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OBJECTIVE: To evaluate a modified subtraction coronary computed tomography angiography (CCTA) technique with a two-breathhold approach in terms of image quality and stenosis grading of calcified coronary segments and in the detection of significant coronary stenosis in segments with severe calcification. MATERIALS AND METHODS: The institutional board approved this study, and all subjects provided written consent. A total of 128 patients were recruited into this trial, of which 32 underwent subtraction CCTA scans and invasive coronary angiography (ICA). The average Agatston score was 356 ± 145. In severely calcified coronary segments, the presence of significant (> 50%) stenosis was assessed on both conventional CCTA and subtraction CCTA images, and the results were finally compared with ICA findings as the gold standard. RESULTS: For severely calcified segments, the image quality in conventional CCTA significantly improved from 2.51 ± 0.98 to 3.12 ± 0.94 in subtraction CCTA (p < 0.001). In target segments, specificity (70% vs. 87%; p = 0.005) and positive predictive value (61% vs. 79%, p < 0.01) were improved using subtraction CCTA in comparison with conventional CCTA, with no loss in the negative predictive value. The segment-based diagnostic accuracy for detecting significant stenosis was significantly better in subtraction CCTA than in conventional CCTA (area under the receiver operating characteristic curve, 0.94 vs. 0.85; p = 0.03). CONCLUSION: This modified subtraction CCTA method showed lower misregistration and better image quality in patients with limited breathhold capability. In comparison with conventional CCTA, modified subtraction CCTA would allow stenosis regrading and improve the diagnostic accuracy in coronary segments with severe calcification.
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Humans , Angiography , Constriction, Pathologic , Coronary Angiography , Coronary Stenosis , Methods , ROC Curve , Sensitivity and SpecificityABSTRACT
Objective@#To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions.@*Methods@#In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization.@*Results@#The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30).@*Conclusion@#Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.
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Objective Myocardial bridging is a congenital anomaly.However,little data is available for patients with myocardial bridging (MB) associated with acute myocardial infarction (AMI).The goals of this study are to evaluate characteristics of MB in patients with AMI.Methods From March 1999 to February 2006,137 patients with both MB and AMI,were identified by coronary angiography,including 117 men and 20 women with an average age of 60.77±12.01 years (range 30-83 years) were enrolled in the present study.Results There were 119 patients with MB at the middle segment of left anterior descending artery (LAD),15 patients at distal segment of LAD,2 patients at middle segment of left circumflex (LCX),and 1 at the proximal segment of the obtuse marginal branch (OM) of LCX.There are 36 patients with non-ST elevation acute myocardial infarction (NSTEAMI),38 patients with anterior ST elevation AMI (STEAMI),40 patients with inferior STEAMI and 23 patients with inferior-posterior STEAMI.Risk factors such as hypertension,diabetes,hyperlipidemia and smoking were not different among four groups.Patients with anterior AMI included 8 patients who showed no stenosis at the segment of MB.Conclusion Patients with MB and ST elevation AMI were mainly inferior AMI.MB might be one of the causes of AMI.
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Objective To investigate the feasibility of subtraction coronary computed tomography angiography (Sub-CCTA) for the diagnosis of coronary heart disease in the segment with severe calcification.Methods A retrospective analysis was performed on 27 patients who underwent clinically indicated digital subtraction angiography (DSA) and CCTA using a 320-detector row CT.Compared with the results of DSA,sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Con-CCTA and Sub-CCTA were calculated.The clinical diagnostic accuracy of the two imaging methods was evaluated using the receiver operating characteristic (ROC) curve.The stenosis of coronary segments was divided into four grades (Ⅰ,Ⅱ,Ⅲ,Ⅳ).Kappa coefficient was used to measure agreement between two imaging methods.Image quality of 4-scale grade scoring method was used and t test was conducted.Results A total of 52 segments with severe calcification were evaluated.The scores of image quality in Con-CCTA and Sub-CCTA were 2.8 ± 0.5 and 3.4 ± 0.7,respectively.There was significant difference between them (t =5.9,P ＜ 0.05).Compared with the result of DSA as the golden standard,the Kappa coefficients were 0.55 and 0.81 respectively in Con-CCTA and Sub-CCTA for the quantitative evaluation of the severe calcified segments.The sensitivity,specificity,positive predictive value and negative predictive value and accuracy of Con-CCTA were 81.0％,63.1％,63.1％,81.1％ and 70.8 ％;and for Sub-CCTA they were 90.5 ％,85.2％,82.1 ％,92.0％ and 87.5 ％ respectively.Compared with Con-CCTA,the area under the ROC curve of Con-CCTA and Sub-CCTA were 0.84 (95％CI:0.70-0.93) and 0.96 (95％ CI:0.86-1.00),respectively,and the difference was statistically significant (P =0.03).Conclusions Sub-CCTA can improve the diagnostic accuracy of coronary artery stenosis in severe calcified segment.Application of subtraction technique in CCTA can reduce or even eliminate the artifacts caused by severe calcified plaque,and has a good clinical application prospect.
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Objective To observe the efficacy of antithrombotic treatment of acute ST-segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden,and its effect on elective percutaneous coronary intervention.Methods Eight acute ST-segment elevation myocardial infarction patients were enrolled,who suffered from failure of primary percutaneous coronary intervention because of high thrombus burden.Summarize the antithrombotic strategies in perioperative and postoperative period,the operative strategies and the follow-up coronary intervention were recorded and reviewed.Results All the patients were male and most of them had acute inferior myocardial infarction with right coronary occluded because of high thrombus burden.Four patients received thrombus aspiration and balloon dilation.One patient received thrombus aspiration and the other three patients did not receive coronary intervention.Tirofiban were given in perioperative period to all the patients.Low molecular weight heparin was given to 6 patients.Dual antiplatelet therapy was given to 6 patients (aspirin 100 mg/day plus clopidogrel 75 mg/day) and 1 patient required up-titration of aspirin to 200 mg/day.Coronary angiography were repeated (29.00 ± 23.25) days later,and the thrombus in the culprit vessels disappeared in two patients,and coronary stent implantation was performed in three patients.Conclusions The routine antithrombotic strategies play limited roles in thrombus clearance in acute ST segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden.The time for the thrombus to be totally organized and the timing of elective percutaneous coronary intervention are still uncertain and need to be further studied.
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Objective To evaluate the long-term clinical outcome of percutaneous coronary intervention ( PCI) with drug-eluting stents ( DES) for distal unprotected left main coronary artery (ULMCA) lesions. Methods Between Jan 2005 and Dec 2009, 111 patients with distal ULMCA disease who underwent drug-eluting stents implantation were enrolled in this retrospective study. The primary end points were major adverse cardiac and cerebrovascular event (MACCE) at follow-up, including death, non-fatal myocardial infarction, cerebrovascular event and target lesion revascularization ( TLR) . Results Patients were 65. 6 ± 10 years old. 21. 6% were diabetic. 31. 5% of the left main bifurcations were classed as Medina 1, 1, 1. Provisional T stent technique was performed for 79. 3% of the population. 30. 6% of cases underwent angiography follow-up. The median follow-up time was 2. 3 years, the MACCE-free survival was 87. 4% and the estimated freedom from TLR was 94. 6% . Diabetes mellitus was identified as the predictor of TLR. Conclusions PCI with DES for distal ULMCA disease was safe and effective when the strategy was made based on the case-by-case assessment.
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Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.
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Objective: To observe the changes of circulating fractalkine and its receptor CX3CR1 level in patients with chronic congestive heart failure (CHF). Methods: Our work included 2 group, CHF group, n=55 patients and Control group, n=25 healthy subjects. Plasma level of soluble fractalkine (sFKN) was measured by ELISA, CX3CR1 in peripheral blood mononuclear cell was examined by lfow cytometry method. The relationship between sFKN and NT-proBNP was studied. Results: Compared with Control group, CHF group had increased sFKN level, P=0.004, and the patients with NYHY III, IV were more than NYHY II, and CHF group also had the higher CX3CR1 expression (14.7 ± 8.1), P Conclusion: The circulating FKN l and its receptor CX3CR1 might be involved in pathogenesis of immune-inlfammatory pathogenesis in CHF patients.
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<p><b>OBJECTIVE</b>To explore the effect and mechanism of rosuvastatin on tumor necrosis factor-α induced human mesenchymal stem cells (MSCs) apoptosis.</p><p><b>METHOD</b>Human MSCs were treated as follows: (1) culture medium; (2) TNF-α (20 µg/ml) for 6 h; (3) rosuvastatin (20 µmol/L) for 24 h; (4) rosuvastatin (20 µmol/L) for 24 h followed by TNF-α (20 µg/ml) for 6 h; (5) TNF-α+rosuvastatin+50 nmol/L antago-miRNA; (6) TNF-α+rosuvastatin+100 nmol/L antago-miRNA. Cell survival and apoptosis were determined by MTT, TUNEL and caspase-3 activity assay. The changes of miRNA-210 in each group were detected with quantitative PCR.</p><p><b>RESULT</b>TNF-α significantly induced human MSCs apoptosis in a concentration-dependent manner, and pretreatment with rosuvastatin significantly reduced MSCs apoptosis (caspase-3 assay: TNF-α+Statin group vs. TNF-α group: (1.63 ± 0.25) vs. (2.05 ± 0.36), P < 0.05). Meanwhile, TNF-α progressively reduced the expression of miRNA-210 in human MSCs in a dose-dependent manner, while the miRNA-210 expression was significantly upregulated in TNF-α+Statin group (P < 0.05). The protective effect of rosuvastatin on TNF-α induced MSCs apoptosis was largely abolished by co-treatment with 100 nmol/L antago-miRNA (TUNEL:TNF-α + Statin + antago-miR group vs. TNF-α + Statin group: (42.58 ± 6.71) % vs. (16.87 ± 9.27) %, P < 0.05).</p><p><b>CONCLUSION</b>Pretreatment with rosuvastatin can significantly improve the viability of human MSCs after TNF-α injury, the protective mechanism of rosuvastatin is partly mediated through miRNA-210 up-regulation.</p>
Subject(s)
Humans , Apoptosis , Caspase 3 , Cell Survival , Fluorobenzenes , Pharmacology , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Mesenchymal Stem Cells , MicroRNAs , Pharmacology , Pyrimidines , Pharmacology , Rosuvastatin Calcium , Sulfonamides , Pharmacology , Tumor Necrosis Factor-alpha , Up-RegulationABSTRACT
<p><b>BACKGROUND</b>Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial. The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.</p><p><b>METHODS</b>Clinical, exercise and angiographic data were retrospectively collected from 602 patients in the study. Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).</p><p><b>RESULTS</b>With similar major clinical features, the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs. group 1, 50.0% vs. 66.9%, P = 0.031 and group 2 vs. group 1, 1.5 vs. 8.5, P = 0.04). At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients, the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60, 95% CI 1.00-2.54, P = 0.049).</p><p><b>CONCLUSION</b>The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.</p>
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Female , Humans , Male , Middle Aged , Coronary Angiography , Coronary Artery Disease , Diagnosis , Electrocardiography , Exercise Test , Prognosis , Retrospective StudiesABSTRACT
10.3969/j.issn.2095-4344.2013.24.020
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Seventy-one patients with variant angina (VA) admitted in the Cardiology Department from January 2003 to March 2011,were divided into non-stenosis group (stenosis ＜ 50％,n =43) and stenosis group (stenosis ≥50％,n =28) according to the degree of stenosis.The differences of the risk factors,clinical manifestations,electrocardiogram,echocardiogram and laboratory examinations between these two groups were compared.The average age of patients in stenosis group 58 ± 8 y was higher than that in non-stenosis group (52 ± 9 y,t =2.43,P =0.02).Other risk factors,including male gender,smoking,hypertension,diabetes mellitus and lipid disorder did not show any differences between the two groups.Percentage of patients with angina pectoris lasting less than 5 min was higher in stenosis group (x2 =5.98,P =0.02),while percentage of effort angina,seeking medical consultation ≤ 6 months of onset and hemodynamic disorders showed no difference.Laboratory examinations had no differences.It is difficult to determine whether the VA patient has fixed coronary stenosis by analyzing the risk factors,clinical manifestations and laboratory examinations; to determine the fixed coronary stenosis coronary angiography is necessary.
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Objective To study the influence of different microembolism on left ventricular systolic synchronism in pigs by detecting the real-time dypyridamole stress contrast echocardiography (RT-MCE).Methods Eighteen miniature pigs were randomly divided into three groups and underwent microembolization injection procedure through the middle of anterior descending coronary artery with different numbers of microsphere injection,as:group A(dosage 50 thousands,3 pigs),group B (dosage 120 thousands,8 pigs) and group C (dosage 150 thousands,7 pigs).The peak values and the time-to-peak circumferential strain(Circ.Strain),radial velocity (Radial Vel.) and radial strain (Radial Strain) were obtained both at mitral valve level and papillary muscle level at left ventricle short axis views using two-dimensional speckle tracking imaging(STI)analyzed by Philips Q-Lab 8.1 workshop,respectively.Results No significant difference in the presence of contraction synchrony was observed using RT-MCE.The time-to-peak Circ.Strain of microembolism related segments were prolonged at 1 week after microembolism detecting with dypyridamole stress RT-MCE (P＜0.05,both intro-group and inter-group).While time-to-peak radial strain were extended since 6 hours after the intervention to 1 week after the procedure.Conclusions Dypyridamole stress RT-MCE can be used to measure the myocardial perfusion accurately.The elongation of time-to-peak circ.strain and radial strain were developed with time in microembolism related segments.
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Objective To assess the effect of ultrasound contrast agent SonoVue on the dimensions and systolic function of left and right ventricle in pigs. Methods Sixteen pigs were randomly assigned to two groups. Intravenous injection of 1 ml of SonoVue were given in study group, and repeated 20 min later. The control group was given the same doses of saline. Before and after the administration of contrast agent, the end-diastolic dimension (LVEDD, RVEDD). end-systolic dimension ( LVESD, RVESD) and fractional shortening(LVFS,RVFS) of left and right ventricle were measured. The time to reach the extreme value of these parameters and the time to return to the baseline were recorded. Results There was no significant difference regarding the parameters at baseline between the two groups. After injection of SonoVue,RVEDD significantly increased from (25. 88 ± 1. 38) mm at baseline to its maximum of (33. 26 ± 0. 99)mm( P < 0. 05). Accordingly,RVFS significantly increased from (26. 90 ± 1. 92) % to (33. 92 ± 2. 53) % ( P <0. 05). Meanwhile,LVEDD remarkably decreased from (38.10 ± 1. 39)mm at baseline to its minimum of (26.25 ± 0. 65)mm( P <0. 05) and LVFS remarkably decreased from (36. 24 ± 1. 93) % to (29.13 ± 3.00) % ( P < 0. 05). There was no change in the control group after administration of the saline. When SonoVue was given repeatedly, the maximum RVEDD and RVFS was (29. 98 ± 1. 23) mm and (31. 09 + 1.90) % , respectively, which had less increase compared to the first time. Minimum LVEDD and LVFS was (31. 91 ± 1, 64)mm and (32. 17 ± 2. 31)%,respectively,with less decrease compared with which at first injection. It took (10. 15±0. 59) min for the right and left ventricle to reach the extreme value and (9.00± 0. 56) min to return to the baseline at the first injection. The time used for the right and left ventricle to reach its peak change and back to baseline after second injection of SonoVue were shorter [(8.73± 0.55) min and (6.89± 0.43) min, respectively,both P <0.05]. Conclusions Administration of SonoVue was associated with acute, transient dilation of right ventricle and compression of left ventricle. The influence of SonoVue on the right and left ventricle became less at it second injection.
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Objective To evaluate the efficacy of the drug-eluting stents in the treatment of coronary artery diseases in patients with diabetes. Methods This study included a retrospective database of 600 consecutive patients with coronary artery disease who underwent drug-eluting stems implantation in Zhong Shan Hospital,including 147 pa-tients with diabetes. The MACE in this study included death of any cause,nonfatal myocardial infarction,target lesion revascularization and target vessel revascularization. All the MACE were recorded. The efficacy of the drug-eluting stents was evaluated by the incidence of MACE and the rate of in-stent restenosis. Results No significant differences were found concerning the incidence of MACE (7. 9% vs 4. 9% ,P = 0. 344) as well as the rate of ISR(6. 0% vs 4.9% ,P =0. 540) between patients with diabetes and patients without diabetes. No significant differences were found concerning the incidence of MACE(7.9% vs 4. 9% ,P = 0. 344) as well as the rate of ISR( 1.4% vs 1.9% ,P = 1. 000) between Cypher stents and TAXUS stents. Conclusion Drug-eluting stents are effective in the treatment of coronary artery disease of patients with diabetes. There was no significant difference in the rate of MACE and in-stent restenosis between the two leading drug-eluting stents of sirolimus eluting Cypher stent and the paclitaxle eluting TAX-US stent.
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Objective To asses the value of ST segment elevation of aVR lead (aVRSTE) in patients with acute ST segment elevation myocardial infarction (STEMI). Method Myocardial enzymes detection, electrocar-dingraphy, emergency eornary artery angiography, echoeardiography [taken(10±2) days after emergency cornary artery angiography] were obtained and analyzed in 140 consecutive patients with STEMI enrolled in this study. The value of aVRSTE (≥0.05 mV) was assessed for detecting left main stem lesions(defined as ≥50% stenosis of or acute embolism of left main stem)or its equivalent (defined as total or subtotal acute occlusion of left anterior de-scending artery), and predicting the left ventricular systolic function after myocardial infarction. Results The sensitivity, specificity, positive predictive value and negative predictive value of aVRSIE in detection of left main stem lesions were 72.73 % (8/11), 83.72 % (108/129),27.59 % (8/29) and 97.30% (108/111), respectively; in detection of left main stem lesions or its equivalent, they were 41.86 % (18/43), 88.66% (86/97), 62.07 % (18/29), 77.48% (86/111); aVRSYE were combined with STaVR-STv1>0 to detect left main stem lesions, the semi-tivity, specificity, positive predictive value and negative predictive value were 63.64% (7/11),98.45%(127/129),77.78%(7/9),96.95% (127/131). Patients were divided into two groups: groups A with aVRSIE and group B without aVRSYE. KIIJJP class,and left ventricular ejection fraction (LVEF) in group A was higher than those in group B (P<0.05). Conclusions For patients with STEMI: (1) aVRSTE indicated left main stem le-sions or its equivalent; if combined with STaVR-STv1>0, it indicated left main stem lesions more strongly; (2)aVRSTE predicted poorer left ventricular systohc function short time after STEMI.
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Objective To investigate the safety and efficiency of China-made stent in patients with acute myocardial infarction(AMI).Methods Thirty-six patients with AMI were enrolled in our study,with mean age(57?9.7)years old.China-made stent were implanted successfully.Eighteen patients had acute anterior myocardial infarction,14 had acute inferior myocardial infarction,2 had acute lateral myocardial infarction,2 had acute posterior accompanied with right ventricular myocardial infarction.There were 12 patients with diabetes,20 patients with hypertension,18 patients with smoking.Results Thirty-seven China-made stents were implanted in the 36 patients.There were no complications during the procedure.All have acquired TIMI 3 flow.There were no thrombosis in the stent in 20 patients at the 7-day following up.Conclusion It is safe and efficient with the China-made stent implanted in patients with acute myocardial infarction.
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A model of fluid dynamics related to the myocardial bridginged and mural coronary artery was designed and manufactured according to the physical principle and characteristic of the mural coronary artery. The model can imitate systematically well the effect of myocardial bridging on hemodynamic change of the mural coronary artery under different controlled experimental parameter. The methodology is proved to be feasible and has good prosperity of experimental study.
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Humans , Coronary Vessels , Physiology , Hemodynamics , Models, Cardiovascular , Myocardial BridgingABSTRACT
Background The 5-year cardiac mortality rate has been reported to be more than 50% in patients with left main coronary artery (LMCA) stenosis. The purpose of this study was to visualize the LMCA using intravascular ultrasound in patients who undergo interventions of the left anterior descending coronary artery (LAD). This was done in order to see the incidence and severity of plaque formation in the LMCA in patients with severe lAD stenosis, and to address if scanning LMCA is able to rule out lAD significant stenosis or vice versa. Methods A total of 293 patients with intervention of the LAD stenosis were examined with intravascular ultrasound(IVUS). The images of 278 patients were suitable for analysis. Results Fifty-three (19%) were found to have angiographic lumen reduction in the LMCA ranging from 11% to 35% (19 ± 8%). Sixty-one patients were found to have native calcification in the LMCA. Atherosclerotic plaques in LMCA were detected in 211/278 (76%) patients, of which 164/211 (78%) were eccentric, and 51/211 (24%) had calcium deposit. The cross-sectional plaque area ranged from 1.5 mm2 to 21 mm2 (8.4 ± 4.7 mm2 ). Area of stenosis was 34 ± 14 % (8-66 % ) and diameter of stenosis was 21 ± 8% ( 7-42% ). A weak relationship concerning severity of stenosis between LAD stenosis and LMCA stenosis was found in the 59 patients with pre-interventional IVUS examinations ( r = 0.47, P ＜ 0.05 ). Condusions LMCA is frequently involved with atherosclerotic lesions in patients with severe LAD stenosis. A weak relationship does exist concerning the severity of stenosis between lAD and LMCA. However, IVUS for LMCA lesion is not able to rule out LAD stenosis.
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Objective To evaluate the safety and efficacy of bone marrow cells(BMCs) transplantation on the improvement of cardiac function and myocardial perfusion in patients with old myocardial infarction. Methods and Results A total of 10 patients with anterior wall myocardial infarction were transplanted with autologous mononuclear BMCs through an infusion catheter which was placed with the tip in the left anterior descending coronary artery after coronary angiography and interventional therapy if necessary. After 3 months of follow-up, a significant increase of left ventricular ejection fraction(LVEF) determined by ultrasonic cardiography was found (54.5%?6.5% vs. 45.3%?9.8% before transplantation, P=0.003); 201-thallium scintigraphy (SPECT) showed that ventricular myocardial perfusion was significantly improved as the semiquantitative score of the immediate and delayed myocardial perfusion defects decreased from 29.5?5.8 and 28.6?6.3 to 23.9?5.7 and 23.0?6.1prospectively (both P