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Objective To explore the significance of treadmill exercise test (TET) in identifying left main coronary artery(LMD) obstruction from proximal left anterior descending(LAD) obstruction.Methods Patients with positive in the TET of the Central Hospital of Dalian from Jan.2008 to Dec.2013 were enrolled in this study and they were divided into LMD group with 21 cases and LAD group with 35 cases according to the results of coronary angiography.Retrospectively study was conducted to analyze the exercise time,the start time of ST segment change,the lead of ST segment between groups.Results Lead aVR ST segment elevation(≥0.10 mV) was 85.7％ (18/21) in the LMD group and 62.9％ (22/35) in the LAD group.Lead aVR ST segment elevation in the LM group was ((0.16 ± 0.07) mV,higher than in the LAD group ((0.11 ± 0.07) mV ; t =2.614,P ＜ 0.05).Accompany ST segment depression of leads and cumulative ST segment depression were (5.7 ±1.7) pcs and (1.13 ±0.42) mV in LMD group,significantly higher than those of LAD group((4.6 ± ± 1.8) pcs and (0.87 ± 0.32) mV ; t =2.314,2.634,P ＜ 0.05).The occurrence rate of ST segment depression (≥0.10 mV) in leads V2 and V6 were 33.3％ (7/21) and 90.5％ (19/21) in LM group,significantly higher than that in LAD group (11.4％ (4/35) and 62.9 ％ (22/35) ; x2 =3.990,5.105 ;P ＜ 0..05).The start time of ST segment deviation of LM group was significantly earlier than that of LAD group ((199.8 ± 70.8) s vs.(273.7 ± 127.3) s;t =-2.787,P ＜ 0.01).The differences were not statistically significant in terms of the exercise time between groups ((315.0 ± 120.0) s vs.(376.1 ± 110.0) s;t =-1.948;P ＞ 0.05),the rate for achieving target heart rate(33.3％ (7/21) vs.48.6％ (17/35) ; x2 =1.244 ; P ＞ 0.05) and the Duke score ((-11.8 ±7.2) vs.(-8.4 ±6.8) ;t =-1:772;P＞0.05).Conclusion Compare with patients with the LAD disease,ST segment elevation of lead aVR is significantly higher induced by treadmill exercise test in patients with left main disease.Meanwhile,the lead accompanied with ST segment depression is significantly higher,and the start time of ST segment deviation is significantly earlier.
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BACKGROUND:The quantity and quality of seed cel s is a critical bottleneck of the development of vascular tissue engineering. To address this issue, stem cel-derived endothelial cel s have been a hot spot in this field due to their potential in providing the ideal seed cel s. OBJECTIVE:To elucidate the effect of vascular endothelial growth factor (VEGF) supplementation combined with hypoxic culture condition on the lineage-specific differentiation of embryonic stem cel s into endothelial cel s. METHODS:Serum-free medium mTeSR?1 was applied to cultivate H9 cel s in vitro. A conditioned medium containing 50μg/L vascular endothelial growth factor was utilized to induce H9 cel s to differentiate into endothelial cel s under the hypoxic culture condition (5%O2). The cel under normal condition (5%CO2) with or without vascular endothelial growth factor served as controls. The phenotype and function of human embryonic stem cel s-derived endothelial cel s were assayed by immunofluorescence staining, quantitative RT-PCR, and low-density lipoprotein uptake experiment. RESULTS AND CONCLUSION:Compared with the control group, the H9 cel s were induced to be differentiated into endothelial-like cel s more efficiently when they were cultivated under a conditioned medium with vascular endothelial growth factor supplementation under the hypoxic condition. These differentiated cel s not only expressed some important surface markers of endothelia cel s, including kdr, pecam, but also took in low-density lipoprotein to form microvessle-like structures. This culture system supports a synergy effect of vascular endothelial growth factor and hypoxic environment that can efficiently promotes the lineage-specific differentiation of embryonic stem cel s into endothelial cel s with good phenotype and functionality.
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Objective To Discuss the Clinical Recognition of Acute Myocardial Infarction(AMI) caused by aortic valve incompetence.Methods Data of 275 AMI patients in our hospital recent two years,7 of them were caused by aortic valve incompetence; all of patients(7 AMI) were received coronary artery angioplasty,ultrasound,left ventricular angiography examination,its clinical feature was analyzed.Results All of 7AMI patients have normal coronary without limited constriction or plaque and with aortic valve incompetence.