Background Inflammation is an important element of the pathophysiological process of heart failure (HF) and is correlated with subtypes of HF. The association between multiple biomarkers of inflammation and HF subtype...Background Inflammation is an important element of the pathophysiological process of heart failure (HF) and is correlated with subtypes of HF. The association between multiple biomarkers of inflammation and HF subtypes in Chinese subjects remains unclear. This study aimed to compare the differences in inflammation biomarkers among Chinese patients with different subtypes of HF who have been identified to date. Methods We included 413 consecutive patients with HF,including 262 with preserved ejection fraction (HFpEF),55 with middle-ranged ejection fraction (HFmrEF) and 96 with reduced ejection fraction (HFrEF). Ten inflammation biomarkers were analyzed and compared according to the HF subtypes. One hundred contemporary non-HF subjects were also recruited as the control group. Moreover,the correlations between the inflammatory biomarkers and left ventricular ejection fraction of the HF subtypes were assessed. Results The mean age of the HF patients was 65.0 ± 12.0 years,65.8% were male. Distinct subtypes of HF demonstrated different inflammation biomarker panels. IL-6,PTX-3,ANGPTL-4 and TNF-α were correlated with HFrEF;IL-1β and PTX-3 were correlated with HFmrEF;and IL-1β and IL-6 were correlated with HFpEF. The multivariable logistic regression showed that IL-1β[relative ratio (RR)= 1.08,95% CI: 1.02–1.15,P = 0.010],IL-6 (RR = 1.03,95% CI: 1.01–1.06,P = 0.016),PTX-3 (RR = 1.31,95% CI: 1.11–1.55,P = 0.001),and ANGPTL-4 (RR = 1.05,95% CI: 1.02–1.07,P < 0.001) were independently associated with HF,while IL-6 (RR = 1.03,95% CI: 1.01–1.04,P = 0.019),PTX-3 (RR = 1.23,95% CI: 1.06–1.43,P = 0.007),and ANGPTL-4 (RR = 1.03,95% CI: 1.01–1.06,P = 0.005) were independently associated with the HF subtype. Conclusions Diverse inflammation biomarkers have multifaceted presentations according to the subtype of HF,which may illustrate the diverse mechanisms of inflammation in Chinese HF patients. IL-6,PTX-3,and ANGPTL-4 were independent inflammation factors associated with HFrEF and HF.展开更多
OBJECTIVE To assess the safety and effectiveness of intravascular lithotripsy(IVL)treatment for de novo coronary lesion involving severely calcified vessels in a Chinese population.METHODS The Clinical Trial of the Sh...OBJECTIVE To assess the safety and effectiveness of intravascular lithotripsy(IVL)treatment for de novo coronary lesion involving severely calcified vessels in a Chinese population.METHODS The Clinical Trial of the ShOckwave Coronary IVL System Used to Treat CalcIfied Coronary ArtEries(SOLSTICE)was a prospective,single-arm,multicentre trial.According to the inclusion criteria,patients with severely calcified lesions were enrolled in the study.IVL was used to perform calcium modification prior to stent implantation.The primary safety endpoint was freedom from major adverse cardiac events(MACEs)at 30 days.The primary effectiveness endpoint was procedural success,defined as successful stent delivery with residual stenosis<50% by core lab assessment without in-hospital MACEs.The morphological changes of calcium modification were assessed by optical coherence tomography(OCT)before and after IVL treatment.RESULTS Patients(n=20)were enrolled at three sites in China.Severe calcification by core lab assessment was present in all lesions,with a mean calcium angle and thickness of 300±51°and 0.99±0.12 mm(by OCT),respectively.The 30-day MACE rate was 5%.Both primary safety and effectiveness endpoints were achieved in 95% of patients.The final in-stent diameter stenosis was 13.1%±5.7% with no patient had a residual stenosis<50%after stenting.No serious angiographic complications(severe dissection grade D or worse,perforation,abrupt closure,slow flow/no-reflow)observed at any time during the procedure.OCT imaging demonstrated visible multiplane calcium fracture in 80% of lesions with a mean stent expansion of 95.62%±13.33% at the site of maximum calcification and minimum stent area(MSA)of 5.34±1.64 mm^(2).CONCLUSIONS The initial coronary IVL experience for Chinese operators resulted in high procedural success and low angiographic complications consistent with prior IVL studies,reflecting the relative ease of use of IVL technology.展开更多
Objective To analyze characteristics of high altitude pulmonary edema(HAPE)in Chinese patients.Methods We performed a retrospective study of 98 patients with HAPE.We reviewed the medical records and summarized the cli...Objective To analyze characteristics of high altitude pulmonary edema(HAPE)in Chinese patients.Methods We performed a retrospective study of 98 patients with HAPE.We reviewed the medical records and summarized the clinical,laboratory and imaging characteristics of these cases,and compared the results on admission with those determined before discharge.Results Forty-eight(49.0%)patients developed HAPE at the altitude of 2800 m to 3000 m.Ninty-five(96.9%)patients were man.Moist rales were audible from the both lungs,and moist rales over the right lung were clearer than those over the left lung in fourteen patients.The white blood cells[(12.83±5.55)versus(8.95±3.23)×109/L,P=0.001)]as well as neutrophil counts[(11.34±3.81)versus(7.49±2.83)×109/L,P=0.001)]were higher,whereas the counts of other subsets of white blood cells were lower on admission than those after recovery(all P<0.05).Serum levels of alkaline phosphatase(115.8±37.6 versus 85.7±32.4 mmol/L,P=0.020),cholinesterase(7226.2±1631.8 versus 6285.3±1693.3 mmol/L,P=0.040),creatinine(85.2±17.1 versus 75.1±12.8 mmol/L,P=0.021),uric acid(401.9±114.2 versus 326.0±154.3 mmol/L,P=0.041),and uric glucose(7.20±1.10 versus 5.51±1.11 mmol/L,P=0.001)were higher,but carbondioxide combining power(CO2CP,26.7±4.4 versus 28.9±4.5 mmol/L,P=0.042)and serous calcium(2.32±0.13 versus 2.41±0.10 mmol/L,P=0.006)were lower on admission.Arterial blood gas results showed hypoxemia and respiratory alkalosis on admission.Conclusions In the present research,men were more susceptible to HAPE than women,and in the process of HAPE,the lesions of the right lung were more serious than those of the left lung.Some indicators of routine blood test and blood biochemistry of HAPE patients changed.展开更多
Objective To explore the changes in plasma angiotensin II (Ang II) and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome (SAS) before and after continuous positive airway pressur...Objective To explore the changes in plasma angiotensin II (Ang II) and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome (SAS) before and after continuous positive airway pressure (CPAP) or surgical treatment.Methods A total of 180 essential hypertension patients were enrolled in our study.The determination of plasma Ang II concentration,ambulatory blood pressure (ABP),and polysomnography (PSG) monitoring were performed before and 3 months after CPAP or surgical treatment.Results Patients were classified into three groups by their apnea-hypopnea index (AHI):essential hypertension group (EH group,n=72;AHI<5),essential hypertension with mild SAS group (EH+mild SAS group,n=60,5≤AHI<20),and essential hypertension with moderate and severe SAS group (EH+moderate-severe SAS group,n=48,AHI≥20).The concentrations of plasma AngⅡ in the above three groups were 13.42±3.27,16.17±3.82,and 18.73±4.05 ng/mL respectively before treatment,and AngⅡ concentration in EH patients combined with SAS was significantly higher than that in EH group (all P<0.05).After treatment the values in the latter two groups significantly decreased to 14.67±2.56 and 15.03±3.41 ng/mL respectively (P<0.05).The incidence of non-dipper blood pressure curve in EH patients was 31.9%,and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%,respectively before treatment.The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone (P<0.05).After CPAP treatment or surgery,the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%,respectively (P<0.05).Conclusions Ang II might play a role in blood pressure variability in patients with obstructive SAS.CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang II level in patients with obstructive SAS.展开更多
In percutaneous coronary intervention (PCI), chronic total occlusion (CTO) coronary artery disease still remains difficult to treat. One of the reasons for the failure is the hard of the CTO lesions that balloon is di...In percutaneous coronary intervention (PCI), chronic total occlusion (CTO) coronary artery disease still remains difficult to treat. One of the reasons for the failure is the hard of the CTO lesions that balloon is difficult to pass through or expand. Previous methods to deal with CTO lesions that cannot be passed by balloon, include selecting reinforced catheter (such as 5 in 6 guiding catheter, Guidzilla catheter, or Tornus microcatheter), guidewire extrusion or rotary grinding technology. In recent years, excimer laser coronary angioplasty (ELCA) has been gradually applied to CTO lesions. Using inert halide as the laser medium, ELCA emits a 308 nm high-intensity unidirectional light wave with absorption depth of only 50 μmL, resulting in less thermal effect and less damage to non-target lesions. In this paper, we will describe a successful PCI case of an in-stent CTO lesion using ELCA with long term coronary angiography follow-up.展开更多
The Journal of Geriatric Cardiology(JGC,ISSN 1671-5141/CN 11-5329/R)is a monthly,open-access,international,and peer-reviewed journal sponsored and published by the Institute of Geriatric Cardiology affiliated with Chi...The Journal of Geriatric Cardiology(JGC,ISSN 1671-5141/CN 11-5329/R)is a monthly,open-access,international,and peer-reviewed journal sponsored and published by the Institute of Geriatric Cardiology affiliated with Chinese PLA General Hospital.It was created in 2004 by Prof.Shi-Wen WANG,and as the current editor-in-chief,Prof.Yun-Dai CHEN has been involved in JGC for eight years and has achieved impressive advancements.展开更多
Deep vein thrombosis(DVT)is a manifestation of venous thromboembolism,which can result from long-term bed and lead to pulmonary embolism(PE),stroke,mesenteric artery embolis,etc.Patients after surgery without bed-off ...Deep vein thrombosis(DVT)is a manifestation of venous thromboembolism,which can result from long-term bed and lead to pulmonary embolism(PE),stroke,mesenteric artery embolis,etc.Patients after surgery without bed-off activity may prone to thrombosis,but traditional anticoagulant therapy is a contraindication for them because of high risk of postoperative hemorrhage.Inferior vena cava filter(IVCF)implantation is the most effective method to intercept thrombosis from lower limb and to prevent PE.However,radiation and contrast agent limit its application.Our team have successfully performed an IVCF implantation guided by a mixed-reality(MR)system,[1]which is a chance for critically ill patients to allow the IVCF implantation exposed under no Xray and require no contrast agent.5G can help remote holographic projection images between distant range,meeting the needs of experts to guide the operation of critically ill patients.We describe a case of weak woman after neurosurgery who can not tolerate traditional interventional surgery to prevent DVT from falling off.We performed a mixed-reality system guided IVCF implantation under remote guidance of 5G communication.展开更多
Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currentl...Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI.展开更多
Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude.Methods One hundred and six Han nation...Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude.Methods One hundred and six Han nationality male individuals were recruited to this research.Dynamic electrocardiogram,treadmill exercise test,echocardiography,routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively.Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness(AMS).Results Approximately 49.05%of the individuals developed AMS.The tricuspid annular plane systolic excursion(22.0+2.66 vs.23.2+3.19 mm,t=l.998,P=0.048)was significantly lower in the AMS group at sea level,while count of eosinophil[(0.264+0.393)×109/L vs.(0.126+0.084)×109/L,t=-2.040,P—0.045],percentage of diflerences exceeding 50 ms between adjacent normal number of intervals(PNN50,9.66%±5.40%vs.6.98%±5.66%,t=-2.229,P=0.028)and heart rate variability triangle index(57.1+16.1 vs.50.6+12.7,t=-2.271,P=0.025)were significantly higher.After acute exposure to high altitude,C-reactive protein(0.098+0.103 vs.0.062+0.045 g/L,t=-2.132,P=0.037),aspartate aminotransferase(19.7+6.7275.17,3±3.95 U/L,t=-2.231,P=0.028)and creatinine(85.1±12.9 vs.77.7±11.2 mmol/L,t=3.162,P=0.002)were significantly higher in the AMS group,while alkaline phosphatase(71.7+18.2 vs.80.6+20.2 U/L,t=2.389,P=0.019),standard deviation of normal-to-normal RR intervals(126.5+35.9 vs.143.3+36.4 ms,t—2.320,P—0.022),ejection time(276.9+50.8 vs.313.8+48.9 ms,t—3.641,P—0.001)and heart rate variability triangle index(37.1+12.9 vs.41.9+11.1,t=2.O2O,P=0.047)were significantly lower.Using the Lake Louise Score as the dependent variable,prediction equation were established to estimate AMS:Lake Louise Score=3.783+0.281Xeosinophil-0.219Xalkaline phosphatase+O.O32XPNN50.Conclusions We elucidated the differences of pl^siological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level.We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.展开更多
Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Met...Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.展开更多
基金supported by the National Natural Science Foundation of China (No.31701155)the National Key Research and Development Program of China (2017YFC 0114001)Chinese PLA General Hospital Medical Big Data Research and Development Project (No.2017MBD-007)
文摘Background Inflammation is an important element of the pathophysiological process of heart failure (HF) and is correlated with subtypes of HF. The association between multiple biomarkers of inflammation and HF subtypes in Chinese subjects remains unclear. This study aimed to compare the differences in inflammation biomarkers among Chinese patients with different subtypes of HF who have been identified to date. Methods We included 413 consecutive patients with HF,including 262 with preserved ejection fraction (HFpEF),55 with middle-ranged ejection fraction (HFmrEF) and 96 with reduced ejection fraction (HFrEF). Ten inflammation biomarkers were analyzed and compared according to the HF subtypes. One hundred contemporary non-HF subjects were also recruited as the control group. Moreover,the correlations between the inflammatory biomarkers and left ventricular ejection fraction of the HF subtypes were assessed. Results The mean age of the HF patients was 65.0 ± 12.0 years,65.8% were male. Distinct subtypes of HF demonstrated different inflammation biomarker panels. IL-6,PTX-3,ANGPTL-4 and TNF-α were correlated with HFrEF;IL-1β and PTX-3 were correlated with HFmrEF;and IL-1β and IL-6 were correlated with HFpEF. The multivariable logistic regression showed that IL-1β[relative ratio (RR)= 1.08,95% CI: 1.02–1.15,P = 0.010],IL-6 (RR = 1.03,95% CI: 1.01–1.06,P = 0.016),PTX-3 (RR = 1.31,95% CI: 1.11–1.55,P = 0.001),and ANGPTL-4 (RR = 1.05,95% CI: 1.02–1.07,P < 0.001) were independently associated with HF,while IL-6 (RR = 1.03,95% CI: 1.01–1.04,P = 0.019),PTX-3 (RR = 1.23,95% CI: 1.06–1.43,P = 0.007),and ANGPTL-4 (RR = 1.03,95% CI: 1.01–1.06,P = 0.005) were independently associated with the HF subtype. Conclusions Diverse inflammation biomarkers have multifaceted presentations according to the subtype of HF,which may illustrate the diverse mechanisms of inflammation in Chinese HF patients. IL-6,PTX-3,and ANGPTL-4 were independent inflammation factors associated with HFrEF and HF.
文摘OBJECTIVE To assess the safety and effectiveness of intravascular lithotripsy(IVL)treatment for de novo coronary lesion involving severely calcified vessels in a Chinese population.METHODS The Clinical Trial of the ShOckwave Coronary IVL System Used to Treat CalcIfied Coronary ArtEries(SOLSTICE)was a prospective,single-arm,multicentre trial.According to the inclusion criteria,patients with severely calcified lesions were enrolled in the study.IVL was used to perform calcium modification prior to stent implantation.The primary safety endpoint was freedom from major adverse cardiac events(MACEs)at 30 days.The primary effectiveness endpoint was procedural success,defined as successful stent delivery with residual stenosis<50% by core lab assessment without in-hospital MACEs.The morphological changes of calcium modification were assessed by optical coherence tomography(OCT)before and after IVL treatment.RESULTS Patients(n=20)were enrolled at three sites in China.Severe calcification by core lab assessment was present in all lesions,with a mean calcium angle and thickness of 300±51°and 0.99±0.12 mm(by OCT),respectively.The 30-day MACE rate was 5%.Both primary safety and effectiveness endpoints were achieved in 95% of patients.The final in-stent diameter stenosis was 13.1%±5.7% with no patient had a residual stenosis<50%after stenting.No serious angiographic complications(severe dissection grade D or worse,perforation,abrupt closure,slow flow/no-reflow)observed at any time during the procedure.OCT imaging demonstrated visible multiplane calcium fracture in 80% of lesions with a mean stent expansion of 95.62%±13.33% at the site of maximum calcification and minimum stent area(MSA)of 5.34±1.64 mm^(2).CONCLUSIONS The initial coronary IVL experience for Chinese operators resulted in high procedural success and low angiographic complications consistent with prior IVL studies,reflecting the relative ease of use of IVL technology.
基金Supported by the National Science and Technology Major Projects for Major New Drugs Innovation and Development [2014ZX09J14102-02A(2014.1-2016.12)]
文摘Objective To analyze characteristics of high altitude pulmonary edema(HAPE)in Chinese patients.Methods We performed a retrospective study of 98 patients with HAPE.We reviewed the medical records and summarized the clinical,laboratory and imaging characteristics of these cases,and compared the results on admission with those determined before discharge.Results Forty-eight(49.0%)patients developed HAPE at the altitude of 2800 m to 3000 m.Ninty-five(96.9%)patients were man.Moist rales were audible from the both lungs,and moist rales over the right lung were clearer than those over the left lung in fourteen patients.The white blood cells[(12.83±5.55)versus(8.95±3.23)×109/L,P=0.001)]as well as neutrophil counts[(11.34±3.81)versus(7.49±2.83)×109/L,P=0.001)]were higher,whereas the counts of other subsets of white blood cells were lower on admission than those after recovery(all P<0.05).Serum levels of alkaline phosphatase(115.8±37.6 versus 85.7±32.4 mmol/L,P=0.020),cholinesterase(7226.2±1631.8 versus 6285.3±1693.3 mmol/L,P=0.040),creatinine(85.2±17.1 versus 75.1±12.8 mmol/L,P=0.021),uric acid(401.9±114.2 versus 326.0±154.3 mmol/L,P=0.041),and uric glucose(7.20±1.10 versus 5.51±1.11 mmol/L,P=0.001)were higher,but carbondioxide combining power(CO2CP,26.7±4.4 versus 28.9±4.5 mmol/L,P=0.042)and serous calcium(2.32±0.13 versus 2.41±0.10 mmol/L,P=0.006)were lower on admission.Arterial blood gas results showed hypoxemia and respiratory alkalosis on admission.Conclusions In the present research,men were more susceptible to HAPE than women,and in the process of HAPE,the lesions of the right lung were more serious than those of the left lung.Some indicators of routine blood test and blood biochemistry of HAPE patients changed.
文摘Objective To explore the changes in plasma angiotensin II (Ang II) and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome (SAS) before and after continuous positive airway pressure (CPAP) or surgical treatment.Methods A total of 180 essential hypertension patients were enrolled in our study.The determination of plasma Ang II concentration,ambulatory blood pressure (ABP),and polysomnography (PSG) monitoring were performed before and 3 months after CPAP or surgical treatment.Results Patients were classified into three groups by their apnea-hypopnea index (AHI):essential hypertension group (EH group,n=72;AHI<5),essential hypertension with mild SAS group (EH+mild SAS group,n=60,5≤AHI<20),and essential hypertension with moderate and severe SAS group (EH+moderate-severe SAS group,n=48,AHI≥20).The concentrations of plasma AngⅡ in the above three groups were 13.42±3.27,16.17±3.82,and 18.73±4.05 ng/mL respectively before treatment,and AngⅡ concentration in EH patients combined with SAS was significantly higher than that in EH group (all P<0.05).After treatment the values in the latter two groups significantly decreased to 14.67±2.56 and 15.03±3.41 ng/mL respectively (P<0.05).The incidence of non-dipper blood pressure curve in EH patients was 31.9%,and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%,respectively before treatment.The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone (P<0.05).After CPAP treatment or surgery,the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%,respectively (P<0.05).Conclusions Ang II might play a role in blood pressure variability in patients with obstructive SAS.CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang II level in patients with obstructive SAS.
基金grants obtained from the National Natural Science Foundation of China (No.: 81170177, 81030002) and science and Technology De- partment of Gansu Province Project (145RJZ104).
文摘In percutaneous coronary intervention (PCI), chronic total occlusion (CTO) coronary artery disease still remains difficult to treat. One of the reasons for the failure is the hard of the CTO lesions that balloon is difficult to pass through or expand. Previous methods to deal with CTO lesions that cannot be passed by balloon, include selecting reinforced catheter (such as 5 in 6 guiding catheter, Guidzilla catheter, or Tornus microcatheter), guidewire extrusion or rotary grinding technology. In recent years, excimer laser coronary angioplasty (ELCA) has been gradually applied to CTO lesions. Using inert halide as the laser medium, ELCA emits a 308 nm high-intensity unidirectional light wave with absorption depth of only 50 μmL, resulting in less thermal effect and less damage to non-target lesions. In this paper, we will describe a successful PCI case of an in-stent CTO lesion using ELCA with long term coronary angiography follow-up.
基金the Project for Excellence Action Plan of China STM Journals(C-074).
文摘The Journal of Geriatric Cardiology(JGC,ISSN 1671-5141/CN 11-5329/R)is a monthly,open-access,international,and peer-reviewed journal sponsored and published by the Institute of Geriatric Cardiology affiliated with Chinese PLA General Hospital.It was created in 2004 by Prof.Shi-Wen WANG,and as the current editor-in-chief,Prof.Yun-Dai CHEN has been involved in JGC for eight years and has achieved impressive advancements.
基金supported by Capital Clinical Application Research Project(No.Z181100001718042)Cultivation and Enrichment of Front-Line Teachers,Battle Field Internal Medicine of Construction of Key Military Disciplines,13th Five Year Plan(No.A350109)。
文摘Deep vein thrombosis(DVT)is a manifestation of venous thromboembolism,which can result from long-term bed and lead to pulmonary embolism(PE),stroke,mesenteric artery embolis,etc.Patients after surgery without bed-off activity may prone to thrombosis,but traditional anticoagulant therapy is a contraindication for them because of high risk of postoperative hemorrhage.Inferior vena cava filter(IVCF)implantation is the most effective method to intercept thrombosis from lower limb and to prevent PE.However,radiation and contrast agent limit its application.Our team have successfully performed an IVCF implantation guided by a mixed-reality(MR)system,[1]which is a chance for critically ill patients to allow the IVCF implantation exposed under no Xray and require no contrast agent.5G can help remote holographic projection images between distant range,meeting the needs of experts to guide the operation of critically ill patients.We describe a case of weak woman after neurosurgery who can not tolerate traditional interventional surgery to prevent DVT from falling off.We performed a mixed-reality system guided IVCF implantation under remote guidance of 5G communication.
基金supported by the Hainan Province’s Key Research and Development Project(ZDYF 2017096&ZDYF2018118)National Natural Science Foundation of China(NSFC:81500202)+2 种基金Beijing Lisheng Cardiovascular Health Foundation Pilot Fund Project(LHJJ201610620)Provincial Key Science and Technology Projects supporting projects in Sanya(2018PT48)Sanya Medical and Health Science and Technology Innovation Project(2017YW10)
文摘Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI.
基金National Science and Technology Major Projects for Major New Drugs Innovation and Development(2014ZX09J14102-02A)Special Topic on Military Health Care(17bjz41)National Natural Science Foundation of China(81170249 and 30700305).
文摘Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude.Methods One hundred and six Han nationality male individuals were recruited to this research.Dynamic electrocardiogram,treadmill exercise test,echocardiography,routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively.Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness(AMS).Results Approximately 49.05%of the individuals developed AMS.The tricuspid annular plane systolic excursion(22.0+2.66 vs.23.2+3.19 mm,t=l.998,P=0.048)was significantly lower in the AMS group at sea level,while count of eosinophil[(0.264+0.393)×109/L vs.(0.126+0.084)×109/L,t=-2.040,P—0.045],percentage of diflerences exceeding 50 ms between adjacent normal number of intervals(PNN50,9.66%±5.40%vs.6.98%±5.66%,t=-2.229,P=0.028)and heart rate variability triangle index(57.1+16.1 vs.50.6+12.7,t=-2.271,P=0.025)were significantly higher.After acute exposure to high altitude,C-reactive protein(0.098+0.103 vs.0.062+0.045 g/L,t=-2.132,P=0.037),aspartate aminotransferase(19.7+6.7275.17,3±3.95 U/L,t=-2.231,P=0.028)and creatinine(85.1±12.9 vs.77.7±11.2 mmol/L,t=3.162,P=0.002)were significantly higher in the AMS group,while alkaline phosphatase(71.7+18.2 vs.80.6+20.2 U/L,t=2.389,P=0.019),standard deviation of normal-to-normal RR intervals(126.5+35.9 vs.143.3+36.4 ms,t—2.320,P—0.022),ejection time(276.9+50.8 vs.313.8+48.9 ms,t—3.641,P—0.001)and heart rate variability triangle index(37.1+12.9 vs.41.9+11.1,t=2.O2O,P=0.047)were significantly lower.Using the Lake Louise Score as the dependent variable,prediction equation were established to estimate AMS:Lake Louise Score=3.783+0.281Xeosinophil-0.219Xalkaline phosphatase+O.O32XPNN50.Conclusions We elucidated the differences of pl^siological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level.We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.
基金supported by grant from the Capital health research and development of special project (2016-15011)
文摘Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.