Cardiology ; trends ; China

The duties of a physician are:serve the people humanely and wholeheartedly;treat the sick and to save their lives;prevent diseases and care for the people's health.It is really a sacred,dignified and noble job.To become a good physician,he or she must be ethical,highly solicitous and sympathetic to a patient's health;must have moral integrity and be wholly responsible to a patient;must possess comprehensive updated medical knowledge and almost always be able to make a correct diagnosis and render appropriate treatment;must have a deep love for medical education to train and bring up young doctors;must be able to engage in scientific research to promote the advancement of medical knowledge;and must study life long to improve medical skills.

Thirty-one patients were investigated with radionudide ventri -culography for assessment of tlhe effects of Nifedipine ( NIF ) on the LV function^ NIF improves the pumping function of LV, markedly , after oral therapy, Mean LVEDV increased 15ml/mz, mean LVESV decreased 2.4ml/m2 and SV increased 17 ml/m2._ LVEF increased to 0. 56 ( P

AIM: To investigate the dynamic alteration of cardiac collagen metabolism in mice with acute,chronic myocarditis and dilated cardiomyopathy(DCM).METHODS: BALB/c mice infected with coxsackievirus B_3 were used to establish animal models of acute,chronic myocarditis and dilated cardiomyopathy,while uninfected animals were also prepared and served as controls.After verification of models by histopathological methods and echocardiography,serum concentration of aminoterminal propeptide of type Ⅲ procollagen(PIIINP),aminoterminal propeptide of type Ⅰ procollagen(PINP) and carboxyterminal propeptide of type I procollagen(PICP) in each group of mice were detected by enzyme linked immunosorbent assay(ELISA).The expression of matrix metalloproteinase 1(MMP1) and its tissue inhibitor(TIMP-1) were determined by Western blotting analysis.The MMP-1 activity was also detected.RESULTS: Marked myocardial fibrosis was observed in all groups of CVB_3-infected mice.Reparative fibrosis,promotion of synthesis and degradation of cardiac collagens were presented in heart tissue of acute myocarditis mice. Both reparative and reactive fibrosis,enhanced synthesis and lightened degradation of collagen were present in chronic myocarditis,while reactive fibrosis and excess collagen synthesis were confirmed in DCM.Expression and activity of(MMP-1) was progressively decreased.TIMP-1 showed unchanged.The ratio of MMP-1/TIMP-1 was progressively descended.CONCLUSION: Collagen metabolism was special in different phase of viral heart diseases,which may play different roles in the progression and prognosis of these kinds of disease.

Obiective To compare the sensitivity and specificity of strain imaging(SI)and restredistribution Tl-201(RR-201 TI)SPECT imaging in evaluating myocardial viability among patients with STelevation acute myocardial infarction(AMI).Methods Twenty-six AMI patients underwent echocardiography and RR-201 Tl-SPECT imaging a week(baseline)after percutaneous coronary intervention(PCI)therapy.At baseline,wall motion score(WMS)and systolic strain were assessed,SPECT scoring were performed on 16 segments of left ventricle(LV).WMS was repeated more than 3 months later to assess myocardial viability,which is deemed as reference.Results ①Two hundred and sixty segments in the"at risk"regions were followed up for(5±2)months,among which 201 were identified as viable and 59 were not,according to the WMS.②In comparison to the reference standard,the sensitivity and specificity of RR-201 Tl-SPECT to predict myocardial viability were 87%(175/201)and 58%(34/59)respectively.③The sensitivity and specificity of systolic strain(Set)to predict myocardial viability after AMl were 81% and 66% respectively at the optimal cut-off value of-60%.④Set was moderately concordant with SPECT scoring(Kappa=0.40)and the agreement between the two methods was 77%(199/260).Conclusions In ST-elevation AMI,SI and RR-201 Tl-SPECT appears equivalent in predicting segmental recovery after reperfusion,and SI could be a convenient and low-cost alternative for the non-invasive evaluation of myocardial viability.