Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity ...Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.展开更多
Introduction: Coronary Angiogram and Percutaneous Coronary Interventions are commonly performed via the femoral route. Then, transradial coronary catheterization became a popular & default technique due to less va...Introduction: Coronary Angiogram and Percutaneous Coronary Interventions are commonly performed via the femoral route. Then, transradial coronary catheterization became a popular & default technique due to less vascular access site complications and bleeding as compared to femoral route. Distal puncture of the radial artery through the anatomical snuff box access, however, has recently been shown potential benefit, like comfort to patients and operators, as well as maintenance of blood flow through the superficial palmar arch, in case of radial artery occlusion. Our aim was to evaluate the safety and feasibility of this new approach. Methods: A cross-sectional observational prospective study of patients underwent invasive diagnostic or therapeutic coronary procedures through the distal trans-radial access and traditional radial access. The primary endpoints were to access difficulties and in-hospital access-site related complications. Results: In 2 months, 190 patients underwent coronary procedures, of which 82 (43%) were selected in both distal transradial & traditional radial group. In 2(2.4%) & 3 (3.6%) cases, distal radial & traditional radial access cannulation was unsuccessful respectively (p >0.05). The mean age was 57.7 ± 10 & 57.2 ± 10 years in successful distal transradial & traditional radial cases respectively. There were no any major vascular complications in distal transradial group while there were 2 vascular complications in traditional radial group (p > 0.05). Conclusions: Distal transradial access is feasible and safe in selected cases, when performed by experienced operators. Larger case series and randomized trials are required to determine its efficacy in reducing vascular complications when comparing to the traditional technique.展开更多
<div style="text-align:justify;"> <strong>Background:</strong><span "=""> Hypertension is associated with an increased risk of cardiovascular events, cardiovascular and...<div style="text-align:justify;"> <strong>Background:</strong><span "=""> Hypertension is associated with an increased risk of cardiovascular events, cardiovascular and all-cause mortality. However, the diagnostic ability of hypertension for the presence and severity of CAD (coronary artery disease) has not been elucidated. This study investigates the relationship between hypertension and CAD complexity using the SYNTAX score to determine hypertension’s roles in coronary heart disease progression. <b>Method:</b> This is a prospective study that include</span>s consecutive 410 adult patients at mean age (61 ± 11 years) who are admitted to Cardiology Department and undergo invasive coronary angiography (CAG) where a significant coronary lesion (SCL) is defined as stenosis ≥<span "=""></span>50% in vessel diameter ≥ 1.5 mm. The SYNTAX scores were<span "=""> calculated using the SYNTAX score algorithm. <b>Results:</b> The mean rank of SYNTAX score </span>was significantly higher among hypertension than non-hypertension (mean rank: 279, 184, p = 0.006) groups. SYNTAX score was positively correlated with age (r: 0.263, p < 0.001) and LDL (correlation coefficient 0.102, p = 0.038) but inversely with HDL (r: 0.107, p = 0.031), in multivariate linear regression age (regression coefficient 0.3, p < 0.001), male (-4.4, p = 0.002), HDL (-6.4, p = 0.002) were significant independent risk factors for SYNTAX score, in ordinal regression model aging (odd ratio: 1.08, p < 0.001), being a male (2.84, p = 0.026), HDL (0.05, p < 0.001), BMI (0.86, p = 0.020) were<span "=""> significantly independent predictor of increase or decrease probability of falling in high syntax score group. <b>Conclusion </b>Hypertension affects the distribution of SYNTAX score among patients with and without hypertension, and the prevalence of significant coronary lesions </span>was more frequent in hypertensive patients. Hypertension was not a predictor of significant or complex coronary artery lesion, but advanced age, being a male, HDL, LDL and BMI are considered as independent risk factors for high SYNTAX score, Subsequently and the complexity of CAD. Therefore, when patients with CAD have these factors, we expect that the Patient’s CAD complexity will be high. </div>展开更多
Purpose: To compare the surgical indicators, perioperative complications and postoperative psychological status of patients with coronary interventional therapy (CIT) by radical artery and femoral artery puncture appr...Purpose: To compare the surgical indicators, perioperative complications and postoperative psychological status of patients with coronary interventional therapy (CIT) by radical artery and femoral artery puncture approaches. Methods: 120 patients with CIT were divided into femoral artery group (FAG) and radial artery group (RAG) according to the operation ways. The interventional operation was performed by the same surgeon team and methods. Data of surgical indicators and perioperative complications were recorded and collected. The psychological questionare survey was made within 48 hours the after surgery by the hospital anxiety and depression scale (HAD), and the results were scored by the psychiatrist. Results: The age, sex, ethnicity, education level, disease type, and combined diseases of the two groups had homogeneity without statistical difference. There was no obvious difference in X-ray exposure time, contrast agent usage and operation time in two ways (P > 0.05). The success rate of one-time catheterization was higher in FAG than in RAG (P Conclusion: CIT via radial artery can reduce the incidence of postoperative complications, postoperative physical discomfort and psychological problems such as anxiety and depression of patients.展开更多
To identify whether plasma Calcitonin gene-related peptide （CGRP） level isindexe for evaluating early cardiac dysfunction in patients with coronaryartery disease.Normal and coronary artery disease total sixty cases ...To identify whether plasma Calcitonin gene-related peptide （CGRP） level isindexe for evaluating early cardiac dysfunction in patients with coronaryartery disease.Normal and coronary artery disease total sixty cases werechosen at random,which were diagnosed by coronary arteriography,foursubgroups （0,1,2,3 lesion branch group） were divided basing on coronaryartery lesion branch,each having fifteen cases.hemodynamic parameters weremeasured by left cardiac cather and left ventricular cineangiography,plasmaCGRP concentration was msaured by radioimmunoassay.results reveal:LVEFdecressed as coronary artery lesion branch increased,but there were nosignificantly difference between subgroups (only P<sub>sio</sub>【0.05);there weresignificantly difference of diastolic function parameters between subgroups,especially T,bad positive relativity to stenosis score （r=0.72,P【0.01）.Plasma CGRP level had positive relativity to stenosis score,time constant（r=0.37～0.38,P【0.05）;bad negative relativity to LVEF （r=-0,46,P【0.01）.in brief,Coronary artery disease imparies diastolic function prior tosystolic function;CGRP is a important index for evaluating early cardiacdysfunction in patients with coronary artery disease.展开更多
文摘Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.
文摘Introduction: Coronary Angiogram and Percutaneous Coronary Interventions are commonly performed via the femoral route. Then, transradial coronary catheterization became a popular & default technique due to less vascular access site complications and bleeding as compared to femoral route. Distal puncture of the radial artery through the anatomical snuff box access, however, has recently been shown potential benefit, like comfort to patients and operators, as well as maintenance of blood flow through the superficial palmar arch, in case of radial artery occlusion. Our aim was to evaluate the safety and feasibility of this new approach. Methods: A cross-sectional observational prospective study of patients underwent invasive diagnostic or therapeutic coronary procedures through the distal trans-radial access and traditional radial access. The primary endpoints were to access difficulties and in-hospital access-site related complications. Results: In 2 months, 190 patients underwent coronary procedures, of which 82 (43%) were selected in both distal transradial & traditional radial group. In 2(2.4%) & 3 (3.6%) cases, distal radial & traditional radial access cannulation was unsuccessful respectively (p >0.05). The mean age was 57.7 ± 10 & 57.2 ± 10 years in successful distal transradial & traditional radial cases respectively. There were no any major vascular complications in distal transradial group while there were 2 vascular complications in traditional radial group (p > 0.05). Conclusions: Distal transradial access is feasible and safe in selected cases, when performed by experienced operators. Larger case series and randomized trials are required to determine its efficacy in reducing vascular complications when comparing to the traditional technique.
文摘<div style="text-align:justify;"> <strong>Background:</strong><span "=""> Hypertension is associated with an increased risk of cardiovascular events, cardiovascular and all-cause mortality. However, the diagnostic ability of hypertension for the presence and severity of CAD (coronary artery disease) has not been elucidated. This study investigates the relationship between hypertension and CAD complexity using the SYNTAX score to determine hypertension’s roles in coronary heart disease progression. <b>Method:</b> This is a prospective study that include</span>s consecutive 410 adult patients at mean age (61 ± 11 years) who are admitted to Cardiology Department and undergo invasive coronary angiography (CAG) where a significant coronary lesion (SCL) is defined as stenosis ≥<span "=""></span>50% in vessel diameter ≥ 1.5 mm. The SYNTAX scores were<span "=""> calculated using the SYNTAX score algorithm. <b>Results:</b> The mean rank of SYNTAX score </span>was significantly higher among hypertension than non-hypertension (mean rank: 279, 184, p = 0.006) groups. SYNTAX score was positively correlated with age (r: 0.263, p < 0.001) and LDL (correlation coefficient 0.102, p = 0.038) but inversely with HDL (r: 0.107, p = 0.031), in multivariate linear regression age (regression coefficient 0.3, p < 0.001), male (-4.4, p = 0.002), HDL (-6.4, p = 0.002) were significant independent risk factors for SYNTAX score, in ordinal regression model aging (odd ratio: 1.08, p < 0.001), being a male (2.84, p = 0.026), HDL (0.05, p < 0.001), BMI (0.86, p = 0.020) were<span "=""> significantly independent predictor of increase or decrease probability of falling in high syntax score group. <b>Conclusion </b>Hypertension affects the distribution of SYNTAX score among patients with and without hypertension, and the prevalence of significant coronary lesions </span>was more frequent in hypertensive patients. Hypertension was not a predictor of significant or complex coronary artery lesion, but advanced age, being a male, HDL, LDL and BMI are considered as independent risk factors for high SYNTAX score, Subsequently and the complexity of CAD. Therefore, when patients with CAD have these factors, we expect that the Patient’s CAD complexity will be high. </div>
文摘Purpose: To compare the surgical indicators, perioperative complications and postoperative psychological status of patients with coronary interventional therapy (CIT) by radical artery and femoral artery puncture approaches. Methods: 120 patients with CIT were divided into femoral artery group (FAG) and radial artery group (RAG) according to the operation ways. The interventional operation was performed by the same surgeon team and methods. Data of surgical indicators and perioperative complications were recorded and collected. The psychological questionare survey was made within 48 hours the after surgery by the hospital anxiety and depression scale (HAD), and the results were scored by the psychiatrist. Results: The age, sex, ethnicity, education level, disease type, and combined diseases of the two groups had homogeneity without statistical difference. There was no obvious difference in X-ray exposure time, contrast agent usage and operation time in two ways (P > 0.05). The success rate of one-time catheterization was higher in FAG than in RAG (P Conclusion: CIT via radial artery can reduce the incidence of postoperative complications, postoperative physical discomfort and psychological problems such as anxiety and depression of patients.
文摘To identify whether plasma Calcitonin gene-related peptide （CGRP） level isindexe for evaluating early cardiac dysfunction in patients with coronaryartery disease.Normal and coronary artery disease total sixty cases werechosen at random,which were diagnosed by coronary arteriography,foursubgroups （0,1,2,3 lesion branch group） were divided basing on coronaryartery lesion branch,each having fifteen cases.hemodynamic parameters weremeasured by left cardiac cather and left ventricular cineangiography,plasmaCGRP concentration was msaured by radioimmunoassay.results reveal:LVEFdecressed as coronary artery lesion branch increased,but there were nosignificantly difference between subgroups (only P<sub>sio</sub>【0.05);there weresignificantly difference of diastolic function parameters between subgroups,especially T,bad positive relativity to stenosis score （r=0.72,P【0.01）.Plasma CGRP level had positive relativity to stenosis score,time constant（r=0.37～0.38,P【0.05）;bad negative relativity to LVEF （r=-0,46,P【0.01）.in brief,Coronary artery disease imparies diastolic function prior tosystolic function;CGRP is a important index for evaluating early cardiacdysfunction in patients with coronary artery disease.
