Objective To explore the effect of atorvastatin on high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in unstable angina pectoris (UAP) patients after intervention.Methods Eighty cases with UAP who underwent percutaneous coronary intervention (PCI) were divided into group A and group B by random digits table method with 40 cases each after PCI.The patients in group A were given regular heart treatment and atorvastatin 20 mg treatment.The patients in group B were given regular heart treatment and atorvastatin 40 mg treatment.The serum hs-CRP and IL-6 was determined before treatment and 24 h,3 weeks after treatment and compared between two groups.Results There was no significant difference in the serum hs-CRP and IL-6 before treatment between group A and group B [(5.6 ± 1.2) mg/L vs.(5.6 ± 1.1) mg/L and (211.9 ± 21.2) ng/L vs.(209.6 ± 19.9) ng/L,P ＞ 0.05].The serum hs-CRP and IL-6 24 h after treatment in group A and group B were increased compared with that before treatment,and there was significant difference(P ＜ 0.05),but there was no significant difference between group A and group B[(8.1 ± 1.1) mg/L vs.(8.5 ± 1.2) mg/L and (311.1 ± 20.9) ng/L vs.(313.3 ± 18.5) ng/L,P＞ 0.05].The serum hs-CRP and IL-6 3 weeks after treatment in group A and group B were decreased compared with that before treatment,there were significant difference (P ＜ 0.05),and there were significant difference between group A and group B [(3.1 ± 1.1) mg/L vs.(1.9 ±0.8) mg/L and (163.3± 18.5) ng/L vs.(123.3± 19.5)ng/L,P ＜ 0.05].No obvious adverse reaction was observed in two groups after treatment and liver function was not seen obvious anomaly.Conclusions Atorvastatin treatment in UAP patients after PCI can significantly reduce the serum hs-CRP and IL-6,and the 40 mg treatment is better than the 20 mg treatment.It is worth of clinical application.

Objective To compare the efficacy and safety between Bivalirudin and Heparin during emergency percutaneous coronary intervention(PCI)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods Retrospective analysis of 80 patients diagnosed with ST-segment elevation myocardial infarction in elderly patients was conducted.The treatment group(n=40) received a bolus intravenous injection of Bivalirudin 0.75 mg/kg before emergency percutaneous coronary intervention,then 1.75 mg · kg 1 · h-1 continuous intravenous drip till the end of the operation from March 2011 to March 2015.Activated clotting time (ACT)was detected at 10 minutes after drug application.If ACT＜225 s,0.3 mg/kg were append.The control group received a bolus intravenous injection of Heparin 100 U/kg during emergency PCI,and after 10 minutes ACT was detected.If ACT＜ 225 s,300 U was appended.When operation extended,1 000 U was appended every 1 hour.Immediate postoperative blood flow,early stent thrombosis,target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,all causes mortality and bleeding conditions at 7 days after operation were compared between two groups.Results The immediate postoperative thrombolysis in myocardial infarction (TIMI)blood flow was significantly improved(P＜0.05) in the treatment group as compared with control group.There was no significant difference in target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,and all-cause mortality between two groups (all P＞ 0.05).The bleeding conditions at 7 days after operation were significant lower in the treatment group [2.5％(1 case)]than in the control group[22.5％ (9 cases)] (x2 =7.31,P＜0.01).Conclusions Bivalirudin treatment does not reduce the major cardiovascular events,but improves the TIMI blood flow after surgery and the incidence of bleeding as compared with control group,which suggests that Bivalirudin is safer in emergency PCI therapy in elderly patients with acute ST-segment elevation myocardial infarction

Objective: To explore the changing features of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) level in patients with hypertrophic obstructive cardiomyopathy (HCM) after alcohol septal ablation (ASA). Methods: A total of 82 HCM patients treated by ASA in our hospital were studied. According to plasmalevel of NT-proBNP, the patients were divided into 2 groups: High NT-proBNP group and Low NT-proBNP group,n=41 in each group. Plasma NT-proBNP was examined by ELISA; ventricular septal thickness (VST), left ventricular posterior wall thickness (LVPWT), maximal ventricular wall thickness (MLVWT) and left atrial diameter (LAD) were measured by echocardiography. There were 50 patients ifnished 1 year clinical or in-hospital follow-up, their NT-proBNP level and echocardiography were detected at 2 days and 1 year post-operation.The relationship between echocardiography parameter and NT-proBNP level was assessed; NT-proBNP was compared between pre- and 2 days, 1 year post-operation. Results:①In all 82 patients: compared with Low NT-proBNP group, High NT-proBNP group had increased VST (23.66±6.46) mm vs (20.79±4.56) mm,P=0.035, LVPWT (12.79±2.99) mm vs (11.50±2.35) mm,P=0.048, MLVWT (28.03±5.66) mm vs (25.18±4.81) mm,P=0.027 and LAD (40.73±4.86) mm vs (38.08±6.17) mm,P=0.049.②In 50 patients who ifnished 1 year follow-up study: compared with pre-operation, NT-proBNP level was slightly increased at 2 days post-operation (1841.79±1310.88) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.066, while decreased at 1 year post-operation (1038.46±714.03) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.000. Conclusion: Plasma NT-proBNP level was affected by atrial size and ventricular thickness in HCM patients, it may obviously decrease during long-term follow-up period.

Objective To analyze the correlation between septal branch characteristics and the prognosis of alcohol septal ablation ( ASA ) in patients with hypertrophic obstructive cardiomyopathy . Methods The clinical , echocardiographic , angiographic and procedural characteristics were analyzed retrospectively in 55 patients.Good prognosis was defined as left ventricular outflow tract gradient decreased by 50%at long term follow-up.The characteristics of septal branch were analyzed in terms of QCA .Results There were no differences in the length of the ablated septal branch , sizes of the adjacent branches , distances between the septal branch and the ostia of the coronary arteries and the volume of alcoholo consumed ( all P>0.05).Compared with poor prognosis group (n =27), the diameter of the ablated septal branches were significantly larger in the good prognosis group ( n=28 ) [ ( 1.75 ±0.36 ) mm vs.( 1.48 ±0.41 ) mm, P=0.012].The distance between the ablated branch and its adjacent branch was farer in the good prognosis group [(18.80 ±10.20)mm vs.(13.04 ±6.65)mm, P=0.020].In multivariate analysis, the diameter of the ablated branch (OR 9.258,95%CI 1.427-60.069, P=0.020)and the distance between the ablated septal branch and its adjacent septal branch (OR 1.102,95% CI 1.002-1.213, P =0.046) were found to be independent risk factors for good prognosis of ASA .Conclusions The diameter of the ablated septal branch and the distance between its adjacent septal branch are associated with better prognosis of ASA .

Objective To assess the condition of left ventricular outflow tract obstruction (LVOTO) under resting conditions and physiological exercise in hypertrophic cardiomyopathy (HCM) patients.Methods A total of 60 patients with HCM and left ventri cular outflow tract gradient (LVOTG) ＜ 50 mm Hg (1 mm Hg =0.133 kPa) at rest were enrolled consecutively,and LVOTG at rest and exercise were measured by echocardiography.Of 51 patients with gradients ＜ 30 mm Hg at rest,26 were latent LVOTO with exercise peak value LVOTG ≥ 30 mm Hg,25 were non LVOTO with exercise peak value LVOTG ＜ 30 mm Hg,and 9 were resting obstruction with LVOTG 30-49 mm Hg.The morphological characteristics of different types of obstruction were analyzed.Results Patients with latent LVOTO were more likely to have SAM(73.1％ vs 8.0％),narrow of LVOT(46.2％ vs 4.0％),higher resting gradients [(16.9 ±7.2) mm Hg vs (7.1 ± 4.3) mm Hg] and mitral regurgitation grade at rest than patients with non-obstructive (all P values ＜ 0.05).The distribution of septal hypertrophy were different in the two groups (P ＜ 0.05).Multivariate logistic regression analysis showed independent predictors of latent LVOTO were SAM (OR 6.431,95 ％ CI 2.323-291.112,P =0.002) at rest and distribution of septal hypertrophy (OR 0.011,95％ CI 0.001-0.179,P =0.008).Conclusions Approximately half of patients with nonobstructive HCM at rest have latent LVOTO.SAM and distribution of septal hypertrophy may be useful to identify patients with latent obstruction.

(0.05)). The sensitivity and the agreement rate were best at dose of Dob 10 ?g?kg~(-1)?min~(-1) with (86.5)% and (86.5)% (Kappa(0.71)), respectively. When Isoket combined with Dob 3,5 ?g?kg~(-1)?min~(-1), the sensitivities and the agreement rates were both significantly improved than either one used (both P

Objective:To explore the relationship between big endothelin-1 (big ET-1) and cardiac remodeling in patients with hypertrophic obstructive cardiomyopathy (HOCM).
Methods:A total of 167 consecutive HOCM patients admitted in our hospital from 2015-01 to 2016-05 were enrolled. Blood levels of big ET-1 and NT-proBNP were measured;electrocardiogram(ECG), dynamicECG,echocardiography (UCG) and cardiovascular magnetic resonance (CMR) were examined for relevant statistical analysis.
Results:In all 167 HOCM patients, blood level of Big ET-1 was positively related to NT pro-BNP (r=0.35, P=0.000), left atrial (LA) diameter (r=0.169, P=0.019) and heart rate (r=0.141, P=0.037);negatively related to hemoglobin (r=-0.173, P=0.013) and the ratio of interventricular septum (IVS)/posterior wall of left ventricle (r=-0.165, P=0.017). Based on the finding of positive correlation between Big ET-1 and LA diameter, the patients were divided into 2 groups:Normal LA group, n=74 and Enlarged LA group, n=93. Compared with Normal LA group,Enlarged LA group had the higher blood level of Big ET-1 (P=0.001);increased left ventricular end-diastolic diameter (LVEDD) (P=0.024), thicker IVS (P=0.003), lower LVEF (P=0.001);enlarged LVED volume (P=0.002) and IVS (P=0.002);elevated ratio of atrial fibrillation(AF);more patients with moderate to severe mitral regurgitation (MR) and NYHA functional classIII/IV.
Conclusion: Blood level of Big ET-1 was positively related to NT pro-BNP and LA diameter in HOCM patients;the patients with enlarged LA had increased Big ET-1, more obvious cardiac remodeling and the higher incidence of AF occurrence which implied that Big ET-1 might play the role in cardiac remodeling in HOCM patients.

Objective: To investigate the short-term outcome of patients with acute myocardial infarction complicating cardiogenic shock due to left main disease. Methods: A total of 24 patients with acute myocardial infarction complicating cardiogenic shock due to left main artery disease hospitalized in Fuwai hospital from June 2012 to May 2018 were included. The clinical data were analyzed,and the patients were divided into survivor group (11 cases) and death group (13 cases) according to survival status at 28 days post the diagnosis of shock. The patients were further divided into thrombolysis in myocardial infarction(TIMI) flow grade 0-2 group (11 cases) and TIMI flow grade 3 group (13 cases) according to TIMI flow grade after the procedure. The patients were then divided into non-three-vessel lesions group (14 cases) and three-vessel lesions group (10 cases) according to coronary angiography results. Results: Compared with survivor group, patients in death group presented with lower worst systolic blood pressure within 24 hours after admission (50(48, 70) mmHg (1 mmHg=0.133 kPa) vs. 73(70, 80) mmHg, P<0.01), lower worst diastolic blood pressure with in 24 hours after admission ((33.5±12.4) mmHg vs. (48.9±9.4) mmHg, P<0.01), higher respiratory rates ((27.3±2.5) times/min vs. (21.5±4.0) times/min, P<0.01), less 24 hours urine output ((422±266) ml vs. (1 680±863) ml, P<0.01), lower platelet counts ((161.9±81.9)×10⁹/L vs. (241.6±94.0)×10⁹/L, P=0.03), higher serum creatinine ((250.0±36.8) μmol/L vs. (132.7±34.2) μmol/L, P<0.01), higher alanine aminotransferase (288(76,846) IU/ml vs. 81(42, 109) IU/ml, P=0.04), lower artery pH (7.11±0.17 vs. 7.39±0.09, P<0.01), higher lactic acid ((10.29±3.62) mmol/L vs. (4.21±2.85) mmol/L, P<0.01), higher incidence of invasive ventilation (7/13 vs. 2/11, P=0.02), higher scores of acute physiology and chronic health evaluation (APACHE) Ⅱ (35.4±6.8 vs. 18.7±1.7, P<0.01) and simplified acute physiology score (SAPS) Ⅱ (73.5±17.4 vs. 47.0±4.3, P<0.01), and higher incidence of target vessel TIMI flow grade 0-2 (10/13 vs. 1/11, P<0.01). Kaplan-Meier survival curve analysis showed that survival rate at 28 days post the diagnosis of shock in TIMI flow grade 3 group was higher than that in TIMI flow grade 0-2 group (76.9% vs. 9.1%, log-rank test, P<0.01), and mortality rate was similar at 28 days post the diagnosis of shock between non-three-vessel lesions group and three-vessel lesions group (35.7% vs. 60.0%, log-rank test, P=0.14). Multivariate logistic regression analysis showed that compared with TIMI flow grade 0-2 group, the OR value of death at 28 days post the diagnosis of shock in TIMI flow grade 3 patients with acute myocardial infarction complicating cardiogenic shock due to left main disease was 0.030(95%CI 0.003-0.340, P<0.01). Conclusion Short-term outcomeof patients with acute myocardial infarction complicating cardiogenic shock due to left main disease remains poor, and final flow of TIMI grade 3 is confirmed as independent protective factor of death at 28 days post the diagnosis of shock in these patients.

Objective: To investigate the efficacy of bare metal stent for treating focal coronary artery aneurysm complicating with severe stenosisin single coronary artery. Methods: This retrospective analysis was performed in 7 patients who were diagnosed as local coronary artery aneurysm complicating with severe stenosis(≥70%) in single coronary artery and treated with bare metal stent during the period from December 2012 to June 2015 in Fuwai Hospital. All 7 patients were male with age of (62±11) years old. During the interventional operation, the narrow parts were pre-expanded,and all patients received bare metal stents implantation to cover aneurysms.The clinical and imaging data of patients immediately post procedure and at postoperative follow-up were collected to evaluate the clinical efficacy. Results: There were 5 cases of left anterior descending aneurysms and 2 cases of right coronary artery aneurysms. The diameter of aneurysm was (5.21±1.28)mm, and the length was (13.71±3.88)mm. There was intracranial vortex in coronary arteriography immediately after intervention.Proximalstenosis of coronary artery aneurysm was disappeared,and the distal blood flow was TIMI class 3.There were no signs of aortic dissection and thrombus formation.During 6(6 16) months follow-up, the aneurysms were disappeared,and there were no major adverse cardiovascular events which including myocardial ischemia, acute myocardial infarction, revascularization,bleeding,and death for all patients. Conclusion Initial experience shows that double-layer bare metal stents implantation for patients with localized coronary artery aneurysm complicating with severe stenosis in single vessel is safe and effective.