Usefulness of Hyperemic Microvascular Resistance Index as a Predictor of Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVES: Microvascular function is a useful predictor of left ventricular functional changes in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated the usefulness of the hyperemic microvascular resistance index (hMVRI) for predicting long-term major adverse cardiovascular events (MACEs) in patients with STEMI assessed immediately after primary percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: hMVRI were evaluated in 145 patients with first acute STEMI treated with primary PCI using an intracoronary Doppler wire. hMVRI was defined as the ratio of mean aortic pressure over hyperemic averaged peak velocity of infarct-related artery. Major adverse cardiovascular events (MACEs) included cardiac death and re-hospitalization for congestive heart failure. RESULTS: During the mean follow-up of 85+/-43 months, MACEs occurred in 17.2% of patients. Using a receiver-operating characteristics analysis, hMVRI >2.82 mm Hg.cm-1.sec (sensitivity: 87%; specificity: 69%; and area under curve: 0.818) was the best cut-off values for predicting future cardiac events. The Cox proportional hazard analysis showed that hMVRI was an independent predictor for long-term MACEs (hazard ratio 1.741, 95% confidence interval 1.348-2.264, p2.82 mm Hg.cm-1.sec (p<0.001). CONCLUSION: hMVRI was a strong predictor of long-term MACEs in patients with STEMI treated with primary PCI.

Antitumor activity and immunoregulatory effect of triterpenes isolated from betulaplatyphylla / 中国免疫学杂志

To study the antitumor activity and immunoregulatory effect of Triterpenes isolated from Betula Platyphylla (TBP)Methods: Inhihition rate (IR) on tumor growth was determined by the mice with transplantable tumors (melanoma B16, Sarcoma 180, Lewislung carcinoma and Ehrlich ascites cancer), splenocyte proliferation induced by ConA was measured by H-TdR incorporation; cytotoxicity ofmacrophage was observed by 3H-TdR release; activity of TNF and NK cell was determined by dye (natural red)release. Results: IR of 0.80 g/kg and 1.20 g/kg TBP on all of above tumor strains were greater than30％ in vivo. TBPdoes not show significant effect of splenocyte Prolifera-tion and NK cell activity, but significantly promoted the activity of TNF producted by macroghage and splenocyte. TBP also increase the cyto-toxicity of macrophage. Conclusion:TBP shows potent antitumor effect in vivo. Promoting nonspecific immunoactivity is one of the antitumormechanism of TBP.