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Objective To assess the condition of left ventricular outflow tract obstruction (LVOTO) under resting conditions and physiological exercise in hypertrophic cardiomyopathy (HCM) patients.Methods A total of 60 patients with HCM and left ventri cular outflow tract gradient (LVOTG) ＜ 50 mm Hg (1 mm Hg =0.133 kPa) at rest were enrolled consecutively,and LVOTG at rest and exercise were measured by echocardiography.Of 51 patients with gradients ＜ 30 mm Hg at rest,26 were latent LVOTO with exercise peak value LVOTG ≥ 30 mm Hg,25 were non LVOTO with exercise peak value LVOTG ＜ 30 mm Hg,and 9 were resting obstruction with LVOTG 30-49 mm Hg.The morphological characteristics of different types of obstruction were analyzed.Results Patients with latent LVOTO were more likely to have SAM(73.1％ vs 8.0％),narrow of LVOT(46.2％ vs 4.0％),higher resting gradients [(16.9 ±7.2) mm Hg vs (7.1 ± 4.3) mm Hg] and mitral regurgitation grade at rest than patients with non-obstructive (all P values ＜ 0.05).The distribution of septal hypertrophy were different in the two groups (P ＜ 0.05).Multivariate logistic regression analysis showed independent predictors of latent LVOTO were SAM (OR 6.431,95 ％ CI 2.323-291.112,P =0.002) at rest and distribution of septal hypertrophy (OR 0.011,95％ CI 0.001-0.179,P =0.008).Conclusions Approximately half of patients with nonobstructive HCM at rest have latent LVOTO.SAM and distribution of septal hypertrophy may be useful to identify patients with latent obstruction.
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Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.
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Objective To determine gender differences in baseline characteristics and intervention treatment in relation to prognosis in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Methods A total of 814 patients (545 men and 269 women) with NSTEACS were randomized to early intervention (coronary angiography ＜ 24 hours after randomization ) or delayed intervention (coronary angiography＞36 hours after randomization). The primary outcome was a composite of death, myocardial infarction, or stroke at 6 months. Results Women were older and more frequently had hypertension, diabtetes, and history of coronary artery disease (CAD) or chronic angina (P＜0.05 for all).Women less were smokers and had elevations in cardiac marker(P ＜ 0. 05 for both). Women who underwent angiography had no significant lesions more often, but the left main stem and/or three-vessel diseases were similar with men. In adjusted multiple logistic regression analysis,the previous myocardial infarction and severe coronary artery disease were independently associated with the risk of primary endpoint in women. On multivariate analysis for men, severe coronary artery disease delayed intervention strategy and at least 3 risk factors for CAD were independently associated with the risk of primary endpoint. Conclusions In NSTEACS patients, different gender had the different prognostic predictor. Severe coronary diseases were as an independent predictor for both male and female patients. An early intervention strategy resulted in a beneficial effect in men which was not seen in women.
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1-(2,6-Dimethylphenoxy)-2-(3,4-dimethoxyphenylethylamino) propane hydrochloride(DDPH) caused parallel rightward shifts of the phenylephrine(Phe) concentration-contractile response curves and did not suppress the maximal contractile response to Phe (pA2=7.24) in isolated rabbit urinary bladder smooth muscle. DDPH decreased the parameters of cystometry in urethane-anesthetized rats. Thirty minutes after DDPH (25 and 50 mg*kg-1 ig) administration, bladder capacity, voiding pressure, voiding threshold pressure were significantly decreased. With the observation of light-microscope and electron-microscope technique, DDPH (25 and 50 mg*kg-1*d-1 ig for 4 weeks) also inhibited the development of testosterone propionate-induced benign prostatic hyperplasia in rats. The results indicate that DDPH may inhibit benign prostatic hyperplasia and improve the urinary flow.