简介：ObjectiveFortycasesofIAMIwereexaminedwithcoronaryangiographyinordertostudytherelationshipofthevesselswiththeECGofIAMI.MethodsForcoronaryangiographyJudkin’smethodwasused;IAMIwasdiagnosedbythe1979WHO’sstandardofISHDandECGwasseparatelymeasuredbytwodoctors.ResultsMostofIAMIwithpolybranchcoronaryoritscollateraldisease(32.5%and42.5%)andonly10cases(25%)withsinglebranchcoronarydisease,whoseECGswereuntypical.ConclusionIAMIwithsingle-branchcoronarydiseasemightexpressasmildsymptomsandhavenotypicalECGchange.WhiletypicalECGchangeemerges,thecoronaryarteryalwaysshowedpoly-branchdiseaseorcollateralbranchobstructionandthediseasewouldbeadvanced.ItisimportanttopaymoreattentiontothecasesofIAMIwithoutclassicECGchangesoastogivediagnosisandtreatmentthemintime.

简介：Depression/anxietyiscommonlypresentinpacedpatientsandisassociatedwithincreasedcardiovascularmorbidityandmortality.Thehighprevalenceofdepression/anxietyinpacedpatientssupportsastrategyofincreasedawarenessandtreatmentfordepression/anxietyinpacedpatients.Health-relatedqualityoflife(HRQoL)isbeingincreasinglyconsideredasanexpectedout-comeoftherapeuticinterventionsandrehabilitationprogramsinclinicalcardiologyincludingpatientsbeforeandafterpacemaker(PM)implantation.Thismultispecialtyconsensusdocumentreviewstheevidencelinkingdepression/anxietywitharrhythmiaandcardiacpacing;HRQoLandcardiacpacing,atthesametime,providesrecommendationsforhealthcareprovidersforthetreatmentofdepression/anxiety.

简介：ObjectivesToinvestigatethecauses,theraputicandpreventivemethodsofcomplicationsassociatedwithtranscatheterocclusionofatrialseptaldefect(ASD)usingtheAmplatzerseptaloccluder(ASO)inchildren.Methods289casesunderwenttranscatheterclosureofASDwithASO.Complicationsoccurredin9cases.Thecomplicationsinprocedureincludedsystemiccirculatorysystemicairembolismin2,pulmonaryairembolismin1,pericardialtamponadein1,ASOmalpositionrequiringemergencysurgicalremovalin1,transientatrialextrasystolesin1andsizingballoonrupturein1case.2caseswithpostoperativecomplicationswerefoundinthefollow-upstudies.TheseincludedperforationofmitralvalveandASOpartiallydislodged.Inthisstudy,5childrenwithintraoperativecomplicationreceivedemergencytherapyincludingsurgicalintervention,andothersneededonlyfollow-up,asthecomplicationsweretransientorasymptomatic.ResultsTherewerenochildrendeathinthisstudy.The5caseswhoreceivedtreatmentwerecompletelyhealing,andtheotherswithintra-procedurecomplicationswerealsohadnosequelaexisted.CaseswithmitralvalveandASOpartiallydislodgedwerestillinfollow-upstudies,asthe2patientshavingnosymptoms.ConclutionsAirembolismwereoccurredeasilyinatrialseptaldefectcaseswhoreceivedASOtherapy.Complicationsmainlycausedbyinappropriateoperativeprocedureandsomecomplicationsneededemergencytreatments.Follow-upstudieswereimportanttocaseswithtranscatheterocclusiontherapy.

简介：ObjectivesToinvestigatetherelatedpathogenicfactorsofhypertensionaffectingthemiddle-agedinsuburbanareasinMudanjiangCityandfurtherpopularizehealtheducationwithregardtohypertension.MethodsAsurveywasconductedon858middle-agedpeopleof35to59yearsoldfromsuchsuburbanareasasJinglongvillage,BadavillageandFengshouvillagebyadoptingthehypertensivedefinitionandclassifyingstandardofanWHO/ISHhypertensivetreatmentguidancein1999.ResultsPositivecorrelationwasshownbetweenoccurrenceofhypertensionandsuchelementsasdietinexcesssalt,drinking,obesity,smoking.ConclusionsItisofgreatclinicalsignificancetocombatandpreventthehypertensionbyregulatingone'sdietandlifestyle.

简介：BackgroundThiazolidinediones(TZDs)notonlyimproveinsulinresistance,loweringbloodsugar,alsohasanti-atheroscleroticeffect.However,whethertheprotectiveeffectoncardiovascularpioglitazoneisstillcontroversial.MethodsTotally98patientswithcoronarydiseaseanddiabetesmellituswererandomlydividedintopioglitazonegroup(n=48)receivingconventionaltherapyandpioglitazone(15mg/day),andcontrolgroup(n=50)merelyreceivingconventionaltherapy.Thepatientswerefollowedupfor12months.TheplasmalevelofPlasminogenactivatorInhibitor1(PAI-1)andP-selectinweredetectedatbaselineandaftertreatmentfor12monthsbyELISA,andmajoradversecardiacevents(MACE)werestudied.ResultsPioglitazonetherapyfor12monthswasassociatedwithasignificantdecreaseofPAI-1[(7.9±1.4vs4.2±0.5)ng/mL,P<0.05]andP-selectin[(16.6±6.8vs12.4±3.6)ng/mL,P<0.05],MACEwassignificantlylowerinthepioglitazonegroupthaninthecontrolgroup[acutecoronarysyndrome(ACS):32.0%vs10.4%,P<0.05;targetvesselrevascularization:22.0%vs6.3%,P<0.05].ConclusionsPioglitazonecaneffectivelyreducetheplasmalevelofPAI-1,P-selectinandtheoccurrenceofMACEinpatientswithcoronaryheartdiseaseanddiabetesmellitus.

简介：ObjectivesThelong-termbenefitoflatereperfusionofinfarct-relatedartery(IRA)afteracutemyocardialinfarction(AMI)iscontroversial,andthebenefitmechanismsremainuncertain.Lowdosedobutaminestressechocardiography(LDSE)canidentifyviablemyocardiumandpredictimprovementofwallmotionafterrevascularization.MethodsSixty-ninepatientswithfirstAMIwhodidnotreceivedearlyreperfusiontherapywerestudiedbyLDSEat5to10daysafterAMI.Wallmotionabnormalityandleftventricularsizeweremeasuredatthesametime.SuccessfulPCIweredoneinallpatientsat10to21daysafterAMIonset.Patientsweredividedintwogroupsbasedonthepresenceorabsenceofviablemyocardium.Echocardiographywasrepeatedsixmonthslater.ResultsTherewere157motionabnormalitysegments.89segments(57%)wereviableduringLDSE.26patients(38%)withviabilityand43(62%)without.Inviablegroup,leftventricularejectionfraction(LVEF)wasincreased(P<0.05),andleftventricularendsystolicvolumeindex(LVESVI)andwallmotionscore(WMS)weredecreased(P<0.05andP<0.01)significantlyat6monthscomparedwithbaseline.Butinpatientswithoutviability,LVEFwasdecreased(P<0.01),andLVESVIandleftventricularenddiastolicvolumeindex(LVEDVI)wereincreased(P<0.05)significantlyafter6months,andtheWMSdidnotchanged(P>0.05).LVEFincreased(P<0.05)andWMSdecreased(P<0.05)onLDSEduringacutephaseinpatientswithviability,buttheywerenotchangedinthenonviablegroup.ConclusionsLaterevascularizationofIRAinpatientswithpresenceofviablemyocardiumafterAMIisassociatedwithlong-termpreservationleftventricularfunctionandlessventricularremodeling.ImprovementofleftventricularsystolicfunctiononLDSEindicateslatephaserecoveryofleftventricularfunctionafterlaterevascularization.

简介：BackgroundDespiteobservationssuggestingabenefitforlateopeningoftotallyoccludedinfarct-relatedarteriesaftermyocardialinfarction,theOccludedArteryTrial(OAT)demonstratednoreductioninthecompositeofdeath,reinfarction,andclassIVheartfailureovera2.9-yearmeanfollow-up.Follow-upwasextendedtode-terminewhetherlatetrendswouldfavoreithertreatmentgroup.MethodsandResultsOATrandomized2201stablepatientswithinfarct-relatedarterytotalocclusion>24hours(calendardays3-28)aftermyocardialinfarction.Patientswithsevereinducibleischemia,restangina,classⅢ-Ⅳheartfailure,and3-vessel/leftmaindiseasewereexcluded.Weconductedextendedfollow-upofenrolledpatientsforanadditional3yearsfortheprimaryendpointandangina(6-yearmediansurvivorfollow-up;longest,9years;12234patient-years).Ratesoftheprimaryendpoint(hazardratio,1.06;95%confidenceinterval,0.88-1.28),fatalandnonfatalmyocardialinfarction(hazardratio,1.25;95%confidenceinterval,0.89-1.75),death,andclassIVheartfailureweresimilarforthepercutaneouscoronaryintervention(PCI)andmedicaltherapyalonegroups.Nointeractionsbetweenbaselinecharacteristicsandtreatmentgrouponoutcomeswereobserved.Thevastmajorityofpatientsateachfollow-upvisitdidnotreportangina.TherewaslessanginainthePCIgroupthroughearlyinfollow-up;by3years,thebetweengroupdifferencewasconsistently<4patientsper100treatedandnotsignificantlydifferent,althoughtherewasatrendtowardlessanginainthePCIgroupat3and5years.The7-yearrateofPCIoftheinfarct-relatedarteryduringfollow-upwas11.1%forthePCIgroupcomparedwith14.7%forthemedicaltherapyalonegroup(hazardratio,0.79;95%confidenceinterval,0.61-1.01;P=0.06).ConclusionsExtendedfollow-upoftheOATcohortprovidesrobustevidencefornoreductionoflong-termratesofclinicaleventsafterroutinePCIinstablepatientswithatotallyocclud