Ponte miocárdica associada a lesões cardiovasculares em bovinos adultos da raça Canchim / Myocardial bridge associated with cardiovascular injuries in bovines adult of Canchim race / Puente miocárdico asociado a lesiones cardiovasculares en bovinos adultos de la raza canchim

FUNDAMENTO: A influência que a ponte miocárdica exerce sobre a corrente sanguínea no curso do segmento arterial sob a ponte tem sido objeto de discussão pela comunidade científica. OBJETIVO: Comparar o tecido muscular ultraestrutural da ponte miocárdica e a parede ventricular; analisar o grau de lesão da camada íntima dos segmentos arteriais e investigar possíveis mudanças que podem preceder ou iniciar o processo de lesões ateroscleróticas. MÉTODOS: Quarenta corações bovinos da raça Canchim foram estudados em relação às alterações da camada íntima das artérias coronarianas nos diferentes segmentos de ponte miocárdica. Para o exame microscópico, foram feitas colorações por hematoxilina-eosina e fucsina-resorcina seguindo técnicas microscópicas convencionais. Para o exame de microscopia eletrônica, os segmentos da ponte miocárdica de doze corações bovinos Canchim foram coletados a partir da parede ventricular e da artéria coronariana e foram processados de acordo com técnicas convencionais. RESULTADOS: Na microscopia de luz, foi observada maior frequência de lesões em segmentos pré-ponte e pós-ponte da camada íntima, em comparação ao segmento ponte. Espessamentos da camada íntima foram seguidos por um desarranjo na lâmina limitante elástica interna. Essas células frequentemente apresentaram seus citoplasmas ingurgitados por gotas lipídicas, compondo as chamadas células de espuma. A microscopia eletrônica revelou que as fibras musculares da ponte miocárdica geralmente se unem de forma reta e lisa apresentando ramos laterais com um número maior de mitocôndrias no músculo ventricular do que na ponte. CONCLUSÃO: Há poucas diferenças entre os tecidos musculares estudados; lesões da camada íntima são menos frequentes em regiões da ponte em comparação com as regiões pré e pós-ponte.

BACKGROUND: The influence that myocardial bridge exercises over blood stream in the course of arterial segment under the bridge has been discussed by the scientific community. OBJECTIVE: To compare ultrastructural muscle tissue of myocardial bridge and the ventricular wall; to analyze the degree of injury to the tunica intima of the arterial segments, and look for possible changes that may precede or initiate the process of atherosclerotic lesions. METHODS: Forty Canchim bovine hearts were studied regarding alterations of the tunica intima from coronary arteries on the different myocardial bridge segments. For the microscopic examination, hematoxylin-eosin and fuchsin-resorcin staining following conventional microscope techniques were made. For the electronic microscopic examination, myocardial Bridge segments from twelve Canchim bovine hearts were collected from the ventricle wall and coronary artery and were processed according to conventional techniques. RESULTS: In the light microscopy, a higher frequency of lesions on prepontine and postpontine segments of the tunica intima was observed, compared to the pontine segment. Tunica intima thickenings were followed by a disarrangement on the internal elastic limitant lamina. These cells often presented their cytoplasmas engorged by lipidic drops, making up the so-called foam cells. Electronic microscopy revealed that the muscular fibers of the myocardial bridge are usually joined in a straight and smooth way presenting lateral branches with a greater number of mitochondria in the ventricular muscle than in the bridge. CONCLUSION: There are few differences between the muscle tissues studied; intimae lesions are less frequent in pontine regions compared to pre and post-pontine regions.

FUNDAMENTO: La influencia que el puente miocárdico ejerce sobre la corriente sanguínea en el transcurso del segmento arterial bajo el puente, ha sido objeto de discusión por parte de la comunidad científica. OBJECTIVO: Comparar el tejido muscular ultra estructural del puente miocárdico y la pared ventricular; analizar el grado de lesión de la capa íntima de los segmentos arteriales e investigar posibles cambios que pueden preceder o iniciar el proceso de lesiones ateroscleróticas. MÉTODO: Cuarenta corazones bovinos de la raza Canchim fueron estudiados con respecto a las alteraciones de la capa íntima de las arterias coronarias en los diferentes segmentos del puente miocárdico. Para el examen microscópico, se hicieron coloraciones por hematoxilina-eosina y fucsina-resorcina secundando las técnicas microscópicas convencionales. Para el examen de microscopía electrónica, los segmentos del puente miocárdico de doce corazones de bovinos de la raza Canchim, fueron recolectados así como de la pared ventricular y de la arteria coronaria y fueron procesados de acuerdo con las técnicas convencionales. RESULTADOS: En la microscopía de luz, observamos una mayor frecuencia de lesiones en segmentos de pre puente y pos-puente de la capa íntima, en comparación con el segmento puente. Los espesamientos de la capa íntima vinieron acompañados por un desarreglo en la lámina limitante elástica interna. Esas células a menudo presentan sus citoplasmas ingurgitados por gotas lipídicas, lo que compone las llamadas células de espuma. La microscopía electrónica reveló que las fibras musculares del puente miocárdico generalmente se unen de forma recta y lisa, presentando ramas laterales con un número mayor de mitocondrias en el músculo ventricular que en el puente. CONCLUSIONES: Existen pocas diferencias entre los tejidos musculares estudiados. Las lesiones de la capa íntima son menos frecuentes en las regiones del puente en comparación con las regiones pre y pos puente.

Correlation study of CXCL16 gene rs3744700 polymorphisms and cerebral infarction subtypes / 中国脑血管病杂志

Objective: To study the correlation between the serum chemokine CXC Ligand 16 (CXCL16) levels or the CXCL16 gene rs3744700 polymorphisms and TOAST subtypes in patients with acute cerebral infarction. Methods: A total of 248 patients with atherosclerotic cerebral infarction within 7 days after symptom onset were selected, among them 149 patients were in a large artery atherosclerotic (LAA) cerebral infarction group, and 99 patients were in a small arterial occlusive (SAO) cerebral infarction group. The polymerase chain reaction (PCR) and gene sequencing were used to detect the genotypes. An enzyme-linked immunosorbent assay was used to detect the serum CXCL16 levels. Results: Circled digit oneSerum CXCL16 level in the LAA cerebral infarction group was 2.5 ± 0.3 μm/L and in the SAO cerebral infarction group were 2.3 ± 0.6 μg/L (P<0.01). Circled digit twoAmong the 149 patients in the LAA cerebral infarction group, the GG genotype frequency at polymorphic loci of CXCL16 gene rs3744700 was 91.9% (137/149) and the G allele frequency was 96.0% (286/298). They were higher than 81.8% and 89.9% in the SAO cerebral infarction group. There were significant differences (P < 0.05). Circled digit threeThe serum CXCL16 level in patients with CG genotype was 2.5 ± 0.3 μg/L in the LAA cerebral infarction group, ant it was higher than 2.1 ± 0.3 μg/L in patients with GT + TT genotype; the serum CXCL16 level in patients with CG genotype was 2.4 ± 0.6 μg/L in the SAO cerebral infarction group, and it was higher than 2.1 ± 0.3 μg/L in patients with GT + TT 2 genotype (all P < 0.01). Among the patients with GG genotype, the serum CXCL16 level in the LAA cerebral infarction group was higher than that in the SAO cerebral infarction group (P = 0.01); there was no significant difference in patients with GT + TT genotype between both groups. Circled digit fourMultivariate Logistic regression analysis showed that the serum CXCL16 level (OR =0.37, 95% CI 0.19 -0.70) and the GG genotype at polymorphic loci of CXCL16 gene rs3744700 (OR =2.57, 95% CI 1.23 -5.36) were the independent risk factors for affecting LAA cerebral infarction. Conclusion: In the TOAST subtypes, the correlation of serum CXCL16 level and the GG genotype at polymorphic loci of CXCL16 gene rs3744700 and LAA cerebral infarction are higher than SAO cerebral infarction.

Endovascular angioplasty for extracranial vertebral artery stenosis caused by atherosclerosis / 中华普通外科杂志

Objectives To evaluate the safety and efficacy of endovascular angioplasty for extracranial vertebral artery ( VA ) stenosis caused by atherosclerosis. Methods We analyzed retrospectively data of the 24 patients with extracranial vertebral artery stenosis who had been placed endovascular angioplasty from April 2006 to March 2010. According to Mori classification, there were 21 type A and 3 type B among all cases.The artery stenosis rate was 60％ -95％ , the average was 79％ ± 10％. Results Twenty-four balloon mounted stents were placed, the successful rate was 100％. Postoperatively the stenosis rate decreased to 4％ ± 6％. Patients were followed up from 3 to 36 months, the average was 22 months. Symptomes disappeared in 15 out of 17 patients. Postoperative restenosis on the treatment site with transient brain ischemia occurred in one patient. The symptoms in another patient of multiple cerebral infarction with ataxia and episodic vertigo were not relieved, although the patient didn't suffer from apoplectic seizure after the intervention. Postoperative color Doppler ultrasound revealed an over 50％ residual stenosis in 5 patients. The postoperative restenosis rate was 20. 8％. According to Malek scoring, 22 patients were scored 1 point, 1 patient scored 2 and one scored 4. Conclusions Endovascular angioplasty with stent placement is a safe and effective treatment. The restenosis rate could be futher reduced by technology improvement.

Teste ergométrico precoce após infarto do miocárdio: comparação com ecocardiograma, monitorização eletrocardiográfica e arteriografia coronariana / Exercise testing early after myocardial infarction: comparison with echocardiography, electrocardiographic monitoring and coronary arteriography

FUNDAMENTO: O teste ergométrico precoce após infarto do miocárdio, realizado antes da alta hospitalar, é útil na estratificação de risco, na prescrição de exercício e na avaliação do prognóstico e do tratamento. OBJETIVO: O objetivo deste estudo foi comparar os achados do teste ergométrico precoce pós-infarto aos resultados do ecocardiograma, da monitorização eletrocardiográfica pelo sistema holter (24 horas) e da cinecoronariografia. MÉTODOS: Avaliaram-se 60 casos (51,42 ± 9,34 anos), 46 do sexo masculino (77 por cento). O teste ergométrico foi máximo sintoma limitante, realizado pelo protocolo de Naughton, entre o sexto dia de internação e a alta hospitalar, realizado em uso de medicação. Durante a internação, os pacientes foram submetidos a ecocardiograma, eletrocardiografia dinâmica e cinecoronariografia. Adotou-se o nível de significância de 0,05 (a=5 por cento). RESULTADOS: O desempenho do teste ergométrico na detecção de doença coronária multiarterial foi reduzido (sensibilidade, 42 por cento; especificidade, 69 por cento). Não houve diferenças significativas quando se comparou a presença de isquemia no teste ergométrico com doença coronária de múltiplos vasos, arritmias ventriculares complexas na eletrocardiografia dinâmica e ocorrência de fração de ejeção inferior a 60 por cento no ecocardiograma (p = 0,56), bem como com a presença de lesões multiarteriais, arritmias ventriculares complexas na eletrocardiografia dinâmica e fração de ejeção anormal no ecocardiograma (p = 0,36). CONCLUSÃO: Durante o teste, a presença de isquemia se associou à ocorrência de arritmias ventriculares na eletrocardiografia dinâmica, à redução da fração de ejeção no ecocardiograma e à presença de lesões coronárias multiarteriais, o que representou um indicador de elevado risco coronário.

BACKGROUND: Predischarge exercise testing early after myocardial infarction is useful for risk stratification, exercise prescription, and assessment of prognosis and treatment. OBJECTIVE: The objective of this study was to compare the findings of exercise testing early after myocardial infarction with those of echocardiography, electrocardiographic monitoring (24-hour Holter monitoring) and coronary angiography. METHODS: We evaluated 60 cases (mean age of 51.42 ± 9.34 years), of which 46 were males (77 percent). The symptom-limited maximal exercise test according to the Naughton protocol12 was performed between the sixth day of hospitalization and hospital discharge, with the patients on medication. During hospitalization, the patients underwent echocardiography, electrocardiographic monitoring and coronary angiography. The significance level was set at 0.05 (a = 5 percent). RESULTS: Exercise testing had a poor performance in the detection of multivessel coronary artery disease (sensitivity, 42 percent; specificity, 69 percent). No significant differences were found when the presence of ischemia on exercise test was compared with multivessel coronary disease, complex ventricular arrhythmias on electrocardiographic monitoring, and the finding of an ejection fraction lower than 60 percent on echocardiography (p = 0.56), as well as with the presence of multivessel lesions, complex ventricular arrhythmias on electrocardiographic monitoring and abnormal ejection fraction on echocardiography (p = 0.36). CONCLUSION: The presence of ischemia during exercise testing was associated with the occurrence of ventricular arrhythmias on electrocardiographic monitoring, with reduced ejection fraction on echocardiography, as well as with the presence of multivessel coronary lesions, which constitutes an indicator of a high coronary risk.

Angiografía coronaria: indicación, resultados y complicaciones en 5.000 pacientes consecutivos / Coronary angiography: indications, results and complications in 5.000 consecutive patients

Background: There are guidelines about equipment, premises, personnel, indications and complications rates for coronary angiography, that every center performing this procedure should adhere. Aim: To report the experience with 5.000 coronary angiographies and to assess the compliance of the center with the current guidelines. Material and methods: Prospective registry of 5.000 patients aged 60±11 years (3.475 males) subjected to coronary angiography since 1992, assessing all aspects of the procedure with special emphasis on complications. Results: The indications for 80 percent of procedures was suspected coronary atherosclerosis. The main risk factors were hypertension and smoking. Coronary atherosclerosis was demonstrated in 62 percent, mainly one vessel disease. These were two deaths due to the procedure (0.04 percent), three patients (0.06 percent) had an acute myocardial infarction or a stroke. These figures are lower than referential values. Conclusions: In this center, coronary angiography is a safe procedure, with complications rates that are even lower than referential values.

Association between 677C/T polymorphism of methylenetetrahydrofolate reductase gene and type 2 diabetes with macrovascular complications in Shanghai / 中华内分泌代谢杂志

Objective To explore the relationship between 677C/T polymorphism of methy lenetetrahydrofolate reductase (MTHFR) gene and diabetic macrovascular complications (including cerebral infarction and coronary heart disease) in Shanghai.Methods Among 416 Chinese subjects, 216 were in macrovascular disease group 〔the atherosclerosis (AS) group〕 which included cerebral infarction (CI) subgroup consisting of 111 subjects (50 cases with and 61 without diabetes) and coronary heart disease (CHD) subgroup consisting of 105 subjects (48 with and 57 without diabetes); 100 subjects were in diabetes group without macrovascular disease (DM); and 100 normal subjects in control group (C). Genotypes were determined by PCR/restriction enzyme digestion and the relationship between 677C/T polymorphism and diabetic macrovascular complications was studied by population based association analysis. Results The frequencies of MTHFR TT genotype and T allele were significantly higher in macrovascular disease group. Logistic regression analysis showed that MTHFR gene was a potential contributor to AS. Comparison of genotype frequencies between diabetic and non diabetic subgroups in macrovascular disease group revealed no difference. Significant difference of high density lipoprotein cholesterol and diastolic blood pressure between different genotype subgroups was observed within some macrovascular disease groups after stratification by sex and diabetes. Conclusion MTHFR contributes to the development of macroangiopathy (cerebral infarction and coronary heart disease) whether associated with type 2 diabetes or not in Shanghai district.

Noninvasive detection and evaluation of coronary atherosclerotic plaques with multi-slice spiral CT:a comparative study with intravascular ultrasonograhy / 中华放射学杂志

Objective To evaluate the capability and accuracy of multi-shce spiral computed tomography(MSCT)in detecting atherosclerotic plaques in nonstenotic coronary arteries with reference to the findings of intravascular ultrasound(IVUS)in a segment analysis.Methods Both IVUS exams and 16-row MSCT scans were performed on 35 consecutive patients among whom 30 patients had successful MSCT scans.A total of 94 coronary segments without significant coronary stenoses were paired-analyzed both on IVUS and MSCT segment by segment.The plaques were classified as calcified,fibrotic and soft types according to the echogeneity on IVUS.Plaque attenuation on MSCT was measured and expressed by Hounsfield units(HU).Results When referred to IVUS,MSCT had a sensitivity of 82.1%(46/56)and specificity of 89.5% (34/38),respectively in detectiong any plaques.For the detection of calcified plaques,the sensitivity and specificity were 92.1%(35/38)and 96.4%(54/56),respectively.For the detection of mixed and noncalcified plaques,MSCT had sensitivity of 73.2%(30/41)and specificity of 88.7%(47/53).But for the detection of the noncalcified plaque,the sensitivity was 66.7%(12/18). According to the findings On IVUS,the plaques were classified as calcified(n=19),fibrotic(n=19)and soft(n=16).The CT attenuation of calcified plaques was(489?169)HU(196 to 817 HU),fibrotic plaques(69?21)HU(25 to 117 HU)and soft plaques(23?18)HU(-12 to 47 HU).Nonparametric Kruskal-Wallis test revealed a significant difference of plaque attenuation among the three groups(P

Experimental study on intravascular ultrasonic features of unstable atherosclerotic plaques / 中华超声影像学杂志

0.05 ).However,there were more eccentric plaques in ruptured than in non-ruptured groups ( P

Effect of nonenzymatically glucosylated low density lipoprotein on in vitro cultured macrophages and monocytes / 中国病理生理杂志

We observed the catabolic characterestics of in vitro prepared nonenzymatically glucosylated low density lipoprotein (glcLDL) in mouse peritoneal macrophages (M?) and human monocyte line (U_(937); and found that glcLDL did not stimulate the increase degradation of glcLDL significantly nor did the accumulation of glcLDL cholesterol in mouse peritoneal M?. However the degradation of glcLDL by U_(937) cells was positively proportional to the concentration of glcLDL. The pre-treatment of U_(937) cells with 12-O-tetradecanoylphorbol 13-acetate (TPA) increased the degradation of glcLDL and was also positively proportional to the concentration of glcLDL. The relationship between these phenomena and the accelerated developement of atherosclerosis in diabetes mellitus was discussed.

Subclasses of serum HDL in middle and old aged patients with hyperlipidemia in Chengdu City / 中国病理生理杂志

AIM: To detect the change of composition and ratio of serum HDL subclasses and explore the relationship between these changes and the plasma lipid level in patients with hyperlipidemia. METHODS: The components of subclasses of serum HDL in 172 middle and old aged patients with hyperlipidemia and 115 healthy middle and old aged were determined by dimensional gel electrophoresis associated with immuno-blotting method. RESULTS: Compared to the healthy controls, the contents of pre ?_1-HDL, HDL_~3b and HDL_~3a were significantly higher (P