Predict value of time to peak of systolic velocity derived from velocity vector imaging on cardiac resynchronization therapy response in refractory heart failure patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the impact of cardiac resynchronization therapy (CRT) on left ventricular systolic function evaluated by velocity vector imaging (VVI) in refractory heart failure patients and the predictive value of VVI on CRT responses.</p><p><b>METHODS</b>This study included 38 patients with medically refractory heart failure (HF) patients underwent CRT in our department from May 2007 to April 2011. Left ventricular long axis dyssynchrony indexes including time to peak of systolic velocity (Ts max-min), standard deviation of the time to peak of systolic velocity (Ts-SD) before and at 3-6 months post CRT. CRT response was defined as 15% decrease in left ventricular end-systolic volume. ROC curve and the area under the curve (AUC) were calculated.</p><p><b>RESULTS</b>Twenty-four patients were defined as responder. No significant difference was observed between responders and non-responders in medical therapy. When using Ts max-min to predict response, the AUC of ROC curves was 0.76 ± 0.07. The sensitivity and specifity was 70.8% and 77.8% respectively with Ts max-min ≥ 124.0 ms. When using Ts-SD to predict response, the AUC of ROC curves was 0.82 ± 0.07. The sensitivity and specifity was 79.2% and 71.2% respectively with Ts-SD ≥ 40.5.</p><p><b>CONCLUSION</b>Ts-SD is a useful index to predict CRT response in refractory HF patients.</p>

The study of application of step-wise diversified teaching mode in cardiac electrophysiology / 中华医学教育探索杂志

Objective To investigate the effect of a step-wise diversified teaching mode on cardiac electrophysiology (EP) education. Methods 64 young doctors (male:36, female:28) who studied in EP sub-specialty were enrolled. The atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) were selected as teaching content. All the doctors were randomly divided into traditional teaching group (TT) and step-wise diversified teaching group (DT) according to cross-over design protocol. In TT group, only teaching and answering the questions by teachers were given to students, for the DT group, in different stages of teaching, multiple teach-ing strategy were combined to complete teaching. T test and Chi square test were used to compare the effect of two teaching methods. Results There was no difference of basic features and time of self-studying between the two groups. In examinations, the students in DT group got higher score than TT group[DT:(92.3±9.8) and (93.1±7.8),TT:(88.3±8.6) and (87.1±10.0),P<0.05], and had better perfor-mance of learning interest, initiative, ability of finding and resolving problems, teamwork spirit and so on. Conclusion The step-wise diversified teaching mode contributes improving the quality of instruction of cardiac EP, moreover, arousing learning interest and initiative, enhancing ability of find-ing and resolving problems, teamwork spirit and so on, which is worthy of wide-popularizing in cardiac EP training.

Impact of body mass index on the development of pocket hematoma：A retrospective study in Chinese people / 老年心脏病学杂志（英文版）

BackgroundPocket hematoma is one of the major complications associated with cardiovascular implantable electronic devices (CIEDs) implantation. The aim of this study is to evaluate the impact of body mass index (BMI) on the occurrence of pocket hematoma after CIEDs implantation.MethodsThe study is a retrospective review of 972 patients receiving CIEDs implantation between 2008 and 2012 in a tertiary hospital.ResultsTwenty two patients (2.2%) developed severe pocket hematoma requiring re-intervention. The hematoma rate (4.6%,n = 15) of patients with a BMI of < 23 kg/m2 was significantly higher compared with that of patients with a BMI of≥23 kg/m2 (1.1%, n = 7,P< 0.001). In multivariate regression analysis, a BMI < 23.0 kg/m2 may be associated with the development of severe pocket hema-toma. An increase of 1.0 kg/m2 in BMI was associated with lower incidence of hematoma formation (OR: 0.84; 95% CI: 0.74-0.95;P = 0.006).ConclusionBMI < 23 kg/m2 was associated with a higher incidence of pocket hematoma, requiring re-intervention. The data sup-port that great care must be taken when patients were with a lower BMI received CIEDs implantation.

Resistin might not be a risk factor for carotid artery atherosclerosis in elderly Chinese males / 老年心脏病学杂志（英文版）

Objective To investigate the correlation between the serum resistin level and carotid artery atherosclerosis in elderly Chinese males. Methods The study enrolled 235 elderly Chinese males [median age 76 (range 60-97) years] scheduled for ultrasound examination of carotid artery plaque and determination of carotid artery intima-media thickness (CIMT). They were divided into carotid atherosclerotic plaque (CAP) and carotid atherosclerotic plaque-free (CAP-free) groups according to the ultrasound results. Their clinical profiles were col-lected, and the serum resistin and other blood biochemistry levels were determined.Results The CAP group was older and had a thicker mean CIMT than the CAP-free group. However, there was no difference in the serum resistin level between the groups. CIMT was positively correlated with age (r = 0.299,P< 0.001). The serum resistin level was not correlated with CIMT, even after controlling for age. Multiple linear regression analysis revealed that age (β = 0.001,P< 0.001) and body mass index (β = 0.002,P= 0.015) were significantly and posi-tively correlated with the mean CIMT. Only age [odds ratio (OR): 1.159; 95% confidence interval (CI): 1.078-1.183,P< 0.001] was associ-ated with the presence of carotid artery atherosclerotic plaque. The serum resistin level was not correlated with the mean CIMT or associated with the presence of carotid artery atherosclerotic plaque.Conclusion The results suggest that resistin might not be a risk factor for atherosclerosis in elderly Chinese males.

The Follow-up Study for Clinical Compliance in Patients With Permanent Pacemaker Implantation / 中国循环杂志

Objective: To analyze the current condition and inlfuencing factors for clinical compliance in patients with permanent pacemaker implantation and to improve the follow-up condition in relevant patients. Methods: A total of 817 patients with permanent pacemaker implantation in our hospital from 2006-01 to 2013-01 were retrospectively studied. The clinical compliance condition and inlfuencing factors were accessed for 1 year period. Results: There were 26/817 (3.18%) patients lost contact and 1 patient died. A total of 790 (96.7%) patients finished the followed-up study by 2 groups: Clinical visit group,n=440 (55.70%) and Telephone visit group,n=350 (44.30%). The education level, medical cost, residency, comprehension of arrhythmia and accompany personnel were different between 2 groups,P<0.05. The patients were with high school education or above, reimbursed medical cost, local residency, comprehension of arrhythmia and accompany personnel had the higher clinical visit rate. The overall 1 year occurrence rate of complication was 1.8% without severe event. There were 59.5% of patients optimized the pacemaker parameters during clinical visit. Conclusion: The patients with permanent pacemaker implantation had the lower rate of clinical follow-up visit which should be improved in several issues.

Experimental drugs for treatment of autoimmune myocarditis / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the experimental drugs for the treatment of autoimmune myocarditis.</p><p><b>DATA SOURCES</b>The literatures published in English about different kinds of experimental drugs based on different therapeutic mechanisms for the treatment of autoimmune myocarditis were obtained from PubMed from 2002 to 2013.</p><p><b>STUDY SELECTION</b>Original articles regarding the experimental drugs for treatment of autoimmune myocarditis were selected.</p><p><b>RESULTS</b>This study summarized the effects of the experimental drugs for the treatment of autoimmune myocarditis, such as immunomodulators and immunosuppressants, antibiotics, Chinese medicinal herbs, cardiovascular diseases treatment drugs, etc. These drugs can significantly attenuate autoimmune myocarditis-induced inflammation and fibrosis, alleviate autoimmune myocarditis-triggered overt lymphocyte proliferation, and meanwhile reduce Th1 cytokines (IFN-γ and IL-2) and increase Th2 cytokines (IL-4 and IL-10).</p><p><b>CONCLUSION</b>This study summarized recent advances in autoimmune myocarditis treatment and further proposes that traditional Chinese medicine and immune regulators will play important roles in the future.</p>

Effect of phosphocreatine on transient outward potassium current in ischemic ventricular mid-myocardial cells of rats / 中国病理生理杂志

AIM: To determine the effect of exogenous phosphocreatine (PCr) at different concentrations on transient outward potassium (Ito) current in rat ischemic ventricular mid-myocardial (M) cells and to explore the antiarrhythmia mechanism in the treatment of ischemic heart disease. METHODS: M cells were isolated enzymatically from left ventricular mid-myocardium of rats. Peak Ito current was recorded by patch-clamp technique in the whole-cell configuration when M cells were superfused with normal Tyrode solution,simple ischemic solution,and simulated ischemic solution containing PCr at concentrations of 5,10,20 and 30 mmol/L for 10 min. RESULTS: Peak Ito current density of M cells superfused with simple simulated ischemic solution was significantly reduced by (76.1±6.3)% (P0.05). CONCLUSION: PCr reverses the inhibition of Ito current under ischemic condition in M cells,which may be the mechanism responsible for arrhythmia prevention in ischemic heart disease. PCr at concentrations of 0～10 mmol/L exerts significant dose-effect relationship.

The prevalence and risk factors for pulmonary hypertension diagnosed by echocardiogram in the elderly hospitalized patients / 中华老年医学杂志

Objective To evaluate the prevalence and potential risk factors for pulmonary hypertension in the elderly hospitalized patients. Methods1093 elderly hospitalized patients aged (80.8 ± 9.8) years were examined by Doppler echocardiography for evaluating pulmonary hypertension which defined by pulmonary artery systolic pressure (PASP)≥40 mm Hg (1 mm Hg=0.133 kPa).The relative clinical testing data were collected. Results 115 patients (10.5％) of the elderly patients were diagnosed as pulmonary hypertension.The prevalence of pulmonary hypertension in patients aged 85-100 years was 16.4％ (82/500),which was higher than in other ages. In the multivariate logistic regression analysis,age (OR=1.085,95％CI=1.025-1.148,P=0.005),left ventricular diastolic dysfunction (OR =3.954,95 ％ CI =1.812-8.627,P=0.001 ),internal diameter of right ventricle (OR=1.271,95％CI=1.112-1.452,P=0.000) and internal diameter of left atrium (OR=1.100,95％CI=1.013-1.194,P=0.023) were risk factors for pulmonary hypertension.ConclusionsThe prevalence of pulmonary hypertension is high in the elderly hospitalized patients,especially those aged 85 years and over,complicated with left ventricular diastolic dysfunction and enlargement of right ventricle and left atrium.

Analysis of therapeutic effect and target location of radiofrequency catheter ablation for idiopathic left ventricular tachycardia / 中国基层医药

ObjectiveTo observe the therapeutic effect of radiofrequency catheter ablation for idiopathic left ventricular tachycardia.To explore the relationship between surface electrocardiography and successful radiofrequency ablation location. MethodsThe electrophysiological data of surface electrocardiography and radiofrequency ablation,and the data of Holter in postorperation after 24 h and a half months,and tracking follow-up of 30 patients (23 males and 7 females)with idiopathic left ventricular tachycardia onset were retrospectively analyzed. ResultsRadiofrequency catheter ablation was successful in 29 patients(96.7%).The Holter was conducted in 29patients before and after the operation,the difference in average beats/24h before the operation(20 997 ± 10 786)and after the operation(921 ± 1 337)was statistically significant(P＜0.01).During the period of 1 to 3 months follow-up,2 patients relapsed and were all successfully re-ablated.No complication was found.The ventricular tachycardia lesions in left ventricular septum were found in 21 patients,of which 19 cases were located in a quadrant axis (-75.83 ± 19.36)°(-30 °～-90 °),and those in the left ventricular apex were in 9 cases,of which 7 cases were in the 2 quadrant axis(-102.6 ± 5.93)°(-91 °～-110 °). ConclusionRadiofrequency catheter ablation was an effeetive treatment technique for idiopathic left ventricular tachycardia with high successful rate,it could be selected as the first line treatment in patients with idiopathic left ventricular tachycardia.During idiopathic left ventricular tachycardia onset,the surface electrocardiography could help determine the initial site of ventricular tachycardia.

Effect of Automatic Nervous System and Personality on Stress-induced Arrhythmias(review) / 中国康复理论与实践

@#There are many factors which can affect the genesis and prognosis of the stress-induced arrhythmias,besides the automatic nerve system,the personality,central nervous system and hereditary factors have been involved.It is very important to comprehend the relationship and effects of these factors for prevention of stress-induced arrhythmias.

Advance in Research of Stress and Ventricular Arrhythmias (review) / 中国康复理论与实践

@#Ventricular arrhythmias closely correlates with stress.Not only individuals with organic heart diseases have a high risk of ventricular arrhythmias,healthy individuals are also susceptible to ventricular arrhythmias during stress.Electrophysiological characteristics of myocardium changes apparently during stress and electrical unstability of myocardium increases,which makes reentry and early afterdepolarization easy to happen.

Comparison between 64-multidetector computed tomography and coronary angiography in quantitative analysis of atherosclerosis / 中国组织工程研究

AIM: To make a comparison between 64-multidetector computed tomography (64-MDCT) and coronary angiography (CAG) for assessing the clinical significance of coronary lesions and the coincidence rate of these two methods. METHODS: From May 2005 to July 2006, totally 85 patients, who were suspected or diagnosed as coronary atherosclerotic heart disease, were performed with both 64-MDCT and CAG in the General Hospital of Chinese PLA. They included 64 males and 21 females, aged 41-83 years, with a mean of 61 years. Informed consents were obtained from all the patients. Coronary artery stenosis was detected with the stenosis rate of diameter method and area method, which was calculated by 64-MDCT and analysis software for vessels. Coronary luminal diameter was evaluated as normal, mild stenosis (25%-49%), mild-moderate stenosis (50%-74%), moderate-severe stenosis (75%-94%), severe stenosis (95%-99%), and occlusion (100%). RESULTS: The 64-MDCT images were evaluated for the existence of occlusions or significant stenosis (≥50% lumen reduction) in native coronary arteries. Its coincidence rate with CAG was 89% in left coronary artery main stem, 93% in left anterior descending coronary artery, 68% in left circumflex coronary artery, and 48% in right coronary artery. CONCLUSION: The 64-MDCT has a high diagnostic accuracy in detecting coronary artery stenosis, and is identical with CAG in the assessment of left coronary artery main stem and left anterior descending coronary artery. Thus it is potential for the clinical application on the evaluation of coronary artery stenosis, qualitative and quantitative detection of coronary atherosclerotic plaque.

SOMATOTYPE OF GANSU YUGU ADOLESCENTS BY THE HEATH-CARTER METHOD / 解剖学报

Objective To study the characteristics and regularities of somatotype growth of Yugu adolescents.Methods The somato-type growth of 989 Yugu adolescents(male:512,female:477)in Sunan was evaluated by the Heath-Carter method.Results The average somatotype of YuGu adolescents in males was mesomorphic ectomorph(3.0-3.6-3.7),and in females,the average somatotype was ectomorphic endomorph(3.8-2.9-3.6).The somatotypes develop from central,endomorphic ectomorph to mesomorphic ectomorph in the male,however,in the female from central,ectomorphic endomorph,endomorphic ectomorph,to mesomorphic endomorph.Conclusion The somatotypes of Yugu adolescents are very different between males and females.In the male group,the somatotypes of the 7-12 year-old group of Yugu adolescents are similar to the Mongolia,Han ethnic,Zhuang ethnic and Hungary.The somatotypes of 13-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Daur.However for the female group,the somatotypes of the 7-9 year-old group are similar to Hungary,and the 10-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Finn.

Effects of L-carnitine on electrophysiological changes induced by atrial ischemia in dogs / 中国实用内科杂志

Objective To investigate the effects of L-carnitine(L-CN)on electrophysiological changes induced by atrial ischemia in dogs.Methods Twelve dogs were divided into normal saline(NS)group and L-CN group.Atrial ischemia was induced by ligation of an atrial arterial branch of right coronary artery.Atrial effective refractory period(AERP)and conduction velocity(CV)of right atrium were measured before and after 3 hour's coronary artery ligation.Atrial wavelength(WL)and inducibility of atrial fibrillation(AF)were calculated.Histological examination was performed.Results (1)AERP and WL shortened dramatically after ligation of coronary artery in NS group;they showed no remarkable change in L-CN group.(2)There was no significant change of CV in the two groups.(3)AF was induced in 0 of 12 dogs under basic condition.(3)After ligation of the right coronary artery,AF was induced in all of the 6 dogs in NS group and 0 of 6 dogs in L-CN group.(5)Histological examination revealed that the ischemic changes occurred only in NS group.Conclusion Electrophysiological changes induced by atrial ischemia could be prevented by infusion of L-CN.

Safety analysis of intravenous amiodarone in wolff parkinson white syndrome with atrial fibrillation / 解放军医学杂志

Objectives To evaluate the safety of intravenous amiodarone in patients with atrial fibrillation and rapid ventricular response via an accessory pathway. Methods Sixteen patients with Wolff Parkinson White syndrome (W P W group) and 16 patients with concealed accessory pathway (control group) were included. The anterograde effective refractory period of accessory pathway (ERP AP ) in W P W group and the effective refractory period of atrioventricular node (ERP AVN ) in control group were measured. Then 150mg of amiodarone was injected intravenously in 10min, the ERP AP and ERP AVN were remeasured 10min later. Results After amiodarone injection, ERP AP was increased slightly ( P