简介：ObjectivesToinvestigatesafetyandeffectivityofpotassiuminpreventionofrestenosisafterPTCA.MethodsEightypatientswithPTCAwererandomizedintotwogroups:Controlgroup(GroupⅡn=40)withconventionaltherapy;Treatmentgroup(GroupⅠn=40)withconventionaltherapyplusoralpotassium(Slow-K1.2g,q8h,given3daysbeforePTCAandcontinuedtotheendofsub-study).Observationindecesoftwogroupswerecomparedinfollow-up.ResultsSeventy-sevenpatientswerefollowed-up(39ingroupⅠ,38ingroupⅡ)Allbloodindices(includingfat,sugar,uricacid,cretonne,Na+,Cl-,Ca2+,Mg2+)exceptbloodpotassiuminbothgroupsweresimilar.Oralpotassiumcouldincreasebloodpotassiumlevelabout0.3mmol/LingroupⅠwithoutcausinganysideeffects.SuspiciousanginapectorisandevidenceofmyocardialischemiabyETTweredevelopedingroupⅡhad14patients(28.9%)andGroupIhad7patients(17.9%);6of17patients(35.3%)ingroupⅠand11of21patients

简介：Coronaryangiographyaftercardiacarrestisimportanttoascertainpotentialtreatablecausesofcardiacarrest,salvagemyocardium,andpotentiallyincreaselong-termsurvival.Thecauseofadultout-of-hospitalcardiacarrestistypicallymyocardialischemia.Morethan50%ofsuchresuscitatedindividualswillhaveanacutelyoccludedepicardialcoronaryonemergencycoronaryangiography.ThisincludesthreeinfourwithST-segmentelevationandoneinthreewithoutSTsegmentelevation.Inthelattertheonlyreliablemethodofdetectioniscoronaryangiography.Numerouscohortstudies,nowincludingmorethan8000patients,haveshownanassociationbetweensurvivalandearlycoronaryangiographyand/orpercutaneouscoronaryintervention.Publicreportingofpercutaneouscoronaryintervention30-daymortalityrateshasbeenanimpedimentforextendingthistherapytoallresuscitatedindividualswhoexperiencedout-of-hospitalcardiacarrest,sincecurrentdatabasestodofullyrisk-adjustratesforthissubgroup.Sincereeffortsareunderwaytocorrectthissituation.

简介：BackgroundShort-termhospitalreadmissionsafterpercutaneouscoronaryintervention(PCI)accountforhighermedicalcostsandpoorprognosisofpatientswithcoronaryarterydisease(CAD).However,patientsathighriskforreadmissionarenotyetidentified.MethodsAtotalof1416patientssuccessfullytreatedwithPCIwereincluded.Dataofage,sex,presentationtypeofCAD,cardiacfunction,coexistentdiseases,contrastdose,numbersoflesionsandstentsimplanted,procedurecomplication,out-of-hospitalmedicationwerecollected.Coxregressionmodelwasemployedtoanalyzethemultiplefactorsinfluencingreadmission.Results75.8%ofallreadmissionswereduetoCADandtheaveragereadmissiontimewas422days.UnivariateanalysisandmultivariateCoxregressionmodeleventuallyshowedthatpatientswithanyprocedurecomplicationsand/ormorelesionsinnumberwereathigherriskforreadmissionwhileolderage,smoke,urgentPCIandmorestentsimplantedpreventedthemfromreadmitting.ConclusionThemajorcauseofreadmissionafterPCIisstillCADitself.DuringtheindexhospitalizationofPCI,patientswithmulti-vesseldiseaseneedcarefultreatmentandprocedurecomplicationsshouldbepreventedinordertoextendtheintervalofreadmission.

简介：ObjectivesTostudythemonitoringofrejectionafterorthotopicheartthansplantation.MethodsFrom1998to2005,10othotopicheartthansplanswereperformed,andacuterejectionwasmonitoredbyendomyocardialbiopsyaswellasbyclinicalfeatures,ECG,ultrasonocardiographyandbloodserumdeterminationofTropinI,andbythecombinationofthesemethods,weanalysedthemonitoringofacuterejectionafterthehearttransplantation.ResultsWiththecombinationofclinicalfeatures,ECG,ultrasonocardiographyandbloodserumtest,5occurencesofacuterejectionwerejudgedinthepostoperativecourse,whichwerecomfirmedbyendomyocardialbiopsytobe2acuterejectionsinⅠbdegree,3acuterejectionsinⅢadegree.Endomyocardialbiopsywereroutinelyperformed21timespostoperativelyinwhichtherewere1acuterejectioninⅠadegreeand5acuterejectionsinⅠbdegree.ConclusionsAcuterejectionisanimportantfactorinfluencingthepostoperativecourseofhearttransplantation,soitisimperativetohaveanin-time,effectiveandplannedmonitoringprocedureforacuterejection.Endomyocardialbiopsyisasensitiveandreliablemethodindiagnosisofacuterejection,butitisinvasiveandprobableforsomecomplications.Thenoninvasivemethodsuchasclinicalfeatures,ECG,ultrasonocardiographyandbloodserumtestcanbeusedasadditivemeansinthediagnosisofacuterejection.Endomyocardialbiopsyshouldbecombinedwithsomenoninvasivemethodsinmonitoringacuterejectionafterthehearttransplantation.

简介：OjbectiveTofindtheindependentpredictorsforrestenosisaftercoronarystenting.MethodsQuantitativeangiographywasperformedon60cases(67successfullydilatedlesions)afterangio-plastyover6-monthsfollow-up,andbothunivariateandmultivariatelogisticregressionanalysisweredonetoi-dentifythecorrelationsofrestenosiswithclinicalfactors.ResultsThetotalrestenosisratewas31.3%(21of67lesions),andaccordingtounivariateanalysisthepatientswhounderwentcoronarystenting≥3.5mmhadalowerrateofrestenosis(P<0.01).Collateralcirculationtotheobstructionsite,highmaximalinflationpressure,smokingandthelessminimallumendiameterafterPTCAmadetherateofrestenosishigherower(P<0.05).Multivariatelogisticregressionanalysisshowedthatcoronarystenting≥3.5mmhadalowrateofrestenosis,buthighmaximalinflationpressureandsmokingmadetherestenosisratehigher.ConclusionCoronarystentsize,maximalinflationpressureand.smokin

简介：Theoptimaldurationofdualantiplatelettherapy(DAPT)ofaspirinandaP2Y12receptorblockerafterstentingisstillbeingdebated.ThecurrentrecommendationsforDAPTdurationaresignificantlyfocusedonreducingstentthrombosis;alessfrequenteventwithlaterthanearliergenerationdrugelutingstents(DES).ApersistentoccurrenceoflateandverylatestentthrombosiswithfirstgenerationDESsupportedextendeduseofDAPTbeyondoneyear.However,recentstudieshavedemonstratedthatextendeddurationDAPTisassociatedwithincreasedbleeding;anindependentpredictorforpooroutcomes,includinglong-termmortality.Second-generationDESareassociatedwithlesslateandverylatestentthrombosis.SomerecentstudieshavesupportedashorterdurationofDAPTforsecondgenerationDES.However,thesestudieswereinadequatelypoweredtoassesssignificantdifferencesinstentthrombosis.Furthermore,extendeddurationDAPThasbeenassociatedwithareducedriskofthromboticeventsinnon-culpritvesselsinadditiontostentthrombosisinpatientswithacutecoronarysyndromes(ACS).ThehigherriskofbleedingassociatedwithextendedDAPTtherapyprovidesastrongrationaleforpersonalizedDAPTbasedonpatientriskfactors(e.g.ACSvs.non-ACS),typeofstents,andcost-benefitanalyses.

简介：Tetralogyoffallot(TOF)occursinapproximately1in5000livebirthsandaccountsfor12%-14%ofcon-genitalheartdisease.Surgicalrepairwasfirstintroducedinthe1950sandthereisnowalargepopulationofadultswithrepairedTOF.

简介：BackgroundDeepsternawoundinfection(DSWI)aftermediansternotomyforcardiacsurgeryisoneofthemostcomplexandpotentiallylife-threateningcomplications.ItsverydifficulttotreatDSWI,andthereislackofagreementregardingthebesttherapystrategy.Thus,weaimedtosummarizeourexperiencesofsurgicaltreatmentforDSWI,inwhichsatisfactoryclinicalresultswereobtained.MethodsWeretrospectivelyanalyzed17caseswhosufferedfromDSWIaftercardiacsurgeryinourdepartmentfromJanuary2010toJune2015.Therewere8maleand9femalepatientswiththeiraverageageof62.7±9.5years(range42~75years).Allpatientsreceivedreservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflaps.ResultsTheaverageintervalbetweencardiacsurgeryanddiagnosedDSWIwas10.9±6.5days(range5~21days).Timeofvacuum-assistedsuctiondrainagewas11.6±4.8days(range5~15days)andwoundhealingtimewas27.3±7.2days(range23~35days).Allpatientshadanuneventfulpostoperativerecoveryandgoodwoundhealing.Follow-uptimewas33.7±13.3months(range8~74months).Norecurrentinfectionwasobserved.ConclusionsReservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflapsisasimpleandeffectivesurgicalstrategyforthetreatmentofDSWIaftercardiacsurgery.

简介：Theetiologyofvasoplegicsyndrome(VS)isnotcompletelyelucidatedandtheclinicalimportanceremainsspeculative.MethodsTwenty-fourpatientswhounderwentcoronaryarterybypassgraftinganddevelopedVSwerecomparedwith48controlpatientswithoutVSina2:1casecontrolstudy.Casesandcontrolswerematchedbygender,age(±5yearsold)andoperationdate(±1week).ResultsTheindependentpredictorsofVSwerelowerejectionfraction(OR10.75,95%CI2.93-39.44,whenLVEF<0.45)anddiureticuse(OR8.98,95%CI2.59-31.10)inlogisticregressionanalysis.Conclusionlowerejectionfraction(<0.45)anddiureticuseareindependentriskfactorsforVSoccurrence.

简介：BackgroundVocalcordmovementdisorder(VCMD)isalaryngealdisordercharacterizedbyparadoxicaladductionofthevocalcordsduringininspiration,expirationorboth.ThenursingexperienceofpatientswithVCMDafteraorticdissectionsurgeryislimited.MethodsWeretrospectivelyanalyzedtheclinicaldataandnursingrecordsof269patientsafteraorticdissectionsurgeryinGuangdongGeneralHospitalbetweenMay2010andMay2012.Weobservedthepatients’pronunciation,andjudgediftherewasdysphagiaundergoingwaterdrinkingtesttwohoursafterextubation,toconfirmwhetherpatientshadVCMD.ResultsSeventeenpatientshadVCMDafteraorticdissectionsurgery,ofwhom2sufferedhoarseness,3haddysphasiaand12hadbothhoarsenessanddysphasia.Aftertimelytreatmentandcarefullynursing,allthepatientsrecoveredwell.ConclusionsWiththeenhancedcareofpatientswithaorticdissection,observinghoarsenessappearanceanddrinkingexperimentimmediatelyafterextubationcandetectVCMDassoonaspossible.Furtherrehabilitationtrainingandpsychologycarecanpreventbuckingandaspirationeffectively,andpromotingrecoveryandimprovingpatient’slifequality.

简介：BackgroundThoracoscopicminimallyinvasivepectusexcavatumrepair(Nussoperation)featuresitslittletrauma,simple,shortoperationtime,andgoodoutcomecomparedwithtraditionaltreatmentofpectusexcavatumsurgery-sternalelevation(Ravitchoperation)andsternalturnover.Theeffectoftheoperationonpatients’heartandheartfunctionremainsunclear.ThisstudyaimedtounderstandthechangesofelectrocardiogramandcardiacfunctionafterNussprocedure.MethodsFrom2008Januaryto2013July,thoracoscopicNussoperationwasperformedin217patientswithpectusexcavatum.Allthepatientsunderwentthepreoperative,postoperativedetectionofECGandcardiacfunctionin3monthsto1yearafteroperation.ResultsAfter3monthsto1yearfollow-up,arrhythmiaspersistedin46outof135patientswithpreoperativesymptoms(P<0.05);Strokevolumeandcardiacoutputsignificantlyincreased(P<0.05);Andcardiacparametersgreatlyimproved(P<0.05).ConclusionsMinimallyinvasiverepairofpectusexcavatumdeformitycancorrectthechestmalformation,alleviatearrhythmia,andimprovecardiacfunction.

简介：ObjectiveThecoronaryanatomicfeatureanddevelopmentafterthrombolysisinacutemyocardialinfarction(AMI)werestudied.Mehtods100patientswithAMIreceivedurokinaseandstrepokinase.Coronaryangiography(CAG)wasperformedat90minutsandagainat3to4weeks.ResultsSuccessfulthrombolysisoccurredin60cases,butfailedin40.Theratioofreperfusionwas60%.CAGshowedtherewereresidualthrombiin84patients(84%)andcompletecoronaryocclusionin40(40%).Angiographyat3to4weeksafterthrombolysisshowedthestenosisworsenedin8patientsandimprovedin10.ConclusionAMIiscausedbysuddencoronarythromboticocclusionandcanbereperfusedbyusingthrombolyticagentormechanicalmethods.Throm-bolyticagentsusuallycannotresolvethrombicompletely.Sopercutaneoustransluminalcoronaryangiography(PTCA)isrecommendedasanimportantmethodtoimproveseriousresidualstenosis.

简介：BackgroundTheimpactofincompleterevascularization(IR)onadverseoutcomesafterpercutaneouscoronaryinterventionremainsinconclusive,andfewstudieshaveexaminedmortalityduringfollow-upslongerthan5years.TheobjectiveofthisstudyistotestthehypothesisthatIRisassociatedwithhigherriskoflong-term(8-year)mortalityafterstentingformultivesselcoronarydisease.MethodsandResultsAtotalof13016patientswithmultivesseldiseasewhohadundergonestentingpro-cedureswithbaremetalstentsin1999to2000wereidentifiedintheNewYorkState'sPercutaneousCoronaryInterventionReportingSystem.Alogisticregressionmodelwasfittopredicttheprobabilityofachievingcompleterevascularization(CR)inthesepatientsusingbaselineriskfactors;then,theCRpatientswerematchedtotheIRpatientswithsimilarlikelihoodsofachievingCR.Eachpatient'svitalstatuswasfollowedthrough2007usingtheNationalDeathIndex,andthedifferenceinlong-termmortalitybetweenIRandCRwascompared.ItwasfoundthatCRwasachievedin29.2%(3803)ofthepatients.Forthe3803pair-matchedpatients,therespective8-yearsurvivalrateswere80.8%and78.5%forCRandIR(P=0.04),respectively.TheriskofdeathwasmarginallysignificantlyhigherforIR(hazardratio=1.12;95%confidenceinterval,1.01-1.26,P=0.04).The95%bootstrapconfidenceintervalforthehazardratiowas0.98to1.32.ConclusionsIRmaybeassociatedwithhigherriskoflong-termmortalityafterstentingwithBMSinpatientswithmultivesseldisease.Moreprospectivestudiesareneededtofurthertestthisassociation.

简介：ObjectivesToanalyzetheriskfactorsforrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhage(HCH).MethodsClinicaldatafrom162HCHpatientswhounderwentsurgerywereretrospectivelyanalyzedforthecorrelationbetweenrecurrenthemorrhageandgender,age,durationofhypertension,historyofdiabetesmellitusandhypercholesterolemia,siteandvolumeofhemorrhageandpost-surgicalsystolicanddiastolicpressure.ResultsPost-surgicalrecurrenthemorrhagewasfoundin24patients.Withmulti-variateregressionanalysis,historyofdiabetes,long-termhypertensionandhigherpost-surgicalsystolicpressurewereprovedpositivelycorrelatedtotheincidenceofrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhage(P<0.05).ConclusionsRiskfactorsforrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhagearehistoryofdiabetes,long-termhypertensionandhigherpost-surgicalsystolicpressure.Patientswithdiabetesandhypertensionareathigherriskforcerebralhemorrhageorpost-surgicalrecurrenthemorrhage.Effectivecontrolonbloodpressureaftersurgerycanreducetheincidenceofrecurrenthemorrhageaftersurgeryforhypertensivecerebralhemorrhage.

简介：BackgroundToinvestigatetheassociationbetweenleftventricularremodelingandstresshyperglycemia(SH)inpatientswithacuteanteriorwallmyocardialInfarction.MethodsPatientswithacuteanteriormyocardialinfarctionandasuccessfulprimarypercutaneouscoronaryintervention(PCI)wereenrolledanddividedintotwogroupsaccordingtothepresenceorabsenceofSH.Patientswithdiabetesmellituswereexcluded.Echocardiographicstudieswereperformedondischargeandat6monthfollow-up.Leftventricular(LV)ejectionfractions(EF),LVend-diastolicvolume(EDV)andLVend-systolicvolume(ESV)wereobtainedatbaselineandat6month.DifferencesbetweenchangesofESV(ΔESV)andchangesofEDV(ΔEDV)inthetwogroupsaswellasEFimprovementrate(ΔEF%)oversixmonthwereobtained.CorrelationbetweenSHandLVremodelingwasinvestigated.Results(1)Atbaseline,thelevelofhemoglobinA1cwassignificantlyhigherinSHgroup(6.9±1.4vs6.2±0.8P=0.04).Otherbaselinecharacteristics,includingpeakserumcreatinekinaseMBandLVfunction,weresimilarbetweentwogroups;(2)EFincreasedsignificantlyover6monthsinbothgroupwithSH((41.1±7.2)%vs(52.7±8.4)%,P=0.02)andgroupwithoutSH.((43.6±8.7)%vs(54.5±9.3)%,P=0.03)(3)OnlyinSHgroup,EDVincreasedsignificantlyat6month(139.6±26.7vs126.1±26.7P=0.04);(4)TherewasaweakcorrelationbetweenΔEDVandtheleveloffastingplasmaglucoseonadmission.(Pearson'sr=0.35,P<0.01).Conclusions(1)Previousglucosemetabolismdisorderisatleastpartiallyresponsibleforhyperglycemiaonadmission;(2)GivensuccessfulprimaryPCIwithinrecommendedtimeinterval,leftventricularfunctionimprovedregardlessofwhetherSHispresentornot;(3)Thedegreeofglucosemetabolicdysfunctiononadmissionisweaklyassociatedwiththeremodelingprocessin6months

简介：ObjectivesToassessfive-yearresultsaftersuccessfulpercutaneousmechanicalmitralcommissurotomy(PMMC).MethodsThirty-fourselectedpatientswithrheumaticmitralstenosisunderwentPMMCsuccessfullyinGuangdongcardiovascularinstitutebetweenFebruary2001andAugust2002.Serialechocardiogramswereperformedinallpatientsatbaseline,dischargeandannuallythereafter.ResultsFive-yearfollow-upratewas97.1%.Five-yearsurvivalratewas100%.BeforeandafterPMMCandatfollow-up,meanmitralvalveareabytwo-dimensionalechocardiographywas(0.87±0.15)cm2,(2.11±0.38)cm2and(1.81±0.36)cm2,respectively(P<0.01).Five-yearmitralrestenosisratewas6.1%.ConclusionPMMCcanachieveexcellentandsustainedlong-termresultsinselectedpatientswithmitralechocardiographicscoreexceedingorbeingequalto9.

简介：backgroundIn-hospital(IH)mortalityforpatientsunderwentpercutaneouscoronaryintervention(PCI)inourcenterfrom1994to2004was1.01%(33/3252).ThePCIvolumeinourstateincreasedquicklyduringthelastfewyears,sodiditinourcenter.MethodsandResultsWeretrospectivelyscreenedatotalof3274caseswhounderwentPCIin2009,amongwhich24(0.73%,P=0.22vs.1994-2004)IHdeathoccurred.Analysisofthese24casesrevealedthatallofthemwerediagnosedasacutecoronarysyndrome(ACS),andhadtheindicationofPCI.Fifteen(63%)carriedachanceof≥10%todieinhospitalaccordingtoGRACEmodel.Significantleft-main(LM)and/ortriple-vesseldisease(TVD)weredefinedin21(88%)cases.SYNTAXscoreswere≥23in15(63%)and≥33in12(50%)cases.CompleterevascularizationwithPCIwasfulfilledinonly5(21%)cases.Myocardialischemiaorheartfunctioncouldn'timprovebyPCIwasthemostfrequentcauseofdeath,whichcontributedtothatof11(46%)cases.Cardiacruptureoccurredinallofthe4patientswithSTelevatedacutemyocardialinfarction(STE-AMI)involvinginferiorventricularwallbut'reserved'anteriorwall,andcontributedmainlytotheirmortality.ConclusionsPost-PCIIHmortalityhasmaintainedlowinourcenter.ItmostlikelyoccursinpatientswithACS.Themajorcauseofdeathisthatmyocardialischemiacouldn'timprovebyPCI,exceptforpatientswithinferiorbutnoanteriormyocardialinfarction,whosufferfromcardiacruptureinstead.

简介：BackgroundClinicalapplicationofimplantablecardioverterdefibrillator(ICD)cansignificantlyreducetheincidenceofsuddencardiacdeath(SCD).However,ICDcannotpreventventriculartachycardia(VT)orventricularfibrillation(VF).PreviousstudiesindicatedthatICDcombinedwithreasonableanti-arrhythmicdrugtherapycanimproveanti-arrhythmiceffect.EMIAT,CAMIAandOPTICtrialsreportedthatcombinedtreatmentofAmiodaroneandβreceptorblockerswassuperiortotheirtreatmentalone.Therefore,itisnecessarytogiveanti-arrhythmictreatmentafterICDimplantation.MethodsTotally180ICDimplantationrecipientsenrolledinourhospitalfromJan2011toMarch2014.Amongthem,39recipientsweretreatedwithAmiodarone(GroupA),89recipientsweretreatedwithβblocker(GroupB),and52recipientsweretreatedwithAmiodaronecombinedwithβblocker(GroupC)afterICDimplantation.Patientswerefollowedupfor3to40monthsbymonitoringtheheartrate,LVEFValueandrapidventriculararrhythmiasevents.ResultsTherewerenosignificantdifferencesonheartratebeforeandafterICDimplantationamongthethreegroups(P=1.28,P=0.85),butthechangeofheartratewasstatisticallyhigher(P=0.04)inGroupBcomparedwithGroupAandGroupC.TherewerenostatisticalsignificanceinLVEFvaluebeforeICDimplantationandafterICDimplantationandthechangeofLVEFvalue(P=0.56,P=0.50,P=0.99).TheoccurrencerateofrapidventriculararrhythmiasinGroupA(10.26%)andGroupB(10.11%)wassignificantlyhigher(P=0.04)thaninGroupC(1.92%).whichwaeslightlyincreasedbyAmiodaroneinGroupAandGroupC.Therewere2casesofthyroiddysfunctioninGroupA,1caseinGroupCandnocaseinGroupB.Nopulmonaryinterstitialfibrosiscaseswerefoundinthisstudy.ConclusionsCombinedtreatmentwithAmiodaroneandβreceptorblockerscouldsignificantlyreducerapidventriculararrhythmiaswhencomparedwithtreatmentofAmiodaroneorβblockeralone.

简介：ObjectivesTostudytherelationshipbetweenplasmaBNPandcardiacstructural,functionalchangesafterAMI,andtoevaluatetheapplicationofplasmaBNPdeterminationinpredictingtheearlyphaseofventricleremodelingafterAMI.MethodsAMIgroupincluded37patients,allpatientunderwentstrictmedicaltreatment;32healthyindividualswereenrolledascontrols.PlasmaBNPwasdeterminatedbyimmunofluorescence.EchocardiogramexaminationwasusedtodeterminateLVEF,V_E,V_A,V_E/V_A,LVEDd,LVEDV;Allpatientsunderwenttheexaminationsat72h,30daysand90daysafterAMIoccurred,respectively,andwerecomparedwithhealthycontrols.ResultsIncomparingtocontrols,PlasmaBNPinAMI72h,30daysand90dayselevatedsignificantly.LVEDdandLVEDVwereincreasedsignificantlyinall3phasesofAMI,andEF,V_E/V_Aweresignificantlylowerthanincontrols.CorrelationanalysisrevealedthatplasmaBNPlevelin72hafterAMIwaspositivelycorrelatedtoLVEDd,LVEDV,andwaspositivelycorrelatedtoEF,V_E/V_Ain30daysand90daysafterAMI.ConclusionsPlasmaBNPlevelin72hafterAMIisapowerfulindextopredictleftventricleremodelingandventriclefunctionasplasmBNPlevelispositivelycorrelatedtoventricleremodeling;loweringtheplasmBNPlevelmightbeusedasanendpointfortreatmentofheartfailure.

简介：ObjectivesToinvestthesuccessprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvessels.Methods290patientswithselectedoremergencystentimplantationinsmallvesselsfromApril,1997toMarch,2002.Total299vessels,304lesionsand316stentswerestatisted.Thesuccesssrateofprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvesselswereassessed.Thepatientswerefollowedup1monthto4years.Re-catheterangiographyweredonein122/290patients.ResultsThenarrowrateoflesiondroppedfrom89%±12%beforeprocedureto5%±5%afterprocedure(diameter).202patientswerefollowedup1month(69.7%).197/202casesweresurvival.5/202casesdiedin3hrsto7days.2/5casesdiedofpersistenthypotensionafterprocedure.1/5casediedofacuteleftheartfailure.2/5casesdiedofsuddendeath.180caseswerefollowedup5monthsto4years.Thenon-eventsurvival(NES)ratewas73.3%(132/180).There-angiographyweredonein122cases.Restenosishappenedin39cases(30.3%).37patientsrepeatedPCI.2patientswenttoCABG.2casesgotanginarecurrenceandwereprovedsecondtimerestenosisbyre-angiography.ThethirdtimePCIwasdonein1patient.TheotherpatientswenttoCABG.1casediedofchronicheartfailureafter2years.1casesufferedacutemyocardialinfarctiononarterystentimplanted.ConclusionsTherearehighsuccessrateofprocedureandperfectimmediateoutcomeinstentplacementinsmallvessels.Mainadversecardiaceventsdidnotincreased.Non-eventsurvialwassatisfiedinlongtermfollow-up.Restenosisratewasshowedslightlyhigherthantheoneofmainvessels.