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简介：BackgroundTotheeffectofpercutaneouscoronaryintervention(PCI)onplasmalevelofN-terminalpro-Btypenatriureticpeptide(NT-proBNP)inpatientswithcoronaryheartdisease(CHD)andnormalleftventricularfunction.MethodsOnehundredandfivepatientswithCHDandnormalventricularfunctionwereenrolled.BloodsamplesforassessmentofNT-proBNPandcTn-TwerecollectedbeforeandafterPCI.ResultsThemeanleftventricularejectionfractionwas60.3±5.3%.Afterrevascularization,theleveloflgNT-proBNPwassignificantlyreduced(2.40±0.44vs2.23±0.43,P<0.001).SubgroupanalysisshowedthattheleveloflgNT-proBNPwasconsistentlydecreasedindifferentclinicalclassifications(stableangina45,unstableangina31andacutemyocardialinfarction29)andtarget-vesselrevascularization(leftanteriordescendingartery30,leftcircumflexartery26andrightcoronaryartery49),andin99patientswithoutelevationofpost-proceduralcTnT,butitshowedatrendofnon-significantincreasein6patientswithelevatedcTn-T.ConclusionsOurstudydemonstratesthatsuccessfulPCIreducesplasmaNT-proBNPconcentrationinpatientswithCHDandnormalventricularfunction.ThisimplicatesthattheimpactofPCIshouldbeconsideredintheinterpretationofNT-proBNPchangeinclinicalpractice,andfurtherstudiesarenecessarytoinvestigatethedirectand/orindirecteffectofmyocardialischemiaonBNP/NT-proBNP.

简介：这研究试图决定血浆睾丸激素是否在经历了选任的冠的angiography的一组803个人与冠的动脉粥样硬化的严厉被联系。睾丸激素层次在根据睾丸激素水平tertiles被分成三个组的803个男病人被测量。所有病人经历了选任的冠的angiography，并且冠的动脉疾病(CAD)的严厉被Gensini分数决定。而且，病人们根据Gensini分数被分类进二个组(20≤；26和20>；26)用是的中部的价值，截止指。血浆睾丸激素层次被一个ELISA工具包测量。睾丸激素的水平否定地与Gensini分数被联系(r=−；0.188；P=0.000)。多重线性回归分析表明那睾丸激素是为Gensini分数的一个独立风险因素(β；=−；0.110；P=0.002)在为使covariates惊讶调整以后。在multivariate逻辑回归模型，CAD的严厉被显示在第三tertile显著地更低(最高)与第一tertile相比的睾丸激素(最低)睾丸激素(机会比率(或)=0.465；95%；信心间隔(CI)：0.327-0.662；P=0.000)。在这研究，有更低的睾丸激素层次的病人在经历了选任的冠的angiography的一组803个人有更高的Gensini分数。另外的研究被需要澄清诱发性和可能的位于\O下面机制的方向。

简介：BackgroundComparedwiththeopensaphenousveinharvesting(OVH),thereisalargerdecreaseinincisioncomplicationsofendoscopicveinharvesting(EVH).Fewerstudieswereconductedtoevaluatethequalityofgreatsaphenousvein(SVG)harvestingbythesetwomethods.Toapplytransittimeflowmeasurement(TTFM)toSVGgraftsincoronaryarterybypassgrafting(CABG),weproperlyevaluatethequalityofSVGandsurgicaleffect.MethodsFromJanuary2012toAugust2012,38casesunderwentEVHand16casesunderwentOVH.Werecordedpulsatilityindex(PI),meangraftflow(MGF)anddiastolicflow(DF)ofSVGgraftsforstatisticalanalysis.ThedysfunctionalgraftsdiagnosticcriteriaisPI>5,MGF<10mL/minorDF<50%.ResultIntermsofSVGgrafts,nosignificantdifferenceexistedinthelengthoftwogroups(P=0.2395).EVHgroupharvestingtimewaslongerthanOVHgroup(P=0.0113),buttheincisionlengthofEVHgroupwasshorter(P=0.0000)anditneededlesssuturetime.EVHgrouppresentednosignificantdifferencesinincisioncomplicationratefromOVHgroup(P=0.7055)within1monthaftersurgery.TTFMdataofwellfunctioninggraftshadnosignificantdifferenceinthetwogroups(PI3.2±1.0vs.2.9±0.9,MGF34.7±20.4vs.36.3±19.2mL/min,DF66.3%±10.6%vs.68.5%±10.3%).Therewasnosignificantdifferenceintherateofdysfunctionalgraftsintwogroups(P=0.7954)aswell.Thecausefordysfunctionalgraftsisanastomoticstricture.Were-anastomosedthegraftswithsatisfactoryeffect.ConclusionEVHisasafeandrecommendableoptionalSVGharvestingmethods.ThesurgicaleffectandthequalityofSVGgraftscanbereasonablyevaluatedbyTTFM.

简介：BackgroundPreviousstudieshavesuggestedthatpatientswithlowendothelialprogenitorcell(EPC)countsandimpairedendothelialcolonyformingactivityhaveahigherincidenceforcardiovasculareventscomparedtopatientswithhighEPCcountsandfavorablecolonyformingactivity.ThepathophysiologicalbasisforthisfindingmaybeaninsufficientendothelialcellrepairbyEPC.TheobjectiveofthisstudywastodeterminewhetherthenumberofEPCsinperipheralbloodwasassociatedwiththepresenceandseverityofangiographicstenosisinpatientsofthelatephaseafteracutemyocardialinfarction(AMI).MethodsOnehundredandonepatientsundergoingcardiaccatheterizationinourhospitalwereenrolledinthestudy.ThenumberofcirculatingEPCswasmeasuredbyafluorescent-activatedcellsorter(FACS).Patientswithacutecoronarysyndromeswereexcluded.ResultsComparedwithpatientswithnormalcoronaryartery,thenumberofcirculatingEPCswassignificantlyreducedamongpatientsinthelatephaseafterAMI(P<0.01).Wealsofoundthatcomparedwiththecontrolgroup,thenumberofEPCsofsingle-vesselstenosisgroupandmulti-vesselstenosisgroupweresignificantlyreduced(P=0.005;P=0.001).ConclusionsThenumberofEPCsintheperipheralbloodisdecreasedinpatientsofthelatephaseafterAMI.TheEPCsnumbercorrelatedwithangiographicstenosisseverity,whichsuggeststhatendothelialinjuryinthedeficientcirculatingEPCsmayaffecttheseverityoftheheartdisorderandtheclinicalpresentations.

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简介：BackgroundAfterpercutaneouscoronaryintervention(PCI),somepatientsmaysufferfromrestenosisandstentthrombosis.Manystudiessuggestthatendothelialprogenitorcell(EPC)hasanimportantroleinpreventingrestenosisandstentthrombosis.AnovelstentwhichcanattractEPChasbeendesignedtoprovideabetteroutcomefortheseproblems.MethodThedataofthepresentreviewwasobtainedbysearchingPUBMEDandotherdatabases(1994-2011)usingthekeytermsof'endothelialprogenitorcell','reendothelialization','restenosis','stentthrombosis',and'percutaneouscoronaryintervention'.ResultRapidreendothelializationisessentialinpreventingrestenosisandstentthrombosis.EPCcandifferentiateintoendothelialcellandacceleratethereendothelialization.Afternumerouspreclinicalandclinicalresearches,thecorrelationbetweencirculatingEPCstorestenosisstillremainspoorlyunderstood.However,manystudieshaveshowntheimportantroleofEPCindiminishingtheriskofthrombosisfollowingstentimplantation.Somepharmacologicalagentshavebeenreportedcanincreasethenumberand/orfunctionsofEPC.Recently,CD34+antibodycoatedstenthasbeendevelopedtoattractEPCtothehealingendothelium,andhasshowedfavorableresults.ConclusionEPChasimportantroleinrapidreendothelializationaftervascularinjury.EPCcanpreventstentthrombosisafterPCI,howevertheeffectsofEPCinpreventingrestenosisneedfurtherinvestigations.ThecapturingCD34+stentissafeandsignificantlydecreasesstentthrombosis.

简介：BackgroundAnomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery(ALCAPA)isararecongenitalanomaly.Itdemonstratedthecombinedeffectsoftheabsenceofanormalcoronaryflowwithacoronarystealandtheprofoundischemiathatcanproduceleftventriculardysfunctionandmitralregurgitation.Wehereintroducethepostoperativemanagementofpatientswithrepairofanomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery,withanemphasisonitsoutcome.MethodsRecordsof31patientswithanomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryreceivingsurgeryfrom1998to2010werereviewedretrospectively,10ofwhichweretreatedwiththemitralvalvesurgicallyatthesametime.Theageofpatientswas4monthsto16years(median,1year)andweightofthosewas5to53kilograms(median,7.8kilograms),allofwhichwerediagnosedofanomalousoriginoftheleftcoronaryarteryfromthepulmonarybyechocardiographyandcardiaccatheterization.Aftersurgery,electrocardiogram,echocardiography,arterialbloodpressure,transcutaneousoxygensaturationandcentralvenouspressureweremonitored.Commonpostoperativecomplicationsinourgroupwereanalysed.Andpreoperativeandpostoperativedataincludingareaofmitralregurgitation,leftventricularsystolicdiameterandleftventriculardistolicdiameterwereobtained.Cardiopulmonarybypasstimeandmechanicalventilationtimeofpostoperativepatientswithnopneumoniawerecomparedwiththosewithpneumonia.Binarylogisticregressionwasappliedfortheanalysisoftheriskfactorsofpostoperativepneumonia.ResultsOf31patients,30survivedaftersurgerywithearlymortalityof3.23%.Onepatientdiedofseverelowcardiacoutputsyndrome.Mechanicalventilationtimewas4hoursto168hourshours(mean,39.68±50.52hours;median,18hours).ICUstaywas16hoursto425hours(mean,111.65±127.03hours;median,44hours).Inourgroup,commonpostoperativecomplicationsweremyocardialischemia(n=12,36.4%),infection(n=

简介：BackgroundAnomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryisararecongenitalcardiaclesionresultinginmyocardialischemiaeveninfarction,morphologicalimpairmentanddysfunctionofleftventricle,togetherwithmitralregurgitation.Herewewillintroduceourexperienceinthesurgicalrepairofthiskindofcongenitallesionandtheretrospectiveanalysisabouttheimprovementofleftventriculardimensionandmitralregurgitationinearlypostoperativeterm.MethodFromMay1998toJuly2012,38consecutivepatientswithanomalouscoronaryarteryfromthepulmonaryarteryunderwentsurgicalcorrection(33receivedleftcoronaryarteryre-implantation,4leftcoronaryarteryligationorprimaryclosure,1Takeuchiprocedure,and10simultaneousmitralvalveplasty).Leftventriculardimension,mitralregurgitation,andejectionfraction,weremeasuredbycolorDopplerechocardiographypreoperatively,and1monthafterdischarge.ResultsHospitalsurvivalwas94.7%(2in-hospitaldeaths).Tenpaptientswithmorethanmoderatemitralregurgitationreceivedsimultaneousmitralplasty,oneofwhomwasconvertedtomechanicalprostheticvalvereplacement.Mitralvalveannuloplastywasappliedin9casesofcoronaryre-implantationcorrection,3ofwhomalsoreceivedadditionalmitralleafletcleftrepair.Meanwhile8patientsunderwentotherdifferentconcomitantoperations.Echocardiographicresultsforthesurvivals1monthafterdischargeshowedthatleftventricularend-diastolic,endsystolicdimensiondecreasedfrom40.05±5.56mmand28.94±6.21mmto33.07±6.82mm(P<0.01)and23.04±5.87mm(P<0.01)respectively.Theaveragemitralregurgitationgradewasalsoreducedfrom2.36±1.08to1.64±93(P<0.05)inthegroup.AllsurvivalpatientsimprovedclinicallyandNYHAfunctionalclassdecreasedsignificantlyfrom2.37±1.08to2.10±0.54(P<0.05).ConclusionsThesurgicalrepairofanomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryissafeandeffective,andcange

简介：BackgroundIntra-aorticballoonpump(IABP)hasbeenwidelyusedatpresent.Wecanuseitatdifferentstagesofperioperativeperiodinoff-pumpcoronaryarterybypassgrafting(CABG).However,whentouseditwasseldomconfirmed.MethodsFromJanuary2008toJune2012,the89coronaryheartdisease(CHD)patientsacceptedimplantationofIABPatdifferentstagesofoff-pumpCABG,preoperativeandpostoperativeventricularsystolicfunction,leftventricularremodelingsituationandthechangesofmyocardialenzymeswereevaluated.ResultsAllthepatientshadleftheartinsufficiencyandmultivesseldisease.TheirpostoperativeleftventricularsystolicfunctionandventricularremodelingweresignificantlyimprovedwhilemyocardialenzymesdecreasedwithpreoperativeinterventionalimplantationofIABP.Theperioperativemortalitywas7.86%(7/89).NopatientshadcomplicationofIABP.ConclusionEarlierIABPimplantationatpreoperationisusefultoimproveheartfunction,improvethetolerabilityofsurgery,reducetheincidenceofpostoperativelowcardiacoutputsyndrome(LCOS)anddecreasethemortality.