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Objective Previous studies have shown that vitamin D deficiency is closely related to cardiac remodeling. How?ever, the underlying mechanisms have not been fully elucidated. Moreover, oxidative stress plays an important role on the pathologies of cardiac remodeling. The aim of this study was to explore the influence of VD deficiency on cardiac oxidative stress and the potential sig?nal pathway. Methods The male C57 mice ( 3 weeks old) were randomly divided into three groups: vitamin D deficiency ( VDD ) group ( vitamin D deficiency feed for 10 weeks) , vitamin D deficiency ( VDA) group ( vitamin D sufficiency feed for 10 weeks) and VDD+calcitriol ( CAL) group ( vitamin D deficiency feed for 10 weeks and then vitamin D sufficiency feed and calcitriol treatment for 10 weeks) . Results There were significant differences between the VDD group and the VDA group in the left ventricular end?diastolic diameter and left ventricular mass index (3.82±0.125 mm vs 3.748±0.092 mm, P<0.05) (119.30±8.54 vs 97.60±3.65, P<0.05). The number of myocardial cells stained with 8?OHDG was higher in the VDD group compared with the VDA group ( 65. 4 ± 2. 3 vs 21. 8 ± 1. 6, P<0.05) whereas was lower after calcitriol supplement. Furthermore, the expression of thioredoxin interacting protein (TXNIP) was sig?nificantly up?regulated and the ratio of p?ASK?1/ASK?1, cytochrome C release, and caspase3 activation were increased in the VDD group . Conclusion VDD can lead to cardiac oxidative injury and the up?regulation of TXNIP and the activation of ASK?1 related apoptotic signal cascade may be involved in this procedure.
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To describe a case with acute myocardial infarction caused by gastric carcinoma-associated thrombotic thrombocytopenic purpura. A 79-year-old man was admitted with abdominal pain and pyrexia. He later developed cardiac complications and microangiopathy that indicated worsening progression. Manifold evidence confirmed the diagnosis of myocardial infarction caused by thrombotic thrombocytopenic purpura. The patient was treated mainly with plasma transfusion incorporated with steroids. This case should remind physicians to consider microangiopathy as a differential diagnosis in patients with unexplained cardiac symptoms or atypical presentation. Early diagnosis and treatment are helpful in decreasing the sequelae of this syndrome
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One hundred and eleven patients with acute myocardial infarction and without known diabetes mellitus who underwent continuous glucose monitoring were divided into normoglycemia(n = 30),transient hyperglycemia(n = 36),and persistent hyperglycemia(n = 45)groups.Compared with other two groups,higher mean blood glucose,standard deviation of blood glucose,largest amplitude of glycemic excursions,mean amplitude of glycemic excursions,and absolute mean of daily differences were observed in the patients with persistent hyperglycemia group(all P<0.01),who were more likely to be female with the history of hypertension and old myocardial infarction(all P<0.05).It was shown that the levels of aspartate aminotransferase,creatine phosphokinase(CK),CK-MB,total cholesterol,triglyceride,low-density lipoprotein cholesterol,HbA1C,and C reactive protein levels were higher in these patients(P<0.01).
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Objective To explore the disparity of severity of cardiac dysfunction and recovery among different glycometabolic patients in the early phase of acute myocardial infarction (AMI) . Methods Consecutive 111 AMI patients without known diabetes underwent continuous glucose monitoring. Patients with different glycometabolic status were compared in terms of cadiac dysfunction and recovery at admission and 3month follow up. Results Compared to patients with normglycemia and transient hyperglycemia, patitents with persistent hyperglycemia were more likely to grade Killip Ⅱ or above,which were 13.3% (4/30) ,33. 3% ( 12/36) ,55. 6% (25/45), 20. 0% ( 6/30), 41.7% ( 15/36 ) and 93.3% (42/45) ( Ps ＜ 0. 01 ). In-hospital left ventricular ejection fraction (LVEF), mitral valve protodiastolic E peak velocities (E) and its ratio to late diastolic (E/A) decreased significantly ( LVEF :0. 52 ± 0. 02,0. 48 ± 0. 01 and 0. 37 ± 0. 02; E: [0. 65 ± 0. 41]m/s,[0.55 ± 0.02] m/s and [0.39 ±0. 12]m/s;E/A:1. 15 ±0.08,1.02 ±0.06 and 0.61 ±0.02,respectively) ( Ps ＜ 0. 01 ), whereas LVESV and WMSI increased significantly ( LVESV: [25.83 ± 0. 51] ml,[31.26 ± 1.23] ml, [37, 72 ± 1.01] ml; WMSI: 1.5 ± 0. 3,1.8 ± 0. 2 and 2. 6 ± 0. 4, respectively) ( Ps ＜ 0. 01 )There months after AMI,patitents with persistent hyperglycemia were more likely to grade NYHA Ⅱ or above compared to patients with normglycemia and transient hyperglycemia [67.5% (27/40), 10.0% (3/30) and 11.8% (4/34),respectively] (P ＜0. 01 ). Echocardiographic recovery was observed in each group,but less in persistent hyperglycemia patients. Conclusion Cardiac function of patients with persistent hyperglycemia suffered more severely from AMI and difficult to recover.
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Objective To approach the effect of hyperglycemia on admission on the prognosis in female pa-tients with acute myocardial infarction (AMI) during hospital stay. Methods 171 female AMI patients without a history of diabetes mellitus from January 1998 to December 2007 were divided into 3 groups according to the blood glucose level on admission. Group Ⅰ included 69 cases with blood glucose <6. 1 mmol/L,group Ⅱ included 49 cases with blood glucose between 6.1 and 7.8 mmol/L,and group Ⅲ included 53 cases with blood glucose >7.8 mmoL/ L. The basic clinical profile, infarct sites, the incidence rates of the main complications and the mortality of the pa-rhythmia among group Ⅲ ,group Ⅰ and group Ⅱ were significantly different ( the incidence rate of cardiac failure was 30.43% (21/69) ,32.65% (16/49) and 58.49% (31/53), the incidence rate of cardiogenic shock was 5.80% (4/69) ,8.16% (4/49) and 24.53% (13/53) ; the incidence rate of severe arrhythmia was 24.64% (17/69) ,30. 61% (15/49) and 54.72% ( 29/53), respeetivley in group Ⅰ, group Ⅱ and group Ⅲ, P < 0.05 for each). The in-hospital mortality in group Ⅲ (28.30% (15/53) ) was remarkably higher than group Ⅰ ( 13.04% (6/69)) ,with significant difference ( P < 0.05 ). Conclusions Elevated blood glucose level on admission is associated with s markedly increased risk of cardiac failure,severe arrhythmia,cardiogenic shock and mortality during hospital stay in female patients suffering from AMI.
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Objective To study the change of diastolic cardiac function in diabetic patients and to determine the diagnostic value of plasma brain natriuretic peptide (BNP) and atria natriuretic peptide (ANP) for diastolic heart failure in patients with type 2 diabetes mellitus.Methods Twelve healthy subjects and seventy-one diabetic patients were included in the study.Plasma BNP and ANP were measured with immunoradiometic assay.Results Plasma levels ofBNP andANP increased significantly with increased severity of diastolic heart dysfunction.The ratio of E/A had significant negative correlation with the plasma levels of BNP (r=0.669,P＜0.001) and ANP (r=0.579,P＜0.01).AUC of ANP and BNP in ROC model was 91.9% and 65.3%,respectively.Conclusions The plasma level of BNP might be a valuable predictor for differential diagnosis of diastolic cardiac function in diabetic patients.
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Objectives To explore cholesteryl ester transfer protein(CETP)level in male patients with different degrees of coronary artery lesion and its clinical significance.Methods ELISA was used to measure CETP of 42 male patients with coronary heart disease(CHD)and 49 healthy male controls.The patients of CHD groups were subdivided into mono-vessel,ambi-vessel,multi-vessel lesion groups;localized,diffuse lesion groups;and mild,severe stenosis groups according to coronary angiography.Results The CETP level of patients with CHD(1.37?1.07 mg/L)was significantly higher than that of healthy control(0.99?0.53 mg/L)(P
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Objective To describe clinical and functional features of patients with left main coronary artery (LM) stenosis. Methods Significant stenosis was defined as ≥ 50%.One hundred and eighty-eight patients with LM stenosis and 200 patients with clinically suspected coronary heart disease (CHD) without LM stenosis were enrolled. Results (1) The incidence rate of LM stenosis was 5.59%.(2) Patients with LM stenosis all had risk factors.Furthermore,featured older age,higher incidence of angina pectoris,and the same incidence of myocardial infarction history when compared with the patients without LM stenosis.(3) The left ventricular ejection fraction was lower in patients with LM stenosis than that in patients without LM stenosis,and it was lower too in patients with isolated LM stenosis than in patients with LM stenosis accompanied by triple vessel stenosis.The left ventricular end diastolic pressure showed no significant difference among various groups. Conclusion Patients with LM stenosis feature older age,severe angina pectoris.Furthermore, most of them are accompanied by other vessel lesions.Most LM stenosis are located at the ostium and the crotch of LM is presented as stenosis
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Objective : To investigate the dynamic changes of the expression of GLUT1 mRNA and GLUT4 mRNA in rats myocardium with transient ischemia and reperfusion, and the relationship between the dynamic changes and the time during reperfusion. Methods : In rats, the left anterior descending coronary artery was occluded for 20 min followed by reperfusion for 4 hours, 1, 3 or 7 days as ischemia reperfusion model. The relative content of GLUT1 mRNA and GLUT4 mRNA in myocardium was detected by RT-PCR and gel electrophoresis imaging. Results: During myocardial post-ischemia and reperfusion, the levels of GLUT1 mRNA got up to the peak at 4th hour[ (0.666?0. 003 ) vs (0. 509?0.002) controls , P 0.05). Conclusion; Transient ischemia and reperfusion induce the expression of glucose transporters GLUT1 and GLUT4 genes in rat myocardi- um, which contribute to promote glucose utilization during ischemia, protect ischemic myocardium and improve functional recovery on reperfusion.
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Objective: To evaluate the effects of stent implantation for treatment of Budd-Chiari syndrome. Methods:A total of 16 patients with pasthepatic inferior vena cave (IVC) obstruction syndrome were treated by balloon catheters ( Polythene and Inoue ) in percutaneous transluminal angioplasty (PTA) , then stent were inserted into the obstruction. Results: The residual pressure gradient after PTA and stent implantation was decreased from (4.6?0. 3 ) kPa to (2. 1?0. 1) kPa. The diameter of IVC after PTA and stent implantation was increased from (3.8?1. 7)mm to (14. 9?2. 0)mm. Conclusion : PTA and stent implantation are effective treatment for pasthepatic inferior vena cave obstruction.
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Objective: To assess the regional systolic and diastolic function of left ventricle by pulsed wave Doppler tissue imaging ( PW-DTI) in patients with coronary artery disease ( CAD ) . Methods : Seventy-seven cases of coronary angiography were adopted for study and grouped in terms of severity of coronary arterial lesion. Peak systolic, peak early diastolic, and peak late diastolic motion velocities (Sm, Em and Am, respectively) were recorded at 6 different sites on the basal and medial segments corresponding to the anteroseptal, posteroseptal, lateral, anterior, inferior, and posterior walls of the left ventricle with PW-DTI. Results: Am in segments corresponding to normal coronary arteries (group A) was lower than in segments corresponding to slightly stenosed coronaries (group B). There was no significant difference in Sm and Em between group A and group B. Compared with group A, Sm, Em and Am were significantly decreased in segments corresponding to severely stenosed coronary arteries ( group D). Conclusion : PW-DTI could be used to evaluate quantitatively and accurately the regional mvocardial function of left ventricle in patients with CAD.
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Objective:TO investigate the effects of the different factors on the quality control of PCI. Methods: Elucidating the correlation of PCI with the different personnel. Results: Success or failure of PCI is related to quality of subsystems in which the most importance is to manage and control concerning personnel including operating staff,nurses and patients. Conclusion:The organic coordination and total quality management of all parts are the safeguard of successful PCI.
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Objective: To determine the diagnostic value of the concentration of plasma BNP and ANP in patients of type 2 diabetes mellitus with diastolic heart failure(DHF). Methods:12 healthy subjects and 71 diabetic patients were selected into the study. Left ventricular ejection fraction(LVEF) ,mitral annular early diastole (E) and late diastole (A) inflow velocities were measured with Doppler echocardiography .According to the result of ratio of E to A, the DHF patients were subdivided into DHF 1 group:0.8 ≤ E/A
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Objective:To investigate the relation between the AT 1 receptor gene polymorphism and some biochemical indices of essential hypertension patients. Methods:Sixty-four patients of mild-moderate essential hypertension were not given any anti-hypertension drugs for 5 half lives,then used the PCR-RFLP to detect the AT 1 receptor gene type and measured the basic blood pressure at the same time. After that, fasting serum glucose , serum total cholesterol(TC) , triglyceride(TG) , high-density lipoprotein cholesterol(HDL-C) , low-density lipoprotein cholesterol(LDL-C) , blood urea nitrogen(BUN) , creatinine(Cr) were measured in all subjects. Results:①The frequency of AC gene type in these essential hypertension patients and the C1166 allete of AT 1 receptor gene was 23.4% and 11.7%. ②There was a remarkable difference on TG between two gene groups. ③There were obvious difference on Cr and UA between two gene groups .④There were no obvious difference on Glu, TC ,HDL-C ,LDL-C ,BUN between AC and AA gene type. Conclusion:①The concentration of TG of AC gene type is lower than that of AA , there may be relativity between two gene type. ② A1166/C gene polymorphism may be associated with renal function. AA gene type may have poorer renal function. ③A1166/C gene polymorphism may be not relative with Glu,TCH ,HDL-C ,LDL-C ,BUN.
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Objective:To explore the relationship between the coronary atherosclerosis and endothelium function or lipidoxidative function. Methods:All subjects underwent selective coronary angiography.Their age,sex,body mass index,smoking status,blood pressure,plasma and serum of levels of glucose,total cholesterol,triglycerides,high density lipoproteins,non-hingh density lipoproteins,oxidized LDL,endothelin(ET)and nitric oxide(NO)were measured. Results: Subjects were divided into two groups,according to coronary lesion(50 cases),and non-coronary lesion(25 cases).The plasma levels of OxLDL〔(65.31?9.87)mmol vs(46.95?7.74)mmol/L〕and ET 〔(91.92?8.50)ng/L) vs (82.81?7.37)ng/L〕 were higher in group with coronary lesion than those of group with non-coronary lesion (P
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Objective:To discuss the protective effect of intestinal ischemic preconditioning(iIPC) on the myocardium and the role of uncoupling protein 2(UCP2) in myocardium with iIPC. Methods: The animal model was built by superior mesenteric artery ligation of rats.Then they were subjected to a sustained coronary occlusion of 30 min and reperfusion of 180 min.We evaluated the degree of the myocardial damage and used RT-PCR method to check the relative content of UCP2 mRNA.The IR control group underwent the coronary occlusion/ reperfusion with no intestinal ischemia and the blank group was sham-operated. Results:①Compared to the blank group,the IR control group showed much heavier damage in the ultramicro structure.And for the iIPC group, the damage in the ultramicro structure 0 h and 24 h after iIPC was lighter than that of the IR control group.②Compared to the expression of the UCP2 mRNA in the myocardium of rats in the IR control group,the expressions of iIPC 0 h,6 h,12 h,24 h,48 h groups increased substantially(P
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Objective To study the risk factors and left ventricular function in acute myocardial infarction (AMI) patients without angiographically coronary artery stenosis, and elucidate the possible mechanisms. Methods 399 AMI patients of selective coronary angiography were divided into two groups in terms of severity of coronary lesion: the group without angiographically coronary artery stenosis (coronary artery diameter stenosis percentage less than 50%) and the group with angiographically coronary stenosis (coronary artery diameter stenosis percentage equal to or more than 50%). The risk factors and left ventricular function were compared between the two groups. Results 5.76% (23/399) cases showed no angiographically coronary artery stenosis, while 94.24% (376/399) cases showed angiographically coronary artery stenosis. Compared with the group with coronary stenosis, the group without angiographically coronary artery stenosis featured more in young people aged less than 40 (26.08% vs 6.12%, P0.05). Left ventricular end diastolic pressure (LVEDP) was lower in the group without angiographically coronary artery stenosis (12.53 mm?Hg?5.46 mm?Hg vs 18.75 mm?Hg?7.10 mm?Hg, P0.05). Conclusion AMI without angiographically coronary artery stenosis is not a rare phenomenon, to which attention should be paid. The group without angiographically coronary artery stenosis features a better left ventricular function, and its prevalence is higher in young patients and female. Both group share the same risk factors such as diabetes, hyparlipedemia and hypertension.
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Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.
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Uncoupling protein 2 (UCP2), a member of the mitochondrial inner membrane carrier family, partly dissipate the proton electrochemical gradient, decrease ATP production. UCP2 limits production of reactive oxygen species (ROS) and inhibits insulin secretion and regulates fatty acid oxidation. FFA, PPAR?,leptin, thyroid hormones and so on could regulate the UCP2 expression. The function of UCP2 in myocardial energy metabolism remains unknown.
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100 U/L were higher than those in group of CK-MB≤100 U/L(P