ABSTRACT
Objective To investigate atorvastatin administration on osteopontin and cardiac function of patients with chronic heart failure(CHF).Methods Sixty CHF patients were randomly divided into control (30 cases) and atorvastatin groups (30 cases).Patients in control group were given regular treatment including conventional oxygen inhalation,digitalis,angiotensin converting enzyme inhibitors,β blockers,diuretics,vasodilator therapy.Patients in treatment group were given atorvastatin at dose of 20 mg/d for 2 months plus regular treatment.The NHYA cardiac function,echocardiography determination of left ventricular ejection fraction(LVEF) were recorded.The levels of plasma osteopontin,plasma N-terminal brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were measured.Results The levels of plasma osteopontin,NT-proBNP and CRP in atorvastatin group were (1 062.68 ± 130.63) ng/L,(609.00 ±62.39) ng/L and ((5.84 ± 0.70) mg/L respectively,lower than those of control group ((1609.94 ± 201.87) ng/L,(922.33 ± 108.68) ng/L,(8.90 ± 0.86) mg/L),and the differences were statistically significant (Z =-1.981,t =2.766,Z =-2.092,P ＜0.05).LVEF in atorvastatin group was (58.7 ± 1.2)％,higher than that in control group ((52.8 ± 1.6) ％ ; P ＜ 0.05).Conclusion Atorvastatin treatment can decrease plasma osteopontin density,alleviate the inflammatory response and inhibit cardiac remodeling in patients with heart failure,which was good for recovery of heart failure.
ABSTRACT
Objective To observe the short-term effect of alprostadil combined with torasemide in the treatment of intractable heart failure.Methods Thirty cases of patients with intractable heart failure and ineffective in routine therapy were given alprostadil and torasemide treatment,with alprostadil 20 mg in 5％ glucose or 0.9％ sodium chloride solution 100 ml intravenous infusion once a day and torasemide 20-40 mg intravenous twice a day 3 days later torasemide dosage was adjusted according to the disease,and the remaining conventional anti-heart failure therapy unchanged.Course was one week.The blood pressure,body weight,urine output,creatinine,electrolytes,N-terminal pro-brain natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF) before and after treatment was observed.Results After treatment,clinical symptoms of dyspnea,edema,pulmonary rales,such as wet and dry significantly improved in all patients.During the course of the treatment,3 patients appeared mild hypokalemia,and potassium was promptly corrected.Body weight after treatment reduced compared with that before treatment [(63.8 ± 7.6) kg vs.(82.6 ± 10.7) kg],urine output increased after treatment compared with that before treatment [(2 328.3 ±367.8) ml/d vs.(568.7 ± 104.6) ml/d],and the differences were statistically significant (P ＜ 0.01).Systolic blood pressure,diastohc blood pressure difference was not statistically significant after treatment,compared with that before treatment (P ＞ 0.05).LVEF after treatment increased compared with that before treatment [(44.5 ± 8.3)％ vs.(31.9 ± 10.2)％],serum creatinine levels reduced [(97.8 ± 18.6) μmol/L vs.(143.8 ±21.7) μmol/L],and the difference was statistically significant (P＜ 0.05) ; NT-proBNP after treatment reduced compared with that before treatment [(567.4 ± 212.3) ng/L vs.(2 726.5 ± 525.3) ng/L],and the difference was statistically significant(P ＜ 0.01).Conclusion Alprostadil combined with torasemide treatment can quickly and effectively improve symptoms and help improve heart and kidney function in intractable heart failure,and has no significant adverse reactions.
ABSTRACT
Objective To evaluate the value of mean platelet volume (MPV) in identifying the location of infarct at left circumflex artery (LCX) in patients with non-ST-elevation myocardial infarction (NSTEMI).Methods In this retrospective study,184 consecutive patients with NSTEMI were eligible to be enrolled from January 1,2009 to June 30,2011 and laboratory examinations including platelet count,B-type natriuretic peptide (BNP),troponins test (TnI),C-reactive protein and serum creatinine (SCr) were done.The demographics and detailed history of patients were documented.In addition,left ventricular ejection fraction (LVEF) test and coronary angiography to determine the culprit vessel implicating in infarction were carried out in all enrolled patients.The patients were categorized into LCX group and N-LCX group according to culprit vessel.Results Of 184 patients,68 patients were in LCX group and 116 patients had left anterior descending artery (LAD) lesion or right coronary artery (RCA) lesion.High percent of LCX infarction were found in patients with high MPV level and low BNP level,and in smokers.And lower proportion of those patients had previous percutaneous coronary artery intervention.The results showed that MPV was larger in patients with LCX infarction than that in patients with LAD or RCA.Receiver operating characteristic curve showed the area under curve was 0.75 (95％ CI:0.675-0.826).An optimized cut off point at 9.15 fL of MPV showed 83.8％ sensitivity and 63.8％ specificity for prediction of LCX infarction.Multivariate analysis also showed that MPV was the only independent predictor of a LCX infarction in patients with NSTEMI [OR=1.32,(95％ CI:1.031-1.688),P＜0.05].Conclusions MPV was the only independent factor associated with LCX infarction in patients with NSTEMI.