Objective To explore the possibility of dynamic pulse pressure (DPP) being used to predict cardiovascular events in old men with normotension. Methods During May 1995 to September 2001, a 24h DPP monitoring was carried out on 858 old men with normotension (60-91 years old, BP60 mmHg, respectively. The first attack of cardiovascular event was recorded. Results In the 3 groups of subjects, the incidence of total cardiovascular events (100 persons per year) was 3.7, 5.8, and 9.1 respectively (log-rank test, P=0.000 9, 0.000 2, 0.000 0). After adjustment for the other risk factors including age, hypertension history, diabetes and previous cardiovascular disease, it has been found that the data of dynamic pulse pressure is of a significant value for predict cardiovascular events (P

Objective To determine the related facuors of side branch occlusion after stent implantion in the main branch of biburcation lesions.Methods We retrospectively analyzed 121 bifurcation lesions in 92 patients who accepted percutaneous coronary interventional therapy in our hospital from 2005 September to 2006 January.We employed quantitive coronary angiography analysis after stenting in the main branch and then evaluated the factors related to side branch stenosis.Results After stenting in the main branch of bifurcation lesions,four factors were found to be involved in causing side branch stenosis,which included:the plaque burden of both branches,the angle of bifurcation and the diameter of the side branch.The plaque burden of both branches was positively correlated but the biburcation angle and the diameter of the side branch were correlated to the formation of side branch stenosis.The severity of side branch stenosis after PCI could be represented by the regression equation:Y=0.48A-11.4B-0.23C+0.22D(Y:the degree of side branch stenosis after main branch stenting,unit:%;A:degree of pre-procedural side branch stenosis;B:diameter of the side brance;C:biburcation angle;D:the degree of pre-procedural main branch stenosis).Conclusion In bifurcation lesions,side branch stenosis after stenting in the main branch is related to plaque burden of both branches,diameter of the side branch and the bifurcational angle.Serious plaque burden in both branches,small side branch and sharper biburcation angle are more likely to cause side branch occlusion after main branch stenting.

Objective To study the anticoagulant activity of hirulog. Methods Rabbits blood samples were collected before and after injecting hirulog. Thrombin clot time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured to investigate the dose-effect and time-effect relationship of hirulog and compared the efficacy with heparin. Results TT, PT and APTT of rabbits blood samples were prolonged remarkably by hirulog, and the action duration was about 60 min, that was similar to heparin. Conclusion Hirulog showed obvious anticoagulant effects with clear dose-effect relationship.

Objective To analyze the clinical characteristics of patients with cardiac amyloidosis.Methods The clinical data of 14 patients with cardiac amyloidosis were retrospectively analysed.Results The patients with cardiac amyloidosis had characteristics of large atriums and hypertrophic ventricular walls in echocardiography.And they also had low limb lead voltage in ECG.The ratio of(SV5+RV1)and left ventricle crossing area of all patients were obviously lower than 1.5.Biopsy behaved staining of congo red.And most patients had renal,dermatic and gastrointestinal involvements.Conclusion The patients of cardiac dysfunction with the characteristics of restrictive cardiomyopathy in echocardiogram and feature of low limb lead voltage in ECG,have the possibility of cardiac amyloidosis and need to prove it through biopsy.(SV5+RV1)/CSA may be a promising method for screening cardiac amyloid.

Objective:To investigate the effect of angiotensin II (ang II), aldosterone (ald) and their receptor antagonists losartan (los) and spironolactone (spi) on the proliferation and collagen production of cardiac ifbroblasts (CFs) in rats.
Methods:CFs were isolated from neonatal SD rats by collagenase II method and puriifed with differential attachment and detachment method. The 3 or 4 passages of the CFs were divided into the following groups:angiotensin II, angiotensin II+aldosterone, aldosterone, angiotensin II+losartan, and aldosterone+spironolactone. The cell viability of the CFs was assessed by Cell Counting Kit-8 (CCK-8) after the drug administration. The mRNA and protein expression levels of COL1A1, COL3A1, MMP1 and TIMP1 were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot respectively.
Results:Ang II and Ald facilitated the proliferation rate of the CFs independently compared with that in the control group (38.5%vs 28.5%;P<0.05), and the proliferation rate in the ang II+ald group was higher than that in the ang II group and ald group alone (54.4%, P<0.05). Los and spi inhibited the effect induced by ang II and ald respectively (P<0.05). Compared with the control group, ang II and ald signiifcantly enhanced COL1A1, COL3A1 and MMP1 expression both at the mRNA and protein levels (P<0.05), but the TIMP1 expression was inhibited (P<0.05), which could be abolished by corresponding receptor antagonists los and spi (P<0.05).
Conclusion:Ang II and ald can promote the proliferation of CFs, and the COL1A1 and COL3A1 expression is enhanced both at mRNA and protein levels. Ang II and ald have synergistic effect when they are used together, while los and spi may restrain the effect. The mechanism is probably linked with the balance of MMPs/TIMPs.

Objective To investigate the relationship between the content of ET-1, CGRP, NO in myocardium and cardiac function in chronic renal ischemia of rats caused by abdominal aortic banding. Methods Male wistar rats (weight 180 - 200g) were randomly divid-ed into 2 groups, operation group (n=30) and sham operation group (n=10). Abdominal aorta ligation between right and left renal ar-tery was made with silk suture in operation group, and the narrow degree of aorta was about 50% which was controlled by ligateing with a syr-inge needle (7#). The aorta was not ligated in sham operation group. After 16 weeks of operation, invasive measurement of blood pressure and cardiac function were performed, and content of ET-1, CGRP and NO in myocardium were determined. Results Compared with sham operation group, the blood pressures of rats in operation group were significantly elevated, with cardiac systolic and diastolic function de-creased and left ventricular mass index increased. After 16 weeks, compared with sham operation group, the content of ET-1 in cardiac tissue were significantly elevated in operation group (P<0.01), while the content of CGRP (P<0.01)and NO (P>0.05)were decreased. There were negative correlation between the content of ET-1 in cardiac tissue and LV +dp/dt max(r = -0.37, P<0. 05). Conclusions In the state of chronic kidney iachemia caused by abdominal aorta ligation, content of ET-1 in cardiac tissues were increased while CGRP and NO were decreased. There were negative correlation between the content of ET-1 in cardiac tissues and LV systolic function.

This study examined the effects of endovascular irradiation on cell proliferation and apoptosis after overstretch balloon angioplasty in a normolipemic swine model of restenosi. Twenty five swine underwent oversized balloon angioplasty in the LAD and/or LCX,and in 13 of them the procedure was followed immediately by endovascular radiation using a guide wire with 3 cm long 192 Ir line source to deliver 20Gy to overdilated segments. All the animals were killed at 3 and 30 days. Cell proliferation was estimated by immunostaining for proliferation cell nuclear antigen (PCNA). Apoptosis was identified by the terminal uridine nick end labeling(TUNEL). The results showed that endovascular radiation significantly reduced the pcna positive cells compared with controls 3 days and 30 days after initial injury. There were no quantitative differences in the amount of TUNEL labeling cells among irradiated and control vessels in any region examined 3 days and 30 days after balloon injury. Endovascular radiation may reduce restenosis by inhibiting the cell proliferation, not by enhancing cell apoptosis.

miniature swines were randomly divided into irradiation group ( n =7) and control group ( n =8). Immediately after balloon overstretch injury to LAD, radioactive liquid perfused balloon irradiation was performed at the target segment; radioactive dose was 24Gy. 35 days after the operation, the target segments were harvested to perform histologic and morphologic study (HE, MS, VVG) and immunohistochemical study (PCNA, ? smooth muscle actin). Results showed that the lumen area was significantly larger, the neointima area and vascular stenosis level were smaller, and less PCNA positive cells were present in the vascular wall in the irradiation group than in the control group ( P all

The aim of this study was to investigate factors contributing to left ventricular dysfunction (LVD) in patients who had survived acute myocardial infarction(AMI). Retrospective regression analysis was performed for all the hospitalized patients with AMI who underwent coronary angiography from 1988 to 1998. 155 patients met the entry criteria. Seven patients(4 5%) died of cardiac events after discharge during the ten years′ follow up. In the multivariate logistic regression analysis and stepwise selection, the following factors appeared to be the significantly independent predictors of the LVD after AMI : age, hypertension, hyperlipidemia, LVEF during the first admission, size of infarction, the number of vessel disease, thrombolytic therapy, PTCA. In the COX regression and stepwise selection, the following factors appeared to be significantly independent predictors of the LVD after AMI : hyperlipidemia, LVED during the first admission, size of infarction, the number of vessel disease, thrombolytic therapy , PTCA. The probability of LVD increased with time. Patients with advanced age, hypertension, hyperlipidemia, large infarction, multivessel disease, reduced LVEF after AMI, no thrombolysis and PTCA are prone to develop LVD.

Totally 896 medical records were statistically analyzed from Jan. 1, ] 998 to Dec. 31 , 2001. There were 65 cases (7. 3%,65/896) of ischemic cardiomyopathy .of which 38 cases (58. 5% .38/65) were myocardial infarction in small area, 27 cases(41. 5% ,27/65) were in large area. The causes of ischemic cardiomyopathy were lack of blood supply in cardiac cells for a long time and pathological changes in branches of coronary artery. If myocardial infarction in small area occurred,the blood vessels should be opened again in acute period, and the risk factors must be prevented and treated.