogrel 75 mg/d and 150 mg/d respectively. Blood were tak?en to examine the phosphorylation levels of serum VASP by ELISA before taking clopidogrel, at time point of loading dose and the fifth day of clopidogrel administration . Results Before treatment, phosphorylation levels of serum VASP were low?er in A, B, C, D groups than those in the normal control group(P0.05).②In group C and group D, phosphorylation levels of serum VASP were significantly increased at loading dose and the fifth day of clopidogrel administration than those before treatment (P 0.05). Conclusion The phosphorylation level of serum VASP was lower in patients with coronary heart disease than that in normal control group. Clopidogrel can improve the phosphorylation level of serum VASP in NST-ACS patients .
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Objective To evaluate the effects of thrombus aspiration on postoperative clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention(PCI).Methods From September 2009 to January 2012,a total of 239 patients with STEMI undergoing emergency PCI (thrombus aspiration + PCI (n =118) and PCI (n =121)) were enrolled in this study.The angiographic and clinical results were retrospectively analyzed and compared between the two groups of patients.Results There were significant differences between the thrombns aspiration group and the PCI group on instant blood flow TIMI3 grade (106 (89.8％) vs.96 (79.3％) ; x2 =5.026,P ＜ 0.05),ST-segment depression rate at two hours after surgery (101 (85.6％) vs.90 (75.2％) ; x2 =5.500,P ＜ 0.05),ejection fraction within one week after surgery (68 (57.6％) vs.52 (43.0％) ; x2 =5.130,P ＜ 0.05),incidence of reinfarction during hospitalization (0 (0) vs.5 (4.1％) ; x2 =4.980,P ＜ 0.05).There were no significant statistical difference between the two groups on the average length of stay ((10.05 ± 5.40) d vs.(10.40 ± 5.03) d; t =-0.525,P ＞ 0.05),incidence of ventricular fibrillation during surgery (4 (3.4％) vs.3 (2.5 ％ ; x2 =0.174,P ＞ 0.05),heart failure during hospitalization (15 (12.7％) vs.18 (14.9％) ; x2 =0.235,P ＞0.05),Malignant arrhythmias (12 (10.2％) vs.15 (12.4％) ; x2 =0.296,P ＞ 0.05),and mortality rate (2 (1.7％) vs.5(4.1％);x2 =1.248,P ＞0.05).Conclusion Application of thrombus aspiration,which is a safe and effective way,may improve the clinical outcomes in acute ST-segment elevation myocardial infarction patients with emergency PCI.
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Objective To observe the levels of matrix metalloproteinases-9 (MMP-9) and tissue factor (TF) as well as blood lipid in patients with acute coronary syndrome (ACS) ,and to study the effect of Fluvastatin on levels of serum MMP- 9 and plasma TF. Methods 40 patients with ACS were selected (including 20 patients with AMI and 20 patients with UAP) ,20 stable angina patients (SAP) and 13 patients without coronary heart dis-ease as control group. 40 patients with ACS were randomly assigned to the Fluvastatin group (n = 20) and the rou-tine group (n = 20) in this study. The MMP - 9 and TF were detected on admission and after 2 weeks treatment. Re-suits The levels of MMP-9 and TF were significantly higher in ACS group than that of SAP and control group (P < 0.001 ,P < 0.05) ,which were elevated in AMI group compared with that of UAP group (P < 0.05). The levels of cholesterol (TC) ,low density Lipoprotein (LDL - C) ,MMP- 9,TF decreased significantly at two weeks after treat-ment in fluvastatin group (P < 0.05), but no significant changes were observed in the routine group (P > 0.05). The change of MMP 9, TF and blood lipid was not related in fluvastatin group (P > 0.05). Conclusion Serum MMP-9 and plasma TF in ACS patients are significantly elevated and fluvastatin decreases the levels of MMP-9 and TF after two weeks treatment,so it may be benefit to atheroaclerotic plaque stabilization and prohihit thrombosis for-marion, and this is not related to regulation of blood lipid.