Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echoca...Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.展开更多
Background Coronary slow flow（CSF） during primary percutaneous coronary intervention（PCI） is closely related to the prognosis of patients with acute myocardial infarction（AMI）. Whether Enhanced External CounterP...Background Coronary slow flow（CSF） during primary percutaneous coronary intervention（PCI） is closely related to the prognosis of patients with acute myocardial infarction（AMI）. Whether Enhanced External CounterPulsation（EECP） could improve the phenomenon and enhance cardiac function in these patients has not been studied. Methods Seventy-eight AMI patients undergoing primary PCI were enrolled and divided into 2 groups, EECP group and sham group. In EECP group, the patients were treated with EECP for 30 min after coronary artery stent implantation; and in sham group, the patients after coronary artery stent implantation were treated with cuffs wrapped for 30 min. Hemodynamics and corrected TIMI Frame Count（c TFC） were recorded at different time points in both groups. CRP, HCY, NT-pro BNP and Killip class were also detected before operation and after treatment. Results In EECP group, compared to pre-and post-EECP treatment, the systolic blood pressure（SBP） was much lower（P〈0.05）, diastolic blood pressure（DBP） and mean arterial blood pressure（MBP）were much higher（P〈0.05）. The heart rate（HR） was not changed during EECP treatment（P〉0.05）. In sham group, SBP, DBP, MBP and HR were not significantly changed during these period（P〉0.05）. In EECP group,the c TFC of patients with CSF decreased significantly after treatment（P〈0.05）; and there was no difference in sham group（P〉0.05）. Compared with pre-EECP treatment, CRP and HCY were increased in post-EECP treatment of both groups（P〈0.05）, while, they were much lower in EECP group（P〈0.05）. The expression of NTpro BNP was decreased after treatment in both groups（P〈0.05）, and it was much lower in EECP group than in sham group（P〈0.05）. The Killip class was much lower after treatment than before operation in EECP group（P〈0.05）, and there was no change in sham group（P〉0.05）. Conclusions The results suggest that EECP is helpful in a short time to the improvement of CSF and recovery of cardiac function in AMI patients during primary PCI,and that CRP and HCY may be involved in this process.展开更多
In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angio...In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angiograms and in 16 patients with normal angiographic coronary flow (NF). A 3.5 F, 20 MHz ultrasound catheter (Boston Scientific) was used for ICUS and a 0.014 inch FloWire (Cardiometrics) was used for ICD. Coronary flow velocity including average peak velocity (APV), maximal peak velocity (MPV) at rest and at hyperemia as well as coronary flow reserve (CFR) were compared in both groups in comparison to the presence or absence of plaque formation based on ICUS. CFR in the SF group (4.2±1.1) was even higher than that of the NF group (3.1±0.6, P<0.001). Department of Cardiology, University GHS Essen, Germany (Ge JB, Simon H, Jeremias A, Liu FQ, Grge G, Haude M, Baumgart D and Erbel R) Significant differences were also found concerning the APV and MPV among both groups (both P <0.001). Plaque formation was found in 7/13 patients with a lumen reduction of 21%±24% in SF group and in 7/16 of the NF group with a lumen reduction of 19%±17%. Comparison of APV, MPV and CFR in SF and NF grups. Comparison of APV, MPV and CFR in SF and NF groups[BHDFG1*2,WK8ZQ1,WK11DW,WK11DWW] SF group NF groupAPV (cm/s) Rest 7.7±2.0 21.1±5.0 * Peak31.7±14.961.3±14.2 *MPV (cm/s) Rest17.4±4.637.0±11.4 * Peak56.8±14.981.8±17.7 *CFR4.2±1.13.1±0.6 # * P<0.001, #P=0.002. Coronary slow flow phenomenon in angiography indicates reduced resting flow velocity without reduction of coronary flow reserve.展开更多
Interstitial fluid plays a vital role in drug delivery and tumour treatment.However,few non-invasive measurement methods are available for measuring low-velocity biological fluid flow.Therefore,this study aimed to dev...Interstitial fluid plays a vital role in drug delivery and tumour treatment.However,few non-invasive measurement methods are available for measuring low-velocity biological fluid flow.Therefore,this study aimed to develop a novel technology called interstitial flow velocity-MRI.The interstitial flow velocity-MRI sequence consists of a dual inversion recovery preparation and an improved stimulated echo sequence(ISTE)combined with phase-contrast MRI.A homemade flow phantom was used to assess the feasibility and sensitivity of interstitial flow velocity-MRI.In addition,xenografts of female BALB/c mouse models of 4T1 breast cancer administered losartan(40 mg/kg)or saline(n?6)were subjected to imaging on a 7.0 T scanner to assess the in vivo interstitial fluid flow velocity.The results showed a significant correlation(P<0.001)between the theoretical velocities and velocities measured using the flow phantom.Interstitial flow velocity-MRI could detect a velocity as low as 10.21±2.65 mm/s with a spatial resolution of 0.313 mm.The losartan group had a lower mean interstitial fluid velocity than the control group(85±16 vs 113±24 mm/s).In addition,compared to the saline treatment,losartan treatment reduced the proportion of collagen fibres by 10%and 12%in the Masson and Sirius red staining groups,respectively.Interstitial flow velocity-MRI has the potential to determine interstitial fluid flow velocity non-invasively and exhibits an intuitive velocity map.展开更多
Objective: To observe the immediate effect and safety of Shexiang Tongxin dropping pills(麝香通心滴丸, STDP) on patients with coronary slow flow(CSF), and furthermore, to explore new evidence for the use of Chinese me...Objective: To observe the immediate effect and safety of Shexiang Tongxin dropping pills(麝香通心滴丸, STDP) on patients with coronary slow flow(CSF), and furthermore, to explore new evidence for the use of Chinese medicine in treating ischemic chest pain. Methods: Coronary angiography(CAG) with corrected thrombolysis in myocardial infarction(TIMI) frame count(CTFC) was applied(collected at 30 frames/s). The treatment group included 22 CSF patients, while the control group included 22 individuals with normal coronary?ow. CSF patients were given 4 STDP through sublingual administration, and CAG was performed 5 min after the medication. The immediate blood ?ow frame count, blood pressure, and heart rate of patients before and after the use of STDP were compared. The liver and kidney functions of patients were examined before and after treatments. Results: There was a signi?cant difference in CTFC between groups(P<0.05). The average CTFC values of the vessels with slow blood ?ow in CSF patients were, respectively, 49.98±10.01 and 40.42±11.33 before and after the treatment with STDP, a 19.13% improvement. The CTFC values(frame/s) measured before and after treatment at the left anterior descending coronary artery, left circumflex artery, and right coronary artery were, respectively, 48.00±13.32 and 41.80±15.38, 59.00±4.69 and 50.00±9.04, and 51.90±8.40 and40.09±10.46, giving 12.92%, 15.25%, and 22.76% improvements, respectively. The CTFC values of vessels with slow ?ow before treatment were signi?cantly decreased after treatment(P<0.05). There were no apparent changes in the heart rate, blood pressure, or liver or kidney function of CSF patients after treatment with STDP(all P>0.05). Conclusions: The immediate effect of STDP in treating CSF patients was apparent. This medication could signi?cantly improve coronary ?ow without affecting blood pressure or heart rate. Our ?ndings support the potential of Chinese medicine to treat ischemic chest pain.展开更多
Urban water supply network is a modern urban survival and development of the infrastructure of a city,and its normal running conditions have important significance. The actual hydraulic process in the variableload wat...Urban water supply network is a modern urban survival and development of the infrastructure of a city,and its normal running conditions have important significance. The actual hydraulic process in the variableload water distribution networks can be treated as the slow transient flow which belongs to the unsteady flow. This paper analyzes the multi-loops network slow transient model based on graph theory,and the link flow matrix is treated as the variables of the discrete solution model to simulate the process of the slow transient flow in the network. With the simulation of hydraulic regime in an actual pipe network,the changing laws of the flow in the pipes,nodal hydraulic heads and other hydraulic factors with the passage of time are obtained. Since the transient processes offer much more information than a steady process,the slow transient theory is not only practical on analyzing the hydraulic condition of the network,but also on identifying hydraulic resistance coefficients of pipes and detecting the leakage in networks.展开更多
Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focuse...Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies,clinical manifestations and treatment of this unique angiographic phenomenon. In our case report,we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries,especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.展开更多
基金This study was supported by grants from National Natural Science Foundation of China （No. 81070166） and Scientific Research Common Program of Beijing Municipal Commission of Education （No. KM201010025020）.Acknowledgement： We are grateful to all staff members of the Department of Cardiology and Catheterization Laboratory, Beijing Anzhen Hospital, Capital Medical University.
文摘Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.
基金supported by Science and Technology Planning project of Guangdong Province(No.2012A03220005)
文摘Background Coronary slow flow（CSF） during primary percutaneous coronary intervention（PCI） is closely related to the prognosis of patients with acute myocardial infarction（AMI）. Whether Enhanced External CounterPulsation（EECP） could improve the phenomenon and enhance cardiac function in these patients has not been studied. Methods Seventy-eight AMI patients undergoing primary PCI were enrolled and divided into 2 groups, EECP group and sham group. In EECP group, the patients were treated with EECP for 30 min after coronary artery stent implantation; and in sham group, the patients after coronary artery stent implantation were treated with cuffs wrapped for 30 min. Hemodynamics and corrected TIMI Frame Count（c TFC） were recorded at different time points in both groups. CRP, HCY, NT-pro BNP and Killip class were also detected before operation and after treatment. Results In EECP group, compared to pre-and post-EECP treatment, the systolic blood pressure（SBP） was much lower（P〈0.05）, diastolic blood pressure（DBP） and mean arterial blood pressure（MBP）were much higher（P〈0.05）. The heart rate（HR） was not changed during EECP treatment（P〉0.05）. In sham group, SBP, DBP, MBP and HR were not significantly changed during these period（P〉0.05）. In EECP group,the c TFC of patients with CSF decreased significantly after treatment（P〈0.05）; and there was no difference in sham group（P〉0.05）. Compared with pre-EECP treatment, CRP and HCY were increased in post-EECP treatment of both groups（P〈0.05）, while, they were much lower in EECP group（P〈0.05）. The expression of NTpro BNP was decreased after treatment in both groups（P〈0.05）, and it was much lower in EECP group than in sham group（P〈0.05）. The Killip class was much lower after treatment than before operation in EECP group（P〈0.05）, and there was no change in sham group（P〉0.05）. Conclusions The results suggest that EECP is helpful in a short time to the improvement of CSF and recovery of cardiac function in AMI patients during primary PCI,and that CRP and HCY may be involved in this process.
文摘In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angiograms and in 16 patients with normal angiographic coronary flow (NF). A 3.5 F, 20 MHz ultrasound catheter (Boston Scientific) was used for ICUS and a 0.014 inch FloWire (Cardiometrics) was used for ICD. Coronary flow velocity including average peak velocity (APV), maximal peak velocity (MPV) at rest and at hyperemia as well as coronary flow reserve (CFR) were compared in both groups in comparison to the presence or absence of plaque formation based on ICUS. CFR in the SF group (4.2±1.1) was even higher than that of the NF group (3.1±0.6, P<0.001). Department of Cardiology, University GHS Essen, Germany (Ge JB, Simon H, Jeremias A, Liu FQ, Grge G, Haude M, Baumgart D and Erbel R) Significant differences were also found concerning the APV and MPV among both groups (both P <0.001). Plaque formation was found in 7/13 patients with a lumen reduction of 21%±24% in SF group and in 7/16 of the NF group with a lumen reduction of 19%±17%. Comparison of APV, MPV and CFR in SF and NF grups. Comparison of APV, MPV and CFR in SF and NF groups[BHDFG1*2,WK8ZQ1,WK11DW,WK11DWW] SF group NF groupAPV (cm/s) Rest 7.7±2.0 21.1±5.0 * Peak31.7±14.961.3±14.2 *MPV (cm/s) Rest17.4±4.637.0±11.4 * Peak56.8±14.981.8±17.7 *CFR4.2±1.13.1±0.6 # * P<0.001, #P=0.002. Coronary slow flow phenomenon in angiography indicates reduced resting flow velocity without reduction of coronary flow reserve.
文摘Interstitial fluid plays a vital role in drug delivery and tumour treatment.However,few non-invasive measurement methods are available for measuring low-velocity biological fluid flow.Therefore,this study aimed to develop a novel technology called interstitial flow velocity-MRI.The interstitial flow velocity-MRI sequence consists of a dual inversion recovery preparation and an improved stimulated echo sequence(ISTE)combined with phase-contrast MRI.A homemade flow phantom was used to assess the feasibility and sensitivity of interstitial flow velocity-MRI.In addition,xenografts of female BALB/c mouse models of 4T1 breast cancer administered losartan(40 mg/kg)or saline(n?6)were subjected to imaging on a 7.0 T scanner to assess the in vivo interstitial fluid flow velocity.The results showed a significant correlation(P<0.001)between the theoretical velocities and velocities measured using the flow phantom.Interstitial flow velocity-MRI could detect a velocity as low as 10.21±2.65 mm/s with a spatial resolution of 0.313 mm.The losartan group had a lower mean interstitial fluid velocity than the control group(85±16 vs 113±24 mm/s).In addition,compared to the saline treatment,losartan treatment reduced the proportion of collagen fibres by 10%and 12%in the Masson and Sirius red staining groups,respectively.Interstitial flow velocity-MRI has the potential to determine interstitial fluid flow velocity non-invasively and exhibits an intuitive velocity map.
基金Supported by the Zhejiang Institute of Integrative Medicine Clinical Special Fund for Pharmacy Research(No.2014LYK009)
文摘Objective: To observe the immediate effect and safety of Shexiang Tongxin dropping pills(麝香通心滴丸, STDP) on patients with coronary slow flow(CSF), and furthermore, to explore new evidence for the use of Chinese medicine in treating ischemic chest pain. Methods: Coronary angiography(CAG) with corrected thrombolysis in myocardial infarction(TIMI) frame count(CTFC) was applied(collected at 30 frames/s). The treatment group included 22 CSF patients, while the control group included 22 individuals with normal coronary?ow. CSF patients were given 4 STDP through sublingual administration, and CAG was performed 5 min after the medication. The immediate blood ?ow frame count, blood pressure, and heart rate of patients before and after the use of STDP were compared. The liver and kidney functions of patients were examined before and after treatments. Results: There was a signi?cant difference in CTFC between groups(P<0.05). The average CTFC values of the vessels with slow blood ?ow in CSF patients were, respectively, 49.98±10.01 and 40.42±11.33 before and after the treatment with STDP, a 19.13% improvement. The CTFC values(frame/s) measured before and after treatment at the left anterior descending coronary artery, left circumflex artery, and right coronary artery were, respectively, 48.00±13.32 and 41.80±15.38, 59.00±4.69 and 50.00±9.04, and 51.90±8.40 and40.09±10.46, giving 12.92%, 15.25%, and 22.76% improvements, respectively. The CTFC values of vessels with slow ?ow before treatment were signi?cantly decreased after treatment(P<0.05). There were no apparent changes in the heart rate, blood pressure, or liver or kidney function of CSF patients after treatment with STDP(all P>0.05). Conclusions: The immediate effect of STDP in treating CSF patients was apparent. This medication could signi?cantly improve coronary ?ow without affecting blood pressure or heart rate. Our ?ndings support the potential of Chinese medicine to treat ischemic chest pain.
基金Sponsored by the National Natural Science Foundation of China(Grant No.50908064 and 51208158)the 46thChina Postdoctoral Science Foundation(Grant No.20090460912)
文摘Urban water supply network is a modern urban survival and development of the infrastructure of a city,and its normal running conditions have important significance. The actual hydraulic process in the variableload water distribution networks can be treated as the slow transient flow which belongs to the unsteady flow. This paper analyzes the multi-loops network slow transient model based on graph theory,and the link flow matrix is treated as the variables of the discrete solution model to simulate the process of the slow transient flow in the network. With the simulation of hydraulic regime in an actual pipe network,the changing laws of the flow in the pipes,nodal hydraulic heads and other hydraulic factors with the passage of time are obtained. Since the transient processes offer much more information than a steady process,the slow transient theory is not only practical on analyzing the hydraulic condition of the network,but also on identifying hydraulic resistance coefficients of pipes and detecting the leakage in networks.
文摘Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies,clinical manifestations and treatment of this unique angiographic phenomenon. In our case report,we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries,especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.
