ABSTRACT
Objective: To investigate the efficacy and safety of left bundle branch pacing(LBBP) in patients after transcatheter aortic valve implantation (TAVI). Methods: This is a retrospective study. A total of 35 patients underwent TAVI and received pacemaker implantation from January 2018 to December 2020 in Beijing Fuwai Hospital were enrolled. Patients were divided into LBBP group (n=12) and right ventricular apex pacing (RVAP) group (n=23) according to the pacing position. The success rate of operation in LBBP group was calculated, and the occurrence of complications were observed, and the parameters of pacemaker were measured on the 3rd day and 1, 3 and 6 months after operation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and ECG indexes were compared between the two groups on the 3rd day and 1, 3, and 6 months after pacemaker implantation. Result: A total of 35 patients were included, The age was (76.4±7.7) years, including 19 males (54.3%). The procedure time ((86.58±17.10)min vs. (68.74±9.18)min, P<0.001) and fluoroscopy duration ((20.08±4.44)min vs. (17.00±2.26)min, P<0.001) were significantly longer in LBBP group compared with RVAP group. The operation success rate of LBBP group was 11/12. There was no serious operation related complications such as pneumothorax, hemothorax, electrode dislocation, infection, and lower limb bleeding. The patients were followed up for 7.43 (5.21, 9.84) months. The programmed parameters of pacemaker were in the ideal range and stable during follow-up. At 3 and 6 months after operation, the left ventricular ejection fraction in LBBP group was higher than that in RVAP Group (at 3 months: (60.75±2.89)% vs. (57.35±3.33)%, P=0.004; at 6 months: (63.17±3.33)% vs. (56.17±3.97)%, P<0.001), NT-proBNP values was lower in LBBP group than that in RVAP Group (at 3 months: 822 (607, 1 150)ng/L vs. 1 052 (902, 1 536)ng/L, P=0.006; at 6 months: 440 (330,679)ng/L vs. 783 (588, 1 023)ng/L, P=0.001). At 1, 3 and 6 months after operation, the QRS duration was shorter in LBBP group than that in RVAP group (1 month: 99 (97, 107)ms vs. 126(124, 130)ms, P<0.001; 3 months: 98(96, 105)ms vs. 129(128, 133)ms, P<0.001; 6 months: 96(94, 104)ms vs. 130(128, 132)ms, P<0.001). Conclusions: For patients with permanent pacemaker indications after TAVI, LBBP is feasible, safe and reliable. It could improve the cardiac function in the short term, the long-term effect of LBBP needs to be further observed.
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Bundle of His , Cardiac Pacing, Artificial/methods , Electrocardiography/methods , Fluoroscopy , Retrospective Studies , Stroke Volume , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Ventricular Function, LeftABSTRACT
Eight new isocoumarin glycosides (1-8) were obtained from the solid culture of the wetland soil-derived fungus Metarhizium anisopliae (No. DTH12-10). Their chemical structures were elucidated by analyses of HR ESI-TOF MS, (1)H, (13)C NMR, (1)H-(1)H COSY, HSQC, and HMBC spectra. The absolute configurations were determined by single crystal X-ray diffraction, circular dichroism (CD) spectrum, and chemical derivatization methods. In addition, inhibition of the biofilm formation and the secretion of virulence factor of the new isocoumarin glycosides against Pseudomonas aeruginosa strain PAOA (clinical isolates) were evaluated. The result revealed that compound 1 showed antibacterial activity comparable with (Z)-4-bromo-5-(bromomethylene)-2(5H)-furanone (BF).
Subject(s)
Anti-Bacterial Agents/pharmacology , Glycosides/pharmacology , Isocoumarins/pharmacology , Metarhizium/chemistry , Pseudomonas aeruginosa/drug effects , Wetlands , Anti-Bacterial Agents/chemistry , Biofilms/drug effects , Biofilms/growth & development , Dose-Response Relationship, Drug , Glycosides/chemistry , Isocoumarins/chemistry , Molecular Structure , Structure-Activity RelationshipABSTRACT
Three new cyclohexenones (1-3, named sarcosones A-C) and two new isocoumarins (4 and 5), together with five known isocoumarins (6-10), were isolated from the solid cultures of an endophytic fungus Sarcosomataceae sp. NO.49-14-2-1. Their chemical structures were elucidated by analyses of HR-ESI-TOF-MS, (1)H, (13)C NMR, (1)H-(1)H COSY, HSQC, and HMBC spectra. Their absolute configurations were determined via modified Mosher's method and circular dichroism spectra method.
Subject(s)
Ascomycota/chemistry , Cyclohexanes/isolation & purification , Isocoumarins/isolation & purification , Cyclohexanes/chemistry , Isocoumarins/chemistry , Molecular Structure , Nuclear Magnetic Resonance, BiomolecularABSTRACT
Galiellalactone analogs (1-4) (including two new compounds), together with their possible precursors (5-9, named pregaliellalactone B-F), were obtained from the solid cultures of an endophytic fungus Sarcosomataceae NO.45-1-8-1. Their chemical structures were elucidated by analyses of HR ESI-TOF MS, 1D-, 2D-NMR, CD spectra and single crystal X-ray diffraction methods. Compounds 5-9, the possible precursors of galiellalactone analogs, were found to exist as enantiomers for the first time. The cytotoxicity of these compounds against six tumor cell lines was examined and preliminary structure-activity relationship (SAR) was also discussed.
