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Objective To evaluate the effect of post-dilatation on in-stent restenosis of long lesion coronary heart disease patients received percutaneous coronary artery interventional(PCI) therapy.Methods A total of 92 cases coronary heart disease patients in Gaoxin Hospital of Xi'an from January 2008 to January 2014 were randomly divided into the post-dilatation deployment group (n =47) and control group (n =45).The postdilatation deployment group were given stent after expansion after conventional coronary stenting, while the control didn't use after expansion.The clinical features and profile of drug-eluting stent(DES) implantation and stent restenosis(examined by 256-shce spiral computed tomography coronary angiography(MSCTCA) and major adverse cardiac events(MACE) within hospitalization and 12 months were observed.Results Stent restenosis occurred in 1 patient(2.1％) in the post-dilatatioh deployment group and 8 patients(17.7％) in the control group in 12 months examed by MSCTCA,the difference was significant(P=0.03).MACE occurred in 3 patients (6.4％) in the post-dilatation deployment group and 11 patients (24.4％) in the control group, the difference was significant (P =0.03).Conclusion Routine post-dilatation tactics is effective for long lesion coronary heart disease patients with PCI.It is associated with lower coronary restenosis and lower MACE.
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Objective:To observe the clinical therapeutic effect of Rho kinase inhibitor-fasudil on no-reflow in pa-tients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) .Methods :A total of 82 ACS patients ,who hospitalized and occurred no-reflow after PCI ,were randomly divided into fasudil group (n=30 , received fasudil 5mg) ,nitroglycerin group (n=25 ,received nitroglycerin 200μg) and tirofiban group (n=27 ,re-ceived tirofiban 10ml) .All patients received drugs via intracoronary injection ,and reviewed coronary angiography and coronary blood flow velocity evaluation after 10min .Thrombolysis in myocardial infarction (TIMI) flow im-provement ,ST segment elevation/depression extent ,left ventricular ejection fraction (LVEF) ,incidence rates of major adverse cardiovascular events (MACE) and complications were observed .Results:Compared with nitroglycer-in group ,there were significant rise in effective rate of TIMI flow improvement (40.0% vs .63.3% ,59.3% ) ,ST segment elevation and depression extent [ (0.15 ± 0.09) mm vs .(0.24 ± 0.11) mm ,(0.26 ± 0.15) mm] and LVEF level [(48.32 ± 5.67)% vs .(56.12 ± 7.11)% ,(55.78 ± 6.99)% ] ,and significant reduction in incidence rate of MACE in fasudil group and tirofiban group , P<0.05~ <0.01 ;for complications of hypotension ,hemorrhage and thrombocytopenia ,incidence rates of fasudil group (13.3% ,6.7% ,16.7% ) were significantly lower than those of nitroglycerin group (68.0% ,4.0% ,12.0% ) or tirofiban group (3.7% ,29.6% ,44.4% ) , P<0.05 all .Conclu-sion:Fasudil is safe and effective on no-reflow after PCI in ACS patients ,and it is worthy of extension .
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Objective: To explore the relation between hepatic lipase (HL) promoter-514C/T polymorphism and coronary heart disease (CHD) in population of this district. Methods: Polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) was used to measure HL promoter-514C/T genotypes in 199 CHD patients (CHD group) and 146 non-CHD patients (non-CHD group) in order to explore its influence on blood lipids and apolipoprotein. Results: In male group, there was significant difference in distribution of HL promoter-514C/T genotype between CHD group and non-CHD group (χ2=15.851，P=0.015); but there was no significant difference in female group (χ2=0.249，P=0.969); Compared with LIPC-514-C/T CC male inpatients, there was significant increase in level of high density lipoprotein cholesterol [(34.6±8.9)mg/dl vs. (38.9±10.2)mg/dl, P=0.02] in CT/TT male inpatients. Conclusion: Hepatic lipase promoter-514C/T polymorphism has certain influence on levels of blood lipids in patients with coronary heart disease.
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Objective To investigate the changes of pulmonary capillary wedge pressure(PCWP) before and after off-pump coronary artery bypass graft(OPCABG) using transesophageal echocardiography(TEE). Methods Mitral valve flow(MVF) and pulmonary veinous flow(PVF) were measured in 46 patients before and after OPCAB using TEE and PCWP was detected by cardiac catheter. The correlations between indices derived from TEE and catheterization-measured PCWP and the differences before and after OPCAB were studied. Results There were obvious differences in the indices derived from TEE and PCWP which could reflect the left ventricular function. The most indices measured in PVF and MVF correlated with PCWP(r=(0.30)-(0.76),P
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Objective To evaluate the clinical efficacy of circumferential ablation at orifice of pulmonary veins with ultrasound energy in the cure of paroxysmal atrial fibrillation(PAF).Methods The study group included 5 patients with PAF who had significant symptom and were drug resistance,and ultrasound ablation was applied at the orifice of their pulmonary veins to get electrical isolation.Results Nineteen pulmonary veins got electrical isolation and among them 3 were combined with radiofrequency ablation.PAF recurred in one patients and atrial premature beats occurred in other two patients but all disappeared after being treated with amiodarone.During the ablation atrial perforation occurred in one patients and severity vague response in another patient.All patients reached a minimum of six months of follow up,and remained in sinus rhythm.Conclusions The circumferential ablation at orifice of pulmonary veins with ultrasound energy is effective in restoration and maintenance of sinus rhythm in patients with PAF.
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To study the electrophysiological mechanism of atrial fibrillation induced by acetylcholine(Ach). The results showed that:①Ach decreased ERP of four atrial sites.When the concentration of Ach was incseased, ERP of 4 sites became shorter but COVERP became bigger.②As the concentration of Ach was increased, the percent of AF induced by Ach and AF was increased with the duration prolonged( P 0 05).③There was a significant correlation between atrial vulnerability with ERP and COVERP( P
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Objective To observe and compare the influences of radiofrequency catheter ablation (RFCA) and through-the-balloon ultrasound ablation (TTB-USA) on coagulable states of blood and evaluate their safety. Methods Eleven mongrel canines of either sex were divided into TTB-USA group (n=5) and RFCA group (n=6). We measured the expression of alphagranule membrane protein (GMP-140) on the surface of activated platelets by flow cytomety before and after cannulation, immediately after ablation, 30 minutes and 48 hours later, respectively. And at the same time,we also examined the change of tissue type plasminogen activatior (T-PA)? plasmingen activator inhibitor-1 (PAI-1). Results The expression of GMP-140 elevated before ablation, reached its peak value at hour 48, but the degree of uprising was lower in TTB-USA group than in RFCA group. Both t-PA and PAI-1 uprising just after ablation, restored to normal 48 hours later, t-PA reached its peak just after ablation, but PAI-1 was 30 minutes later and there was no difference in uprising degree between the two groups. Conclusion Both TTB-USA and RFCA could activate platelets and result in the change of blood coagulable states, but TTB-USA was slighter than RFCA, so TTB-USA seems to be more safely in ablating pulmonary vein orifice than RFCA in treatment of focal atrial fibrillation.
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Objective To observe the influence of catheter ablation of the orifice of pulmonary veins (PVs) using ultrasound energy on hemodynamic parameters and explore the safety and efficacy of ultrasound ablation. Methods Nineteen PVs of six canines received ultrasound ablation, with a preset ablation temperature between 55 ℃-65 ℃, for 60 seconds. Ultrasound ablation catheter was positioned on the orifice of PVs via transseptal approach under fluoroscopic. Selective pulmonary venography was undertaken and the hemodynamic data were measured before ablation? immediately and three months later after the ablation.Results All except one canine completed the experiment. All the PVs got effective electrical isolation, and had no stenosis with pulmonary venography, no significant change in hemodynamic parameters was observed before, immediately or three months later after the ablation. Conclusion Catheter ablation within PVs by ultrasound energy was safe and efficient, it was a useful method to treat focal atrial fibrillation derived from PVs in clinical practice.
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14 aged patients received radiofrequency current ablation(RFCA)to treat drug-refractory tachycardia. The success rate was 97%(13/14).In conjunction with the charcteristicaof aged patients often with long clinical history and apt to be complicated,the paper especially discussed the distinctive feature of application of RFCA to aged patients.
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0. 05) in rate of success, recurrence and complication between RFCA and OHO for the patients with AVRT. Medical workers were fewer, operation, du-ration, hospital days (including days of pre-operation preparation and post-operation recovery) and days of looking after the patients in RFCA were shorter than those in OHO,p