Objective To investigate clinical characteristics of patients with ST-elevation myocardial infarction (STEMI) and hypokalemia and the effects of hypokalemia on prognosis. Methods Consecutive 216 cases with STEMI who underwent emergency PCI were divided into group A (serum potassium ＜ 3.5 mmol/L) and group B (serum potassium＞3.5 mmol/L). Infarct site, infarct interrelated artery, peak level of CK-MB and cTnT were compared between two groups. Post-infarctional angina pectoris, arrhythmia, heart failure and cardiac death were compared. Results (1 )The percentage of anterior wall myocardial infarction , left anterior descending artery (LAD) lesions in group A were significantly higher than those in group B [61.2%(41/67) vs. 44.3%(66/149),55.2%(37/67)vs. 38.9%(58/149),P = 0.022,0.026]. The peak levels of CK-MB and cTnT in group A were significantly higher than those in group B [(194.39 ± 101.27) μg/L vs. (115.35 ±78.62)μg/L,(19.16 ±11.48)μg/L vs. (9.07 ±7.65) μg/L,P = 0.004,0.002].(2)Left ventricular ejection fraction in group A was significant lower than that in group B (P - 0.003). The incidence rates of post-infarctional angina pectoris, ventricular tachycardia, ventricular fibrillation and heart failure were significantly higher in group A [43.3%(29/67),32.8%(22/67), 11.9%(8/67),37.3%(25/67)] than those in group B [24.8%(37/149),18.1%(27/149),4.0%(6/149),20.8%(31/149)](P = 0.006, 0.017, 0.029, 0.010). Conclusions Hypokalemia is associated with infarct site and infarct interrelated artery. Hypokalemia has bad effect on prognosis of STEMI.

AIM: To elucidate the effect of ginsenoside Rb1 (Gs-Rb1) on the glucose metabolism to improve the viability of the cardiomyocytes under hypoxia, and whether hypoxia-inducible factor 1α(HIF-1α) and/or AMPKαare involved in the process.METHODS: The neonatal rat cardiomyocytes were cultured, and randomly divided into control group, hypoxia (1% O2 , 94% N2 and 5% CO2 ) group, Gs-Rb1 (200 μmol/L) group, Ara-A (500 μmol/L) group, Gs-Rb1 +Ara-A group, YC-1 (5 μmol/L) group, Gs-Rb1 +YC-1 group, Ara-A +YC-1 group and Gs-Rb1 +YC-1 +Ara-A group.After the intervention for 8 h, the cell viability was analyzed by MTT assay.The protein levels of AMPK, HIF-1αand glucose transporter-4 (GLUT-4) were determined by Western blot.The activities of heterophosphatase (HK), phos-phofructokinase (PFK) and lactic dehydrogenase (LDH) were measured by ELISA.RESULTS: Gs-Rb1 significantly im-proved the viability of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 and Ara-A.In addition, YC-1 and Ara-A had a synergistic effect.Gs-Rb1 increased the protein levels of AMPK and HIF-1αin the hypoxic cardiomyo-cytes, which was significantly inhibited by Ara-A and YC-1.Gs-Rb1 significantly increased the expression of GLUT-4 on the cytomembrane of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 or Ara-A, especially Ara-A +YC-1.Gs-Rb1 significantly increased the activities of HK, PFK and LDH, all those were significantly inhibited by YC-1 or Ara-A.Besides, YC-1 and Ara-A had a synergistic effect.CONCLUSION: Gs-Rb1 improves the viability of hypoxic car-diomyocytes, which may be related to the regulation of glucose uptake and enhancement of glycolysis by synergy of both
HIF-1αand AMPK.

Objective To study whether the contrast volume and radiation dose can be reduced by automated contrast injection system(ACIS) in coronary angiography compared with manual contrast injection system(MCIS).Methods 200 patients undergoing coronary angiography with transradial approach in the People′s Hospital of Liaoning Province were enrolled in the study from January 2016 to June 2016.They were divided into the ACIS group (n=100) and the MCIS group (n=100).The clinical data, the net amount of contrast the total amount of contrast media consumed, number of angiographic views performed, fluoroscopy time, air kerma (AK) and dose area product (DAP) of the two groups were statistically analyzed.Results There were no statistical differences in the clinical data, the net amount of contrast used, number of angiographic views performed and fluoroscopy time between the two groups (all P>0.05).The total amount of contrast media used, AK, and DAP were less in the ACIS group than in the MCIS group (all P<0.05).Conclusions The volume of contrast consumption and radiation dose can be reduced by ACIS during coronary angiography with transradial approach compared to MCIS.

OBJECTIVETo assess the complications of percutaneous tansluminal septal myocardial ablation (PTSMA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).

METHODSSeventy-two patients with symptomatic left ventricular outflow tract obstruction were diagnosed by echocardiography or catheterization procedures. Absolute ethanol was injected into the target coronary artery branch (branches) for septal myocardial ablation. Documented complications were recorded.

RESULTSSixty-nine patients had severe chest pain, 19 developed different degrees of heart block during the periprocedural period, but only one developed a complete AV block, requiring permanent pace-maker implantation. Temporary right bundle branch block occurred in 50% of patients and permanent block occurred in 38.9% of patients. Acute inferior myocardial infarction occurred in six patients (8.3%) and acute anterior myocardial infarction occurred in one patient. During two-year follow-up of 24 cases, there were no deaths. All patients had improvement in heart function and none experienced heart failure.

CONCLUSIONThe most common complication of PTSMA is right bundle branch block. The most significant complication of the procedure is heart block. PTSMA is a good technical, non-surgical treatment for HOCM.

Adolescent ; Adult ; Arrhythmias, Cardiac ; etiology ; Cardiomyopathy, Hypertrophic ; surgery ; Catheter Ablation ; adverse effects ; Female ; Heart Block ; etiology ; Heart Septum ; surgery ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Postoperative Complications ; etiology

Objectives:To investigate the prognostic value of soluble growth stimulation expressed gene 2 protein(sST2)combined with N-terminal pro-brain natriuretic peptide(NT-proBNP)in patients with ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PCI). Methods:A total of 206 patients who were diagnosed with STEMI for the first time and underwent emergency PCI from August 2020 to February 2021 in the People's Hospital of Liaoning Province were enrolled.Patients were followed up for 3 years and divided into major adverse cardiac event(MACE,a composite endpoint event including cardiac death,stroke,heart failure,and ischemia-driven revascularization)group and MACE-free group.Multivariate cox analysis was performed to determine the independent risk factors for the prognosis of primary PCI in STEMI patients;the predictive value of sST2 and NT-proBNP for the occurrence of MACE in STEMI patients undergoing primary PCI was assessed by ROC analysis and the prediction of MACE by each factor by itself and the combined variables was analyzed with the Delong test. Results:There were 62 cases of MACE during the 3-year follow-up.Compared with the MACE-free group,patients in the MACE group had higher levels of sST2 and NT-proBNP,higher proportion of patients with left anterior descending branch lesions,anterior wall myocardial infarction,lower LVEF,and higher proportion of coronary artery slow flow(all P<0.05).Multivariate Cox analysis showed that sST2(HR=1.018,95%CI:1.012-1.024,P<0.001)and NT-proBNP(HR=1.001,95%CI:1.000-1.010,P<0.001)were independent predictors of MACE.According to the statistical analysis of ROC and Delong test,the AUC of combined sST2 and NT-proBNP in predicting MACE was 0.854,the sensitivity was 64.5%,the specificity was 93.1%,and the combined prediction of prognosis was better than that of individual prediction,with statistically significant difference(Z=2.119,P=0.034;Z=2.178,P=0.029). Conclusions:Serum sST2 and NT-proBNP are valuable predictors of MACE after emergency PCI in patients with STEMI,and the predictive efficacy increases with combined assessment of both sST2 and NT-proBNP.