ABSTRACT
Objective :To explore clinical features ,therapeutic program and prognosis of patients with post-infarction ventricular septal rupture (PI-VSR).Methods :Clinical data of 36 PI-VSR patients ,who were treated in our hospital from Dec 2009 to Dec 2016 ,were retrospectively analyzed .According to in-hospital death condition ,patients were divided into in-hospital survival group (n＝14) and in-hospital death group (n＝22).General data were compared between two groups .Multi-factor Logistic regression analysis was used to analyze influencing factors for in-hospital death in PI-VSR patients .Results :All PI-VSR patients received routine medication ,10 cases received intra-aortic balloon pump (IABP) simultaneously , eight cases received transcatheter intervention to occlude VSR and stent im- plantation ,and two cases received ventricular septal repair surgery .In-hospital mortality of PI-VSR patients was 61.1%(22/36).Compared with in-hospital survival group ,there were significant rise in age [55 (46 ,64) years vs . 67 (52 ,82) years] ,percentages of diabetes mellitus (21.4% vs.59.1%) and renal insufficiency (42.9% vs. 90. 9%) ,and significant reductions in LVEF [41 (20 , 48 )% vs.31 (20 , 38 )%] and percentage of surgery (57.1% vs.9.1%) in in-hospital death group ,P＜0.05 or ＜0.01. Multi-factor Logistic regression analysis indica-ted that LVEF and surgery were independent protective factors for in-hospital death in PI-VSR patients (OR＝0.519 ,0.001 ,P＝0.032 ,0.023).Conclusion : PI-VSR is a rare fatal complication of myocardial infarction ,and therapeutic effect of conservative treatment is poor .Transcatheter interventional occlusion is an alternative transi-tional program that might replace surgery in PI-VSR treatment .
ABSTRACT
Objective To investigate the effect of lorsartan on rat model of atherosclerosis. Methods Totally 30 male Wistar rats were randomly divided to three different groups: control group, model group (high lipid + Vitamin D overload+ endothelium injury), and treatment group(high lipid + Vitamin D overload + endothelium injury + lorsartan). Rat model of atherosclerosis was established by high lipid plus Vitamin D overload plus baloon angioplasty-induced endothel ium injury, a nd animals in the treatment group were models treated with lorsartan. After 90 days the blood samples were drawn to examine the serum lipids and calcium, H-E staining was used to observe the structure changes of thoracic aorta, and immunohistochemistry assay was used to observe CD68 and cractin expression in the thoracic aorta. To study the relationship between Ang TJ and severity of AS, radio-immunity analysis was used to assay Ang TJ in each group, with the thickness of intima used as the index of AS severity. Results The serum levels of total cholesterol (TC), triglyceride (TG), LDL-C and serum calcium in model and treatment groups were significantly higher than those in the control group (P<0. 01). Compared with the control group, the model group had a thicker intima and thinner media. Compared with model group, the treatment group had a significantly thinner intima and thicker media (P<0. 01). Immunohistochemistry showed that CD68 was negative in the control group, strongly positive in the model group and weakly positive in the treatment group. Compared with model group, cractin positive level was higher in the treatment group. The serum Ang Tj levels were not significantly different between the three groups. Ang TJ level in the thoracic aorta tissue in the treatment group was significantly lower than that in control group and higher than that in the model group (P<0. 05). Ang E level in the thoracic aorta tissue was positively related with the intima thickness (P<0. 01). Conclusion Lorsartan has anti-atherosclerosis effect in rats.