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Objective To investigate the clinical symptoms and pathogeny of acute myocardial infarction (AMI) in emergency normal coronary angiography ( CAG). Methods From October 2015 to October 2017,the clinical data of 207 AMI patients withemergency CAG in the First People's Hospital of Huainan were retrospectively analyzed,including 7 patients with normal CAG. The clinical symptoms and pathogeny of these patients were analyzed. Results Among the patients with AMI,the patients with normal CAG accounted for 3. 38 ％ (7 / 207),the average age was (49. 00 ± 11. 94)years old,4 patients were men,3 patients were smokers and 3 patients had hypertension. The results of laboratory examination were cTnI (7. 81 ± 4. 32)μg/ L,myoglobin (231. 43 ± 136. 03)μg/ L,CK - MB (15. 3 ± 4. 63)μg/ L. The pathogeny of these patients were one case with coronarospasm(14. 29 ％ ),one case with myocardial bridge(14. 29％ ),two cases with intracoronary thrombolysis(28. 57％ ),two cases with aortic dissection (28. 57％ ),and one case with myocarditis(14. 29％ ). In addition to aortic dissection in 1 case of death,1 case was transferred outside,the rest of the patients discharged after hospitalization. Conclusion AMI mainly occurres because of vascular thrombosis caused by the unstable coronary atherosclerosis plaque rupture,but some patients with normal CAG can also occure AMI,it has different clinical characteristics and pathogenys. In practice it should be carefully identified in order to improve the cure rate and prognosis.
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Objective To evaluate the safety and feasibility of reconstruction technique of atrial septum puncture trajectory with the help of three - dimensional mapping system in performing radiofrequency catheter ablation for atrial fibrillation. Methods Sixty- eight consecutive patients with atrial fibrillation received two times of atrial septum puncture under fluoroscopic guidance to perform radiofrequency catheter ablation. Carto 3, a three - dimensional mapping system, was employed to construct the real time left atrium and pulmonary vein anatomy by using a rapid anatomical mapping (FAM) model. Then, FAM model was used to construct the trajectory, along which the ablation catheter passed from left atrium through the long sheath to the right atrium and finally into the inferior vena cava. The safety and the feasibility of this catheter trajectory, which could allow the catheter repeatedly enter the left atrium, were evaluated. Results By using 3D-reconstruction technique of atrial septum puncture trajectory, the ablation catheter could repeatedly enter the left atrium at right anterior oblique position as well as at left anterior oblique position under zero X-ray fluoroscopy. The average time spent for the procedure was (12. 18±2. 28) seconds. No any complication occurred. Conclusion The reconstruction technique of atrial septum puncture trajectory with the help of three-dimensional mapping system is simple and feasible, the ablation catheter can repeatedly enter the left atrium, the X-ray exposure time spent for catheter ablation of atrial fibrillation can be greatly reduced. (J Intervent Radiol, 2018, 27: 204-206)
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AIM: To explore the effect of atorvastatin on cardiac remodeling in spontaneous hypertension rats(SHR).METHODS: Twelve spontaneous hypertension rats were divided randomly into two groups: group of atorvastatin(atorvastatin 50 mg?kg~(-1)?d~(-1)) and group of SHR(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)).Additionally,six male Wistar-Kyoto rats(0.5% mucilage of arabic gum,10 mL?kg~(-1)?d~(-1)) were selected as control group.Systolic blood pressure was assessed with the tail-cuff method.After six weeks,entire heart,and left ventricle were weighed.The left ventricular weight index was calculated and myocardial hydroxyproline and collagen protein concentration were measured.The serum high sensitivity CRP(hs-CRP) was measured by nephelometry.The localization of vascular cell adhesion molecule(VCAM) in myocardium was investigated by immunohistochemistry assays.The level of NF-?B mRNA expression was detected with in situ hybridization.Ultrastructure in cardiac muscle was also observed under transmission electron microscope.RESULTS: The expression of myocardial VCAM and NF-?B in SHR group was stronger than that in WHY group.Compared with SHR group,entire heart weight,left ventricular weight,left ventricular weight index,serum hs-CRP,myocardial hydroxyproline and collagen protein concentration was decreased,the expression of myocardial VCAM and NF-?B in SHR group was weaker than that in atorvastatin treatment group.The myocardial pathological change such as incomplete karyotheca in cardiac muscle cells,no clear of transverse striation and the mess in myofibril alignment,and hyperplasy in interstitial collagen fibre were observed in SHR group and these changes were improved in atorvastatin treatment group.CONCLUSION: The cardiac remodeling in SHR is improved by atorvastatin.The molecular mechanism may be related to its down-regulating the expression of VCAM protein and NF-?B and inhibiting myocardial chronic inflammation.
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Iretreatment with tea polyphenol (TP) at a dose of 10mg/kg ip to rats five days before isoproterenol (ISO) challenge (1mg/kg sc, for two days), resulted in decreases of malonydialdehyde concentration, creatine phosphokinase, lactic dehydrogenase (LDH) and LDH1,activities; increased LDH2/LDH1 ratio and inhibited the extent of myocardial injury, similar to the action of propranol. At the same time TP decreased rat plasma renin activity.The results suggested that the mechanism by which TP protects heart from ISO-induced myocardial injury is due to its antioxygen free radical and inhibition of renin activities.