ABSTRACT
Objective:Explore the characteristics of injury current changes in ventricular septal myocardium during left bundle branch area pacing (LBBAP) surgery.Methods:Retrospective analysis of clinical data of patients who underwent permanent pacemaker implantation at The Second People's Hospital of Wuxi in Jiangsu Province from January 2020 to November 2022. Among them, 42 patients were treated with LBBAP (LBBAP group) and 56 patients with Right ventricle septum pacing (RVSP group). Compare the conventional parameters such as threshold, perception, impedance during electrode implantation, damage current values at 0, 5, and 10 minutes before and after electrode rotation, and the correlation between damage current and conventional parameters. The measurement data is represented by xˉ± s, analysis of variance is used for comparison between multiple groups, t-test is used for comparison between two groups, and repeated measurement analysis of variance is used for comparison between two groups at multiple time points; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 Inspection; Pearson correlation analysis was used to analyze the correlation between the two variables. Results:There was no statistically significant difference in pacing threshold, perception, and impedance between the two groups of electrode implantation surgery (all P>0.05). The damage current values at 0, 5, and 10 minutes before and after electrode rotation in the LBBAP group were higher than those in the RVSP group [(7.19±1.26) mV compared to (5.33±0.79) mV, (22.50±3.06) mV compared to (10.85±1.70) mV, (15.75±2.63) mV compared to (8.01±1.09) mV, (9.24±2.00) mV compared to (5.51±0.98) mV]. The damage current values at 0 minutes after electrode rotation in both groups were higher than before electrode rotation, and gradually decreased thereafter, After 10 minutes of electrode placement, the damage current value of the LBBAP group was still higher than the level before electrode rotation (all P<0.05), while there was no statistically significant difference between the RVSP group and the level before electrode rotation ( P>0.05). The damage current value at 0 minutes after the LBBAP group electrode was in place was positively correlated with ventricular septal thickness and left ventricular posterior wall thickness ( r values 0.45 and 0.46, P values 0.003 and 0.002, respectively), and negatively correlated with conventional pacing parameter impedance ( r=-0.32, P=0.037). There was no correlation with threshold and perception ( r values 0.08 and 0.01, P values 0.604 and 0.968, respectively). The damage current value at 0 minutes after the RVSP group electrode was in place was negatively correlated with the threshold ( r=-0.28, P=0.036). Conclusions:The COI value of LBBAP interventricular septum myocardium increased significantly after the electrode was rotated out. The COI value at 0 min after the electrode put in place was positively correlated with the interventricular septum thickness and left ventricular posterior wall thickness, and negatively correlated with the electrode impedance, but there was no correlation with threshold and perception.
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Objective To reveal the role of PDK1 in vascular endothelial cells. Methods PDK1 was knocked out in endothelial cells by recombinase-mediated Cre to observe it′s effects on vascular endothelial cells. Results Abnormality of vascular development in rats could be found as a result of endothelial PDK1 deletion. Meanwhile, vascular leakage and bleeding phenotype were observed, and tissue analysis showed vascular endothelial cells abnormalities. Conclusions PDK1 plays an important role in the functioning and integrity of vascular endothelial cells, which made tentative explanation for PDK1-Akt signal path and laid basis for further research.
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Objective To verify the dynamic changes of ANP during the diastolic heart failure and the protective effect of amlodipine. Methods Male SD rats underwent the abdominal aorta ligation. Four weeks after Surgery, 40 rats were divided into 4 groups: hypertension model group (group B), low-dose group (group C), mid-dose group (group D), high-dose group (group E). Another 10 healthy male SD rats were used as sham group (group A). During the experiment, different drugs were gavaged to different groups and the normal saline was used for control group. Results After 12 weeks, ANP levels increased in group B much more than in group A, while lower in group C(P 0.05); HW/BW and LW/BW decreased in group B than in group A, while higher in group C than in group B (P 0.05). Conclusion ANP level gradually increased accompanying with the aggravation of heart failure, which is related with the dose of the drug within limits. Amlodipine can inhibit cardiomyocyte remodeling by interfering ANP secretion.