Takotsubo cardiomyopathy in a 90-year-old Chinese man / 中华医学杂志(英文版)

A 90-year-old Chinese man was transferred to the Emergency Department of the Affiliated Shantou Hospital of Sun Yat-sen University for treatment of an acute myocardial infarction. He suffered chest pain with three days of cough, dyspnea and fever. A diagnosis of Takotsubo cardiomyopathy was made in normal coronary arteries from urgent coronary angiography and characteristic apical dyskinesis and basal hyper contractility in left ventriculography. The patient died from severe multi-organ failure on the second day of hospitalization.

Clinical value of plasma N-terminal pro-brain natriuretic peptide in diagnosis of diastolic heart dysfunction / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) detection in the diagnosis of diastolic heart dysfunction.</p><p><b>METHODS</b>Ninety patients with diastolic heart dysfunction and left ventricular ejection fraction (LVEF)>or=45% were divided into 3 groups according to the findings by conventional echocardiography and/or tissue Doppler imaging, namely impaired relaxation pattern group (n=58), pseudonormal pattern group (n=22) and restrictive filling pattern group (n=10). Ten patients with normal heart function served as the control group. Plasma NT-proBNP level was determined in all the subjects and its correlation to diastolic heart dysfunction was analyzed.</p><p><b>RESULTS</b>Compared with the control group, all the 3 case groups had significantly higher plasma NT-proBNP level (P<0.01). Plasma NT-proBNP level increased gradually with the severity of diastolic dysfunction. Spearman rank correlation analysis indicated that lg(NT-proBNP) was positively correlated to the severity of diastolic dysfunction. Simple linear regression showed that 52.7% of the total variation of lg(NT-proBNP) was correlated to the severity of the condition. The ROC curve demonstrated a sensitivity of 80%, specificity of 90%, positive predictive value of 84.2% and the negative predictive value of 87.1% for NT-proBNP level of 133 ng/L in predicting diastolic heart dysfunction regardless of the clinical manifestations, and the sensitivity was 81.7% and specificity was 75% for NT-proBNP level at 280.25 ng/L in predicting symptomatic diastolic heart dysfunction; the sensitivity was 81.2% and the specificity was 92.6% for NT-proBNP at 655 ng/L in predicting moderate to severe diastolic heart dysfunction.</p><p><b>CONCLUSION</b>Plasma NT-proBNP level increases gradually with the severity of diastolic dysfunction and has a high clinical value in severity rating and assisting the diagnosis of diastolic dysfunction.</p>

Clinical observations of emergent PTCA combined with Lipo-PGE_1 for the young patients with acute myocardial infarction / 中国基层医药

Objective To evaluate the clinical effect in the treatment of the young patients(≤45 years old) with acute myocardial infarction(AMI)underwent emergent percutaneous transluminal coronary angioplasty(PTCA) combined with Lipo-PGE_1.Methods 39 patients with AMI(paroxysm within 12 hours),were underwent emergent PTCA(coronary stem performed in some patients),including 18 cases which were treated combined with Lipo-PGE_1 in the mean time.And the clinical efficacy and the results of short-period follow-up were recorded.Results The in- farctive vasculars were re-open in 37 patients(23 cares were routinely placed translunrinal srents),and the successful rate was 94.9 %.Those who also used Lipo-PGE_1 were re-open in 17 patients.The successful rate was 94.4 %,their ST segments on EKG 30 minutes after operations reduced significantly than that of patients who did not use Lipo- PGE_1,their cardial functions were also improved significantly 24 hours after operations and no side effects on blood pressure and heart rate were observed.Conclusion The emergent PTCA combined with Lipo-PGE_1 for acute my- ocardial infarction can protect the cardial function and show a better early therapy effect.

Correlation between pressure-derived coronary collateral flow and Rentrop grade after primary percutaneous intervention of acute myocardial infarction / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the correlation between pressure-derived collateral coronary flow (PDCF) and Rentrop grade of patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>PDCF, determined by the ratio of P(w)/P(a), was measured in 29 patients with AMI of the first onset who received primary percutaneous coronary intervention (PCI) within 12 h after the onset. Sufficient collateral flow (group A, n=19) was defined as PDCF>0.24 and insufficient collateral flow (group B, n=10) as PDCF< or =0.24. Rentrop grade of the collateral flow was evaluated by coronary angiography. Echocardiography was performed on the 3rd and 30th day after PCI. The left ventricular ejection fraction, end-systolic and end-diastolic volumes, and the related indexes were obtained.</p><p><b>RESULT</b>Rentrop grade was significantly related to PDCF (r=0.75, P<0.01), but a wide range of PDCF was observed in patients with Rentrop grade< or =1.</p><p><b>CONCLUSION</b>PDCF measurement allows quantitative evaluation of the collateral flow in patients with AMI.</p>