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@#【Objective】To observe the levels of CD11b expressions in the surface of neutrophils in serum，and its correlation with left atrial diameter ，and to study the inflammatory mechanisms in atrial fibrillation（AF） patients. 【Methods】Clinical characteristics and blood samples of AF group and sinal rhythm group were collected. CD11b levels in the surface of neutrophils were examined by flow cytometry. Left atrial diameter was examined by echocardiography. 【Results】The AF group included 85 patients ：36 with paroxysmal AF；26 with persistent AF；23 with permanent AF. The sinal rhythm group includes 57 patients. PMN- CD11b levels were significantly higher in Af group than in sinal rhythm group（P＜0.01）. The left atrial diameter was larger in AF group than in sinal rhythm group（P＜0.01）. Multivariate analysis revealed that PMN-CD11b，left atrial diameter and Valvular heart disease were independent predictors of atrial fibrillation.【Conclusions】PMN- CD11b levels were elevated in paroxysmal AF when AF was present and in persistent， permanent AF patients，implying atrial fibrillation was closely related to inflammation；PMN-CD11b were correlated with left atrial diameter，inflammation might participate in the atrial structural remodeling in AF patients ；PMN-CD11b levels were elevated in AF patients with high risk thrombosis，inflammation might have some value to embolic risk stratification according to CHA2DS2-VASc score.
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AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .
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Objective To investigate the effect of statins and angiotensin receptor blocker (ARB) on paroxysmal atrial fibrillation in patients with chronic congestive heart failure. Methods All of 145 patients with chronic congestive heart failure and paroxysmal atrial fibrillation were randomly divided into four groups, Ⅰ group (treated with amiodarone ), Ⅱ group( treated with amiodarone and valsartan), Ⅲ group( treated with amiodarone and pravastatin)and Ⅳ group (treated with amiodarone,valsattan and pravastatin). After 2- year follow-up, observed the changes of left atrium diameter (LAD), C-reactive protein (CRP) and maintenance rate of sinus rhythm before and after treatment. Results After treatment, the data of LAD of the four groups were (44.1 ± 2.1 ), (41.7 ± 2.8), (44.4 ± 3.1 ), (40.1 ± 2.5) mm respectively. The LAD data of beth Ⅰ group and Ⅲ group were significantly higher than those of Ⅱ group and Ⅳ group (P < 0.05), but there was no significant difference either between Ⅰ group and Ⅲ group, or between Ⅱ group and Ⅳ group. The levels of CRP of the four groups were (4.56 ± 0.24), (4.47 ± 0.45 ), (2.87 ± 0.53 ), (2.54 ± 0.42) mg/Lrespectively, and the levels of CRP of Ⅰ group and Ⅱ group were obviously higher than those of Ⅲ group and Ⅳ group(P< 0.05 ), but there was no significant difference either between Ⅰ group and Ⅱ group,or between group and Ⅳ group. Maintenance rate of sinus rhythm of the four groups was 57.9%,79.4%,77.1%,85.3% respectively,the maintenance rate of sinus rhythm of Ⅰ group was significantly lower than that of Ⅱ,Ⅲ and Ⅳ group (P<0.05). Conclusions Va]asrtan and pravastatin may reduce recurrence of paroxysmal atrial fibri]lation in patients with chronic congestive heart failure. Valsartan may inhibit dilatation of left atrium, and pravastatin may decrease the level of CRP in blood.
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Objective To study the feasibility, safety, effectiveness of left atrial circumferential ablation of pulmonary veins for atrial fibrillation(Af) guided by EnsiteNavX mapping system. Methods Seventeen patients with paroxysmal or persistent Af were included. Real time 3-dimensional left artial (LA) and pulmonary veins (PVs) maps were constructed through EnsiteNavX mapping system. Pulmonary veins isolation was performed by encircle the left and right sides PVs at adistance of 1 to 2 cm away from the ostium of PVs. Results Seventeen patients were all reached the endpoint of abalation completely. The mean procedure time and fluoroscopy time were (226.1 ± 36.2) minutes and (41.3 ± 12.8) minutes. Mean radiofrequency energy delivery time was (61.9 ±15.4) minutes. Recur-rence of Af occurred in two patients, one was repeat ablation succnssfully. During 3 ～ 36 months followup, fourteen patients (82.3%) were free of Af without any antiarrhythmic drugs. Recurrence of Af occurred in three(11.7%) patients treated with amiodarone. No complications occurred during the procedure and the following up. Conclusion Left atrial circumferential isolation of pulmonary veins for Af guided by Ensite NavX mapping system was effective and salty.
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BACKGROUND: As atrial fibrillation occurs in the patients with hypertensive heart disease, the functional abnormalities of heart become more severe and the risk of systemic and cerebral embolization increases. In this study we checked left atrial dimension and other parameters with echocardiography in hypertensive patients with atrial fibrillation. METHODS: In an attempt to define the difference in left atrial dimension and the relation between left atrial size and various echocardiographic parameters, M-mode echocardiography was used to study 63 hypertensive patients, 33 patients with atrial fibrillation, and 30 patients with sinus rhythm. RESULTS: The mean left atrial dimension was 51.7±8.7mm in hypertensive patients with atrial fibrillation versus 39.3±8.4mm in hypertensive patients with sinus rhythm(p < 0.001). In hypertensive patients with atrial fibrillation left atrial dimension was over 50mm in 82%(27 of 33). Left atrial size had positive correlations with end-systolic and -diastolic internal dimension of left ventricle(LV), LV mass and E-point septal separation, and negative correlations with fractional shortening and ejection fraction of LV. CONCLUSION: The echocardiographic measurement of left atrial dimension in patients with hypertension was useful in evaluating the hypertensive heart disease.
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Humans , Atrial Fibrillation , Echocardiography , Heart , Heart Diseases , HypertensionABSTRACT
Objective:To study the role of the ligament of Marshall in atrial fibrillation arising at pulmonary veins. Methods:20 mongrel dogs were randomly divided into two groups(10 dogs in each group). Paroxysmal atrial fibrillation arising at the pulmonary veins was built in all dogs. After Ligament of Marshall ablation in group1,pulmonary vein ablation was performed in both group1 and 2. Epicardial electrograms,effective refractory period,and atrial inducibility were analyzed before and after two ablations. Results:The activation cycle length slowed down and atrial fibrillation inducibility was significantly decreased after the ligament of Marshall ablation in group1;atrial fibrillation inducibility were both decreased after pulmonary vein ablation. Conclusion:Ligament of Marshall might serve a electrical connections between pulmonary vein and left atrium or be another source of rapid activations in atrial fibrillation arising at the pulmonary veins.