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Objective To explore the predictive value of Tei index and plasma brain natriuretic peptide(BNP) on major adverse cardiovascular events(MACE) during long term follow up in the patients with anteriormyocardial infarction(MI).Methods A total of 238 patients with anterior MI were selected and divided into four groups according to the median of Tei index and BNP:G1 group(Tei≤0.66,BNP≤532.60 ng/mL,n=70),G2 group(Tei≤0.66,BNP＞532.60 ng/mL,n=51),G3 group(Tei＞0.66,BNP≤532.60 ng/mL,n=50) and G4 group(Tei＞0.66,BNP＞532.60 ng/mL,n=67).The follow up end was the MACE occurrence.Results There was a significant positive correlation between the Tei index and BNP(r=0.582,P=0.000).Tei entered the BNP regression equation(β=0.658,P＜0.05).The MACE-free survival rate had no statistical difference among 4 groups(x2 =9.975,P=0.019).The Cox regression analysis showed that Tei index and BNP were the independent predictive factors for MACE.Tei combined with BNP had stronger predictive value to MACE(AUC=0.781,95CI:0.721-0.841,P=0.000),its sensitivity was 72.52％ and specificity was 76.89％.Conclusion Tei combined with BNP has stronger predictive value for anterior MI during long term follow up.
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Objective: To study the relationship between insulin resistance (IR) and coronary collateral circulation in patients with impaired glucose tolerance (IGT). Methods: A total of 227 patients with coronary angiography (CAG) were studied. There were 131 patients with male gender and the average patient’s age was (53.2 ± 11.0) years. IR (HOMA2-IR) index was measured by HOMA2 method, the severity level of coronary stenosis was assessed by Gensini scoring system, collateral circulation condition was determined by Rentrop classiifcation. 187 IGT patients were divided into 4 groups: Rentrop 0 group,n=55, Rentrop 1 group,n=42, Rentrop 2 group,n=39 and Rentrop 3 group,n=51; in addition, Control group,n=40 patients with normal glucose tolerance and coronary stenosis<50%. Results: Compared with Control group, all patients in 4 Rentrop groups had increased 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while decreased fasting insulin (FINS), allP<0.05. Compared with Rentrop 3 group and Rentrop 2 group, the patients in Rentrop 1 group and Rentrop 0 group had elevated 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while Rentrop 0 group had reduced FINS, allP<0.05. Multivariable regression analysis showed that HOMA2-IR index (R=0.518,P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=2.130,P<0.05) and FINS (R=1.547,P<0.05) might be related to the severity of coronary stenosis. Binary regression analysis indicated that poor collateral circulation (the patients in Rentrop 0 group and Rentrop 1 group) was related to HOMA2-IR index (OR=1.679, 95% CI 1.101-2.558,P=0.016). Conclusion: HOMA2-IR index could be signiifcantly higher in patients with IGT combining chronic coronary occlusion. IR was the independent risk factor for the severity of coronary stenosis and coronary collateral formation.
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Purpose To explore the relationship of Tei index and the concentration of plasma brain natriuretic peptide (BNP) in patients with dilated cardiomyopathy. Materials and Methods Fifty healthy individuals (control group) and fifty dilated cardiomyopathy patients (study group) were recruited in this study. BNP level was measured by enzyme-linked immunosorbent assay (ELISA). Color Doppler echocardiography were performed to measure the cardiac indices including left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), interventricular septal thickness at diastole (IVSd), left ventricular ejection fraction (LVEF). Tei index was then calculated. The indices between the two groups were compared and correlation of Tei index and BNP with cardiac indices was analyzed. Results LVEDd, LVESd, Tei index, and BNP were significantly higher in study group than those in control group (t=14.4, 23.4, 21.9 and 22.3, P<0.01). IVSd and LVEF were significant lower in the study group (t=12.4 and 12.5, P<0.01). BNP was negatively correlated with LVEF (r= -0.266, P<0.05), and positively correlated with Tei index and LVEDd (r=0.401 and 0.326, P<0.05). Tei index was negatively correlated with LVEF and E/A (r= -0.480 and - 0.241, P<0.05), and positively correlated with LVEDd (r=0.375, P<0.05). Multiple stepwise regression analysis showed that the variates of BNP stepwise regression equation were Tei index, LVEF and LVEDd (t=5.984, -2.477 and 2.326, P<0.05); after correcting LVEF, the stepwise regression analysis showed closer relationship between Tei index and BNP (t=2.728, P<0.05). Conclusion There is correlation between Tei index and BNP. Tei index may be a good index for accurately estimating global ventricular function.
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Objective To evaluate the effect of trimetazidine in ischemic cardiomyopathy patients with impaired systolic function. Methods There were 90 cases in total, and were divided into two groups randomly: 42patients took conventional therapy,and 48 patients took trimetazidine additionally. Plasma levels of brain natriuretic peptide (BNP), left ventricular ejection fraction(LVEF) and left ventricular end-diastolic dimension(LVEDD) were measured before and after trimetazidine therapy at 6 months, 12 months. Results Compared to conventional therapy group, LVEF, LVEDD and BNP were significantly improved in the trimetazidine group (P ＜ 0.01 ). Conclusions Trimetazidine additional to conventional therapy might improve heart function and reverse ventricles reconstitution in ischemic cardiomyopathy patients with impaired systolic function.
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Objective To explore the difference of plasma pentraxin 3 (PTX3) levels in acute coronary syndrome (ACS) patients,and to evaluate the correlation between plasma PTX3 levels and ACS as well as hypersensitive C-reaction protein (hs-CRP), through detecting the plasma levels of PTX3 and serum levels of hs-CRP in ACS patients, stable angina pectoris (SAP) patients and normal controls. Methods According to coronary angiography results,78 subjects were divided into control group (n = 20), stable angina pectoris (SAP) group (n = 22), and acute coronary syndrome (ACS) group (n = 36). The plasma levels of PTX3 and serum hs-CRP as well as routine blood biochemical markers were detected on the second day after admission. SPSS10.0 was used for one-factor analysis of variance and Logistic regression analysis. Results The logarithm level of plasma PTX3 in ACS group was significantly higher than that of the other two groups (P <0.05). The difference between the SAP group and the control group was not statistically significant (P > 0.05). Logistic regression analysis revealed that the estimated value of the plasma PTX3 logarithm level was 2.32 (P < 0.05), that of the serum hs-CRP was 0.447 (P > 0.05). Conclusion The plasma PTX3 level in ACS group is significantly higher than that of the SAP group and the control group. The correlation between plasma FTX3 levels and the ACS is stronger than that of the serum hs-CRP levels.