The effects of vitamin D deficiency on the cardiac oxidative stress in mice and the underlying mechanisms / 医学研究生学报

Objective Previous studies have shown that vitamin D deficiency is closely related to cardiac remodeling. How?ever, the underlying mechanisms have not been fully elucidated. Moreover, oxidative stress plays an important role on the pathologies of cardiac remodeling. The aim of this study was to explore the influence of VD deficiency on cardiac oxidative stress and the potential sig?nal pathway. Methods The male C57 mice ( 3 weeks old) were randomly divided into three groups: vitamin D deficiency ( VDD ) group ( vitamin D deficiency feed for 10 weeks) , vitamin D deficiency ( VDA) group ( vitamin D sufficiency feed for 10 weeks) and VDD+calcitriol ( CAL) group ( vitamin D deficiency feed for 10 weeks and then vitamin D sufficiency feed and calcitriol treatment for 10 weeks) . Results There were significant differences between the VDD group and the VDA group in the left ventricular end?diastolic diameter and left ventricular mass index (3.82±0.125 mm vs 3.748±0.092 mm, P<0.05) (119.30±8.54 vs 97.60±3.65, P<0.05). The number of myocardial cells stained with 8?OHDG was higher in the VDD group compared with the VDA group ( 65. 4 ± 2. 3 vs 21. 8 ± 1. 6, P<0.05) whereas was lower after calcitriol supplement. Furthermore, the expression of thioredoxin interacting protein (TXNIP) was sig?nificantly up?regulated and the ratio of p?ASK?1/ASK?1, cytochrome C release, and caspase3 activation were increased in the VDD group . Conclusion VDD can lead to cardiac oxidative injury and the up?regulation of TXNIP and the activation of ASK?1 related apoptotic signal cascade may be involved in this procedure.

Comparison of results and complications of surgical and Amplatzer device closure of perimembranous ventricular septal defects.

BACKGROUND: Surgery for perimembranous ventricular septal defects (VSD) is widely accepted procedure with minimal operative mortality. Recent publications have reported the feasible, safe, and effective with the new Amplatzer VSD occluder. This study was done to compare the effectiveness, cost, and complications of both the techniques. METHODS: One hundred twenty-one consecutive patients from 2 to <18 years of age underwent VSD closure: 48 patients were treated surgically and 73 patients were treated with percutaneous Amplatzer occluder. Success rate, complications, cost, hospital stay, and home convalescent times were measured. RESULTS: The closure rate was similar in the 2 groups: 48/48 patients (100%) in the surgical group versus 71/73 patients in the Amplatzer group (97%). Procedure complications affecting management occurred in four patients of the Amplatzer group (5.5%) and four patients of surgical patients (8.3%) (p=NS). The complications that did not need treatment were observed 25/48 patients (52%) in the surgical group versus 14/73 patients (19%) in the Amplatzer group (p<0.01). Both hospital stay and home convalescent times were significantly shorter after Amplatzer closure (median hospital stay: Amplatzer three days and surgery eleven days; median convalescent time: Amplatzer two weeks and surgery six weeks). Median cost was similar for both groups. CONCLUSIONS: The closure rate was similar in the Amplatzer VSD closure and surgical closure. There were more complications in the surgical group but the majority of these was minor and did not require any change in management. Hospital stay and home convalescent times were significantly shorter after Amplatzer closure. The cost of both techniques was similar. Nevertheless, the surgeon's ability to close any VSD, regardless of anatomy, remains an important advantage of surgery.

Impact of glycometabolic status on cardiac function and recovery in the early phase of acute myocardial infarction / 中国综合临床

Objective To explore the disparity of severity of cardiac dysfunction and recovery among different glycometabolic patients in the early phase of acute myocardial infarction (AMI) . Methods Consecutive 111 AMI patients without known diabetes underwent continuous glucose monitoring. Patients with different glycometabolic status were compared in terms of cadiac dysfunction and recovery at admission and 3month follow up. Results Compared to patients with normglycemia and transient hyperglycemia, patitents with persistent hyperglycemia were more likely to grade Killip Ⅱ or above,which were 13.3% (4/30) ,33. 3% ( 12/36) ,55. 6% (25/45), 20. 0% ( 6/30), 41.7% ( 15/36 ) and 93.3% (42/45) ( Ps ＜ 0. 01 ). In-hospital left ventricular ejection fraction (LVEF), mitral valve protodiastolic E peak velocities (E) and its ratio to late diastolic (E/A) decreased significantly ( LVEF :0. 52 ± 0. 02,0. 48 ± 0. 01 and 0. 37 ± 0. 02; E: [0. 65 ± 0. 41]m/s,[0.55 ± 0.02] m/s and [0.39 ±0. 12]m/s;E/A:1. 15 ±0.08,1.02 ±0.06 and 0.61 ±0.02,respectively) ( Ps ＜ 0. 01 ), whereas LVESV and WMSI increased significantly ( LVESV: [25.83 ± 0. 51] ml,[31.26 ± 1.23] ml, [37, 72 ± 1.01] ml; WMSI: 1.5 ± 0. 3,1.8 ± 0. 2 and 2. 6 ± 0. 4, respectively) ( Ps ＜ 0. 01 )There months after AMI,patitents with persistent hyperglycemia were more likely to grade NYHA Ⅱ or above compared to patients with normglycemia and transient hyperglycemia [67.5% (27/40), 10.0% (3/30) and 11.8% (4/34),respectively] (P ＜0. 01 ). Echocardiographic recovery was observed in each group,but less in persistent hyperglycemia patients. Conclusion Cardiac function of patients with persistent hyperglycemia suffered more severely from AMI and difficult to recover.

A continuous glycemic observation during early phase of acute myocardial infarction in patients without known diabetes mellitus / 中华内分泌代谢杂志

One hundred and eleven patients with acute myocardial infarction and without known diabetes mellitus who underwent continuous glucose monitoring were divided into normoglycemia(n = 30),transient hyperglycemia(n = 36),and persistent hyperglycemia(n = 45)groups.Compared with other two groups,higher mean blood glucose,standard deviation of blood glucose,largest amplitude of glycemic excursions,mean amplitude of glycemic excursions,and absolute mean of daily differences were observed in the patients with persistent hyperglycemia group(all P<0.01),who were more likely to be female with the history of hypertension and old myocardial infarction(all P<0.05).It was shown that the levels of aspartate aminotransferase,creatine phosphokinase(CK),CK-MB,total cholesterol,triglyceride,low-density lipoprotein cholesterol,HbA1C,and C reactive protein levels were higher in these patients(P<0.01).

Gender and age differences in the prevalence of coronary artery calcification in 953 Chinese subjects.

BACKGROUND: To investigate gender and age differences in coronary artery calcium (CAC) as determined by electron beam computed tomography (EBCT) in a Chinese population. METHODS: Consecutive patients undergoing EBCT were subdivided into groups based on gender and decades of life. They were further subdivided into three groups with respect to symptoms of coronary artery disease: typical, atypical and asymptomatic. Total calcium score was calculated for each patient and means calculated for each subgroup. Groups were then compared with respect to age, gender and symptoms. RESULTS: During the study period, 953 patients (736 men and 217 female) aged 17-86 years (mean 55+/-11 years) underwent EBCT. The prevalence of CAC increased significantly with increasing age. The mean total calcium score also increased with increasing age in males and females of each symptom subgroup. The prevalence of coronary artery calcification was significantly higher in males than females until age in excess of 69 years (p<0.05). The prevalence of coronary artery calcification and mean calcium scores were significantly different between each symptom subgroup (p<0.001) with higher scores and prevalence in patients with typical symptoms of coronary disease. CONCLUSIONS: There is an increase in the prevalence of coronary artery calcification with age in Chinese subjects. Male subjects are more likely than female subjects to have detectable coronary calcification up until an age in excess of 69 years. Patients under the age of 70 years, with typical symptoms of coronary artery disease have a higher prevalence and mean calcium score than those with atypical or no symptoms.

Plasma brain natriuretic peptide and atria natriuretic peptide as predictors for diastolic heart failure in patients with type 2 diabetes mellitus / 老年心脏病学杂志（英文版）

Objective To study the change of diastolic cardiac function in diabetic patients and to determine the diagnostic value of plasma brain natriuretic peptide (BNP) and atria natriuretic peptide (ANP) for diastolic heart failure in patients with type 2 diabetes mellitus.Methods Twelve healthy subjects and seventy-one diabetic patients were included in the study.Plasma BNP and ANP were measured with immunoradiometic assay.Results Plasma levels ofBNP andANP increased significantly with increased severity of diastolic heart dysfunction.The ratio of E/A had significant negative correlation with the plasma levels of BNP (r=0.669,P＜0.001) and ANP (r=0.579,P＜0.01).AUC of ANP and BNP in ROC model was 91.9% and 65.3%,respectively.Conclusions The plasma level of BNP might be a valuable predictor for differential diagnosis of diastolic cardiac function in diabetic patients.

Relationship between blood gluocose level on admission and prognosis in female patients with acute myocardial infarction / 中国综合临床

Objective To approach the effect of hyperglycemia on admission on the prognosis in female pa-tients with acute myocardial infarction (AMI) during hospital stay. Methods 171 female AMI patients without a history of diabetes mellitus from January 1998 to December 2007 were divided into 3 groups according to the blood glucose level on admission. Group Ⅰ included 69 cases with blood glucose <6. 1 mmol/L,group Ⅱ included 49 cases with blood glucose between 6.1 and 7.8 mmol/L,and group Ⅲ included 53 cases with blood glucose >7.8 mmoL/ L. The basic clinical profile, infarct sites, the incidence rates of the main complications and the mortality of the pa-rhythmia among group Ⅲ ,group Ⅰ and group Ⅱ were significantly different ( the incidence rate of cardiac failure was 30.43% (21/69) ,32.65% (16/49) and 58.49% (31/53), the incidence rate of cardiogenic shock was 5.80% (4/69) ,8.16% (4/49) and 24.53% (13/53) ; the incidence rate of severe arrhythmia was 24.64% (17/69) ,30. 61% (15/49) and 54.72% ( 29/53), respeetivley in group Ⅰ, group Ⅱ and group Ⅲ, P < 0.05 for each). The in-hospital mortality in group Ⅲ (28.30% (15/53) ) was remarkably higher than group Ⅰ ( 13.04% (6/69)) ,with significant difference ( P < 0.05 ). Conclusions Elevated blood glucose level on admission is associated with s markedly increased risk of cardiac failure,severe arrhythmia,cardiogenic shock and mortality during hospital stay in female patients suffering from AMI.

Clinical and functional features of patients with left main coronary artery stenosis / 中国医师进修杂志

Objective To describe clinical and functional features of patients with left main coronary artery (LM) stenosis. Methods Significant stenosis was defined as ≥ 50%.One hundred and eighty-eight patients with LM stenosis and 200 patients with clinically suspected coronary heart disease (CHD) without LM stenosis were enrolled. Results (1) The incidence rate of LM stenosis was 5.59%.(2) Patients with LM stenosis all had risk factors.Furthermore,featured older age,higher incidence of angina pectoris,and the same incidence of myocardial infarction history when compared with the patients without LM stenosis.(3) The left ventricular ejection fraction was lower in patients with LM stenosis than that in patients without LM stenosis,and it was lower too in patients with isolated LM stenosis than in patients with LM stenosis accompanied by triple vessel stenosis.The left ventricular end diastolic pressure showed no significant difference among various groups. Conclusion Patients with LM stenosis feature older age,severe angina pectoris.Furthermore, most of them are accompanied by other vessel lesions.Most LM stenosis are located at the ostium and the crotch of LM is presented as stenosis

Cholesteryl ester transfer protein level in male patients with different degrees of coronary artery lesion and its clinical significance / 临床检验杂志

Objectives To explore cholesteryl ester transfer protein(CETP)level in male patients with different degrees of coronary artery lesion and its clinical significance.Methods ELISA was used to measure CETP of 42 male patients with coronary heart disease(CHD)and 49 healthy male controls.The patients of CHD groups were subdivided into mono-vessel,ambi-vessel,multi-vessel lesion groups;localized,diffuse lesion groups;and mild,severe stenosis groups according to coronary angiography.Results The CETP level of patients with CHD(1.37?1.07 mg/L)was significantly higher than that of healthy control(0.99?0.53 mg/L)(P

Quality control on all the parts of percutaneous coronary intervention / 医学研究生学报

Objective:TO investigate the effects of the different factors on the quality control of PCI. Methods: Elucidating the correlation of PCI with the different personnel. Results: Success or failure of PCI is related to quality of subsystems in which the most importance is to manage and control concerning personnel including operating staff,nurses and patients. Conclusion:The organic coordination and total quality management of all parts are the safeguard of successful PCI.

Transient ischemia and reperfusion induce the expression of glucose transporters GLUT1 and GLUT4 in rat myocardium / 医学研究生学报

Objective : To investigate the dynamic changes of the expression of GLUT1 mRNA and GLUT4 mRNA in rats myocardium with transient ischemia and reperfusion, and the relationship between the dynamic changes and the time during reperfusion. Methods : In rats, the left anterior descending coronary artery was occluded for 20 min followed by reperfusion for 4 hours, 1, 3 or 7 days as ischemia reperfusion model. The relative content of GLUT1 mRNA and GLUT4 mRNA in myocardium was detected by RT-PCR and gel electrophoresis imaging. Results: During myocardial post-ischemia and reperfusion, the levels of GLUT1 mRNA got up to the peak at 4th hour[ (0.666?0. 003 ) vs (0. 509?0.002) controls , P 0.05). Conclusion; Transient ischemia and reperfusion induce the expression of glucose transporters GLUT1 and GLUT4 genes in rat myocardi- um, which contribute to promote glucose utilization during ischemia, protect ischemic myocardium and improve functional recovery on reperfusion.

Percutaneous stent implantation for treatment of inferior vena cave obstruction / 医学研究生学报

Objective: To evaluate the effects of stent implantation for treatment of Budd-Chiari syndrome. Methods:A total of 16 patients with pasthepatic inferior vena cave (IVC) obstruction syndrome were treated by balloon catheters ( Polythene and Inoue ) in percutaneous transluminal angioplasty (PTA) , then stent were inserted into the obstruction. Results: The residual pressure gradient after PTA and stent implantation was decreased from (4.6?0. 3 ) kPa to (2. 1?0. 1) kPa. The diameter of IVC after PTA and stent implantation was increased from (3.8?1. 7)mm to (14. 9?2. 0)mm. Conclusion : PTA and stent implantation are effective treatment for pasthepatic inferior vena cave obstruction.

Evaluation of regional systolic and diastolic function of left ventricle in coronary artery disease using pulsed wave Doppler tissue imaging / 医学研究生学报

Objective: To assess the regional systolic and diastolic function of left ventricle by pulsed wave Doppler tissue imaging ( PW-DTI) in patients with coronary artery disease ( CAD ) . Methods : Seventy-seven cases of coronary angiography were adopted for study and grouped in terms of severity of coronary arterial lesion. Peak systolic, peak early diastolic, and peak late diastolic motion velocities (Sm, Em and Am, respectively) were recorded at 6 different sites on the basal and medial segments corresponding to the anteroseptal, posteroseptal, lateral, anterior, inferior, and posterior walls of the left ventricle with PW-DTI. Results: Am in segments corresponding to normal coronary arteries (group A) was lower than in segments corresponding to slightly stenosed coronaries (group B). There was no significant difference in Sm and Em between group A and group B. Compared with group A, Sm, Em and Am were significantly decreased in segments corresponding to severely stenosed coronary arteries ( group D). Conclusion : PW-DTI could be used to evaluate quantitatively and accurately the regional mvocardial function of left ventricle in patients with CAD.

The prevalence of coronary calcification detected by electron beam computed tomography in 959 Chinese cases / 医学研究生学报

Objectives:In situ coronary calcium is a specific anatomic marker of coronary atheroma. Electron beam CT is the first noninvasive method to determine coronary artery calcium. The aim of this study was to investigate the coronary artery calcium(CAC) in Chinese. Methods:Nine hundred and fifty-nine Chinese cases undergoing electron beam screening were divided into six age groups: ①younger than 29,②30～39,③40～49,④50～59,⑤60～69,⑥older than 70 years old, and were divided into another three groups according to coronary artery disease(CAD) symptoms.①symptomatic group: symptomatic patients with CAD;②doubtful symptom group: patients had atypical chest pain, but without sufficient information of angina,③asymptomatic group: patients without CAD symptoms. Results:① Prevalence of CAC and the total scores of CAC in asymptomatic men and women increased significantly with increased ages. ② There was a large increase in the prevalence of CAC in asymptomatic women between the age of 40～49 and 50～59. Conclusions: ①Coronary artery calcium prevalence increases with age in both men and women.②There is a marked difference in the prevalence of calcium between men and women.③The noninvasive detection of CAC by EBCT has certain prognostic and predictive value for coronary artery disease.

The current progress of uncoupling protein 2 in myocardial energy metabolism / 医学研究生学报

Uncoupling protein 2 (UCP2), a member of the mitochondrial inner membrane carrier family, partly dissipate the proton electrochemical gradient, decrease ATP production. UCP2 limits production of reactive oxygen species (ROS) and inhibits insulin secretion and regulates fatty acid oxidation. FFA, PPAR?,leptin, thyroid hormones and so on could regulate the UCP2 expression. The function of UCP2 in myocardial energy metabolism remains unknown.

The research progress of animal model of heart failure / 医学研究生学报

It is important to establish successfully animal models in the study of pathogenesis,diagnosis and treatment of heart failure.This article reviewe drecent animal models of heart failure.

Mitochondrial dysfunction and atherogenesis / 医学研究生学报

Atherosclerosis is a multifactorial disease for which the molecular etiology of many of the risk factors is still unknown.Reactive oxygen species(ROS) mediate various signaling pathways that underlie vascular inflammation in atherogenesis: from the initiation of fatty streak development through lesion progress to ultimate plaque rupture.The mitochondrial respiratory chain is the major source of reactive oxygen species as byproducts of normal cell respiration.Mitochondria may also be important target for reactive oxygen species,which may lead to mitochondrial dysfunction.Moreover,in patients with mitochondrial diseases,vascular complications are commonly observed at an early age,often in the absence of traditional risk factors for atherosclerosis.The aim of this review is to summarize the data linking mitochondrial dysfunction to the pathogenesis of atherosclerosis.

Long-term follow-up after intracoronary stent implantation / 医学研究生学报

Intracoronary stent implantation is a safe and effective treatment for coronary artery disease.In-stent restenosis has been significantly reduced by utilization of drug eluting stents.This article reviews the results of long-term follow-up after intracoronary stent implantation and their implication.

Expression and function of the glucose transporter and their correlation with heart failure / 医学研究生学报

The glucose transporter(GLUT) is an energy-related carrier protein located on the cell membrane.Most researches have shown that changes of energy metabolism play an important role in the development of heart failure.This review summarizes recent advances in the understanding of the relationship between GLUT and heart failure.

Risk factors and risk stratification of angina pectoris and their implications / 医学研究生学报

Angina pectoris is an important event in coronary heart disease.Many researches are conducted on the risk factors and risk stratification of the problem,so as to classify the patients into different risk groups,properly predict their prognosis,take the most effective therapeutic measures and achieve the best results with the least risks and expenses.