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 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 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.

50%). All the patients were catagorized into 3 groups according to the intervention (stenting, PTCA or no touch) applied in the side branches and the clinical outomes of the three different groups were compared. Results Among the 93 patients, 21 patients received stenting and 24 patients received balloon angioplasty in the side branches. No intervention was given in 48 patients. Although patients in the stenting group and the PTCA group could maintain a greater vessel lumen in the side branches compared with patients without intervention (40.21%, 41.76% and 80.23%, P

Objective To investigate the diagnostic accuracy of 3-dimensional reconstruction(3DR) coronary angiography in the evaluation of coronary artery disease compared with conventional quantitative coronary angiography with IVUS result as the reference standard.Methods Twenty vessel segments in nineteen patients who underwent coronary angiography and IVUS were studied.With the IVUS result as the reference standard,the 3D reconstruction images and the single plane(2D) images of each angiograph were retrospectively studied and compared.Results In all the 20 segments,the minimal vessel diameter/area rate of the stenosed vessels and the reference vessels,and the minimal cross-sectional stenosis rate had no significant differences among the conventional 2D angiograph the 3DR angiograph and the IVUS results.According to the IVUS results,all the 20 vessel/segments were further divided into two groups which were:the eccentric stenosis group(n=7) and the centripetal stenosis group(n=13).In the centripetal stenosis group,all the angiographic parameters detected by the three methods had no statistical difference.In the eccentric stenosis group,the 3DR angiograph showed more consistent results as detected by IVUS compared with the 2D angiograph in terms of cross-sectional stenosis rate.Conclusion Three dimentional reconstruction of coronary angiography showed higher accuracy in the quantitative analysis of coronary artery stenosis compared with conventional coronary angiography,especially in eccentric stenosis.

Objective To analyze the effect on side branch with diameter ≥2.0 mm after stenting with cross-over technique in non-left main coronary bifurcation by using IVUS and QCA.Methods Comparative analysis was made on the IVUS and QCA results of the side branches in 35 non-left main bifurcation lesions which were intervened by cross-over technique.Results The diameter and area stenosis rates of the side branches examined by IVUS compared with QCA before intervention were 18.67%?16.29% vs 29.06%?23.16% and 31.17%?25.54% vs 42.22%?31.81% respectively.After cross-over interventional therapy,acute occlusion of the side branches detected by both IVUS and QCA was 2.86%.The rates of aggravated stenosis and newly developed stenosis in the side branches shown by IVUS and QCA were 14.29% vs 48.57%(P=0.012) and 11.43% vs 14.29%(P=0.294).Post-intervention morphology of the side branches detected by IVUS included plaque shift,vessel wall shrink,spasm and deformation.By using logistic analyzing,existence of soft plaque in the main branches was an independant factor affecting the fate of the side branches.Conclusion Comparing with IVUS results,QCA may over-estimate the degree of stenosis of the side branches after cross-over technique.The possible mechanism of side branch complications shown by IVUS included plaque shift,vessel wall shrink,spasm and deformation.Soft plaque in the main branch is an independant influencing factor of the result in the side branches.

Forty patients with hypertension suspected to stenosis of renal artery were selected from Department of Cardiology, General Hospital of Chinese PLA between June 2007 and March 2008, including 28 males and 12 females with an average age of (60.0?15.6). Capoten test and renal artery angioplasty were performed in all patients to detect brain natriuretic peptide changes before and after the Capoten test and renal artery stent implantation. Among 40 patients underwent Capoten test, 30 showed positive result and 10 negative. The levels of brain natriuretic peptide before and after Capoten test in patients with positive result were statistically different (P 0.05). Among thirty patients with positive Capoten test undergoing renal artery angioplasty, twenty-three patients underwent stent implantation, and their brain natriuretic peptide showed statistical differences between before and after stent implantation (P 0.05). The results of the study show that levels of brain natriuretic peptide can be used to evaluate possible effect of stent implantation for patients with hypertension suspected to stenosis of renal artery.

Objective To verify the application of intravascular ultrasound(IVUS)in the classification of coronary bifurcation lesions.Methods There were 62 coronary bifurcations verified by CAG.Additional to conventional CAG,all patients received IVUS exam.Observation and determination of the plaque position in the main vessel(MV)and the side branches(SB)was made as well as the plaque morphological characters in these bifurcations.Results A 93.55% of the MV and 98.39% of the SB plaque at the bifurcation were eccentric and 77.42% of the plaques located at the external side of the vessel wall of both the MV and SB.There were 6 types(Type A,B,C,D,E,F)of bifurcations elassified by IVUS in this study.Type A(90.32%)was eccentric plaque in the MV which located at the opposite site of SB with the plaque in SB located at the opposite site of carina.Type B(1.61%)was concentric plaque found only in MVwith no plaque in the SB.Type C(1.61%)was concentric plaque in MV with eccentric plaque in SB which sited at the opposite of the carina.Type D(3.23%)was concentric plaque in MV which involved both of the ostium and the carina of SB.Type E(1.61%)was eccentric plaque in MV which located at the opposite side of SB which has concentric plaque at ostium.Type F(1.61%)was eccentric plaque in MV located at its the internal wall and involved carina of MV.A total of 6.45% of the all the lesions involved carina of the bifurcation.Conclusion Classification of coronary bifurcation based on IVUS was different from conventional CAG classification.The main IVUS classification criteria include ubtact carina,eccentricity and distribution of plaque on the external side of the vessel wall.

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.