Synthesis and photoluminescence properties of orange-red carbon dots from the paper tissues as the precursor.

In recent years, stable and photoluminescence (PL) tunable fluorescent materials known as carbon dots (CDs) have seen rapid development. Here, a simple, low-cost, and environmentally friendly approach has been developed to synthesize the orange-red CDs (OR-CDs) with paper tissues as the precursor in the presence of ethanol and concentrated sulfuric acid. The average diameter of the OR-CDs was measured at around 1.25 nm. The as-prepared OR-CDs are composed of carbon cores with the graphite structure distributed in the middle and wrapped or entangled by polymers for the outside. Moreover, the PL characteristics of the OR-CDs under the dilute solution state and the concentrated solution state, respectively, were explored. The former with the blue light showed prominent excitation-dependent characteristics in the range from 365 to 420 nm; the latter rendered the excitation-independent property with distinguished orange-red fluorescence emission. With an increase in the concentration, the emission fluorescence intensities gradually increased under the excitation wavelength of 540 nm, which can be attributed to the aggregation-induced emission property of the OR-CDs. By virtue of their excellent PL properties and low toxicity, we believe that the OR-CDs have potential applications in various optoelectronic areas, especially in white LED fields.

Flavor classification and year prediction of Chinese Baijiu by time-resolved fluorescence.

Baijiu is a traditional and popular Chinese liquor with enormous sale potential, which is affected by factors such as flavor and storage time. Chinese Baijiu is a complex and transparent mixture that makes analyzing difficult. The utility of time-resolved fluorescence helped to develop a new method to analyze Baijiu. Forty-two Baijiu samples among six brands with three flavors were prepared, and their fluorescence spectra were analyzed with an excitation light of 374.2 nm. Hexanoic acid and ethyl butyrate were found to have an impact on Baijiu fluorescence. The properties of lifetimes in Baijiu were investigated, and its mechanism was studied by calculations through density function theory. Using parameters of fluorescence lifetimes, Baijiu samples were classified according to their flavors. Additionally, the correlations between fluorescence lifetimes and storage time of Baijiu in Luzhou flavor were obtained, leading to a reliable and efficient method to establish the year forecast model of Chinese Baijiu with a mean error of 2.79 months. It also provides an important reference of the utility of time-resolved fluorescence for quantitative research of multi-component systems.

U-Shaped Relationship Between Left Atrium Size on Echocardiography and 1-Year Recurrence of Atrial Fibrillation After Radiofrequency Catheter Ablation　- Prognostic Value Study.

BACKGROUND: The larger the left atrium anteroposterior dimension (LAD) and left atrium volume (LAV), the stronger the association with recurrent atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). Patients with a smaller left atrium (LA) size, however, also have increased AF recurrence.Methods and Results:In 521 patients, routine 48-h Holter electrocardiogram and echocardiography were obtained at each outpatient visit every 3 months for 12 months. On multivariate analysis, AF type, LAD, and LAV calculated using the ellipsoid model/body surface area (LAVe/BSA) were independent predictors of AF recurrence. Patients were divided into 7 groups at 0.4-cm increments of LAD: ≤3 cm, LAD≤3 cm, 3.05.0 cm. Compared with the 3.4-3.8-cm group, the adjusted HR were 3.88 (95% CI: 2.02-7.46, P<0.001), 1.03 (95% CI: 0.50-2.12, P=0.939), 0.96 (95% CI: 0.52-1.77, P=0.901), 1.36 (95% CI: 0.72-2.57, P=0.347), 3.04 (95% CI: 1.67-5.53, P<0.001), and 4.07 (95% CI: 1.93-8.60, P<0.001), respectively. Similarly, we divided LAVe/BSA into 8 groups and also observed a U-shaped curve for AF recurrence. CONCLUSIONS: Both larger and smaller LAD and LAVe/BSA were associated with a higher risk of AF recurrence 1 year after RFCA. The association of LA size and AF recurrence after RFCA is represented by a U-shaped curve.

Nuclear factor-κB as a link between endoplasmic reticulum stress and inflammation during cardiomyocyte hypoxia/reoxygenation.

Endoplasmic reticulum stress (ERS) can initiate inflammation, and the coupling of these responses is thought to be fundamental to the pathogenesis of cardiovascular disease. However, the mechanism linking ERS and inflammation in myocardial ischemia/reperfusion needs further investigation. Cultured cardiomyocytes were pretreated with SP600125 or salubrinal, followed by tunicamycin to clarify the involvement of the IRE1α and PERK pathways in ERS inflammation. The cardiomyocytes were given hypoxia/reoxygenation (H/R), and the effects of the NF-κB inhibitor, SN50, were followed. GRP78 protein levels were similar in the tunicamycin (Tm), salubrinal, and SP600125 groups, but were lower in cells treated with SN50. SN50 might effectively block the H/R-induced link between ERS and inflammation in cardiomyocytes by decreasing GRP78. This knowledge will aid in the development of therapies for myocardial ischemia/reperfusion injury.

A virtual histology intravascular ultrasound analysis of coronary chronic total occlusions.

OBJECTIVES: We used virtual histology intravascular ultrasound (VH-IVUS) to investigate plaque composition of chronic total occlusions (CTO). BACKGROUND: There are limited data on the composition of CTOs, especially in vivo. METHODS: VH-IVUS was performed in 50 CTO lesions (49 patients) after guidewire crossing or pre-dilation using a 1.5-2 mm balloon. Plaque composition in the proximal reference, distal reference, and CTO segment (subsequently divided into proximal, middle, and distal subsegments) was analyzed and reported as median and interquartile range. VH-IVUS phenotype was also assessed. The definition of a fibroatheroma was >10% confluent necrotic core (NC) in more than three consecutive frames. RESULTS: Overall, the maximum NC within the CTO [35.5% (28.7, 44.3%)] was similar to the proximal reference [35.6% (24.1, 42.1%)] and greater than the distal reference [31.5% (22.6, 35.2%), P < 0.01]. There was no difference in maximum NC observed among proximal [31.4% (25.2, 10.4%)], middle [31.0% (23.3, 38.3%)], and distal CTO subsegments [30.4% (22.0, 39.5%)]. Overall, 42/50 CTOs contained a VH-fibroathroma; and 8/50 did not. CTOs containing a VH-fibroatheroma had more NC and dense calcium while CTOs not containing a fibroatheroma had more fibrotic and fibrofatty plaque. Importantly, 60.5% of VH-fibroatheroma-containing CTOs had a thin-cap fibroatheroma (NC abutted to the lumen) in the proximal reference. CONCLUSIONS: Using VH-IVUS, CTO morphology can be divided into two patterns: (1) CTO with VH-fibroatheroma or (2) CTO without VH-fibroatheroma. This suggests two mechanisms of CTO formation-the majority evolving from acute coronary syndrome and thrombosis and the minority from atherosclerosis progression.

SERS Detection of Benzoic Acid in Milk by Using Ag-COF SERS Substrate.

Benzoic acid, which has a pivotal role in food additive, is prohibited to add as a preservative in dairy products. China, Brazil, and other countries have proposed standard methods to detect the addition of benzoic acid in food. Surface-enhanced Raman scattering (SERS) is an upcoming spectral detection technique, which has been widely used in the field of material analysis with the advantages of non-invasive, fast detection speed and complex environment with little interference. To detect the illegal use of benzoic acid in dairy industry, we developed Ag-COF (covalent-organic framework) material as SERS substrate to detect benzoic acid in liquid milk. The great enhancement ability of Ag-COF substrate is controlled by the addition of acetic acid and complex interplay between COF material and benzoic acid. This detection method has high sensitivity and reliability that allows us to achieve limit of detection (LOD) of 0.13 µg/mL in milk and 0.00372 µg/mL in water by applying this method. In experiment on recovery rate of real samples, the detection time is less than 15 minutes and the relative standard deviation (RSD) ranged from 2.82% to 5.69%. Therefore, this method has practical significance of the detection of benzoic acid in dairy products.

A Sensitive Surface-Enhanced Raman Spectroscopy Method for Detecting Tetracycline in Milk.

Tetracycline, an animal antibiotic, may remain in milk to cause harm to human health. For economic reasons, the abuse of antibiotics is becoming more and more common. Therefore, the abuse of tetracycline has alarmed the dairy industry and many countries such as New Zealand, China, and the USA have proposed strict standards. Surface-enhanced Raman scattering (SERS) is an emerging detection method which has been applied in food detection with the advantages of no complex pretreatment, fast detection, and weak water environment interference. Considering the abuse of antibiotics in dairy industry, we used polydimethylsiloxane (PDMS) plasma cavity as SERS substrate to detect tetracycline in milk. We found that the enhancement ability of PDMS substrate is affected by addition of 4-amino-1-butanol and complex interplay in the milk--tetracycline system. The modified PDMS plasma cavity has high SERS sensitivity that allows us to achieve low detection limit of 0.28 µg/L. The correlation coefficient was 0.987. The detection of tetracycline in milk using PDMS substrate is quick (within 10 min) and it provides a possible method for in-site detection of tetracycline.

Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study.

PURPOSE: The relation between dyslipidemia and atrial fibrillation (AF) development remains controversial. We conducted a prospective study to investigate the association of lipids with the risk of recurrence of AF after radiofrequency catheter ablation (RFCA). METHODS: This study enrolled 287 consecutive patients who underwent initial circumferential pulmonary vein ablation (CPVA). Fasting levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured at baseline before ablation. Patients were classified according to lipid quartiles. AF recurrence was confirmed by 48-h electrocardiograms at follow-up visits. RESULTS: A total of 71 patients (24.7%) experienced AF recurrence during 3 to 12 months after ablation. By univariate Cox regression survival analysis, TC (HR, 0.63; 95%CI, 0.48-0.82), LDL-C (HR, 0.61; 95%CI, 0.44-0.84), non-paroxysmal AF type (HR, 2.56; 95%CI, 1.52-4.21), and left atrial diameter (HR, 2.18; 95%CI, 1.46-3.24) were significantly associated with AF recurrence. By multivariate Cox regression survival analysis, lower quartiles of TC (HR, 3.66; 95%CI, 1.56-8.56) and LDL-C (HR, 2.28; 95%CI 1.09-4.77) were associated with higher risk of AF recurrence compared with the highest quartiles. After adjustment by sex, lower TC (HR, 11.70; 95%CI, 2.79-49.13) and LDL-C (HR, 11.00; 95%CI, 2.77-43.72) levels were associated with the recurrence of AF in women, but not in men. HDL-C and TG levels showed no association with AF recurrence in both genders. CONCLUSIONS: TC and LDL-C levels were negatively correlated with AF recurrence after RFCA in women. HDL-C and TG were not independently associated with AF recurrence in both genders.

Reduced testosterone levels in males with lone atrial fibrillation.

BACKGROUND: Sex hormones play an important role in the development of cardiovascular disease. Testosterone and estradiol have been reported to be down-regulated in subjects with coronary artery disease and heart failure, but has not been studied in atrial fibrillation (AF). HYPOTHESIS: Levels of sex hormones may be associated with susceptibility to lone AF in men. METHODS: Fifty-eight male subjects who had electrocardiographic evidence of paroxysmal or chronic AF and a structurally normal heart on echocardiography were enrolled. Subjects were excluded if they had been taking angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), or statins within 3 mo or had a history of coronary artery disease, rheumatic heart disease, cardiomyopathy, significant valvular disease, hyperthyroidism, or hypertension. Fifty-eight controls were recruited from a healthy outpatient population. Serum total testosterone and estradiol levels were determined using a commercially available radioimmunoassay. RESULTS: Mean levels of testosterone were significantly lower in subjects with lone AF when compared with controls (476 ng/dl versus 514 ng/dl, p = 0.005). No significant differences were found in the estradiol levels between the 2 groups (31.9 pg/ml versus 32.4 pg/ml, p = 0.789). CONCLUSION: Reduced testosterone levels may be associated with susceptibility to lone AF in men.

[Interleukin-1beta upregulates matrix metalloproteinase-2 expression and activity in cardiac fibroblasts via nitric oxide synthase pathway].

OBJECTIVE: To investigate the effect of interleukin-1beta (IL-1beta) on expression and activity of matrix metalloproteinase-2 (MMP-2) of cultured human cardiac fibroblasts and related signaling pathway. METHODS: Primary human cardiac fibroblasts seeded in 6-well tissue culture plates and cultured to 80% to 90% confluence were harvested at passage 3 to 6 and exposed to IL-1beta at various concentrations for 24 h, culture supernatant and cell protein were obtained. MMP-2 mRNA was determined by RT-PCR. The activity of MMP-2 was analyzed by zymography and the expression of inducible nitric oxide synthase (iNOS) protein level was detected by Western blot analysis. Assessment of NO production in the culture supernatant was performed using the Griess method. RESULTS: IL-1beta (4 ng/ml) significantly increased MMP-2 activity of cultured fibroblasts in a time-dependent manner. MMP-2 mRNA expression was significantly upregulated by IL-1beta (4 ng/ml and 10 ng/ml, all P<0.01). Moreover, IL-1beta also significantly increased NO production in supernatant (P<0.01) and these effects could be significantly blocked by cotreatment with L-NMMA (10(-3) mol/L, all P<0.01). Western blot analysis showed that iNOS could not be detected in unstimulated human cardiac fibroblasts but could be detected in cardiac fibroblasts exposed to IL-1beta. CONCLUSION: IL-1beta increased MMP-2 activity and transcription of human cardiac fibroblasts via iNOS-NO pathway.

Carbon nitride supported Ni0.5Co0.5O nanoparticles with strong interfacial interaction to enhance the hydrolysis of ammonia borane.

Ammonia borane (AB) is an ideal hydrogen-storage material for fuel cells but its application has been strongly limited by using rare noble-metal-based catalysts. Here we have prepared a hybrid material of Ni0.5Co0.5O nanoparticles on nitric-acid treated carbon nitride (NCN) for the hydrolysis of AB. The Ni0.5Co0.5O-NCN catalyst achieves a high total turnover frequency (TOF) value of 76.1 (H2) mol per (Cat-metal) mol min in pure water at room temperature, with a good stability by keeping 83.2% activity after 6 runs. The TOF is comparable to the best values ever reported for noble-metal-free catalysts without extra conditions such as light illumination or a strong alkaline environment. Synchrotron radiation based X-ray absorption spectroscopy reveals that the carbon nitride substrate has two reaction centers to form stable interfacial interaction with the NPs, in which carbon can act as the electron acceptor while nitrogen acts as the electron donor. Thus the NP-NCN system has a hybridized electronic structure which is favorable for the catalytic reaction to produce hydrogen. In-depth understanding of the interfacial interaction between NCN and NPs may also shed light on the mechanism study of various energy-related applications based on carbon nitride.

Tissue characteristics of culprit lesion and myocardial tissue-level perfusion in non-ST-segment elevation acute coronary syndromes: The EARLY-MYO-ACS study.

OBJECTIVE: The impact of tissue characteristics of culprit lesion on myocardial tissue-level perfusion in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains unclear. EARLY-MYO-ACS study was a prospective observational study to investigate the relationship between pre-percutaneous coronary intervention (PCI) culprit plaque characteristics and post-PCI myocardial tissue-level perfusion with iMap intravascular ultrasound (IVUS) in NSTE-ACS patients. METHODS: A total of 408 patients with coronary artery disease (246 NSTE-ACS and 162 stable angina pectoris) undergoing coronary angiography, grayscale-IVUS and iMap-IVUS were enrolled. Tissue characteristics of culprit lesion were analyzed by the iMap-IVUS system as fibrotic, lipidic, necrotic, or calcified tissue. Epicardial coronary perfusion was assessed by TIMI flow grade (TFG), and myocardial tissue-level perfusion was assessed by both TIMI myocardial perfusion grade (TMPG) and TIMI myocardial perfusion frame count (TMPFC). RESULTS: The percentages of necrotic volume within the culprit lesion were significantly greater in NSTE-ACS than that in stable angina pectoris (20.8 ±â€¯7.9% vs. 15.9 ±â€¯7.2%, P < 0.001). Patients with impaired epicardial coronary perfusion (TFG 0-2) had higher necrotic percentage within the culprit lesion than those with normal TFG (27.9 ±â€¯7.3% vs. 19.6 ±â€¯7.4%, P < 0.001). Moreover, patients with impaired myocardial tissue-level perfusion (TMPG 0-2) had greater necrotic percentages within the culprit lesion than those with normal TMPG (25.0 ±â€¯8.1% vs. 18.4 ±â€¯6.7%, P < 0.001). Multivariate analysis revealed that iMap-derived necrotic volume percentage was independently associated with reduced post-PCI TMPG (OR 2.39 [95% CI 1.60 to 3.57], P = 0.009) and impaired post-PCI TMPFC (OR 2.89 [95% CI 1.62 to 5.16], P = 0.008). The ROC curve showed that the optimal threshold of necrotic volume percentage was 20.09% and 21.03% to predict impaired TMPG and TMPFC, respectively. CONCLUSION: Increased necrotic fraction of the culprit lesion is independently associated with impaired myocardial tissue-level perfusion in NSTE-ACS patients. Thus, plaque composition assessed by pre-PCI iMap-IVUS could predict post-PCI impaired myocardial tissue-level perfusion in NSTE-ACS patients (Trial Registration: ChiCTR-OCH-13003046).

Puerarin reduces endothelial progenitor cells senescence through augmentation of telomerase activity.

Endothelial progenitor cells (EPCs) play an important role in both reendothelialization and neovascularization. Ex vivo expansion of EPCs might be useful for potential clinical cell therapy of ischemic diseases. However, ex vivo cultivation of EPCs leads to rapid onset of EPCs senescence, thereby severely limiting the proliferative capacity and clonal expansion potential. Therefore, we investigated whether puerarin might be able to prevent senescence of EPCs. EPCs were isolated from peripheral blood and characterized. After ex vivo cultivation, EPCs became senescent as determined by acidic beta-galactosidase staining. Puerarin dose dependently prevented the onset of EPCs senescence in culture. Moreover, puerarin increased proliferation of EPCs as assessed by BrdU incorporation assay and colony-forming capacity. To get further insights into the underlying mechanisms of these effects induced by puerarin, we measured telomerase activity and determined the phosphorylation of serine/threonine protein kinase Akt by using western blot. Puerarin significantly increased telomerase activity and phosphorylation of Akt, a downstream effector of phosphoinositide 3-kinase (PI-3K). Moreover, pretreatment with PI-3K blockers, either wortmannin or LY294002, significantly attenuated the puerarin puerarin-induced telomerase activity. Taken together, the results of the present study indicated that puerarin delayed the onset of EPCs senescence, which may be related to the activation of telomerase through the PI-3K/Akt pathway. The inhibition of EPCs senescence by puerarin in vitro may improve the functional activity of EPCs in a way that is important for potential cell therapy.

Proteomic analysis of the serum in patients with idiopathic pulmonary arterial hypertension.

Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease of unknown etiology. The exact pathogenesis of pulmonary arterial hypertension is still not well known. In the past decades, many protein molecules have been found to be involved in the development of IPAH. With proteomic techniques, profiling of human plasma proteome becomes more feasible in searching for disease-related markers. In present study, we showed the protein expression profiles of the serum of IPAH and healthy controls after depleting a few high-abundant proteins in serum. Thirteen spots had changed significantly in IPAH compared with healthy controls and were identified by LC-MS/MS. Alpha-1-antitrypsin and vitronectin were down-regulated in IPAH and may be valuable candidates for further explorations of their roles in the development of IPAH.

Drug-eluting balloons versus drug-eluting stents for the management of in-stent restenosis: A meta-analysis of randomized and observational studies.

OBJECTIVES: The aim of this study was to evaluate the efficacy of drug-eluting balloons (DEB) with drug-eluting stents (DES) in patients with in-stent restenosis (ISR). BACKGROUND: DES implantation and DEB were available strategies in percutaneous coronary intervention (PCI) for ISR, but the optimal management for ISR lesions remains controversial. METHODS: Electronic databases were searched for randomized controlled trials and observational cohort studies which reported the clinical outcomes of using DEB comparing with DES implantation in patients with ISR. Clinical endpoints such as major adverse cardiovascular events (MACE), death, and myocardial infarction were assessed. RESULTS: Five randomized controlled trials and five observational cohort studies with 962 patients in the DEB group and 908 patients in the DES group met inclusion criteria. There was no significant difference between DEB and DES in major clinical outcomes, such as MACE (OR 1.01; 95% CI: 0.64-1.58; p=0.97; I2=0%), all-cause death (OR 1.04; 95% CI: 0.54-1.98; p=0.91; I2=0%), cardiovascular death (OR 1.44; 95% CI: 0.57-3.65; p=0.44; I2=0%), stent thrombosis (OR 0.61; 95% CI: 0.16-2.33; p=0.47; I2=0%), and myocardial infarction (OR 1.02; 95% CI: 0.53-1.94; p=0.96; I2=0%). DEB was associated with a significant increase in target lesion revascularization (OR 1.54; 95% CI: 1.10-2.15; p=0.01; I2=57%). CONCLUSION: Treatment of ISR using DEB led to comparable clinical outcomes with DES implantation.

Association of interleukin-1 gene cluster polymorphisms with ischemic stroke in a Chinese population.

BACKGROUND AND AIMS: Chronic inflammatory process plays an important role in atherothrombosis. Interleukin-1 (IL-1) is one of the key modulators of the inflammatory response and its activity is critically regulated by its receptor antagonist (IL-1Ra). A variable number tandem repeat polymorphism in intron 2 of IL-1Ra gene and a C to T single base polymorphism in the promoter of IL-1beta gene (C(-511)-->T) have been reported to affect the levels of IL-1 as well as its antagonist, IL-1Ra. It is also reported in several studies that these polymorphisms are associated with the susceptibility to cardio-cerebral vascular disease. However, data are limited in China. In this article, we studied the relationships between these polymorphisms and the risk of ischemic stroke in China. MATERIALS AND METHODS: One hundred and twelve patients committed ischemic stroke were compared with 95 demographically matched healthy volunteers. RESULTS: The frequencies of the IL-1Ra 1/1 genotype and IL-1Ra allele 1 (Ra*1 allele) in stroke patients were significantly higher than those in healthy volunteers [93.7% vs. 82.1%, P =0.014; 0.964 vs. 0.905, P =0.007]. No significant differences were found in the IL-1beta -511 genotype and the allele distribution between the two groups. CONCLUSIONS: Our results implicated that IL-1 gene polymorphism might be associated with the susceptibility to ischemic stroke.

Perindopril for the prevention of atrial fibrillation recurrence after radiofrequency catheter ablation: One-year experience.

BACKGROUND: Recurrence of atrial fibrillation (AF) after ablation is still high. Perindopril plays an essential role in AF induction and maintenance. OBJECTIVE: We aimed to prove that perindopril (8 mg) could prevent recurrence after pulmonary vein isolation. METHODS: Patients with paroxysmal AF who received radiofrequency ablation were randomized to a 3-month course of perindopril 8 mg once daily (perindopril group) or placebo (placebo group). Angiotensin-II (Ang-II) therapy and standard transthoracic echocardiography were performed. All 256 patients with paroxysmal AF who received radiofrequency ablation were randomized. And we followed them for complete 1 year. The 3-month recurrence and the 1-year recurrence were compared between the 2 groups. RESULTS: The 3-month recurrence of AF was observed in 33 (26.19%) of 126 patients in the placebo group vs 19 (14.62%) of 130 patients who received perindopril 8 mg once daily (χ2, P = .021). One-year recurrence of AF was observed in 36 (28.5%) of 126 patients in the placebo group as compared with 21 (16.2%) of 130 patients who received perindopril after 1 year (P = .017). The κ value was 0.94 in the control group (P < .001) and 0.96 in the perindopril group (P < .001) between 3-month and 1-year recurrence. The Ang-II level was related to the left atrial distance with the reduction in AF recurrence (r = 0.17, P = .005 at 3 months; r = 0.25, P < .001 at 1 year). CONCLUSION: Perindopril is an effective and safe treatment for the prevention of AF recurrence after radiofrequency catheter ablation. This effect seems to be strongly associated with a significant decrease in Ang-II level and left atrial distance.

Level of Pregnancy-associated Plasma Protein-A Correlates With Coronary Thin-cap Fibroatheroma Burden in Patients With Coronary Artery Disease: Novel Findings From 3-Vessel Virtual Histology Intravascular Ultrasound Assessment.

Pregnancy-associated plasma protein-A (PAPP-A) level is an independent predictor of acute cardiovascular event occurrence. To test the hypothesis that increased PAPP-A levels would be associated with a higher burden of coronary thin-cap fibroatheroma (TCFA) thereby underlying the heightened risk for cardiovascular events in patients with coronary artery disease; 154 patients (462 vessels and 975 plaques) with stable angina or non-ST-segment elevation acute coronary syndrome (NSTE-ACS) referred for percutaneous coronary intervention were assessed using 3-vessel virtual histology (VH)-intravascular ultrasound (IVUS). Thin-cap fibroatheroma virtual histology was defined as focal, necrotic core (NC)-rich (≥10% of cross-sectional area) plaques in contact with the lumen, and plaque burden ≥40%. Pregnancy-associated plasma protein-A levels were determined by sandwich enzyme-linked immunosorbent assay, and patients were divided into 3 groups based on PAPP-A level tertiles. Although the highest PAPP-A level tertile was not associated with 3-vessel plaque number, it was associated with 3-vessel VH-TCFA number and necrotic core volume. Patients with ≥3 VH-TCFAs had a higher PAPP-A level than patients with 1 to 3 VH-TCFAs or without any VH-TCFA (13.3 ±â€Š11.8 versus 7.8 ±â€Š4.7 versus 7.4 ±â€Š4.7 mIU/L, P < 0.001, respectively). Moreover, PAPP-A level was an independent predictor of higher total number of VH-TCFAs (OR 1.18; 95% CI 1.07-1.29, P = 0.001). This VH-IVUS study demonstrated, for the first time to our knowledge, that higher PAPP-A levels are associated with higher 3-vessel TCFA burden in patients with coronary artery disease. Pregnancy-associated plasma protein-A, therefore, might be a useful serum biomarker to predict increased coronary TCFA burden and plaque instability.

Effects of percutaneous balloon mitral valvuloplasty on plasma B-type natriuretic peptide in rheumatic mitral stenosis with and without atrial fibrillation.

BACKGROUND AND AIM OF THE STUDY: The study aim was to evaluate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on plasma B-type natriuretic peptide (BNP) levels in patients in sinus rhythm (SR) and with atrial fibrillation (AF). METHODS: Thirty patients with rheumatic mitral stenosis who underwent successful PBMV were included in the study. Of these patents, 21 were in SR (SR group) and nine had AF (AF group). Plasma BNP levels were measured using the Triage BNP Test in all patients before, and at 20 min and 24 h after, PBMV. Control levels were measured in eight healthy volunteers. RESULTS: Basal plasma BNP levels in patients were significantly higher than those in controls (123.5 +/- 69.5 versus 16.4 +/- 7.6 pg/ml, p < 0.01), and correlated with mean left atrial pressure (mLAP; r = 0.441, p < 0.05) and pulmonary artery pressure (PAP; r = 0.488, p < 0.01). No significant difference was observed in BNP levels between the SR and AF groups. In the SR group, BNP levels decreased after PBMV (pre-PBMV 128.7 +/- 75.9 pg/ml; at 20 min, 88.6 +/- 62.0 pg/ml; at 24 h, 43.4 +/- 26.7 pg/ml; respectively, p < 0.05). Changes in plasma BNP (deltaBNP) correlated positively with those in mLAP (deltamLAP) (r = 0.696, p < 0.01) and PAP (deltaPAP) (r = 0.456, p < 0.05). Left ventricular end-diastolic volume (LVEDV) (96.1 +/- 21.6 versus 111.5 +/- 25.2 ml, p < 0.01) and stroke volume (SV) (59.2 +/- 15.8 versus 69.0 +/- 17.9 ml, p < 0.05) augmented accordingly without any changes in left ventricular end-diastolic pressure (LVEDP) (p = NS). In contrast, in group AF, BNP levels remained unchanged (pre-PBMV 111.6 +/- 53.4 pg/ml; at 20 min, 122.0 +/- 68.7 pg/ml; at 24 h, 106.1 +/- 56.2 pg/ml; respectively, p = NS), while LVEDP increased (6.4 +/- 3.6 versus 8.6 +/- 3.2 mmHg, p < 0.01), without any changes in LVEDV and SV (p = NS). CONCLUSION: The study results indicate that, in mitral stenosis patients, a high BNP level is associated with high mLAP and PAP. Cardiac rhythm may play an important role in changes of BNP level after PBMV. BNP may be a valid marker to reflect changes in mLAP and PAP after PBMV in patients with SR, but not in those with AF.

A novel splice mutation of HERG in a Chinese family with long QT syndrome.

Congenital long QT syndrome (LQTS) is a genetically heterogeneous disease in which six ion-channel genes have been identified. The phenotype-genotype relationships of the HERG (human ether-a-go-go-related gene) mutations are not fully understood. The objective of this study is to identify the underlying genetic basis of a Chinese family with LQTS and to characterize the clinical manifestations properties of the mutation. Single strand conformation polymorphism (SSCP) analyses were conducted on DNA fragments amplified by polymerase chain reaction from five LQT-related genes. Aberrant conformers were analyzed by DNA sequencing. A novel splice mutation in C-terminus of HERG was identified in this Chinese LQTS family, leading to the deletion of 11-bp at the acceptor splice site of Exon9 [Exon9 IVS del (-12-->-2)]. The mutation might affect, through deficient splicing, the putative cyclic nucleotide binding domain (CNBD) of the HERG K(+) channel. This mutation resulted in a mildly affected phenotype. Only the proband had a history of syncopes, while the other three individuals with long QT interval had no symptoms. Two other mutation carriers displayed normal phenotype. No sudden death occurred in the family. The 4 affected individuals and the two silent mutation carriers were all heterozygous for the mutation. It is the first splice mutation of HERG reported in Chinese LQTS families. Clinical data suggest that the CNBD mutation may be less malignant than mutations occurring in the pore region and be partially dominant over wild-type function.