1.Warm-up angina and the application of a KATP channel blocker
Zhian JIANG ; Mei ZHENG ; Xianghua FU
Chinese Journal of Internal Medicine 2009;48(10):821-824
Objective To explore the protection for ischemic myocardium with warm-up phenomenon and KATP channel blocker interventional effect on it. Methods Patients with chronic stable angina who came into the study were divided into three groups according to the presence of diabetes and its treatment ways: 25 patients without diabetes came into a NDM group, 22 patients with diabetes treated with glibenclamide came into a DMG group and 25 patients with diabetes but on diet only came into a DMD group. All the patients underwent sequential bicycle ergnmeter exercise test twice (EX1, EX2)with a time interval of 15 min. Parameters including exercise duration (ED), time for 1 mm ST-segment depression (T-STD), maximum STD (mm) and corresponding heart-rate systolic blood pressure product (RPP) were observed respectively. The parameters obtained during EX2 were compared with those obtained during EX1.Results In the group NDM,ED and T-STD were prolonged [(546. 04±103.78)s vs (617.52±106. 96) s, P < 0.05 and (378.64±92.34)s vs (436.84±91.25)s, P<0.05], STDmax was shortened [(2.06± 0.37) mm vs(1.75±0.41)mm,P<0.01]and RPP was increased[(173.77±34.73) beats±min~(-1)·nun Hg~(-2) vs (199.23±37.07 beats·min~(-1)·mm Hg~(-2), p<0.05]as the parameters during EX2 were compared with those during EX1. In the group DMG, there was no difference in these analysed parameters except that T-STD was prolonged [(328.45±64.66)s vs (363.00±81.48)s, P<0.01]when these of EX2 and EX1 were compared. In the group DMD,all the analysed parameters improved significantly during the second test (EX2) in comparison with the first test (EX1) as the results in the group NDM. Conclusions Exercise test can induce warm-up phenomenon in patients with chronic stable angina poctoris.The KATP channel blocker glibenclamide can block the warm-up phenomenon.
2.The establishment of minipigs model of no-reflow after percutaneous coronary intervention of acute myocardial infarction
Xinshun GU ; Xianghua FU ; Ning MA
Chinese Journal of Interventional Cardiology 2003;0(06):-
Objective To investigate the extablishment of minipigs no-reflow models after percutaneous coronary intervention of AMI. Methods A total of 20 wuzhishan minipigs (9?1 months old with body weight of 25?5 kg) were chosen. Left ventriculography and coronary angiography (CAG) were performed sequentially by femoral approach,AMI and no-reflow was set up by diliating balloon to occlude the coronary coronary and reperfusion after the injection of microthrombus into the left anterior descending artery. At the same time, left ventricular hemodynamics parameters were recorded. Changes in ECG and IC-ECG were monitored. Results (1) Sixteen animals survived after the procedures and fourteen of them reached the criterion of AMI with no-reflow (TIMI≤2, CTFC≥36.2). The model extablishment success rate was 70%. (2)The hemodynamics parameters including heart rate, PRI, LVEDP, and PCWP increased, but blood pressure decreased at the time no-reflow was formed compared with those before LAD was occluded. (3) During the experiment, the changes in ECG and IC-ECG were similar to those observed in human in AMI. Conclusion Minipig is an ideal species for the establishment of animal no reflow model reperfusion after microthombus injection and balloon occlusion of LAD.
3.Establishment of diabetk rat model of angioplasty
Lili ZHENG ; Xianghua FU ; Jun WANG
Chinese Journal of Interventional Cardiology 1996;0(01):-
0.05). The mortality in group A was obviously higher than that in group AI ( P
4.Comparison of coronary artery lesions and ventricular performance for non-ST-segment and ST-segment elevation myocardial infarction
Xianghua FU ; Jun LIU ; Weili WU
Chinese Journal of Interventional Cardiology 1993;0(03):-
Objective To compare the characteristics of coronary artery lesions and ventricular systolic, diastolic and synchronous function of non-ST-segment elevation (NSTEMI) with those of ST-segment elevation myocardial infarction (STEMI) in Chinese. Methods One hundred and sixty-eight consecutive patients with NSTEMI 116 and STEMI 52 were enrolled into this study. Coronary angiography (CAG) was performed within 72 hours in all patients, while the parameters of left ventricular function were measured by equilibrium radionuclide angiography (ERNA) with ventricular phase analysis (PA) within 1 week after acute myocardial infarction. Results (1) The incidences of patients associated with diabetes and old myocardial infarction in NSTEMI group were higher than those in STEMI group (30.77% vs 10.34%; 34.62% P
5.Development and validation of no-reflow phenomenon risk score in patients with acute myocardial infarction
Yuhong PENG ; Xianghua FU ; Leisheng RU ; Jiaan SUN
Chinese Journal of Emergency Medicine 2016;25(7):871-877
Objective To establish a bedside available risk scoring system of no-reflow in the acute stage of STEMI.Methods Data from STEMI patients treated with PCI divided into model group and validation group were analyzed.Multivariable binary logistic regression analysis was used to identify independent no-reflow predictors of the model group.Finally,a score according to the odds ratio on logistic regression analysis was designed,and then risk stratification was established,and no-reflow high-risk patients with myocardial infarction were selected.The authenticity and reliability of the logistic regression courses were validated using receiver operator characteristic curve (ROC)and Hosmer-Lemeshow goodness-of-fit.Results Multivariate logistic regression analysis demonstrated that female (OR =0.587,P =0.019),Killip class of myocardial infarction≥2 (OR =3.656,P <0.01),TIMI flow ≤2 before primary PCI (OR =0.774,P =0.013),thrombus burden score ≥4 on baseline angiography (OR =2.629,P <0.01),pain to balloon time ≥ 6 h (OR =1.485,P =0.083)were independent correlate predictors of no-reflow phenomenon in the STEMI after PCI.The risk score system demonstrated a good risk prediction in the model group with AUC of 0.716 (95%CI:0.671 -0.761)based on ROC analysis.There was no significant discrepancy between multivariate logistic regression analysis and Hosmer-Lemeshow goodness-of-fit (χ2 =1.027,P =0.994).In risk stratification,total value <2 was assigned into low risk level,and 2-5 was put into the medium risk level,and >5 was arranged into high risk level.The risk score system demonstrated a good risk prediction in the validation group with AUC of 0.891 (95%CI:0.822 -0.959)based on ROC analysis.ROC analysis in the validation group was applied to Killip class,thrombus burden,score and risk stratification in the validation group ,and the no-reflow score was more accurate,with a larger area under the curve (AUC = 0.851,95% CI:0.776 -0.927 ).Conclusions Establishment of no-reflow scoring system with STEMI patients undergoing PCI was benefit to select high risk patients with no-reflow.
6.Effects of sanqi qiancao recipe on hemorheological parameters of rabbits with copper intrauterine device
Yuhua SHEN ; Xianghua YIN ; Zhaoling YOU ; Lingmei FU ; Zhaoyang TAN
Journal of Integrative Medicine 2005;3(6):473-5
OBJECTIVE: To explore the mechanism of Sanqi Qiancao Recipe (SQR) in treating metrorrhagia caused by copper intrauterine device (IUD) in rabbits and to provide experimental evidence for preventing and treating this disease. METHODS: Fifty-six rabbits were randomly divided into seven groups, which were normal control group, sham-operation group, untreated group, indomethacin-treated group, low-dose SQR-treated group, medium-dose SQR-treated group and high-dose SQR-treated group. Copper IUD insertion was operated in rabbits of the last five groups. Rabbits in the last four groups were treated orally with indomethacin and low-, medium- and high-dose SQR respectively for a week. Rabbits in the untreated group, normal control group and sham-operation group were given distilled water orally. Hematocrit, blood viscosity at low, medium and high shear rate, plasma viscosity and blood sedimentation were examined after treatment. RESULTS: The hematocrit, blood viscosity at low, medium and high shear rate and plasma viscosity were higher in the untreated group than those in the normal control group with significant differences (P<0.01) while those indexes in low-, medium- and high-dose SQR-treated groups were significantly lower than those in the untreated group (P<0.05 or P<0.01). CONCLUSION: SQR can lead to a decrease in blood viscosity and improve the blood flow, which may be one of the mechanisms of SQR in treating metrorrhagia after copper IUD insertion.
7.Impact of Ticagrelor on Myocardial Microcirculation in Patients of Non-ST Elevation Myocardial Infarction After Percutaneous Coronary Intervention
Bing FU ; Xinshun GU ; Yanbo WANG ; Weize FAN ; Yunfa JIANG ; Yi LI ; Xianghua FU
Chinese Circulation Journal 2017;32(4):353-357
Objective: To explore the impact of ticagrelor on myocardial microcirculation in patients of non-ST elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods: A total of 80 NSTEMI patients treated in our hospital from 2015-03 to 2015-12 were enrolled. All patients received coronary angiography (CAG) and PCI, they were randomly divided into 2 groups: ticagrelor (TA) group and clopidogrel (CA) group, n=40 in each group. The baseline condition, PCI related parameters, plasma levels of SOD, MDA at pre- and 24h, 72h post-PCI were compared, the incidence of major adverse cardiac events (MACE) within 30 days after PCI was also compared between 2 groups. Results: The baseline condition, proportion of infarction-related vessels, average length and diameter of implanted stents were similar between 2 groups, all P>0.05. Compared with CA group, TA group had the less post-operative CTFC in LAD and RCA, P<0.05; while CTFC in LCX was similar between 2 groups, P>0.05. The ratios of acute pre-operative, post-operative TIMI grade 3 and slow flow incidence were similar between 2 groups, P>0.05. The peak values of CK-MB and cTnI in TA group were lower than CA group, P<0.05. Compared with baseline condition, MDA levels at 24h and 72h post-operation were increased in both groups, all P<0.001; compared with CA group, TA group had the lower MDA level at 24h post-operation, P=0.023, MAD was further reduced at 72h post-operation in TA group, P=0.043. Compared with baseline condition, SOD levels at 24h and 72h post-operation were decreased in both groups, all P<0.001; compared with CA group, TA group had the higher SOD level at 24h post-operation, P=0.013, SOD was elevated at 72h post-operation in both groups, the elevation was more obvious in TA group, P=0.049. The incidence of MACE was similar between 2 groups within 30 days of PCI,. Conclusion: Ticagrelor could improve myocardial microcirculation in NSTEMI patients after PCI; it was safe and without obvious adverse effects.
8.Effect of percutaneous coronary intervention at different time of acute myocardial infarction on the reversal of ventricular aneurysm and on heart function
Ling XUE ; Xianghua FU ; Jun LIU ; Weili WU ; Qing MIAO ; Yunfa JIANG ; Liang LI ; Xinshun GU
Chinese Journal of Geriatrics 2010;29(2):103-106
Objective To evaluate the effect on the reversal of left ventricular aneurysm (LVA) and on heart function of percutaneous coronary intervention (PCI) therapy at different time of acute myocardial infarction (AMI). Methods A total of 326 patients with primary anterior AMI-accompanied LVA diagnosed by left ventriculography (LVG) from January 2001 to July 2004 were enrolled in this study. They were randomized into 4 groups according to the time of accepting PCI:≤3 h group, 4-6 h group, 7-12 h group and one week group. At the baseline and 6 months after AMI, the parameters of left ventricular diastolic volume index (LVEDVI), left ventricular systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score (LVWMS) and left ventricular end diastolic pressure (LVEDP) were measured by LVG. The paradox volume index (PVI) was measured by equilibrium radionuclide at one week and 6 months after AMI.At 3 year following up to, the major adverse cardiac events (MACE) were recorded. Results At 6 months after PCI, the LVESVI, LVEDVI, WMS and LVEDP were all decreased while LVEF was increased in the four groups as compared with pre-PCl (P<0.05, respectively). Those parameters changed most obviously in ≤3 h group. At the 6th month after PCI, the PVI was lower in ≤3 h group (12.1±2.1)% than in 4-6 h, 7-12 h and one week group [(15.4±2.4)%, (16.5±2.5)% and (20.4±3.7)%, all P<0.05]. Within the 3 years follow-up, the MACE was significantly lower in 3 h, 4-6 h and 7-12 h groups than in one week group, and the mortality was lower too [(2.8%, 3.0% and 3.1% vs. 17.9%, all P<0.05]. Conclusions The early, fully and permanent open of the infraction-related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve LV function and prognosis.
9.Effects of anisodamine on sodium current in isolated ventricular myocytes from ischemia-reperfusion myocardium of rabbits
Chao DING ; Xianghua FU ; Yuying ZHAO ; Huixiao CHEN ; Ling XUE ; Junxia LI
Chinese Journal of Pathophysiology 2010;26(3):457-460
AIM: To investigate the effects of anisodamine on the sodium current (I_(Na)) in left ventricular myocytes of rabbit heart undergoing ischemia/reperfusion, so as to explore the cellular (ionic) basis of anisodamine treatment for antiarrhythmia. METHODS: Forty-five rabbits were randomly divided into three groups: ischemic/reperfusion group (I/R), anisodamine intervention group (Ani+I/R) and sham-operated control group (CON). Anesthetized rabbits were subjected to 30 min ischemia by ligation of the left anterior descending coronary artery and 60 min reperfusion. The animals in Ani group were injected with anisodamine at a dose of 5 mg/kg via femoral vein 1 min before operation. The incidence of ventricular arrhythmia was observed. Single ventricular myocytes were isolated enzymatically from the epicardial zone of the infracted region derived from the hearts in I/R, Ani+I/R group and the same anatomy region in CON. Whole cell patch clamp technique was used to record I_(Na). RESULTS: Anisodamine intervention decreased the incidence and duration of ventricular arrhythmia by reperfusion compared to I/R group, resulting in significant decrease in the scores of arrhythmia (2.6±0.7 vs 3.6±0.8, P<0.05). The peak I_(Na) current density (at-30 mV) was significantly decreased in I/R group (-22.46±5.32 pA/pF, n=12) compared to CON (-42.78±5.48 pA/pF, n=16, P<0.01), while it was significantly increased in Ani+I/R group (-38.89±5.24 pA/pF, n=13) compared to I/R group (P<0.01). CONCLUSION: Anisodamine has the ability to reduce the occurrence of ventricular arrhythmia. Ischemia-reperfusion induces significant down-regulation of I_(Na), while pretreatment with anisodamine attenuates this change, suggesting that anisodamine reverses this electrical remodeling, which may be partly responsible for its antiarrhythmia effects.
10.Effects of Intravenous Recombinant Human Brain Natriuretic Peptide on Ventricular Remodeling and Ventricular Systolic Synchrony in Acute Myocardial Infarction Patients After Percutaneous Coronary Intervention
Ling XUE ; Xianghua FU ; Weili WU ; Xinshun GU ; Qing MIAO ; Yunfa JIANG ; Qingmin WEI
Chinese Circulation Journal 2009;24(3):170-173
Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.