Objective To study the effects of combined telmisartan and ramipril on heart function and renin-angiotensin-aldosterone system and ventricle remodeling and brain natriuretic peptide in patients with chronic heart failure(CHF).Methods 100 patients with chronic heart failure were randomly divided into three groups: telmisartan group(A group,treated with telmisartan 80mg once daily,n=33),ramipril group(B group treated with ramipril 5mg once daily,n=33) and telmisartan plus ramipril group(treated with telmisartan 40mg plus ramipril 2.5mg once daily,n=34).Left ventricular end-diastolic dimensions(LVEDD) and left ventricular ejection fraction(LVEF) were assessed,and plasma renin activity(Ren),angiotensinII(AngII),aldosterone(Ald) and brain natriuretic peptide(BNP) were measured before and after therphy.Results After 6 months of treatment,LVEDD and LVEF were improved in all groups(P0.01).The concentration of Ald and BNP was decreased in all groups(P

Objective To study the effects of combined telmisartan and ramiprll on heart function and renin - angiotensin - aldoste-tone system and ventricle remodeling and brain natriuretie peptide in patients with chronic heart failure (CHF). Methods 100 patientswith chronic heart failure were randomly divided into three groups: telmisartan group (A group, treated with telmisartan 80mg once daily, n =33), ramipril group (B group treated with ramipril 5mg once daily, n =33) and telmisartan plus ramipril group (treated with telmis-artan 40mg plus ramipril 2.5mg once daily, n = 34). Left ventricular end - diastolic dimensions (LVEDD) and left ventricular ejection fraction (LVEF) were assessed, and plasma renin activity (Ren) , angiotensinIl (Angll), aldosterone (Aid) and brain natriuretic pep-tide (BNP) were measured before and after therphy. Results After 6 months of treatment, LVEDD and LVEF were improved in all groups(P < 0.01). All changs were significant in C group than those in A group or B group(P < 0.01). The concentration of Ren were in-creased in all groups(P <0.01). The concentration of Angll was increased in A group and decreased in B group(P <0.01)while there was no difference at pre or post treatment in C group (P > 0.01). The concentration of Ald and BNP was decreased in all groups (P < 0.01). Ald and BNP were decreased more significantly in C group than those in A group or B group. Conclusion Combination of low dose of telmisartan and ramipril therapy has more benificial clinical features than telmisartan or ramipril alone in patients with CHF.

Objective To evaluate the correlations of red blood cell distribution width (RDW) and short term prognosis of patients with acute coronary syndrome.Methods 179 patients with acute coronary syndrome (ACS) treated in our hospital between Jan.2008 to Apr.2009 were grouped by cutoff value of 14.4%.The incidence of acute myocardiac infarct( AMI),malignant arrhythmia,heart falure,sudden cardiac death(SCD) were compared in the two groups when patients were hospitalized and in half years of discharged.High-sensitivity C-reactive protein.(hs-CRP) ,BNP were also compared between the two groups.Results The incidences of cardiac adverse event were different between the two groups(AMI:39.47% vs.15.53% ,HF:22.22% vs.6.80% ,SCD:9.21% vs.1.94% and malignant arrhythmia:11.84% vs.3.90%,P values all less than 0.05 ).hs-CRP were ( 9.44 ± 8.03 ),(4.64 ±4.42) mg/L and BNP were (357.07 ± 161.60),(233.17 ± 134.76) ng/L in the two groups ( P ＜ 0.05 ).RDW is positively correlated with hs-CRP and BNP (r is 0.42 and 0.58 respectively,P-value all less than 0.05).Conclusions The RDW is related to the short term progonosis in patients with ACS,and also positively correllated with plasma hs-CRP and BNP levels.

Objective To verify the hypothesis whether resting heart rate(RHR)was able to predict the activities of renin angiotensin aldosterone system(RAAS)and left ventricular hypertrophy(LVH)in patients with hypertension.Methods One hundred and seventy-five essential hypertensive patients were categorized into three groups based on the levels of blood pressure(BP):140-160/90-100;160-180/100-110;≥180/110 mmHg.Each group were subdivided into four groups according to the levels of RHR.RHR1:RHR

Objective To investigate the abnormal characteristics of electrocardiogram and its early diagnostic value in acute pulmonary embolism (PE) of different positions.Methods A total of 147 hospitalized patients of acute PE diagnosed by the pulmonary artery CT angiography (CTA) were enrolled in this study and divided into the following two groups:pulmonary trunk or main pulmonary artery (MPA) embolism (group A) and lobar artery or remote branch embolism (group B).ECG,D-dimer,BNP,cTnT were collected and determined,the varieties of abnormal ECG were counted.Then,the relationships between the severities of the PEs at different positions and the corresponding ECG abnormalities as well as the degree of right ventricular hypertrophy (RVH) were analyzed.Results There were significant differences in dyspnea,syncope,in-hospital mortality and the level of cTnT,BNP between the two groups (P ＜ 0.05).There were significant differences in the occurrence of SIQ Ⅲ T Ⅲ,right bundle branch block (RBBB),ST segment depression (STD) in leads Ⅲ and aVF,ST segment elevation (STE) in lead aVR,negative T waves (NTWs) in leads Ⅲ and aVF,STD in leads V1-V3/V6,and STE in leads V1-V3 in combination with STD in leads V4-V6 between the two groups (P ＜ 0.05).The proportion of RVH diagnosed via ECG has significantly different between the two groups.The result of correlation analysis showed that the incidence of pulmonary trunk or MPA embolism was significantly related to the number of ECG abnormalities (r =0.782,t =-7.086,P ＜ 0.05).Conclusions The number of abnormal ECGs increase and the RVH is more serious when PE occurring in pulmonary trunk as well as in the MPA,early recognition of electrocardiographic abnormalities is of greater value in the diagnosis of acute pulmonary trunk and MPA embolism.

Objective To reveal the effect of lutein on the status of oxidative stress in rats with high homocysteine levels (HHcy) and relevent molecular mechanisms.Methods The wistar rat HHcy model was established by intra-gastric administration with L-methionine suspension and treated with lutein.The oxidative stress status and the gene expression changes of transcription Nf-E2-related factor2 (Nrf2),a regulation factor of down stream antioxidant protein gene expression,were detected in HHcy rats and lutein intervention rats.Results Compared with the rat serum SOD activities (134.32 ± 12.65) U/mL in the control group,the serum SOD activities in the HHcy model group (95.6 ± 10.92) U/mL were significantly lower (P ＜ 0.05).The serum glutathione peroxidase (GPx) activities in the HHcy model group (121.66 ± 18.64) U/mL were also significantly lower as compared with the the control group (183.17 ± 21.29) U/mL,P ＜ 0.05.However,the serum SOD (126.75 ± 11.26) U/mL and GPx activities (167.18 ± 19.66) U/mL in the lutein intervention group were significantly higher as compared with the HHcy model group.As compared with the rat serum malondialdehyde (MDA) content (5.11 ± 0.68) μmol/L as well as the hydroxyl free radical levels (0.53 ± 0.05) U/L in the control group,the serum MDA content (7.65 ± 0.87) μmol/L and the hydroxyl free radical levels (0.92 ± 0.09) U/L in the HHcy model group were significantly higher.The serum MDA content (6.44 ±0.91) μmol/L and the hydroxyl free radical levels (0.74 ± 0.06) U/L in the lutein intervention group were significantly lower as compared with the HHcy model group.RT-PCR and Western blot results also showed decreased expression of SOD2 and GPxl mRNA in aorta epithelial tissues of HHcy model rats.With lutein intervention,the expressions ofSOD2 and GPx1mRNA were significantly increased and the gene expression of Nrf2 also up-regulated.Conclusions The Hhcy model rats were under the status of augmented oxidative stress,and carotenoid lutein could attenuate the Hcy-mediated oxidative stress,and its mechanism might be potentially associated with up-regulating the expression of Nrf2,thereby inducing the expression of its downstream antioxidant proteins.

Objective To investigate the effects of 10 mg and 20 mg atorvastatin and 10 mg rosuvastatin on inflammatory factors in patients with acute coronary syndrome (ACS).Methods 66 patients with ACS were randomly divided into three groups:the 10 mg atorvastatin group,the 20 mg atorvastatin group and the 10 mg rosuvastatin group(n=22 for each group).The levels of blood lipids,serum matrix metalloproteinases-9 (MMP-9)and plasminogen activator inhibitor-1 (PAI-1)were measured before and after two-week treatment.19 patients with normal coronary angiography were assigned to the control group.Results The concentration of serum MMP-9 and PAI-1 was higher significantly in patients with ACS than those in control subjects(P＜0.05 or P＜0.01).After two weeks'treatment,the serum MMP-9 and PAI-1 levels were lowered significantly (P＜0.01),which were much better in groups of 20mg atorvastatin and of 10mg rosuvastatin than those in group of 10mg atorvastatin (P＜0.05 or P＜0.01 ).No relationship was observed between the levels of above inflammatory markers and serum hpids levels(P＞0.05).Conclusion 10 mg Rosuvastatin can greatly reduce the serum level of MMP-9 and PAI-1 as compared to 10 mg atorvastatin in patients with ACS ,equivalent to the effect of 20 mg atorvastatin,suggesting that the anti-inflammatory effect is independent of lipid-lowering action.

Objective To investigate the impact of hyponatremia on the short-term prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).Methods The present study included 324 patients with acute STEMI treated with PCI within 12 hours after admission from March 2014 to May 2016.Patients were divided into three groups according to plasma sodium levels (Na+) at admission:group A with Na+ ＜ 130 mmoL/L,group B with Na + 130-134 mmol/L and group C with Na + ≥ 135 mmol/L (normal plasma sodium level).Clinical data and biochemical variables were compared among the three groups.Logistic regression analysis was used to examine the correlation between plasma sodium levels and short-term prognosis.Results There were significant differences in age,fasting glucose,NT-proBNP,LVEF (left ventricular ejection fraction) and hsCRP (high sensitive C-reactive protein) among the three groups (P ＜ 0.05).The mortality in group A was obviously higher than that in Group B (20.0％ vs.6.3％,P ＜ 0.05) and in group C (20.0％ vs.6.0％,P ＜ 0.05).In addition,there were significant differences in rates of cardiogenic shock and acute renal failure among three groups.Logistic regression analysis showed that old age,low LVEF and hyponatremia were independent risk factors for 30-day mortality (P ＜ 0.05).Compared with group B,patients in group A had significantly high risks of death (OR =3.058,95％ CI:1.339-4.358,P =0.003),suggesting that the high risk of 30-day mortality associated with the severity of hyponatremia.Conclusions At admission,the hyponatremia in patients with acute STEMI treated with PCI is an independent risk factor for 30-day mortality,and prognosis worsens with the severity of hyponatremia.

Objective To study the changes of lipoprotein(a)[LP(a)] in patients with essential hypertension(EH) and coronary heart disease(CHD).Methods One hundred and fifty-nine EH older patients were recruited in the study.Eighty-six elderly patients were diagnosed as EH combined with CHD,and 73 patients were diagnosed as simple EH.All patients were tested for the fasting blood glucose(FBG),creatinine(Cr),total cholesterol(TC),triglyceride(TG),HDL-C,LDL-C,LP(a),and the body mass index(BMI) was calculated.Results Plasma Lp(a) increased(0.48±0.18)mmol/L in the EH combined with CHD patients,which were significantly higher than the increasing of(0.34±0.12) mmol/L in the simple EH patients(t=-11.367,P＜0.05).The level of plasma Lp(a) increased with the severity of the stenosis of the coronary artery(Lp(a):(0.37±0.14) mmol/L in single arterial branch stenoses,(0.46±0.15)mmol/L in double arterial branch stenoses,(0.66±0.12)mmol/L in triangle arterial branch stenoses,F=31.842,P=0.012).Conclusion The Lp(a) concentration in patients with EH are correlated with the occurrence and severity of coronary heart disease.As a risk of coronary heart disease,Lp(a) can predict the severity of coronary artery stenosis.