ABSTRACT
Objective To identify the mechanisms of oral administered rapamycin on the prevention of restenosis after stent implantation with intravascular ultrasound (IVUS) and pathology.Methods Twenty-four New Zealand white rabbits underwent balloon-induced abdominal aortic wall injury and were given a diet of 1 ％ cholesterol for 8 weeks.Then,the rabbits were divided into three groups:the bare metal stent group(BMS group),the bare metal stent with oral rapamycin group(BMS + RAPA group) and the rapamycin eluting stent group(DES group).Rabbits in the RAPA and BMS + RAPA groups received a daily oral dose of rapamycin(0.5 mg/kg),whereas rabbits in the DES group received no drugs.All the rabbits were euthanized after the 4-week intervention.Serum lipids were measured.IVUS and pathologic studies were performed.The minimal luminal diameter (MLD),external elastic membrane (EEM) area,lumen area (LA),and plaque area(PA),plaque burden(PB) were measured.Mammalian target of rapamycin(mTOR) expression level was examined by immunohistochemistry.Results After the 4-week intervention,there was no significant difference of serum lipid levels among the three groups.IVUS showed that oral administration of rapamycin in the BMS + RAPA groups showed similar effects in reducing PA and PB as the DES group,which all were better than the BMS group.The BMS + RAPA and DES groups showed much more MLD and less lumen reduction,compared with the BMS group( P ＜0.05).Level of mTOR expression of the BMS + RAPA group and DES group was significantly lower than that of BMS group.Conclusions Oral administration of rapamycin demonstrates the same effect in the reduction of plaque burden and stent restenosis as the rapamycin eluting stent.Inhibition of mTOR by rapamycin involves in the stent restenosis.
ABSTRACT
ObjectiveTo elucidate the clinical application value of intravascular ultrasound(IVUS) in assessing intermediate lesions and the relationship between serum levels of fractalkine,CD36 and LP-PLA2and severity of coronary artery atherosclerosis.MethodsOne hundred and twenty patients with unstable angina underwent coronary angiography.Then the patients were divided into two groups:severe lesion group (lumen diameter stenosis greater than 70％,including 40 patients),and the intermediate lesion group lumen diameter stenosis(50％～70％,80 patients).IVUS were performed in all patients to analysis the coronary lesions.Concentrations of CD36,fractalkine and LP-PLA2 were measured by means of ELISA.Results IVUS found that 74％ intermediate lesion patients had soft lipid plaques,while 48％ severe lesion patients had lipid plaques ( P＜0.01 ).Patients with severe lesion had larger plaque burden and vascular remodeling index than those of patients with intermediate lesions(P＜0.05～0.01).There were 59 patients(74％) in the intermediate lesion group underwent PCI.IVUS also found the PCI patients had larger plaque burden and vascular remodeling index.Concentration of CD36 was significantly higher in severe lesion group than that of intermediate lesion group (P＜0.05).ConclusionsIVUS could further clarify the characteristics of the intermediate and severe lesions,and provide guidance for PCI treatment.Plasma CD36 level could be used to predict pathological severity of coronary atherosclerosis.
ABSTRACT
Objective To access the alterations of ischemic myocardial regional motion time caused by different extent of coronary artery stenosis by 2D-strain technique. Methods Two-dimensional images were acquired of the standard parasternal and apical (4-chamber,2-chamber and long-axis) views and short-axis views (mitral annulus, papillary muscle and apex) in 140 patients with coronary artery disease. All left ventricular segments were divided into 5 groups according to coronary stenosis seen on angiography:normal,25% -49% ,50% -74% ,75% -99% and 100%. The time to segmental systolic peak strain, systolic peak strain rate, end systolic strain, early diastolic peak strain rate and late diastolic peak strain rate in longitudinal, radial, circumferential directions and the systolic peak rotation, systolic peak rotation rate, early diastolic rotation rate,late diastolic rotation rate were analyzed with EchoPAC offline software. Results In longitudinal direction,compared with normal group,the time to early diastolic peak strain rate of segments with 75% - 99% coronary stenosis increased significantly, the time to systolic peak strain rate, early diastolic peak strain rate of segments with occluded artery were significantly delayed compared with the other 4 groups (P ＜0.05). In radial, circumferential directions, the time to systolic peak strain, systolic peak strain rate,late diastolic peak strain rate of segments with 25% - 49% was shorter than that of normal segments. Those indices for segments with 50% - 74% coronary stenosis were delayed compared with segments with 25% - 49% stenosis, however, those for segments with 75% - 99% coronary stenosis showed some improvement in the comparison with segments with 50% - 74% stenosis. All time indices for segments with occluded arteries were delayed ( P ＜0.05). About rotation, the time to the systolic peak rotation,systolic peak rotation rate,early diastolic peak rotation rate with 25% -49% stenosis was shorter than those of normal segments, the time to systolic peak rotation and early diastolic peak rotation rate for segments with 75% - 99% stenosis improved compared with segments with 50% - 74% stenosis.Conclusions 25% -49% coronary stenosis could lead to alterations of peak myocardial systole and diastole motion time in radial,circumferential and rotation directions,and ≥75% coronary stenosis caused the all 4 directions motion delays. Also the time indices for segments with 75% - 99% coronary stenosis showed some improvement in the comparison with segments with 50% -74% coronary stenosis.
ABSTRACT
w biomarker to predict the presence of vulnerable plaque.
ABSTRACT
Objective To study the protective effects of the coronary collateral circulation to ischemic myocardial regional function with coronary artery stenosis≥75%using 2D-strain technique.Methods Two-dimensional images of apical four-,two-chambers,long-axis views and LV short-axis views were obtained in 121 patients.According to the results of coronary angiogram,all the 121 patients were divided into 3 groups:group 1,with normal coronary artery;group 2,with stenosis≥75%in≥1 main coronary artery involved right coronary artery,left anterior descending branch and left circumflex branch and with the presence of coronary collateral circulation(CCC);group 3,with stenosis≥75% in≥1 main coronary artery but with no presence of CCC.The segments' systolic peak strain(Sps),strain rate (SRs),end systolic strain (Yes),early diastolic strain rate (SRe) and late diastolic strain rate (SRa) in longitudinal (L),radial (R),circumficial (C) directions and the rotation (Rot),rotation rate were analyzed with EchoPAC offline software.Results Compared with 1 group,LSps,LSes,LSRs,LSRa,RSRe,RSRa,CSRe,Rotsre,Rotsra of 2 group,LSps,LSes,LSRs,LSRa,LSRe,RSes,RSRs,RSRe,RSRa,CSps,CSes,CSRs,CSRe,CSRs,Rotps,Rotsrs,Rotsre,Rotsra of 3 group decreased significantly (P＜0.05) ;compared with 2 group,LSps,LSes,LSRs,RSes,RSRs,CSps,CSes,CSRs,CSRa,Rotps,Rotsrs,Rotsre of 3 group decreased markedly (P＜0.05).Conclusions Coronary collateral circulation provides a protection effection to ischemic myocardial regional function.2D-strain technique may serve as an efficient method to assess ischemic myocardial regional function.
ABSTRACT
Objective To explore the effects of sodium ferulate injection on CTGF, MMP-9 and TIMP-I in the serum of the patients with idiopathic pulmonary fibrosis(IPF). Methods 46 cases with IPF were randomly divid-ed into control group of 20 eases and treatment group of 26 cases. Control group was given the usual treatment and the treatment group was given the usual treatment and sodium ferulate injection. The levels of CTGF, MMP-9 and TIMP-1 in the serum were measured before and after treatment. Results After treatment,the concentration of CTGF,MMP-9 and TIMP-1 in patients in the treatment group was significantly improved than that in the control group(P < 0.05). Conclusion The treatment with sodium ferulate injection could improve the IPF through improving the production of CTGF,MMP-9 and TIMP-1.
ABSTRACT
Objective To explore the effects of Levoeitirize dihydrochloride on interleukin-13(IL-13)and interleukin-18(IL-18)in the serum of the patients with cough variant asthma(CVA).Methods 70 cases with CVA were randomly devided into control group of 35 cases and treatment group of 35 cases.Control group was given Chlort rimeton and the treatment group was given Levocitirize dihydroehloride.The levels of IL-13 and IL-18 in the serum were measured before and after treatment.Results After treatment,the concentrations of IL-13 and IL-18 in patients in the treatment group were(46.7±17.3)ng/L and(145.2±27.1)ng/L，and those in the control group were(98.5±30.7)ng/L and(179.6±30.5)ne/L，which were significantly improved.Conclusion The treatmem of Levoeitirize dihydrochloride could improve the CVA through improving the production of IL-13 and IL-18.
ABSTRACT
Objective To establish a mini pig model suitable for interventional studies in vivo. Methods The endothelia of unilateral renal arteries in 8 purebred Chinese experimental mini pigs(CEMP)was denuded by inflated balloons after the animals were fed with high cholesterol diet for 13 weeks.The CEMP were fed with h high cholesterol diet continuously till the 40th week.The levels of blood lipid panel and creatinine were tested at week 1,14 and 40.Bilateral renal arteries were examined with intravascular uhrasonography at week 14 and 40.The vessel samples were collected at week 40 and stained with haematoxylin-eosin,Masson trichrome technique, oil O and anti-macrophage immunohistological technique. Results Significant differences of blood lipid panel and creatinine were found between week 1 and week 40.Focal ischemic renal injury could be observed pathologically.Renal arteries of CEMP were suitable for interventional procedure such as angiography and intravascular ultrasonography.Cross-sectional information of vessels could be provided clearly by intravascular ultrasonography and the intimamedian thickness of injured renal arteries was much thicker than that of non-injured ones[(0.89±0.03)mm vs (0.30±0.02)mm,P＜0.05]as evidenced by this diagnostic technique.Pathological findings demonstrated the atheroselerotic profiles of the injured renal arteries.Fibrous and fibro-fatty plaques were the main pathologic types in this CEMP model. Conclusions An animal model with renal arterial atherosclerosis mimicking the progression of atheroselerotic renovaseular disease,which is suitable for interventional procedure is established successfully.Intravascular ultasonography may have potential clinical prospect on the evaluation of atherosclerotic renovaseular disease.
ABSTRACT
Objective To evaluate the effect of injecting UK and Herbesser into the target coronary artery where no-reflow happened during percutaneous coronary intervention. Methods Among the 820 acute coronary syndrome (ACS) patients who underwent PCI from Jan. 1990 to Apr. 2004, no-reflow phenomenon occurred in 86 patients. Three hundred cases with acute myocardial infraction (AMI) underwent primary PCI, no-reflow phenomenon occurred in 50 cases. In the other 520 unstable angina pectoris (UAP) cases, no-reflow phenomenon occurred in 36 cases during PCI. All the 86 patients with no-reflow were given intra-coronary arteries nitroglycerin but 78 of them showed no improvement in coronary perfusion and were in turns devided into 3 groups randomly. Group A (n=26) was given intra-vessel UK and Herbesser alternately. The maximan dosage of UK was 2?105 U kIU and 2 mg for Herbesser. Group B (n=24) was given intra-coronary Herbesser 500 ?g each time until the maximum amount reached 2 mg. Group C (n=28) was given UK which maximun dosage was 2?105 U. Results All the 26 cases in Group A showed significant improvement in blood flow (P
ABSTRACT
0 05). In PCI group,the balloon inflation time, the highest inflation pressure and the number of placed stents in the patients with the increased level of cTnI had not significant difference compared with those in the patients without the increased level of cTnI. There were 2 patients with side branch occlusion, whose cTnI level obviously elevated. Conclusion PCI could lead to minor myocardial injury in some patients, the reason of which might be side branch occlusion. The number of placed stents and balloon inflation time were not associated with the minor myocardial injury.
ABSTRACT
AIM: Inflammatory responses play an important role in the post- percutaneous transluminal coronary angioplasty (PTCA) restenosis and has been demonstrated occuring immediately after PTCA. Interleukin-6(IL-6) and tumor necrosis factor-?(TNF-?) are the main inflammatory cytokines. We try to compare the changes in interleukin-6(IL-6) and TNF-? after PTCA in the patients with and without collateral circulation to probe into the pathogenesis of early inflammatory response. METHODS: The extent of myocardial ischemia induced by balloon inflation was quantified by a scoring system referring to the Leaman coronary score. The IL-6?TNF-? levels of coronary heart disease group and control group before and after PTCA are calculated. RESULTS: The concentrations of IL-6 and TNF-? were (9.592?1.847) ng/L and (26.959?1.967) ng/L, respectively, and were significantly increased [(27.423?1.882) ng/L and (78.542?1.573) ng/L)] 4 hours after PTCA. CONCLUSION: IL-6 and TNF-? are sensitive indicators of the early inflammatory response after PTCA. Ischemia scores reflected the extent of ischemia reperfusion injury during PTCA. Collateral circulation decreased the early inflammatory response after PTCA.