Rapid analysis of nine lignans in Schisandra chinensis by supercritical fluid chromatography using diode array and mass spectrometric detection.

Lignans are the bioactive constituents in Schisandra chinensis fruits. For the first time major representatives could directly be determined in plant extracts by using Supercritical Fluid Chromatography. Based on nine commercially available standards the method was developed, finally permitting their baseline separation in less than 10 min. The optimum setup showed to be a Viridis HSS C18 SB column, supercritical carbon dioxide and methanol. The compounds could be assigned in the extracts either at 210 nm or by MS, for which no modifications except of an additional sheath liquid (0.1 % acetic acid in methanol) were required. The determined lignan patterns were typical for S. chinensis, with schisandrol A being the most abundant compound, followed by schisandrin B or schisandrol B. As method validation results also complied well with the requirements the here presented method is definitely an interesting alternative to established techniques like UHPLC for the analysis of lignans in Schisandra chinensis.

Huge saphenous vein graft aneurysm presenting as non-ST elevation myocardial infarction and compressing the heart.

Coronary artery bypass grafting (CABG) surgery maintains an important role in the treatment of coronary artery disease. The huge saphenous vein graft aneurysm (HSVGA) is rare and occurs as a late complication after CABG. Here, we reported a case of HSVGA presenting as non-ST elevation myocardial infarction.

Association between hematologic parameters and in-hospital mortality in patients with infective endocarditis.

Early and accurate risk prediction is an important clinical demand in patients with infective endocarditis (IE). The platelet-to-lymphocyte ratio (PLR) is an independent predictor of worse prognosis in various cardiovascular diseases. The aim of this study was to determine the value of PLR in the prediction of in-hospital mortality among IE patients. We retrospectively analyzed the clinical, laboratory, and echocardiographic data of 59 adult patients with definite IE and in 40 adult controls. In-hospital mortality occurred in 16 (27%) patients. Vegetation size, levels of high-sensitive C-reactive protein and procalcitonin, neutrophil-to-lymphocyte ratio, and PLR were significantly higher in the in-hospital-mortality-positive group than in the in-hospital-mortality-negative group (p = 0.004, p = 0.009, p = 0.030, p = 0.001, and p = 0.008, respectively). Lymphocyte count was, however, significantly lower in the in-hospital-mortality-positive group (p = 0.004). In the receiver-operating characteristic analysis, PLRs over 191.01 predicted in-hospital mortality with 56.3% sensitivity and 81.4% specificity [area under the curve 0.725, 95% confidence interval (CI) 0.594-0.833; p = 0.0027]. In the multivariate analysis, PLR was found to be an independent predictor of in-hospital mortality in patients with IE (odds ratio 1.022, 95% CI 1.003-1.042; p = 0.021). In conclusion, higher PLR may predict in-hospital mortality in patients with IE.

Influence of preoperative coronary collateral circulation on in-hospital mortality in patients undergoing coronary artery bypass graft surgery with intra-aortic balloon pump support.

BACKGROUND: Outcomes in patients requiring coronary artery bypass graft (CABG) surgery have been improved with devices such as the intra-aortic balloon pump (IABP). Good coronary collateral circulation (CCC) has been shown to reduce mortality in patients with coronary artery disease (CAD). We aimed to investigate whether poor preoperative CCC grade is a predictor of in-hospital mortality in CABG surgery requiring IABP support. METHODS: Fifty-five consecutive patients who were undergoing isolated first time on-pump CABG surgery with IABP support were enrolled into this study and CCC of those patients was evaluated. RESULTS: Twenty-seven patients had poor CCC and 28 patients had good CCC. In-hospital mortality rate in poor CCC group was significantly higher than good CCC group (14 (50%) vs. 4 (13%), P = 0.013). Preoperative hemoglobin level (OR: 0.752; 95% CI, 0.571-0.991, P = 0.043), chronic obstructive pulmonary disease (OR: 6.731; 95% CI, 1.159-39.085, P = 0.034) and poor CCC grade (OR: 5.750; 95% CI, 1.575±20.986, P = 0.008) were associated with post-CABG in-hospital mortality. Poor CCC grade (OR: 4.853; 95% CI, 1.124-20.952, P = 0.034) and preoperative hemoglobin level (OR: 0.624; 95% CI, 0.476-0.954, P = 0.026) were independent predictors of in-hospital mortality after CABG. CONCLUSION: Preoperative poor CCC and hemoglobin are predictors of in-hospital mortality after CABG with IABP support.

Preoperative poor coronary collateral circulation can predict the development of atrial fibrillation after coronary artery bypass graft surgery.

AIM: Coronary collateral circulation (CCC) helps to protect and preserve myocardium from episodes of ischemia, and reduce angina symptoms, arrhythmia, and cardiovascular events. Atrial fibrillation (AF) is the most frequent form of arrhythmia after coronary artery bypass graft (CABG) surgery. The aim of this study was to investigate the association between CCC and the development of AF in patients undergoing CABG surgery. METHODS: A total of 165 patients (mean age 63±10 years, 74% men, 26% women) who were undergoing CABG surgery at our department were enrolled into this study. Patients were categorized into two groups according to preoperative CCC using the Rentrop method. RESULTS: Of the patients, 79 had poor CCC and 89 had good CCC. The AF incidence rate in the poor collateral group was significantly higher than that in the good collateral group [37 (49%) vs. 12 (14%), P<0.001]. In univariate analysis, age, left atrium size, and poor CCC grade were associated with AF after CABG surgery. Multivariate analysis showed that only poor CCC grade (odds ratio: 11.500; 95% confidence interval 3.977-33.253, P<0.001) was an independent predictor of the development of AF after adjustment of other potential confounders in patients undergoing CABG surgery. CONCLUSION: The present study showed that preoperative poor CCC is a powerful predictor of the development of AF after CABG surgery.

Circumflex-to-bronchial artery fistula with saccular aneurysm.

We report a case of fistulous communication with two saccular aneurysms (9 mm and 7 mm) between the sinoatrial branch of the circumflex artery and the bronchial arteries.