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Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.
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Objective To study the correlation between single point pulse wave velocity (PWVβ)of different peripheral arteries and coronary artery stenosis quantity obtained by coronary arteriongraphy so as to explore the diagnostic value of PWVβin coronary heart disease.Methods We made a retrospective analysis of 183 patients receiving coronary arteriongraphy in our hospital from October 2013 to May 2014.Based on stenosis quantity of coronary artery,the patients were divided into one-vessel lesion group,double-vessel lesion group,multi-vessel lesion group,and nonstenosis as control group.Clinical data of all the patients were collected before coronary arteriongraphy.Different peripheral artery PWVβwas measured with vascular echo tracking (ET)technology for statistical analysis.Results As the lesion vessel number increased,PWVβandβvalues in three peripheral arteries presented a rising tendency.Correlation analysis indicated that PWVβvalues in the three peripheral arteries showed a positive correlation with coronary artery involvement degree.The correlation between PWVβvalue of the common carotid artery and coronary artery involvement degree was most obvious,followed by the femoral artery and the popliteal artery.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the common carotid artery PWVβvalue to diagnose coronary heart disease were 91.2%,84.5%,92.7%,81.7 and 0.76,respectively.Non-conditional multi-factor Logistic regression analysis was implemented by choosing age, sex,smoking history,hypertension history,diabetes history,hyperlipemia,BMI,HDL-C,LDL-C,TC,TG,GLU,SBP,DBP,UA,Cr,and PWVβ value as independent variables,and the degree of coronary artery disease as dependent variable.The results revealed that age,hypertension history,diabetes history,and PWVβ value were independent risk factors for coronary heart disease.Conclusion PWVβ value can be regarded as one index for observing artherosclerosis lesion degree and predicting early lesion.PWVβvalue of the common carotid artery can be an important index for dynamically observing the occurrence and development of artherosclerosis.
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Objective To observe the clinical effect of transradial approach for coronary intervention. Methods The clinical data of 189 patients accepted transradial coronary intervention were analyzed retrospectively. Results Transradial catheterizations were performed in 189 patients, while 176 cases had satisfying result, the success rate was 93. 12%. Thirteen patients had severe spasticity in radial artery, which could not be released from injection of nitroglycerin, lidocaine, verapamil, alternatively they accepted transfemoral artery coronary intervention. After the operation 3 cases had radial artery stricture, 10 cases had local ann swelling,6 cases had blisters from the device oppression. No acute coronary occlusion, arteriovenous fistula, upper limb ischemia, hand nerve damage, bleeding or other complications were observed in the cases enrolled. Conclusion The transradial approach for coronary angiography and intervention showed high success rate, few complication, indicating good clinical application promise.
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Objective To identify the causes of coronary angiographic hazy lesions by intravascular ultrasound (IVUS) to avoid inappropriate stenting. Methods Twenty-five cases with hazy regions on coronary angiogram were consecutively identified from July 2009 to March 2010. Hazy regions were defined by coronary arteriongraphy as reduced contrast density without a clearly defined intimal tear, dissection,thrombus,or stenosis ( ＞ 50% ). This cohort of patients were subsequently underwent IVUS examinations and treated according to the results of IVUS. Results The lumen CSAs were settled as ＞ 4. 0 mm2 in all examinations. Among all 25 cases,hazy lesions were located in left anterior descending in 12 patients, right coronary artery in 6 patients, left circumflex in 5 patients, and left main artery in 2 patients. According to the IVUS findings, 2 cases showed absolutely normal or near-normal arterial wall structure image, 10 cases showed calcified plaque,5 cases showed plaque rupture,3 cases showed eccentric plaque ,2 cases showed thrombosis formation,2cases showed dissection,1 case showed subintimal hematoma. Seven patients received stent implantation, and the rest accepted medical therapy. There were no in-hospital MACEs reported among all patients. Conclusion Nearly half of the coronary arteriongraphic hazy lesions were caused by calcified plaque. IVUS can distinguish calcified plaques from intimal tears, thrombus and other underlying etiologies,and help to avoid unnecessary stenting.
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Non-invasive coronary artery angiography is one of the hotspots of imaging.This article reviewed the status and the relevant advancement of the cardiac EBCT, DSCT, MSCT and MR imaging.
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@#Objective To evaluate the effect of metabolic syndrome(MS)on prognosis of patients with cardiovascular diseases(CVD).Methods The data of 143 CVD patients including the age,waistline,blood pressure,body mass index(BMI),coronary arteriongraphy,ultrasound and blood glucoset,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),creatinine(Cr)were analyzed to detect the incidence of MS,the position and degree of coronary atherosclerosis,organ functional failure(OFF)and ventricular remodelling in the MS patients and those without MS.Results Of 143 CVD patients,72 cases(50.35%)were diagnosed with MS,and UA,Cr,waistline,systolic blood pressure(SBP),diastolic blood pressure(DBP),blood sugar,TG,body mass index(BMI),MS index,HDL-C,left ventricular end-systolic diameter(LVESD),ejection fraction(EF),left atrial dimension(LAD),interventricular septum thickness(IVST),posterior wall thickness(PWT),left ventricular mass(LVM),left ventricular mass index(LVMI),myocardial infraction(MI),stroke,cardia insufficiency,the position and degree of coronary atherosclerosis had difference between the patients with MS and without MS(P<0.05).Conclusion MS is a condition characterized by clustering of CVD risk factors.MS not only increases the incidence of CVD and OFF in the patients,but also effects the prognosis.
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@#Objective To evaluate the effect of metabolic syndrome(MS)on prognosis of patients with cardiovascular diseases(CVD).Methods The data of 143 CVD patients including the age,waistline,blood pressure,body mass index(BMI),coronary arteriongraphy,ultrasound and blood glucoset,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),creatinine(Cr)were analyzed to detect the incidence of MS,the position and degree of coronary atherosclerosis,organ functional failure(OFF)and ventricular remodelling in the MS patients and those without MS.Results Of 143 CVD patients,72 cases(50.35%)were diagnosed with MS,and UA,Cr,waistline,systolic blood pressure(SBP),diastolic blood pressure(DBP),blood sugar,TG,body mass index(BMI),MS index,HDL-C,left ventricular end-systolic diameter(LVESD),ejection fraction(EF),left atrial dimension(LAD),interventricular septum thickness(IVST),posterior wall thickness(PWT),left ventricular mass(LVM),left ventricular mass index(LVMI),myocardial infraction(MI),stroke,cardia insufficiency,the position and degree of coronary atherosclerosis had difference between the patients with MS and without MS(P<0.05).Conclusion MS is a condition characterized by clustering of CVD risk factors.MS not only increases the incidence of CVD and OFF in the patients,but also effects the prognosis.
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Objective To evaluate the value of coronary arteriongraphy(CAG)in diagnosing angina.Methods 219 patients with angina in clinical analysis were selected and divided into 2 groups:the stable angina(SA)group and unstable angina(UA)group.They all were accepted CAG first time.Then analysis were carried out between clinical diagnosis and results of CAG.Results The total positive rate of CAG in diagnosing angina is 58.90%.The positive rate of SA group(56.52%)shows no significant difference with that of UA group(60.00%).Single vessel lesion and multiple vessels lesion of SA group have little difference,however,the main coronary artery lesions of UA group is single vessel.Conclusions CAG is extremely important in diagnosing angina,but it has its own limit.Experience and new technique should be applied to retrieve locatization of CAG.