Impact of different admission ways on treatment efficiency in patients with acute ST-segment elevation myocardial infarction / 中华心血管病杂志

Objective: To analyze the impact of different admission ways on the timeliness of percutaneous coronary intervention and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 1 044 patients with STEMI, who received primary percutaneous coronary intervention (PPCI) in 9 hospitals in Chengdu from January 2017 to June 2019, were retrospectively enrolled. According to the admission ways, patients were divided into ambulance group (n=100), self-transport group (n=584) and transferred group (n=360). Timeliness and in-hospital mortality were compared among the groups. Indicators of timeliness included the time from symptoms onset to arrive at the hospital, the time from arrive at the hospital to balloon and the total myocardial ischemia time (the time from symptoms to balloon). Multivariate logistic regression analysis was used to verify whether the admission ways was the determinant for in-hospital death in STEMI patients receiving PPCI. Results: The median total myocardial ischemic time in the ambulance group was significantly shorter than that in the self-transport group (180.0 (135.0, 282.0) minutes vs. 278.0 (177.8, 478.5) minutes, P<0.05) and the transferred group (180.0 (135.0, 282.0) minutes vs. 301.0 (204.3, 520.8) minutes, P<0.05). The median time from symptoms to door was as follows: ambulance group<self-transport group<transferred group (100.0 (56.3, 198.0) minutes vs. 149.0 (72.0, 313.5) minutes vs. 238.0 (135.0, 545.0) minutes, all P<0.05). The median door-to-balloon time was significantly shorter in the ambulance group and transferred group than in the self-transport group (75.0 (44.3, 101.8) minutes vs. 97.0 (71.0, 140.5) minutes, 67.0 (40.0, 91.8) minutes vs. 97.0 (71.0, 140.5) minutes, both P<0.05). There was no significant difference in all-cause mortality among the three groups (P>0.05). Multivariate logistic regression analysis showed that admission way was not significantly associated with in-hospital death (P>0.05). Conclusions: STEMI patients, who are admitted through the medical emergency system, are more likely to receive timely interventional therapy.Different admission ways have no impact on in-hospital mortality.

Cardiovascular risk factors among dermatomyositis patients with positive anti-Jo-1 antibody / 中国免疫学杂志

Objective:To assess the association between anti-Jo-1 antibody and cardiovascular risk factors among patients with dermatomyositis (DM).Methods:87 patients with DM were included from 2006 to 2013.Serum anti-Jo-1 antibody was measured by ELISA,and cardiovascular risk factors were evaluated.Multiple linear regression was used to assess the association between anti-Jo-1 antibody and cardiovascular risk factors in these patients.Results:The prevalence of hypertension,diabetes,hyperuricemia,and dyslipidemia were 16.09%,22.99%,10.34% and 67.82%,respectively.16.09% of DM patients had a positive anti-Jo-1 antibody and these patients had higher frequency of arthralgia/Raynaud's phenomenon/interstitial lung disease,and higher level of leukocyte and C reactive protein,while had lower level of serum uric acid (P<0.05).Multiple linear regression demonstrated that anti-Jo-1 antibody was closely associated with the level of C reactive protein and serum uric acid.Conclusion:Positive anti-Jo-1 antibody is associated with inflammation marker;however,the detailed mechanism remains further research.

Safety and efficiency of pacing at right ventricular outflow versus at ventricular cardiac apex / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the safety and efficiency of pacing at right ventricular outflow versus right ventricular apex.</p><p><b>METHOD</b>Patients were divided into two groups: pacing at ventricular cardiac apex (common pacing group, n = 22) and pacing at right ventricular outflow tract (uncommon pacing group, n = 18).</p><p><b>RESULTS</b>Impedance and amplitude of R-wave were similar during implantation between the two groups (all P > 0.05). The pacing threshold and electric current were significant higher in uncommon group than those in common pacing group (all P < 0.05), however, these differences disappeared at 1 month post pacemaker implantation (all P > 0.05). The mean QRS duration tended to be shorter in uncommon pacing group compared to that in common pacing group (P > 0.05). There was no pacemaker associated adverse effect in both groups.</p><p><b>CONCLUSION</b>The safety and efficiency of pacing at right ventricular outflow was similar as those of pacing at right ventricular apex.</p>

Report on initiating clinical research for electrical and mechanical synchronism of selective region pacing in the right ventricular / 中华心血管病杂志

<p><b>OBJECTIVE</b>To verify the electric synchronism, mechanic synchronism and hemodynamics of selective site pacing.</p><p><b>METHODS</b>Pacing in the right ventricular cardiac apex (RVA), the right ventricular His bundle region (His), and the septum of right ventricular high-positioned outflow tract (RVOT), CO and CI were recorded. The electrical synchronism was assessed by observing the width and shape in a 12-lead surface ECG. The mechanical synchronism was estimated by using the VVI (vector velocity imaging) technology of the Acuson Sequia 512.</p><p><b>RESULTS</b>The results showed that CO and CI were lower while pacing in RVA, but they were not significant different (P>0.05). The QRS width: (124 +/- 5.3) ms while pacing in His, (144 +/- 7.1) ms while pacing in RVOT and (156 +/- 8.6) ms while pacing in RVA. The QRS width while pacing in His and in RVOT were narrower than in RVA and there were significant differences (P<0.01). Vector velocity imaging showed that mechanical synchronism was better while pacing in RVOT than that in RVA.</p><p><b>CONCLUSION</b>Pacing in RVOT seems better than pacing in traditional RVA, and the operation was no more difficult than the traditional operation.</p>