Résumé
Objective To explore the effect of renal sympathetic denervation (RDN) on cardiac remodeling in myocardial infarction (MI) rats and to investigate the related mechanism. Methods MI rats were induced by ligation of the anterior descending coronary artery. A total of 30 Wistar rats were randomly assigned to MI group (n = 10), MI + RDN group (rats with RDN one weekafter MI, n = 10), and Sham group (n = 10). Four weeks after modeling, the left ventricular cardiac remodeling and function of ratswere examined by echocardiography; the cardiac tissues in the infarct border zone were stained with Masson trichrome for fibrotic analysis. Protein expressions of collagen I, collagens H and transforming growth factor (TGF-(3i) were evaluated by immunohistochemistry. Results Compared with the MI group, the MI + RDN group had significantly increased ejection fraction (EF) and fractional shortening (FS) and significantly decreased left ventricular internal dimensions at end systole and end diastole (all P<0. 05). The results of Masson staining showed that RDN after MI attenuated the collagen deposition around the border area of the infarct region. RDN treatment also inhibited the protein expression of collagen I, H and TGF-β1 in the border area of MI rats (P<0. 05). Conclusion RDN treatment can attenuate cardiac remodeling and improve lett ventricular function after MI, which might be associated with the inhibition of myocardial TGFβ1 expression and the subsequent suppression of collagen deposition.
Résumé
Objective To observe the clinical characteristics of kidney transplant patients combined with coronary heart disease, and to analyze the safety and efficacy of coronary angiography and percutaneous coronary intervention for them. Methods Six kidney transplant patients underwent coronary angiography in our department between 2005 and 2011. The clinical characteristics, coronary angiography data and prognoses of the patients were retrospectively analyzed. Results Three patients had normal coronary angiograms and the other 3 combined with diabetes mellitus also had coronary heart diseases as found by coronary angiography. One case had unstable angina and was implanted with a total of 5 stents during 2 sessions. Another case had acute inferior wall myocardial infarction (caused by complete occlusion of the right coronary artery) was implanted with 2 stents. The other case had acute non-ST-segment elevation myocardial infarction and coronary angiography revealed multi-segment diffuse lesions in 3 arteries; stent implantation failed in this patient. There was no significant difference in renal functions before and after coronary angiography in the 6 patients, and there was no deterioration of renal function during the follow-up. Conclusion Coronary angiography and percutaneous coronary intervention are safe and feasible for kidney transplant patients, and they can greatly improve the quality of life of the patients.
Résumé
Objective: To analyze the association of type 2 diabetes mellitus (DM) with the clinical and coronary angiographic features of coronary heart disease (CHD) in patients aged over 70 years old. Methods: A total of 310 elderly patients with coronary angiograph-confirmed coronary diseases, who were treated in Changhai Hospital during Apr. 2006 to Jul. 2008, were retrospectively analyzed. The patients were further divided into 2 subgroups according to the presence of DM: DM-CHD group (n = 155) and non-DM-CHD group (n = 155). The age, gender, blood pressure, blood lipid, ejection fraction (EF), the angiographic outcomes, etc. were analyzed and compared between the two groups. Results: The incidence of hypertension was significantly higher in the DM-CHD group than in the non-DM-CHD group (P<0.05). The fasting blood glucose (FBG), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and fibrinogen (FIB) were significantly higher than those in the other group (P<0.01), and the high density lipoprotein cholesterol (HDL-C) was lower than that in the other group (P<0.05). The EF value in the DM-CHD group was significantly lower than that in the non-DM-CHD group (P< 0.01). Among the 35 (22%) patients preliminarily diagnosed as having DM, 14 (40%) would be misdiagnosed if the diagnosis depends solely on FBG without oral glucose tolerance test (OGTT). The prevalence of diffusive coronary lesions in the DM-CHD group was significantly higher than that in the non DM group (P<0.01). DM-CHD group also had significantly higher coronary stenosis index (P<0.01) and more occlusive vessels than non-DM-CHD group. Conclusion: The missed diagnosis rate of DM is high in CHD patients. Compared with non-DM-CHD patients, DM-CHD patients are at higher risks for coronary disease and have more severe coronary lesions.