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Objective To estimate the patterns and frequency of anomalous coronary origin with angiography in the Chinese elderly population and evaluate the correlation between anomalous coronary origin and development of coronary atherosclerotic stenosis. Methods A retrospective analysis was performed on the basis of angiographic data among elderly patients who underwent coronary arteriography in Beijing University First Hospital. Those with anomalous origin of coronary arteries were selected for further assessment and significant stenosis in coronary arteries was recorded.Results Among 2031 patients, 46 patients were found to have anomalous origin of coronary artery,with an incidence rate of 2.3%. Right coronary artery was the most common anomalous vessel, being involved in 26 patients (56.5%). The anomalous origin was more frequent in right coronary artery than in left coronary artery (41.3%). The most common anomaly was right coronary artery arising from left coronary sinus in 13 patients (28.3%). Significant atherosclerotic lesions in the anomalous arteries were seen in 37 patients (80.4%). Conclusions In Chinese elderly population, the anomalous origin of coronary artery is more frequent in right coronary artery, the most common anomaly resides in right coronary artery arising from left coronary sinus. The anomalous coronary artery increases risk for development of coronary atherosclerotic stenosis.
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To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p＞0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NTBNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460. 1±92.7pg/mL, p＜0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities.The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction.
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Objective: To observe the influence of different tocopherol isoforms on oxidized low density lipoprotein (oxLDL) or recombinant human C reactive protein (rhCRP) induced expression of intercellular adhesion molecule 1 (ICAM 1) in human umbilical vein endothelial cells (HUVECs) and to investigate the potential mechanisms and effects of different tocopherols on atherosclerosis. Methods: Cultured HUVECs were incubated with oxLDL,oxLDL+? tocopherol,oxLDL+? tocopherol,oxLDL+mixed tocopherols,rhCRP,rhCRP+? tocopherol,rhCRP+? tocopherol, rhCRP+mixed tocopherols for 24 hours, respectively. The ICAM 1 expressions of protein and mRNA were detected by cell enzyme linked immunosorbent assay (ELISA), flow cytometric technique and RT-PCR. Results : Incubation of HUVECs with oxLDL or rhCRP for 24 hours significantly increased ICAM 1 expressions of proteins and mRNA . The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs in a concentration dependent manner(50-200 ?mol/L) and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone. However, rhCRP induced ICAM 1 expression in HUVECs was not inhibited by tocopherols. Conclusion :The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone, which may be important for the beneficial effects of tocopherols on atherosclerosis and cardiovascular disease.
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Objective To observe the influence of pre-infarction angina on ventricular function and prognosis of first acute myocardial infarction in old people. Methods 76 first acute myocardial infarction old patients was divided into two groups: angina pectoris group (n=42); no angina pectoris group (n=34). Global left ventricular function was assessed by echocardiography, arrhythmia, cardiogenic shock, heart failure, post-infarction angina and mortality was observed in hospital. Results The rate of cardiogenic shock and heart failure and mortality was lower in angina pectoris group (33.3% vs 58.8%; 2.4% vs 23.5%), LVEF and E/A was higher in angina pectoris group (0.52±0.056 vs 0.45±0.03,0.86±0.29 vs 0.54±0.35), P<0.05. Conclusion pre-infarction angina possesses the protecting effects on ventricular function of first acute myocardial infarction in old people, and can improve the prognosis of first acute myocardial infarction in old people.
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Objectives To investigate the relationship between homocysteine (Hcy), folic acid, vitamin B12(VitB12),lipids and the carotid artery atherosclerosis(CAAs) and the significance of their levels in predicting cardiac and cerebral vascular events of older patients. Methods Both sides of the common carotid artery and internal carotid artery were measured by B-mode ultrasound in 74 examinees in A, B, C, and D groups and a control group. With fasting serum, cholesterol, triglyceriade, apolipoprotein AI(Apo AI), apolipoprotein B (Apo B), lipoprotein (a) ［Lp(a)］, creatinine, glucose, folic acid, Vit B12 and Hcy were detected. Results When carotid artery atherosclerosis became severer, serum Hcy was higher. The levels of the control and A, B, C, D groups were (10.2±3.6) μmol/L, (11.5±4.4) μmol/L, (17.9±4.5) μmol/L, (24.7±10.3) μmol/L, and (41.4±22.3) μmol/L respectively. SNK test showed a significant difference between D and other groups (P>0.05). Folic acid and Vit B12 were negatively correlated with the severity of carotid artery atherosclerosis, but only A and D groups showed statistical significance. Spearman correlation coefficient showed that serum Hcy had significant negative correlation with folic acid and Apo AI(P=0.035 and P=0.000).Multiple linear regression analysis between CAAs and various risk factors showed Apo AI had negative correlation, but Apo B, Lp(a) and Hcy had positive correlation with CAAs, especially Hcy(P=0.009).Conclusion Hyperhomocysteinaemia is an important risk factor of artery atherosclerosis and the degree of CAAs is highly correlated with Hcy concentration. Hcy, Apo AⅠ,Apo B, Lp(a) are sensitive and reliable indexes for evaluating and predicting CAAs.