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Objective To investigate the influence of Bisoprolol on plasma brain natriuretic peptide level for congestive heart failure.Methods 84 patients of chronic congestive heart failure were selacted as study object.All patients in the conventional anti-heart failure therapy based on the application of bisoprolol,2.5mg/d,one time of day,adjusting the 5 ～ 10mg/d,one time of day,according to the situation of patients,the heart rate,blood pressure,changes in ejection fraction,and BNP before and after treatment were observed.Results The BNP level of 84 patients decreased as the heart function gradually increased(t =4.241,4.573,4.074,7.328,all P ＜ 0.01).After treatment,heart rate,blood pressure,left ventricular ejection fraction was significantly higher than that before treatment (t =3.585,3.245,3.347,all P ＜ 0.05).After treatment,BNP level was significantly lower(t =4.876,P ＜ 0.01).Conclusion BNP level in patients with congestive heart failure could reflect the level of heart function,the application of bisoprolol in patients with congestive heart failure could improve cardiac function and reduce BNP levels in patients.
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Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.
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Objective To discuss the role of endothelicyte activation in the development of pulmonary hypertension (PH) and vascular remodeling. Methods A total of 10 patients with simple ventricular septal defect(VSD)of congenital heart disease(CHD)were choosen as controls, and 30 patients with different degree of PH were studied. Plasma levels of interleukin-1(IL-1), endothelin-1 (ET-1) and nitric oxide (NO) which represented the degree of endothelicyte activation were measured by radioimmunoassay and commercial available kit. The specimens taken from right lung before cardiopulmonary bypass were fixed by formaldehyde solution. The percentage of vascular wall thickness/vascular external diameter (WT/D) and the percentage of vascular area/total vascular area (WA/A) which represented vascular remodeling, were measured by QTM970 analysator. Results Compared with patients of simple VSD, the plasma levels of IL-1, ET-1/NO and WA/A, WT/D increased in patients with PH. Conclusion The activation of endothelicytes and imbalance of ET/NO play an important role in the development of PH and vascular remodeling. Positive correlations were seen between IL-1, ET-1/NO and WA/A, WT/D(P
ABSTRACT
The electromicroscopic observation of atrialbiopsy was carried out in 10 patients with ventric-ular septal defect (VSD) and middle, severe pul-monary hypertension (PH). The observation sug-gests that there are myofibrillar lysis to disappearwith various degrees, dilated rough endoplasmreticulum and the increase in lipofuscin granulesand lipid droplets; mitochondral hyperplasia, theirsize and shape being different, disorganizing of mi-tochondria, disintegration of cristae, mitochondralretrograde degenration and decreased matrix elec-tron density. The dilated intercalated discs and in-crease in myocardial fibrous tissue were found inpart of patients. These structural changes areprobably due to chronic myocardial ischemia.
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The potassium content in serum, red cells andsome factors involved in hypopotassium were ob-served in 30 cases with open heart surgery. Ac-cording to the results, we conclude that (1) Hy-popotassium tendency before and during cardiopul-monary bypass was mainly produced by the potas-sium moving into the red cells from the serum. Af-ter Cardiopulmonary bypass it was mainly owing tothe excretion of potassium through the urine. (2)The potassium shifting into the red cells waschiefly affeced by the bypothermia, pH, and perfu-sion time. (3) The red cell potassium lost whenplasma potassium value set below 4. 0 m mol/L.1. 56 m mol/kg of potassium administered was atleaset reqired to maintain plasma potassium leverover 4. 0 m mol/L.
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The paper reports the myocaraial protection in 590 cases having undergone open heart surgery with CPB. The following methods were administered for heart preserving: Lowering the blood temperature to 24～27℃ under CPB; perfusing coronary arteries with cardioplegic solution(high potassium at 4℃) every half an hour; Keeping hemodilution at the middle degree(HCT: 20～25%, Hb: 80g/L); Lowering the temperature of the heart surface to 20～9℃ with snow ice. Automatic rebeating of the heart was in 413(68%) cases and defibrillative rebeating in 177(32%). Th method was characterized by complete hypo-temperature of the heart, decreaseing oxygen consumption and micro-thrombus etc. And therefore it made the automatic rebeating rate higher.