Five-case report for transvenous epicardial pacemaker implantation via coronary sinus in patients after prosthetic tricuspid valve replacement / 中南大学学报(医学版)

Five patients after prosthetic tricuspid valve, who received pacemaker implantation via coronary sinus during Oct, 2011 and Jul, 2014, were enrolled. Pacemakers were implanted via coronary vein in 5 patients without complications. The stimulation thresholds keep stable and symptoms (such as short breath and fatigue) were disappeared during the follow-up. For patients after tricuspid valve replacement, implantation of pacemaker via coronary sinus provides a safe and invasive approach and avoids opening the chest again.

Predict value of monitoring changes of urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 after coronary angiography and percutaneous coronary intervention on early diagnosis of contrast-induced nephropathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the predict value of monitoring changes of urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1(KIM-1) after coronary angiography (CAG) and percutaneous coronary intervention (PCI) on the early diagnosis of contrast-induced nephropathy(CIN).</p><p><b>METHODS</b>One hundred and sixty patients underwent CAG and PCI were enrolled in this prospective study. There were 14 patients with CIN and non-CIN patients were selected with the proportion of 2: 1 (n = 28).Serum creatinine (SCr) was measured before and at 24, 48 and 72 h after the procedure. Urinary NGAL and KIM-1 were measured before and at 4 and 24 h after the procedure. The relationship between NGAL, KIM-1 and CIN were analyzed. Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to analyze the diagnostic sensitivity and specificity of CIN by urinary NGAL and KIM-1.</p><p><b>RESULTS</b>(1) The values of urinary NGAL was significantly higher in the CIN group than in non-CIN group at 4 h after CAG or PCI (P < 0.01); the value of urinary NGAL was significantly increased from the baseline to 4 h after the procedure in the CIN group (P < 0.01). (2) Uurinary KIM-1 levels of CIN group was significantly higher than in non-CIN group at 24 h after the CAG or PCI (P < 0.01) ; the urinary KIM-1 levels was significantly increased from baseline to 24 h after the procedure in the CIN group (P < 0.01). (3) Pearson correlation analysis showed that there was a positive correlation between urinary NGAL and SCr (r = 0.814, P < 0.01) and urinary KIM-1(r = 0.758, P < 0.01) in the CIN group. (4) ROC curve analysis showed that the AUC for urinary NGAL was 0.897. When the cut-off value of NGAL was set at 11.950 µg/L, the sensitivity and specificity for the diagnosis of CIN were 92.9% and 71.4%, respectively. The AUC for urinary KIM-1 was 0.839. With the cut-off value of urinary KIM-1 set as 4.595 µg/L, the diagnostic sensitivity and specificity for CIN were 85.7% and 71.4%, respectively.</p><p><b>CONCLUSIONS</b>Urinary NGAL serves as a good biomarker for early diagnosis of CIN suggesting acute kidney injury at 4 h post CAG and PCI. Urinary KIM-1 can reflect the change of renal function after contrast injection earlier than SCr and may also be a good biomarker for early diagnosis of CIN.</p>

Effect of benazepril on plasma copeptin and N terminal brain natriuretic peptide in patients with chronic heart failure / 中国综合临床

Objective To investigate the effects of benazepril on plasma copeptin and N terminal brain natriuretic peptide (NT-proBNP) in the patients with chronic heart failure (CHF) in order to explore the mechanism of benazepril on ventricular remodeling.Methods Two hundred and thirty-eight patients with CHF were randomized into control group (n =118) and therapy group (n =120).Patients in control group were received regular treatment including medicine of treating cardiotonic diuretic and vasodilator for 6 months,while in therapy group were given benazepril beside regular treatment.The levels of copeptin,NT-proBNP were measured before and after treatment.The left ventricular ejection fraction (LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end diastole diameter(LVEDD) were recorded and compared before and after treatment.Results In treatment group,the levels of copeptin and NT-pro BNP,LVEF,LVEDD,LVESD were (4.9 ± 1.3) pmol/L and (327.8 ± 226.8) ng/L,(33.5 ± 6.2) ％,(47.6 ± 8.9) mm,(60.2 ± 7.1) mm before treatment,different from that after treatment ((17.8 ± 7.9) pmol/L,t =7.331,P =0.008 ; (1 779.6±838.3) pg/mL,t =10.236,P =0.002; (50.5 ±5.2)％,t =3.336,P=0.009;(32.9 ±5.7) mm,t =2.767,P =0.010 ; (43.2 ± 5.6) rmm,t =2.882,P =0.009).After treatment the levels of copeptin,NT-proBNP,LVEF,LVESD and LVEDD in treatment were lower than that of control group(control group:copeptin:(10.5 ± 2.4) nmol/L; NT-proBNP:(1076.6 ± 486.6) pg/L; LVEF:(36.6 ± 5.6) ％ ; LVESD:(45.9 ± 6.8)mm; LVEDD:(57.5 ± 5.4) mm),and there was significant difference between groups (P =0.049,0.010,0.035,0.038,0.048 respectively).Conclusion Benazepril treatment could decrease the level of plasma copeptin and NT-proBNP in CHF patients,inhibit neuroendocrine and the ventricular remodeling,and then improve the heart function.

The impact of serum uric acid level to CSFP / 中国基层医药

ObjectiveTo investigate on the impact of the serum uric acid (UA) level coronary slow flow phenomenon(CSFP).MethodsSelected 30 cases of coronary slow flow patients as CSFP group,30 cases of patients with coronary heart disease,30 cases of patients with angiographically normal as the control group.The serum UA level was measured in three groups.The CSFP group and the control group were measured left anterior descending,circumflex and right coronary artery TIMI frame count(TFC) value.To analyze the mean TFC value of CSFP patients and the relationship between the serum UA level.ResultsCompared with the control group,the left anterior descending,circumflex and right coronary TFC results were significantly higher(all P ＜ 0.05) in the CSFP group.The mean serum UA level of CSFP group ,control group and CHD group were(340.79 ± 79.40)μmol/L, (220.45 ± 82.34)μmol/L,(42625 ± 87.02) μmol/L, the difference was statistically significant (all P ＜ 0.05).The mean serum UA level and TFC value of CSFP group was positively correlated(r = 0.943, P = 0.007).ConclusionElevated level of serum UA is closely related to the occurrence and development of the CSFP.

Dendritic cells and coronary collateral circulation in coronary heart disease / 中南大学学报(医学版)

OBJECTIVE@#To determine the relationship between the number,phenotype and functional status of dendritic cells (DCs) and coronary collateral circulation (CCC) in coronary heart disease (CHD).@*METHODS@#Forty patients with severe coronary stenosis were recruited and divided into a CCC formation group (Group A, n=22) and a non-CCC formation group (Group B, n=18). Density gradient centrifugation was applied to separate the mononuclear cells (MNCs) from coronary artery blood samples, and MNCs were cultured and proliferated in vitro. The morphology of DCs was observed under converted microscope. The number of harvested cells and DCs was counted by hematocytometer. Flow cytometry was applied to investigate the phenotype and the mean fluorescence intensity (MFI). Mixed lymphocyte reaction was used to test the function of DCs to stimulate the proliferation of T lymphocytes. Stimulation index (SI) was calculated and compared.@*RESULTS@#(1) After in vitro proliferation, DCs were cultured successfully from the mononuclear cells from coronary artery blood samples and the morphology of DCs was not different in the 2 groups. (2) The number of mononuclear cells (MNC no) was (3.95+/-1.41)*10(6), in the CCC group and (2.76+/-0.92)*10(6) in the non-CCC group. The MNC number was significantly increased in the CCC group (P=0.003). (3) The number of DCs was (1.54+/-0.96)*10(6) in the CCC group, and (0.99+/-0.46)*10(6) in the non-CCC group (P=0.033). (4)There was no statistical significance in the percent of CD1a+, CD1a+CD80+, CD1a+CD83+, CD1a+CD86+ cells, and MFI in the 2 groups (P>0.05). (5) SI was 4.96+/-2.30 in the CCC group, whereas 2.66+/-1.04 in the non-CCC group. The SI in the CCC group increased significantly(P=0.0003).@*CONCLUSION@#In CHD patients with severe coronary stenosis, patients with CCC formation have higher number of DCs and stronger potential of T lymphocyte stimulation.

Effect of Tongxinluo on endothelial function and hypersensitive C-reactive protein in acute coronary syndrome patients undergoing percutaneous coronary intervention / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein (hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI).@*METHODS@#Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group (n = 19) which took routine treatment or a tongxinluo group (n = 20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed.@*RESULTS@#NOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P < 0.05), but hs- CRP obviously increased (P < 0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P < 0.05 or P < 0.01), but hs-CRP obviously decreased (P < 0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P < 0.05). NO was negatively correlated with hs-CRP (r = -0.3219, P<0.01).@*CONCLUSION@#Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.

Changes of the cardiac morphology and size after transcatheter closure of atrial septal defect / 中国医师杂志

Objective To evaluate the changes of the right atrium,right ventriculum,left atrium and left ventriculum after transcatheter closure of atrial septal defect(ASD) during a short to mid-term follow-up.Methods The right ventricular end-diastolic anterior-posterior diameter(RVEDD),right atrial long diameter(RADl),right atrial transverse diameter(RADt),left ventricular end-diastolic ante-posterior diameter(LVEDD),left ventricular end-diastolic volume(LVEDV) and left atrial anterior-posterior diameter(LAD) in 36 patients with secundum ASD were measured before ASD closure,after 3 days,3 months and 6 months of ASD closure with transthoracic echocardiography(TTE).Results RVEDD,RADl and RADt were significantly decreased,while LVEDD,LVEDV and LAD significantly increased 3 days after ASD closure.During 3 months follow-up,RVEDD,RADl and RADt continuously became smaller;LVEDD,LVEDV and LAD continuously became larger.At 6 months,RVEDD was significantly smaller and LVEDD,LVEDV were significantly larger than those at 3 months.No remarkable difference of RADl,RADt and LAD was found between 6 months and 3months follow-up.Conclusion Transcatheter closure of ASD not only decreases the preload of right heart and causes right atrium and right ventriculum become smaller,but also improves the geometry of left heart and causes the narrowed left atrium and left ventriculum gradually return to almost normal status.