Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect / 中南大学学报(医学版)

OBJECTIVE@#To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD).@*METHODS@#Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up.@*RESULTS@#Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4.@*CONCLUSION@#Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.

Short and mid-term effects of percutaneous transcatheter closure of ventricular septal defects on the cardiac remodeling / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the short and mid-term changes of the cardiac morphology after percutaneous transcatheter closure of ventricular septal defects (VSD) with transthoracic echocardiography (TTE).@*METHODS@#The left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left atrial diameter (LAd), and right ventricular diameter (RVd) in 30 VSD patients were measured before the VSD closure,and on the 3rd day, 3rd month, and 6th month after the VSD closure by TTE.@*RESULTS@#LVEDD and LVEDV significantly decreased on the 3rd day after the VSD closure compared with pre-VSD closure. LVEDD and LVEDV continuously decreased on the 3rd month and 6th month after the VSD closure. LAd was smaller on the 3rd month and 6th month after the VSD closure, but there was not significant difference between the 3rd and 6th month. RVd increased on the 3rd day after the VSD closure, while no significant difference was found among the 3rd month and 6th month before and after VSD closure.@*CONCLUSION@#Percutaneous transcatheter VSD closure may effectively improve the cardiac remodeling in VSD patients in the short and mid-term follow-up.

Expression of cardiotrophin-1 and effects of irbesartan in adriamycin induced cardiomyopathy in rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate cardiotrophin-1(CT-1) expression in the ventricle and the effects of angiotensin II type I receptor antagonist (AT(1)RA) irbesartan on the ventricular remodeling in adriamycin myocardiopathy.@*METHODS@#Thirty male SD rats were randomized into 2 groups: a control group (n=10) and a model group (n=20). The model group was administered adriamycin and 18 rats survived. And theses rats were randomized again into 2 groups. One was treated with irbesartan [50 mg/(kg x d), with stomach-tube], and the other received equal saline, so did the control group. After 12 weeks, the protein level of CT-1 was detected by immunohistochemistry.@*RESULTS@#Ventricular CT-1 in the model control group and the treatment group was higher than that in the control group and the correlation analysis showed that ventricular CT-1 of the model control group was positively correlated with the left ventricular weight index, and CT-1 of the treatment group was lower than that of the model control group.@*CONCLUSION@#CT-1 was assumed to take part in the ventricular remodeling. The mechanism of irbesartan on the ventricular remodeling may be related to the downregulation of CT-1 expression.

Simultaneous transcatheter therapy for ventricular septal defect combined with atrial septal defect / 中南大学学报(医学版)

OBJECTIVE@#To access the possibility, methods and efficacy of simultaneous transcatheter therapy for ventricular septal defect ( VSD ) combined with atrial septal defect (ASD).@*METHODS@#In 68 patients with VSD, four patients ranging from 3 to 24 years old were combined with ASD. The diameters of perimembranous VSD were 2 approximately 10.5 mm, and the diameters of secundum ASD were 4.6 approximately 7 mm under the echocardiography before the operation. Another 4 patients with VSD occluded by left ventriculography: 3 patients were occluded by VSD occluder first, and then occluded by ASD occuder. The other was only occluded by VSD occluder.@*RESULTS@#All VSD was treated successfully at one time in 4 patients. The diameters of VSD occluder were 4, 8, 10, and 16 mm. ASD was occluded successfully at one time in 3 patients. The diameters of ASD occluder were 8, 10, and 10 mm. The successful rate of the operation was 100%. No complication occurred in the operation and follow-up.@*CONCLUSION@#Simultaneous transcatheter closure for VSD combined with ASD is a safe, feasible and effective therapy.

Serum level of homocysteine and the development of collateral circulation in patients with severe coronary artery stenosis / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relationship between serum level of homocysteine and the development of collaterals in patients with severe coronary artery stenosis (SCAS).@*METHODS@#Eighty patients with at least one vessel stenosis over 90% among the 3 main vessels of coronary artery were consecutively enrolled into the study according to angiographic estimation. The development of collaterals was classified by Rentrop's method.@*RESULTS@#The serum levels of homocysteine among the single-vessel, bi-vessel and tri-vessel coronary artery disease groups had no significant difference; there was no linear correlation between the serum level of homocysteine and Gensini's score. The level of homocysteine in the poorly developed collaterals was significantly higher than that in the well-developed collaterals in the SCAS patients (P<0.001). Multiple stepwise logistic analysis revealed that homocysteine negatively correlated with the development of collaterals (P<0.001, odds ratio=0.353; 95% confidence interval=0.201 - 0.620), whereas it positively correlated with the number of stenosis vessels.@*CONCLUSION@#The serum level of homocysteine is independently and negatively associated with the development of collateral circulation in severe SCAs patients.

Effects of intracoronary diltiazem on no-reflow phenomenon after emergent percutaneous coronary intervention in patients with acute myocardial infarction / 中南大学学报(医学版)

OBJECTIVE@#To assess the effects of intracoronary diltiazem on no-reflow phenomenon of infarct-related artery (IRA) after emergent percutaneous transluminal coronary angioplasty or/and intracoronary stenting (PTCA/Stenting) in the patients with acute myocardial infarction (AMI).@*METHODS@#We studied 34 AMI patients with no-reflow phenomenon of IRA after emergent PTCA/Stenting between January 1999 and August 2005. Urokinase-treated group (n=16) was given intracoronary urokinase 30,0000 - 50,0000 units within 15 - 30 minutes between January 1999 and April 2002 while diltiazem-treated group (n=18) was given intracoronary diltiazem 0.5 - 2 mg within 10 - 30 minutes between May 2002 and August 2005. Fifteen minutes later, coronary arteriography (CAG) was performed and the thrombolysis in myocardial infarction (TIMI) flow grade was measured.@*RESULTS@#No apparent change of TIMI flow grade was found between pre-administration and post-administration of intracoronary urokinase, but TIMI flow grade was significantly improved after intracoronary diltiazem (P<0.01). TIMI flow grade of diltiazem-treated group was significantly higher than that of urokinase-treated group after the administration (P<0.05). The percentage of the patients who reached TIMI flow grade 3 after the intracoronary administration was higher in the diltiazem-treated group than that in the urokinase-treated group (P<0.01).@*CONCLUSION@#The intracoronary administration of diltiazem 0.5~2mg can effectively improve the no-reflow phenomenon after emergent PTCA/Stenting in patients with AMI.

Effects of GM-CSF on the proliferation and activation of dendritic cells in vivo / 中南大学学报(医学版)

OBJECTIVE@#To explore the effects of granulocyte macrophage-colony-stimulating factor (GM-CSF) on the proliferation and activation of dendritic cells (DC) in vivo.@*METHODS@#Balb/c mice were randomly assigned into the control and GM-CSF treatment group. After the lethal dosage of irridiation, green fluorescence protein labelled hematopoietic stem cells (HSC) were injected into the tail veins of the mice. The dosage of 0.1 micorg GM-CSF was administer subcutaneously every 2 days after the HSC infusion. The numbers and activation status of splenic DC were observed by flow cytometry 1, 2, 3, and 4 weeks after the HSC transplantation.@*RESULTS@#The numbers of splenic DC in the GM-CSF treatment group were significantly higher than those of the control group. The expressions of surface marker CD40, CD80, and CD86 in the GM-CSF treatment group were also higher than those of the control group.@*CONCLUSION@#GM-CSF can enhance the proliferation and activation of DC in vivo.

Therapeutic effect and safety of transcatheter occlusion of ventricular septal defects in 50 patients / 中南大学学报(医学版)

OBJECTIVE@#To determine the therapeutic effect and safety of transcatheter closure of ventricular septal defects (VSD) in 50 patients.@*METHODS@#Fifty patients were diagnosed by transthoracic echocardiography. To perform the operation, transthoracic echocardiography and X ray were used continuously to monitor the procedure. Transthoracic echocardiography and ECG were performed at 1, 3, and 6 months after the operation to evaluate the therapeutic effect.@*RESULTS@#The VSD diameter ranged from 1.8 to 13.4 (5.54 +/- 2. 75) mm. The successful rate of the operation was 96.0%, and the complication rate of the operation was 16.7%. A 3 month follow-up was completed in 20 patients, and the median left ventricle end-diastolic dimension significantly decreased from (40.20 +/- 8.80) mm to (32.90 +/- 8.36) mm (P < 0.001).@*CONCLUSION@#Transcatheter closure of ventricular septal defects is a good method with a high success rate of placement, fewer complications, and a good occlusion effect.