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OBJECTIVE@#To explore the predictive value of overall longitudinal strain for the development of cardiomyopathy without hypertrophic changes.@*METHODS@#Sixty five patients with suspected hypertrophic cardiomyopathy (HCM) but without hypertrophic changes were selected. Genetic variant, overall longitudinal strain, left ventricular ejection fraction, end diastolic volume, end systolic volume, interventricular septal thickness, left ventricular diameter and end diastolic diameter were detected. The risk factors of HCM were analyzed.@*RESULTS@#Forty four variants of 16 genes were identified, among which MYBPC3 13659G>A was the commonest (73.20%) and MYH7 13252C>T was the second (31.25%). MYBPC3 GG genotype, overall longitudinal strain and apical longitudinal strain were correlated with HCM (P<0.05).@*CONCLUSION@#The increase of longitudinal strain is of great value in predicting the occurrence of HCM.
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Objective To investigate certain risk factors for postoperative atrial fibrillation (AF) in elderly patients with coronary heart disease after off-pump coronary artery bypass grafting (OPCAB)surgery in order to provide a basis for the prevention and treatment of AF after OPCAB.Methods A total of 139 elderly patients with coronary heart disease who had undergone OPCAB surgery in our hospital were collected as research subjects and divided into the AF group and the nonAF group according to the occurrence of AF after operation.The patients' general information and clinical data were retrospectively analyzed.Risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease were investigated.Results The incidence of AF after OPCAB was 15.8％ in elderly patients with coronary heart disease.There were no statistical differences in gender,history of diabetes,history of myocardial infarction,preoperative β-blocker usage,number of coronary artery lesions,or operation time between the AF group and the non-AF group (P＞0.05).The percentage of patients who were of older age (t=9.960) or had a left ventricular ejection fraction ≥40％ (x2=4.942),a left atrial diameter ≥40 mm (x2 =4.491),a history of hypertension (x2 =12.357),dopamine medication after operation (x2 =8.511),or a bypass vessel count≥ 3 (x2 =5.385) was higher in the AF group than in the non-AF group (all P＜0.05).Logistic regression analysis showed that age,history of hypertension,dopamine medication after operation,left atrial diameter and bypass vessel count were the risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease (OR 3.080,2.435,2.465,3.593,and 1.921,respectively,P＜0.05 for all).Conclusions The incidence of AF after OPCAB is high in elderly patients with coronary heart disease and is affected by many risk factors.These risk factors should be assessed before surgery so that appropriate prevention measures can be taken.
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To explore the relationship of the perioperative B-type natriuretic peptide [BNP] level with heart function among patients undergoing on-pump coronary artery bypass graft surgery on a beating heart. Total 90 patients expected to undergo coronary artery bypass graft surgery were selected and their left ventricular ejection fraction [LVEF] were examined before operation. Patients with LVEF greater than or equal to 50% were selected as the A group [n=46], and those less than 50% formed the B group [n=44]. BNP levels of the patients were examined and its relationship with cardiac function was analyzed. BNP levels of group A was lower than that in group B pre-and post-operatively [until 7 days after the surgery], the difference is statistically significant [p<0.05]. Pearson analysis showed that the BNP level was negatively correlated with the LVEF [r = 0.767, p< 0.05]. The area under the Roc curve is 0.865. BNP level was negatively correlated with the LVEF. Perioperative BNP level can be used as the prediction for heart function of patients with on-pump coronary artery bypass graft surgery on a beating heart
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Humans , Male , Female , Perioperative Care , Heart Function Tests , Coronary Artery BypassABSTRACT
<p><b>BACKGROUND</b>The radial artery (RA) is becoming a popular conduit for coronary artery bypass grafting (CABG), yet data reporting the long-term results are rare. We reported our clinical, angiographic and intravascular ultrasound findings on 93 patients who had the RA used as part of the conduit for the CABG procedures during a 12-year period from June 2001 to June 2013.</p><p><b>METHODS</b>A total of 118 radial artery conduits were harvested in 87 males and 6 females, age from 28 to 66 (mean 49.9) years. An "intra-operative Allen's test" was developed to safeguard blood supply to the arm and hand. A "double-clip & scissors-cut" technique was carried out to minimize the thermal injury to the radial artery from the diathermy. The left radial artery was used in 67 patients, the right in one, and bilateral radial arteries in 25 patients. One hundred and twenty-two out of 272 distal anastomoses (44.9%) were constructed with radial arteries, with an average of 2.9 grafts per patient (range 2-6).</p><p><b>RESULTS</b>Follow-up angiography and intravascular ultrasound study at 3-139 postoperative months (mean 59 months) revealed a 93.1% RA patency. String sign occurred in one patient in whom the RA was directed to a big right coronary artery with a stenosis of around 50%. The patency for the internal mammary artery was 96.4%.</p><p><b>CONCLUSIONS</b>The RA is an excellent conduit that broadens the options for total arterial CABG surgery. Good graft patency could be achieved through careful harvesting techniques and choice of proper target coronary vessels.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anastomosis, Surgical , Methods , Coronary Artery Bypass , Methods , Coronary Artery Disease , General Surgery , Radial Artery , General SurgeryABSTRACT
Objective Biodegradable polycaprolactone (PCL)/poly D,L-lactic/glycolic acid (PLGA) scaffold is a promising modality for diffuse coronary atherosclerosis diseases unavailable to bypass graft.The purpose of this study was to evaluate the long-term performance of PCL/PLGA scaffold in vivo following polymer degradation.Methods Two scaffolds with and without heparin modification [Heparinized Scaffold (HS) and Blank Scaffold (BS)] were implanted.Except for control group,bone marrow mesenchymal stem cells (MSCs) were also transplanted around the scaffold.Animals were grouped into control BS group,BS-MSCs group and HS-MSCs group (each n =6) and survived 6 months.Patency and integrity of scaffold were evaluated by echocardiography and 3D-DOCTOR software.Endothelium coverage of the lumen was evaluated by scanning electron microscopy.Neovessles and collagen fiber within the scaffold were identified by histological staining.Prostacyclin (PGI2) and thromboxane (TXA2) production in the plasma were measured by ELISA.The expression of cyclooxygenase (COX-1,COX-2) and prostacyclin synthase PGIS was detected by Western blot.Results The heparinized scaffold kept patent up to 6 months and the lumen was covered by confluent endothelial cells.Histological staining revealed remodeling of collagen fiber and reconstruction of neovascular network immediately around the lumen.PGI2 production and PGIS expression in BSMSCs group and HS-MSCs group significantly increased compared with BS group (P ＜ 0.05 and P ＜ 0.01,respectively).Nonetheless,TXA2 production and COX-1 expression in BS-MSCs group was more pronounced than HS-MSCs group (P ＜ 0.01),showing no difference between BS-MSCs and BS group (P ＞ 0.05).Conclusion Despite polymer degradation and entire heparin release,the scaffold could continuously keep the structual integrity and lumen patency until 6 months by reinforcement of host collagen fiber and PGI2 expression.