目的探讨EnSite NavX标测指导下房室结折返性心动过速(AVNRT)射频消融术的可行性和安全性。方法 124例阵发性室上性心动过速的患者接受射频消融术被随机分为采用EnSite NavX系统标测指导组和常规透视组(X线)。结果 65例为AVNRT,其中标...目的探讨EnSite NavX标测指导下房室结折返性心动过速(AVNRT)射频消融术的可行性和安全性。方法 124例阵发性室上性心动过速的患者接受射频消融术被随机分为采用EnSite NavX系统标测指导组和常规透视组(X线)。结果 65例为AVNRT,其中标测指导组32例,常规透视组33例。所有手术均获得即刻的成功,无手术并发症。与常规透视组比较,标测指导组手术时间长(64.6±12.7 min vs 37.5±13.6 min,P<0.01);而X线透视时间少(27.62±31.5 s vs 324.2±108.3 s,P<0.01),其中有21例(65.6%)未接受X线透视。平均随访6个月均无心动过速复发。结论 EnSite NavX标测指导下AVNRT射频消融安全有效,且显著减少了X线透视时间。展开更多
目的评价在低X线曝光下应用En Site Nav X三维标测系统引导射频消融阵发性室上性心动过速的安全性、有效性。方法选择2011年1月至2015年6月在我院住院的阵发性室上性心动过速患者134例,将入选患者分为研究组和常规组,研究组为低X线曝光...目的评价在低X线曝光下应用En Site Nav X三维标测系统引导射频消融阵发性室上性心动过速的安全性、有效性。方法选择2011年1月至2015年6月在我院住院的阵发性室上性心动过速患者134例,将入选患者分为研究组和常规组,研究组为低X线曝光组72例和另一组为常规X线透视消融组62例分别进行心内电生理检查及标测消融。观察两组的手术成功率、手术操作时间、放电次数、放电时间、X线曝光时间和术中术后并发症。结果常规组1例后间隔旁路消融不成功后改用En Site Nav X三维标测系统引导消融成功,其余研究组及常规组均成功完成手术,两组成功率差异无统计学意义。研究组与常规组比较,手术时间减少[(46.8±11.9)min vs.(64.4±14.7)min,P<0.01],X线曝光时间明显缩短[(217±105)s vs.(546±117)s,P<0.01],放电次数显著减少[(5±2)次vs.(10±3)次,P<0.01],放电时间显著缩短[(192±71)s vs.(411±78)s,P<0.01]。术中常规消融组发生1例房室传导阻滞。结论低频率X线曝光下在En Site Nav X三维标测系统引导射频消融阵发性室上性心动过速安全有效,可明显缩短X线曝光时间,减少放电次数和时间,同时手术时间也显著减少。展开更多
Objective：To investigate the effect of cardiomyocyte proliferation induced by human hepatocyte growth factor（HGF）in pigs with chronic myocardial infarction（CMI）.Methods：A steerable,deflectable 7F catheter incorp...Objective：To investigate the effect of cardiomyocyte proliferation induced by human hepatocyte growth factor（HGF）in pigs with chronic myocardial infarction（CMI）.Methods：A steerable,deflectable 7F catheter incorporating a 27-guage needle was advanced percutaneously to the left ventricular myocardium of 18 pigs with CMI.Pigs were randomized（1：1：1）to receive adenoviral vector HGF（total dose,1×10^10 genome copies）,which was administered as five injections into the infarcted myocardium（total,1.0 mL）,or saline,or Ad-null（control groups）.Injections were guided by Ensite NavX left ventricular electroanatomical mapping.HGF and cyclin proteins were detected by western blot and immunoprecipitation analysis.Histological and immunohistochemical analysis determined proliferating cardiomyocytes.Myocardial perfusion and cardiac function were estimated by Gated-Single Photon Emission Computed Tomography（G-SPECT）.Results：Western blot analyses showed that HGF were predominantly expressed in the infarct core and border in the myocardium of the infarcted heart.G-SPECT analysis indicated that the HGF group had better cardiac function and myocardial perfusion four weeks after the injection of Ad-HGF than before the injection of Ad-HGF.After treatment there were more proliferating cardiomyocytes in the HGF group compared to either of the control groups.Furthermore,the HGF group myocardial samples expressed higher levels of p-Akt,cyclin A,cyclin E,cyclin D1,cdk2,cdk4 than those in the control groups.Conclusion：The over-expression of HGF activates pro-survival pathways,induces cardiomyocyte proliferation,and improves the perfusion and function of the porcine CMI heart.展开更多
文摘目的探讨EnSite NavX标测指导下房室结折返性心动过速(AVNRT)射频消融术的可行性和安全性。方法 124例阵发性室上性心动过速的患者接受射频消融术被随机分为采用EnSite NavX系统标测指导组和常规透视组(X线)。结果 65例为AVNRT,其中标测指导组32例,常规透视组33例。所有手术均获得即刻的成功,无手术并发症。与常规透视组比较,标测指导组手术时间长(64.6±12.7 min vs 37.5±13.6 min,P<0.01);而X线透视时间少(27.62±31.5 s vs 324.2±108.3 s,P<0.01),其中有21例(65.6%)未接受X线透视。平均随访6个月均无心动过速复发。结论 EnSite NavX标测指导下AVNRT射频消融安全有效,且显著减少了X线透视时间。
文摘目的评价在低X线曝光下应用En Site Nav X三维标测系统引导射频消融阵发性室上性心动过速的安全性、有效性。方法选择2011年1月至2015年6月在我院住院的阵发性室上性心动过速患者134例,将入选患者分为研究组和常规组,研究组为低X线曝光组72例和另一组为常规X线透视消融组62例分别进行心内电生理检查及标测消融。观察两组的手术成功率、手术操作时间、放电次数、放电时间、X线曝光时间和术中术后并发症。结果常规组1例后间隔旁路消融不成功后改用En Site Nav X三维标测系统引导消融成功,其余研究组及常规组均成功完成手术,两组成功率差异无统计学意义。研究组与常规组比较,手术时间减少[(46.8±11.9)min vs.(64.4±14.7)min,P<0.01],X线曝光时间明显缩短[(217±105)s vs.(546±117)s,P<0.01],放电次数显著减少[(5±2)次vs.(10±3)次,P<0.01],放电时间显著缩短[(192±71)s vs.(411±78)s,P<0.01]。术中常规消融组发生1例房室传导阻滞。结论低频率X线曝光下在En Site Nav X三维标测系统引导射频消融阵发性室上性心动过速安全有效,可明显缩短X线曝光时间,减少放电次数和时间,同时手术时间也显著减少。
基金financially supported by a project grant of the key faculty of Medical Renaissance program of Jiangsu Province,National Basic Research Program(973 program,2008CB517303)
文摘Objective：To investigate the effect of cardiomyocyte proliferation induced by human hepatocyte growth factor（HGF）in pigs with chronic myocardial infarction（CMI）.Methods：A steerable,deflectable 7F catheter incorporating a 27-guage needle was advanced percutaneously to the left ventricular myocardium of 18 pigs with CMI.Pigs were randomized（1：1：1）to receive adenoviral vector HGF（total dose,1×10^10 genome copies）,which was administered as five injections into the infarcted myocardium（total,1.0 mL）,or saline,or Ad-null（control groups）.Injections were guided by Ensite NavX left ventricular electroanatomical mapping.HGF and cyclin proteins were detected by western blot and immunoprecipitation analysis.Histological and immunohistochemical analysis determined proliferating cardiomyocytes.Myocardial perfusion and cardiac function were estimated by Gated-Single Photon Emission Computed Tomography（G-SPECT）.Results：Western blot analyses showed that HGF were predominantly expressed in the infarct core and border in the myocardium of the infarcted heart.G-SPECT analysis indicated that the HGF group had better cardiac function and myocardial perfusion four weeks after the injection of Ad-HGF than before the injection of Ad-HGF.After treatment there were more proliferating cardiomyocytes in the HGF group compared to either of the control groups.Furthermore,the HGF group myocardial samples expressed higher levels of p-Akt,cyclin A,cyclin E,cyclin D1,cdk2,cdk4 than those in the control groups.Conclusion：The over-expression of HGF activates pro-survival pathways,induces cardiomyocyte proliferation,and improves the perfusion and function of the porcine CMI heart.
