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Objective: To observe the relationship among blood pressure, left ventricular hypertrophy (LVH) and sinus heart rate turbulence (HRT) in patients with essential hypertension (EH) and its clinical significance. Methods: A total of 125 EH patients received 24h ambulatory blood pressure monitoring, dynamic electrocardiogram and echocardiography examination in order to measure 24h mean blood pressure, turbulence onset (TO), turbulence slope (TS) and left ventricular mass index (LVMI). According to 24h mean blood pressure, patients were divided into hypertension stage 1 group (n=46), stage 2 group (n=41) and stage 3 group (n=38); according to LVMI, patients were divided into non- LVH group (n=74) and LVH group (n=51). TO and TS were compared among all groups. Results: TO: Compared with hypertension stage 1 and stage 2 group, there was significant increase in TO [(-2.48±1.75) % vs. (-1.86±1.19) % vs. (-0.87±1.14) %] in hypertension stage 3 group, and that of stage 2 group was significantly higher than that of stage 1 group（P<0.05～<0.01）; compared with non- LVH group, there was significant increase in TO [(-0.15±0.45) % vs. (1.08±1.19) %] in LVH group, P<0.01. TS: compared with hypertension stage 1 and stage 2 group, there was significant decrease in TS [(3.76±1.87) ms/RR interval vs. (2.33±1.48) ms/RR interval vs. (1.55±1.06) ms/RR interval] in hypertension stage 3 group, and that of stage 2 group was significantly lower than that of stage 1 group （P<0.05～<0.01）; compared with non- LVH group, there was significant decrease in TS [(4.76±1.75) ms/RR interval vs. (3.02±1.08) ms/RR interval] in LVH group, P<0.01. Conclusion: The higher the blood pressure is, the more abnormality the heart rate turbulence is; the heart rate turbulence abnormality of patients complicated with LVH is more severe than that of non- LVH patients in patients with essential hypertension, so heart rate turbulence is help to judge prognosis and guide treatment.
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AIM:To investigate the effects of Akt1 gene transfection into myocardium after ischemia-reperfusion (I/R) on mitochondrial permeability transition. METHODS:Forty adult male SD rats were divided randomly into five groups with 8 rats each:control group,I/R group,Ad-gene group,Ad-blank group and Ad-inhibitor group. The rats in Ad-gene group were injected with 30 μL Lipofectamine 2000 solution including Akt1 gene to the myocardium 48 h before ischemia while those in control group and I/R group were injected with PBS of the same volume. Rats in Ad-blank group were injected with Lipofectamine 2000 of the same volume into myocardium. In Ad-inhibitor group 30 μL Lipofectamine 2000 and gene complexes with LY294002 were injected. Hemodynamics,apoptotic index,the concentrations of lactate dehydrogenase,creatine kinase,the expression of Akt1,cytosolic,mitochondrial cytochrome C and MPT were also measured. RESULTS:The lowest level of Akt1 protein expression was observed in control group. The protein expression of Akt1 in Ad-gene group was higher than that in I/R group,Ad-blank group and Ad-inhibitor group. The AI,LDH and CK in Ad-gene group were significantly lower than those in other groups except control group. Transfection of Akt1 markedly reduced the loss of mitochondrial cytochome C after I/R injury. Ad-gene transfection led to a significant increase in absorbance at 540 nm compared to I/R group,Ad - black group and Ad-inhibitor group (P<0.05). CONCLUSION:Akt1 gene prevents myocardial apoptosis after I/R injury. Akt1 gene also inhibits the opening of mitochondria permeability transition and protects mitochondrial functions of myocardium in I/R injury.
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Objective To compare the accuracy of real-time myocardial contrast echocardiography (RT-MCE) with DISA-SPECT in detecting hibernating myocardium. Methods Fourteen hospitalized patients with regional wall motion abnormalities (RWMA) underwent RT-MCE, DISA-SPECT, coronary angiography and percutaneous coronary intervention(PCI). Every left ventricular myocardial segment image was acquired and evaluated according 16-segment model of American Society of Echocardiography. The Motion of every segment was observed by echocardiography after 1,3,6 months. The gold standard is that the motion of ventricular segment get better after PCI. The images of RT-MCE and DISA-SPECT were analyzed semi-quantitatively. Results The sensitivity,specificity,accuracy of RT-MCE and DISA-SPECT in detecting hibernating myocardium were 74.60%, 91.7%, 81.3% and 93.3%, 75.0%, 86.2%, respectively. RT-MCE had more value in specificity while DISA-SPECT had more value in sensitivity. The correlation between two methods was good in detecting hibernating myocardium. Conclusions RT-MCE and DISA-SPECT can be used as valuable methods to detect hibernating myocardium, the correlation between two methods is good and they have more value in specificity and sensitivity respectively.
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Objective To evaluate value of multi-indexes of real-time myocardial contrast echocardiography (RT-MCE) for the detection of coronary artery disease(CAD). Methods A total of 35 patients scheduled for coronary angiography underwent RT-MCE, and were undergone gated single photon emission computed tomography(gated-SPECT) after RT-MCE shortly. Coronary angiography was performed within one week of RT-MCE in all patients. All patients were divided CAD and no-CAD group. The observing indexes included: (1)The images of RT-MCE were analyzed quantitatively from microbubble replenishment curves for myocardial perfusion by using the Qlab software; A,β and A×β were compared between two groups. The sensitivity and specificity of RT-MCE for detection of CAD were performance by ROC curves Gensini score were calculated in 22 patients. Then the correlation analysis was used for comparing the value of A,β and A×β with Gensini score. (2) The sensitivity and specificity of gated-SPECT and RT-MCE for assessment of CAD were calculated by 4 score method. (3) RT-MCE for the detection of coronary artery stenosis with multi-indexes. Results (1) A,β and A×β were significant difference between two groups. The cutoff of A,β and A×β was 4. 58,0. 64 and 2. 73,then the sensitivity and specificity of RT-MCE for detection of CAD were 86. 0% , 80. 2% , 88. 9% and 84.1 % , 64. 6% , 79. 9 % , respectively. The correlation index was - 0. 79, - 0. 51 and - 0. 76 comparing the results of A, β and A ×β with Gensini. (2) The sensitivity and specificity of gated-SPECT for assessment of CAD were 84. 8 % and 82. 7% ,respectively. (3) The sensitivity of multi-indexes RT-MCE increased, the sensitivity was 89. l%,90. 4% and 96.3% when combinated A and β,A and A×β,and β and A×β, respectively. Conclusions RT-MCE with multi-indexes has a valuable application for assessment of CAD. The severity of CAD could be evaluated by RT-MCE.
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Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.
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0.05). H/R injury significantly decreased the GSH level (P
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BACKGROUND: Acute myocardial ischemia can activate the c-Jun N-terminal protein kinase(JNK) and, in turn, the ischemia damage can be aggravated by JNK. While in chronic hibernating myocardium, whether chronic myocardial ischemia can activate JNK1/2 or not and what is the role of JNK1/2 in developing the chronic hibernating myocardium, is not clear.OBJECTIVE :To identify protein expression of JNK1/2 and the p-JNK1/2 changes in chronic hibernating myocardium.DESIGN: Randomly controlled experimental research.SETTING: This study was performed in Cardiovascular Disease Institute, the Affiliated Hospital of Xuzhou Medical College.MATERIALS: Animal models were prepared in the Catheter Department of the Affiliated Hospital of Xuzhou Medical College, protein expression of JNK1/2 and the phosphorylation(p-JNK1/2) changes were measured in the Department of Biochemistry of Xuzhou Medical College. Fourteen small Chinese domestic pigs were randomly divided into two groups, experiment group( n = 8) and control group( n = 6) . Right coronary artery was selected as target vessel in experiment group, and home-made constrictor was delivered through right femoral artery to induce chronic hibernating myocardium and myocardial infarction.MAIN OUTCOME MEASURES: Normal myocardial tissue in control group, normal myocardial tissue and chronic hibernating myocardium sample in experiment group were checked with light microscope and electron microscope,protein expression of JNK1/2 and the phosphorylation changes in myocardium tissue of three groups were analyzed by immunoblotting (Western blotting).RESULTS: p-JNK1/2 was higher in chronic hibernating myocardium of experiment group than that of normal myocardium in experiment and control group. Immunological activity of p-JNK1/2 in control group, normal myocardium, and chronic hibernating myocardium in experiment group was 1,1.42 ± 0.52, 2.6 ± 0.59, respectively.CONCLUSION: JNK1/2 can be activated in chronic hibernating myocardium tissue and also participated in its occurrence and development.
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Objective To observe the effect of Isoket on standard dobutamine stress echocardiography(DSE).Methods Thirty-seven patients were divided into three groups according to the results of quantitative coronary angiography(QCA):the control group(CON) including 12 patiens,the coronary artery disease group 1(CAD1) including 15 patients,and the coronary artery disease group 2(CAD2) including 10 patients.Among the three group,the DSE+Isoket was done in CAD2,while the standard DSE was done in the other two groups.The improvement of segments of left ventricular after percutaneous transluminal intervention(PCI) was looked as the standard evaluating DSE.Results Isoket could increase heart rate and decrease systolic blood pressure,but could hardly affect diastolic blood pressure.The rate of biphysic response was 62.5% in group CAD1,and the sensitivity of detecting viable myocardium was 61%,while the specificity was 76%.In group CAD2,the rate of biaphysic response was 72.2% ,and the sensitivity of detecting viable myocardium was 82%,while the specificity was 88%.The rate detecting viable myocardium and sensitivity was improved significantly in group CAD2.Conclusions DSE combined with Isoket was beneficial for detecting viable myocardium.
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Objective To observe the characteristics of coronary hemodynamics in acute hibernating myocardium (AHM) model by intracoronary doppler guidewire. Methods 13 little domestic Chinese swine were established to the model of AHM by interventional method (closed chest),intracoronary Doppler guidewire were used to measure average peak velocity (APV),diastolic systolic velocity ratio (DSVR) and coronary flow velocity reserve (CFVR) distal to the stenosis in the period of pre model,post model and reperfusion.Then animals were executed,the histomography changes of AHM cells were observed.Results 10 animals (76 92%) were established to the model of AHM successfully,myocardium necrosis were not found under microscopical examination.APV and CFVR distal to the stenosis decreased significantly in AHM model ( P
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AIM:To investigate the protective effects of Danshen Tablet on the brachial artery flow-mediated dilatation(FMD)in the subjects accompanied with risk factors of coronary heart disease(CHD). METHODS: Fifty-five subjects were randomly assigned to two groups,therapy group(32 cases)were administrated Danshen Tablet(three tablets once,three times a day),the control group(23 cases) were received placebo and then observed their brachial artery FMD before and after three months' therapy.Meanwhile 19 healthy cases were compared with the subjects. RESULTS: The brachial artery endothelium-dependent dilation(EDD) of the subjects accompanied with risk factors of CHD was significantly lower than that in the normal group[(5.98?1.13)%,(5.95?1.14)%vs((8.11?1.25)%,) P
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The effects of Amrinone (AMR)on left ventricular function in 30 cases of congestive heart failure patients was assessed by M-mode and pulsed Doppler echocardiography. AMR improves the systolic and diastolic function of left ventricle during and after 10 min (AMR lmg ? kg-1, infusion ). The mean stroke volume increased 20% and 18% ; cardiac output increased 23% , 19% ; cardiac index increased 23% and 23% ; ejection fraction increased 32% , 30%; mVcf increased 50% and 48% ; filling velocity in early diastole increased 30% and 21 %; respectively. There were no significant differently between during and after AMR infusion, but there were signifcantly difference a-mong before, during and after AMR infusion. The heart rate changed slightly without statistic significance. The results suggest that AMR could improve the systolic and diastolic function of left ventricle in congestive heart failure patients.
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AIM:To investigate the effects of celecoxib,a selective cyclooxygenase-2 inhibitor,on antioxidative capability and apoptosis of cardiac myocytes after myocardial infarction.METHODS:24 New Zealand rabbits were divided into three groups randomly(8 in each group):sham-operated group(sham group),myocardial infarction group(MI group),celecoxib group(Cele group,10 mg kg-1?d-1,qd,with the drugs gastric gavage for six weeks).The NO concentration,total antioxidative capability(T-AOC),the activity of constitutive nitric oxide synthase(cNOS)and inducible NOS(iNOS)in cardiac tissue homogenate,adjacent to the infracted area,were detected.The pathological changes were observed by light microscope and electron microscopy.The expressions of Bcl-2 and Bax protein in myocytes were observed using immunohistochemistry,and the degree of apoptosis were examined by TUNEL.RESULTS:Cardiac tissue in MI group presented interstitial edema,fibroplastic proliferation,inflammatory cellular infiltration,and vacuolar degeneration in cardiac myocytes.The results of electron microscopy showed that myocytes presented more changes caused by ischemic injury:widened interspace of myofibril,disordered myofibrillae,focal lysis of myofilament,ectasia of sarcoplasmic reticulum.In Cele group,the pathological changes were light,the NO-_2/NO-_3 concentration,the activity of iNOS were lower(P