Therapeutic effects of sodium nitroprusside combined verapamil for no-reflow during percutaneous coronary intervention / 心血管康复医学杂志

Objective:To explore therapeutic effects of sodium nitroprusside (SNP) combined verapamil on no-reflow during percutaneous coronary intervention (PCI).Methods: A total of 106 patients, who suffered from no-reflow during PCI in our department from Jan 2011 to Dec 2013, were selected.According to random number table method, patients were divided into SNP group (n=55, received SNP based on routine treatment) and combined treatment group (n=51, received verapamil based on SNP group).Cardiac troponin I (cTnI) level before and 16h~18h after PCI, cardiac function indexes after 12-month follow-up, incidence of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before PCI, there were significant rise in cTnI level in both groups on 16~18h after PCI, P=0.001 both;compared with SNP group, there were significant reductions in cTnI level [(1.31±0.44)μg/L vs.(0.11±0.02)μg/L] and percentage of cTnI>0.10μg/L (94.5% vs.54.9%) in combined treatment group, P=0.001 both.Compared with SNP group after 12 months, there was significant rise in left ventricular ejection fraction [(62.29±3.06)% vs.(65.65±3.94)%], and significant reductions in left ventricular end-diastolic dimension[(50.24±3.73)mm vs.(47.60±4.72)mm] and left ventricular end-systolic dimension [(33.29±2.11)mm vs.(31.00±4.33)mm] in combined treatment group, P<0.05 all.There were no significant adverse reactions during hospitalization and follow-up in both groups.Conclusion: When no-reflow occurs during PCI, intracoronary injection of SNP combined verapamil can improve cardiac function, and its safety is good, which is worth extending.

Effect of Probucol on Enzyme and Receptors of High Density Lipoprotein During Reverse Cholesterol Transportation in Experimental Rabbits With Atherosclerosis / 中国循环杂志

Objective: To explore the effect of probucol on enzyme and receptors of high density lipoprotein (HDL) during reverse cholesterol transportation in experimental rabbits with atherosclerosis. Methods: A total of 24 New Zealand rabbits were randomly divided into 3 groups: Control group, the rabbits were fed by normal diet, High cholesterol group, the rabbits were fed by high cholesterol diet and Probucol group, the rabbits were fed by high cholesterol diet with probucol.n=8 in each group, all animals were treated for 12 weeks. Blood levels of lipids were examined by colorimetric method, serum lecithin cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) were detected by ELISA, expressions of ATP binding cassette transporter A1 (ABCA1) and scavenger receptor class B type I (SR-BI) in aortic plaque were measured by immunohistochemistry; the above indexes were compared among different groups. Results: ① for blood lipids by mmol/L, the following indexes in Probucol group were lower than High cholesterol group: TC (15.95±1.51 vs 21.95±3.71), LDL-C (13.01±2.28 vs 17.90±3.51), HDL-C (0.56±0.10 vs 1.13±0.12), all PConclusion: Probucol may increase blood levels of LCAT, CETP via up-regulating the expressions of ABCA1, SR-B1 and elevating the reverse cholesterol transportation of HDL, therefore improve HDL function in experimental rabbits with atherosclerosis.

The antithrombotic therapy for patients with atrial fibrillation undergoing percutaneous coronary intervention / 实用医学杂志

Objective To compare the efficacy and safety of singular double antithrombotie therapy (DT) using warfarin plus clopidogrel and the combined antithrombotie therapy of 3-month triple antithrombotie therapy (TT) using warfarin, aspirinand clopidogrel and 9-month double antithrombotie therapy (DT) for the patients with atrial fibrillation undergoing PCI. Methods Ninety patients with atrial fibrillation undergoing PCI were randomly divided into two groups evenly: one group was treated with dual antithrombotic therapy group (DT) and the other group with the combined therapy, e. g. 3-month triple antithrombotie therapy (TT) and 9-month double antithrombotie therapy (DT + TT for short). All patients were followed-up by 12 months. The two groups were compared in terms of incidences of death , myocardial infarction , stroke , target-vessel revascularisation , stent thrombosis and bleeding adverse events. Results The incidences of myocardial infarction, stroke, target-vessel revascularisation , stent thrombosis and bleeding adverse events in the TT + DT group were all significantly lower than the DT group (P 0.05). Conclusion There is no significant difference in safety between the two groups. However, the therapy of TT + DT is more effective.

Therapeutic effect of combined therapy of esmolol hydrochloride and amlodipine on patients with hy-pertension complicated aortic dissection / 心血管康复医学杂志

Objective:To explore therapeutic effect of esmolol hydrochloride combined amlodipine on patients with hyper-tension complicated aortic dissection (AD) and its influence on patient's blood pressure (BP) and heart rate (HR) .Meth-ods:A total of 110 patients with hypertension complicated AD were randomly and equally divided into amlodipine group and combined treatment group (received amlodipine and esmolol) .Results:Compared with before treatment , after treat-ment 0. 5 ,1. 5 and 7h ,there were significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both groups ,P<0.01 ,on 7h after treatment ,SBP level of combined treatment group significantly reduced than that of amlodipine group [(101.5 ± 7.8) mmHg vs .(123.4 ± 10.2) mmHg ,P<0.01];on 0.5 ,1.5 and 7h after treatment ,HR and rate pressure product (RPP) of combined treatment group significantly reduced than those of amlodipine group , P<0. 01 all. Compared with amlodipine group after treatment , there were significant rise in standard-reaching rates of BP (56.36% vs .87.27% ) ,HR (38.18% vs .92.73% ) and BP+HR (25.45% vs .81.82% ) in combined treatment group , P<0.01 all. Conclusion:Esmolol combined amlodipine can control blood pressure and heart rate rapidly ,safely and effec-tively in patients with hypertension complicated aortic dissection .

Diagnostic value of cardiac magnetic resonance in patients with acute viral myocarditis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute viral myocarditis.</p><p><b>METHODS</b>Thirty patients with suspected acute viral myocarditis admitted in first people's hospital of Shunde from June 2011 to June 2013 were included in this prospective study. The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of acute viral myocarditis were evaluated by clinical diagnosis. Diagnostic value among different scan methods and Lake Louise criteria were compared.</p><p><b>RESULTS</b>Acute viral myocarditis was diagnosed in 63.33% (19/30) patients.Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 57.89%, 72.73%, 78.57%, 50.00%, 63.33%, respectively by edema imaging (ER).Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 78.95%, 63.64%, 78.95%, 63.64%, 73.33%, respectively using global relative enhancement (gRE).Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 78.95%, 54.55%, 75.00%, 60.00%, 70.00%, respectively using late gadolinium enhancement (LGE) criteria.Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 84.21%, 81.82%, 88.89%, 75.00%, 83.33% using Lake Louise criteria. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy using Lake Louise criteria were significantly higher than using ER, gRE, LGE alone(all P < 0.05).Specificity was higher using ER than using gRE and LGE (both P < 0.05). The sensitivity, NPV, and diagnostic accuracy were significantly higher using gRE than using ER (all P < 0.05) and was similar as using LGE (all P > 0.05).</p><p><b>CONCLUSION</b>Cardiac magnetic resonance is an excellent imaging modality for the diagnosis of acute viral myocarditis.</p>

Occurrence and prognosis of coronary slow flow in emergency percutaneous coronary intervention: correlations with homocysteine / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation of the occurrence and prognosis of coronary slow flow phenomenon (CSF) with blood homocysteine (Hcy) levels in patients receiving emergency percutaneous coronary intervention therapy (PCI).</p><p><b>METHODS</b>From January, 2010 to December, 2011, 138 patients with ST-elevation myocardial infarction received emergency angioplasty, among whom 46 patients developed CSF and 92 did not (control group). Blood Hcy levels were determined in these patients. The patients with CSF were classified into two groups with mild and moderate Hcy elevations (32 and 14 cases, respectively), and the left ventricular ejection fraction (LVEF) during hospitalization and at 3 months of follow-up as well as major adverse cardiac events (MACE) were compared between the two groups and analyzed for their association with Hcy level.</p><p><b>RESULTS</b>The patients with CSF showed significantly higher blood Hcy levels than the control patients (P=0.001). At 3 months of follow-up, the patients with CSF and moderate Hcy elevation had significantly lower LVEF (P=0.031) and higher incidence of MACE (P=0.019) than those with mild Hcy elevation. Hcy levels were negatively correlated with LVEF (r=-0.310, P=0.036) and positively with MACE (r=0.342, P=0.02).</p><p><b>CONCLUSION</b>A high blood Hcy level is closely correlated with the occurrence of CSF in emergency PCI, affects the recovery of LVEF and increases the incidence of MACE.</p>

Effect and safety of tirofiban in acute coronary syndrome patients with no reflow after intevention procedure / 中国基层医药

Objective To observe the clinical effect and safety of platdet GP Ⅱb/Ⅲa receptor antagonist firofiban on acute coronary syndrome(ACS)patients with nO reflow after intevention procedure.Methods 48 ACS patients with no reflow were randomly divided into tirofiban group(n=26)and control group(n=22),the tirofiban group received intravenous tirofiban for 48-36homs,control group received nitroglycerin and urokinase.The rate of the TIMI grade offorward flow and the primary end pints(death,persistent myocardial isehemic and new onset myocardial infarction)and adverse reactions of drags were observed Resalts Tirofiban improved target vessel TIMI flow significantly than control groug(73.8%vs 18.2%,P＜0.01),the rate of the main end point events significantly decreased(15.4%vs 63.6%,P＜0.05),the bleeding complications was similar between two groups,no severe bleeding events occurred.Condusion Tirofiban is effecfive and safe in treating ACS patients with no reflow.

The study on the application of active fixation electrodes in patients with right ventricular outflow tract septal pacing / 中国医师进修杂志

Objective To explore the feasibility of right ventricular outflow tract (RVOT) septal pacing. Methods Fifty-two patients implanted with pacemaker were randomly divided into two groups. One group underwent the RVOT septal pacing with active fixation electrodes (active fixation electrodes group, 22 cases),and the other group underwent the right ventricular apical pacing with passive fixation electrodes (passive fixation electrodes group, 30 cases). The parameters of two groups in operation were recorded. Results The successful rate of RVOT septal pacing was 100%, active fixation electrodes group took more time to plant electrodes and expose in X-ray than passive fixation electrodes group [ (56.13±1.18)min vs (15.42±1.24) min, (18.77±6.14) min vs (10.12±8.14) min, P<0.05]. The width of the QRS wave of active fixation electrodes group was narrower than that of passive fixation electrodes group [(0.14±0.02)ms vs (0.16±0.04) ms, P< 0.05]. The parameters of two groups were stable in follow-up period and none of electrodes was extracted. Conclusion The usage of active fixation electrodes in patients with RVOT septal pacing is feasible and safe.

Analysis and reduction strategy of complication in 103 older patients with pace markers implantation / 中国基层医药

Objective To explorethe complication and its cause and treatment of pace markers implantation in older patients. Methods To analyze the complication in 103 older patients with pace markers implantation. Resuits 5 patients happened complication(4.8 % ), the common complications related to operation were blood effusion and he matoma formation in pocket 4 cases,pocket infection 1 case. Occurrence of blood effusion was related to aspirin administration. Conclusion The older patient with pace marders implantation is safe.

Clinical application of emergency percutanous coronary intervention in the treatment of acute myocardial infarction / 中国基层医药

Objective To analyze the immediate and following up result of 122 patients with acute myocardlal infarction(AMI)which underwent emergency percutaneous coronary interventlon(PCI).Methods 122 cases of AMI patients underwent the emergency PCI by transfemoral artery approach during June 1998 to December 2005.119 casea performed primary PCI,3 performed rescue PCI.Results The successful rate of vessel visualization and operation were 95.1%.93.4%.respectively.5 eases were with the help of intra-aortic balloon pumping.Subacute instent thrombosis occurred in 2 patients.In-hopital mortality was 4.1% (5/122).The left ventricular ejection fraction in echocardiography one after week was(0.55±0.16).Average hospital day is(9.5±5.8)(1～36).6-month mortality was 5.7%(7/122).Conclusion Primary PCI expanded the indication for the treatment of STEMI patients wlth establishment of patent infarct related artery and normal blood flow,increased tlle survival of high-risk patients,and shortened the hospitalization.Rescue PCI was an effective measure for the patients failing to intravenous thrombolysis.

Therapeutic effect of losartan on cardiac remodeling for patients with idiopathic dilated cardiomyopathy / 中国实用内科杂志

Objective To assess the therapeutic effect of losartan on cardiac remodeling for patients with idiopathic dilated cardiomyopathy (IDCM). Methods From Jan.1997 to Dec.2002,UCG was performed in 56 patients with IDCM.They were divided into two groups.The first group of 30 patients were treated with losartan (50mg) plus ?-receptor blocker per day.The other group of 26 patients received standard conventional therapy,including cardiac,diuretic and potassium-spring.All patients were interviewed once a month for the following 6 months.The results of UCG were based on the examination taken by the end of 3 months and 6 months. Results In the first group,UCG improved significantly ( P 0.05). Conclusion Losartan may be effective to restrict the heart reconstruction and reduce the heart weigh and improve the heart function after 3-month therapy and may be more effective after 6 months of therapy.