1.Placement of coronary stent by using the mobile digital imaging system (a report of 13 cases)
Yong WANG ; Changsheng MA ; Yuannan KE
Chinese Journal of Interventional Cardiology 1996;0(04):-
By using the OEC 9600 mobile digital imaging system, 14 coronary stents were successfully implanted in all 13 cases of coronary heart disease. After the procedure,immediate satisfactory angiographic results were obtained without residual stenosis, and chest pain was relieved or disappeared in all cases. No major complications occurred except for groin hematoma in one case,these results suggest that intracoro-nary stenting is a safe and effective management for coronary heart disease.
2.Sensitivity and specificity of identification of the infarct-related artery by electrocardiogram
Xiaojiang ZHANG ; Hongbing YAN ; Yuannan KE
Chinese Journal of Interventional Cardiology 2003;0(05):-
Objective To evaluate the sensitivity,specificity and accuracy of the algorithm for electrocardiographic identification of the IRA and exact site of occlusion of the IRA.Methods According to the algorithm for electrocardiographic identification,we predicted the IRA by analyzing ECG in 896 patients with ST-segment elevation myocardial infarction(STEMI),who were enrolled in this study and underwent primary coronary angiography.Results The results indicated that left main coronary disease showed a sensitivity of 100%,specificity of 99% and accuracy of 99%;and at the same time the left anterior descending artery(LAD) with 99%,99% and 99%(proximal LAD: 84%,90% and 88%;middle and distal LAD: 57%,94% and 88%);the left circumflex artery with 64%,95% and 91%;the right coronary artery(RCA):89%,92% and 91%(proximal RCA: 51%,96% and 88%;middle and distal RCA: 68%,92% and 85%) respectively.Conclusion This study suggests that electrocardiogram is a crucial tool in the identification of the IRA in left main coronary,LAD and proximal RCA with predicting exact site of culprit lesion.The LCX or middle and distal RCA can be difficult to discriminate.
3.Effect of antihypertensive therapy on brachial-ankle pulse wave velocity in patients with essential hypertension
Tingli QIN ; Hong JIANG ; Yuannan KE
Chinese Journal of Geriatrics 2011;30(1):13-16
Objective To investigate the effect of antihypertensive therapy on brachial-ankle pulse wave velocity (baPWV) in patients with essential hypertension (EH). Methods The 150 EH patients (EH group)receiving antihypertensive therapy with valsartan 80 mg/d, and 135 healthy controls (control group) were enrolled in this study. Automatic pulse wave velocity (PWV)measurement system was employed to examine baPWV, and the investigation about cardiac risk factors, physical and laboratory examination was performed. The baPWV was used as an index to show artery stiffness.Results The baPWV was significantly higher in EH group than in control group [(2105.8±378.4) cm/svs. (1371.5±176.5) cm/s, t=4.05, P<0.001]. The detection rate of atherosclerosis was 82.0% and 21.8% in EH and control group respectively. In EH group, there were positive relationships between age and baPWV (r= 0.51, P<0. 001), SBP and baPWV (r=0.53, P<0.001), pulse pressure (PP) and baPWV (r=0.43, P<0. 05), PP index (PPI) and baPWV (r=0.51, P<0.05), blood glucose and baPWV (r=0.39, P<0.01). The baPWV decreased significantly from (2105.8±378.4) cm/s to (1704.2±332.0) cm/s (t=3.85, P<0. 05) in EH group. The baPWV was significantly lower in the subgroup with a target BP than without a target BP in EH patients [(1588.8±278.7) vs. (1857.7±324.9) cm/s, t=3.67, P<0.001].Conclusions The age and SBP are primary risk factors for baPWV in EH patients. The antihypertensive therapy can relieve baPWV with a target blood pressure.
4.Expressions of tissue factor and tissue factor pathway inhibitor in the atherosclerotic plaque
Na LI ; Lianfeng CHEN ; Yuannan KE ; Wenling ZHU
Basic & Clinical Medicine 2006;0(07):-
Objective To observe the expression and location of TF and TFPI in femoral artery atherosclerotic plaque.Methods We detected the expressions and locations of TF and TFPI in femoral artery atherosclerotic plaque by immunohistochemical and double-stain immunohistochemical method.We detected TF mRNA and TFPI mRNA expressions in atherosclerotic plaque by RT-PCR,with the normal umbilical artery as a control.ResultsThe normal umbilical artery contained little TF,TFPI and their mRNA in the adventitia.A great deal of TF,TFPI and their mRNA were found in the tunica intima of the femoral artery atherosclerotic plaque.Conclusion Expression of TF,TFPI and their mRNA of all types of cells and stroma in the proliferative tunica intima.
5.The effects of olmesartan on ambulatory blood pressures and blood pressure variability in patients with mild to moderate essential hypertension
Jing LI ; Tingli QIN ; Hong JIANG ; Hao WANG ; Yuannan KE
Chinese Journal of Internal Medicine 2014;53(10):788-792
Objective To evaluate the effect of olmesartan medoxomil tablets (olmesartan) in comparison with Olmetec on 24 h ambulatory blood pressure (ABPM) and blood pressure variability (BPV)in patients with mild to moderate hypertension.Methods A randomized,double-blind,double-mimic controlled trial was performed.Forty-eight patients with mild to moderate essential hypertension were randomly into treatment group (olmesartan) and control group (Olmetec) for eight weeks.The ABPM was taken before and at the end of the trial.Results After eight weeks,treatment with olmesartan induced a significant reduction in ABPM in patients [(9 ± 3)/(11 ± 3) mmHg (1 mmHg =0.133 kPa)],which is similar with the reduction by Olmetec [(9 ± 4) / (9 ± 5) mmHg],P > 0.05.This situation holds for BPV with the standard deviations of 24 h,systolic blood pressure/diastolic blood pressure of pre-treatment and pro-treatment were (10 ± 2)/(11 ± 3) mmHg vs (10 ± 3)/(12 ± 2) mmHg in olmesartan group,and (10 ± 3)/(11 ±3) mmHg vs (12 ±3)/(12 ±4) mmHg in Olmetec group.(3) There is no difference in the rate of adverse event between olmesartan (10.42%) and Olmetec (8.33%) treatment(P > 0.05).Conclusion Similar to Olmetec,treatment with olmesartan once daily can significantly reduce ABPM in patients with mild to moderate essential hypertension.
6.The efficacy of Nebivolol on patient with mild or moderate mssential hypertension by different smbulatory blood pressure monitoring methods
Shan JING ; Yuanyuan CHEN ; Ningling SUN ; Yuannan KE ; Zhenyu YANG
Clinical Medicine of China 2014;30(2):121-124
Objective To evaluate the efficacy of Nebivolol on patients with mild or moderate essential hypertension(EH) using different methods of ambulatory blood pressure monitoring.Methods Forty-seven patients with mild or moderate EH were enrolled as our subjects after a 2-week administration of placebo.They were administrated Nebivolol (5 mg) once daily for 12 weeks.All the patients completed ambulatory blood pressure monitoring before and after taking Nebivolol for 12 weeks.The overall and individual methods were used to calculate the trough-to-peak ratio (T/P ratio) and smooth index (SI).Results (1) For all of 42 patients treated with Nebivolol (5 mg) for 12 weeks,the systolic blood pressure(SBP),diastolic blood pressure(DBP) of the whole-day,daytime and nighttime after treatment were decreased compared to before treatment (the whole day:(144.1 ± 9.8),(124.4 ± 10.4) mmHg vs.(93.2 ± 6.3),(79.2 ± 7.2) mmHg;daytime:(148.9 ± 9.7),(128.3 ± 10.5) mmHg vs.(96.8 ±6.1),(82.2 ±7.5) mmHg;nighttime:(133.9 ± 11.9),(115.9 ± 12.0) mmHg vs.(85.7 ± 8.0),(72.5 ± 7.5) mmHg),and there was significant difference (t =8.06,8.74,8.00,8.82,5.75,and 6.57 respectively; P < 0.01).T/P ratios of SBP/DBP calculated by overall method were 78.4% (17.4/22.2) and 61.2% (9.0/14.7),but it were (79.3 ±0.4) % and (58.5 ±0.5) % by individual calculation method.(2) Among 30 patients with better effect,the SBP,DBP of the whole-day,daytime and nighttime after treatment were decreased compared to before treatment (the whole day:(143.4 ± 9.1),(127.5 ±10.7) mmHgvs.(92.6 ±6.2),(81.6±7.6) mmHg;daytime:(147.8 ±9.1),(131.0 ±10.5)mmHg vs.(95.8 ± 6.4),(84.1 ± 7.5) mmHg; nighttime:(134.7 ± 11.6),(119.6 ± 13.2) mmHg vs.(86.2 ± 7.4),(75.2 ± 8.5) mmHg),and there was significant difference(t =11.18,12.77,11.14,12.85,7.37,and 8.74 respectively,P <0.01).T/P ratios of SBP/DBP were 78.9% (18.3/23.2),75.3% (11.6/15.4) and SIof SBP/DBP were 7.4(19.5/2.6),7.1 (14.2/2.0) calculated by overall method,but T/P ratios of SBP/DBPwere (78.4 ± 0.4) %,(74.6 ± 0.4) % and SI were (1.35 ± 0.73),(1.34 ± 0.54) calculated by individualmethod.Conclusion Nebivolol (5 mg once daily) can significantly reduce ambulatory blood pressure.Overall calculation method is better than individual method in terms of assessing the time of durative action and smooth effect by trough peak ratio and smooth index.
7.Association of urotensin Ⅱ with angiographic severity of coronary artery disease
Zhang LIFANG ; Ke YUANNAN ; Wang YONG ; Li XIANLUN ; Chen LI
Journal of Geriatric Cardiology 2007;4(4):229-232
Objective The goal of this study was to examine the association between urotensin Ⅱ (U Ⅱ) concentration and the severity of coronary artery disease (CAD). Methods We studied U Ⅱ concentrations in 100 patients with known or suspected CAD referred for cardiac catheterization. Based on coronary angiograms, subjects were classified as having no or mild CAD (stenosis <50%) and significant CAD (stenosis=50%). Micheal score system was used to estimate the severity of CAD. Result U Ⅱ concentration in the significant CAD group had no difference compared with the no or mild CAD group (1.95±1.18 pmol/L vs 2.04±1.47 pmol/L, P>0.05),but higher in the severe group (score =9) than in the normal or nearly normal group (score<3)( 2.50±1.62 pmol/L vs 1.61±1.05 pmol/L,P=0.03). U Ⅱ concentration had no relationship with other known risk factors, but it correlated with CAD severity (r=0.213, P=0.034).In multiple regression analysis, U Ⅱ is one of the determinants of the severity of CAD, other than age, abnormal glucose, hypertension and gender. Conclusios U Ⅱ is elevated in severe CAD and there is a significant relationship between U Ⅱ concentration and CAD severity.
8.Comparison of real-time and intermittent triggered myocardial contrast echocardiography in evaluation of mini-swine myocardial no-reflow phenomenon
Aili LI ; Yuannan KE ; Xianlun LI ; Peng YANG ; Wenhua PENG ; Jing LI ; Changan YU
Chinese Journal of Medical Imaging Technology 2010;26(1):25-28
Objective To assess the value of real-time myocardial contrast echocardiography (RTMCE) and intermittent triggered myocardial contrast echocardiography (ITMCE) in the detection of myocardial no-reflow phenomenon after reperfusion in acute myocardial infarction on mini-swine models. Methods Thirty close-chest mini-swines were used to create acute myocardial infarction and reperfusion model through interventional method. RTMCE and ITMCE were performed at baseline, 2 h after occlusion of left anterior descending coronary artery and 3 h after reperfusion. The myocardial perfusion defects after occlusion was measured as risk area (RA) and that after reperfusion was measured as no-reflow area (NRA). NRA/RA was calculated and compared with pathological findings. Results The whole study protocol was successfully performed in 27 mini-swines. NRA/RA obtained from RTMCE, ITMCE and pathological staining was (47.94±21.29)%, (38.20±21.04)% and (30.07±14.62)% , respectively. NRA/RA had no significant difference by ITMCE and pathological staining (P=0.124), RTMCE and ITMCE (P=0.071). The correlation coefficient of RTMCE and staining was 0.700 (P<0.001), ITMCE and staining was 0.765 (P<0.001), RTMCE and ITMCE was 0.897 (P<0.001). The sensitivity, specificity and accuracy in the detection of myocardial no-reflow was 100%, 58.33% and 79.17% for RTMCE, 91.67%, 73.33% and 81.48% for ITMCE. Conclusion Both RTMCE and ITMCE could be used as noninvasive methods to reveal the myocardial perfusion and quantitatively detect myocardial no-reflow after reperfusion therapy.
9.Effect of PM2.5 on sympathetic innervation by stimulating the secretion of cardiac nerve growth factor in healthy rat hearts
Jun DUAN ; Luhong CONG ; Gang LI ; Li YI ; Yuannan KE ; Yifeng ZHOU
Journal of Chinese Physician 2012;14(6):721-724
ObjectiveTo assess the effect of PM2.5 on sympathetic innervation and the relationship with cardiac nerve growth factor in healthy rat hearts,identify the ability to the sympathetic nerve reconstruction,and explore the possible arrhythogenic mechanism of PM2.5.MethodsForty healthy SD rats were instilled into trachea with two different solutions twice per week for four weeks:control group with saline and experimental group with PM2.5 25 mg/kg.Then these rats were killed,and biatrial appendages,two ventricular anterior walls were left.Immune cytochemical staining of cardiac nerves was performed using anti-tyrosine hydroxylase antibodies and cardiac nerve growth factor was detected by western blotting.ResuitsCompared with the control group,both the density of sympathetic nerves and the expression of cardiac NGF protein in the experimental group were much higher in the left ventricular anterior wall ( P<0.01 and P<0.05) and in the right ventricular anterior wall ( P<0.01 and P<0.05).ConclusionsPM2.5 can induce regional sympathetic hyperinnervation in both ventricular anterior walls in healthy rats by stimulating the NGF protein secretion,and the sympathetic nerve reconstruction effect of PM2.5 was confirmed.
10.Effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy
Hong JIANG ; Jiahui LI ; Rui ZHANG ; Shenshen LI ; Yunfei LI ; Yangfeng WU ; Yuannan KE ; Shengkai YAN
Chinese Journal of General Practitioners 2012;(7):502-506
Objective To evaluate the effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy.Methods The blood-lipid report was reformatted by adding three tables from the Chinese Guideline on the Prevention and Treatment of Adult Dyslipidemia on its back.The same questionnaire was used twice to evaluate the patients' behavior and knowledge of dyslipidemia therapy before and after reformat.Results Before and after reformat,the rates of correct deterination of their own risk stratification were 26.0% ( 112/430 ) and 26.3% ( 115/438 ) respectively.The awareness rates of Different LDL-C goals among different persons wcre 37.0% (159/430) and 35.8% (157/438).Only 0.7% (2/306) and 1.0% (3/299) of patients knew their blood lipid goals (P =0.557).When the report showed normal blood lipid levels,the percentages of taking lipid-lowering drug were 47.6% ( 230/483 ) and 46.6% ( 216/464 ),20.5% ( 99/483 ) and 19.0% ( 88/464 ) of patients questioned the prescription.Non-medication rates were 31.9% ( 154/483 ) and 34.5% ( 160/464 ) respectively before and after reformat ( P > 0.05 ).For patients requiting lipid-lowering drug therapy by the guideline,treatment rate improved significantly in the low-risk group (13.3% vs.75.0%,P =0.002).Treatment rate slightly increased in the high-risk and very high-risk groups after reformat (54.0% vs.56.8%,62.4% vs.69.0%,P > 0.05 ).Rates of achieving lipid goal showed no change [ 41.5% ( 102/ 245 ) vs.44.5% ( 114/256 ),P > 0.05 ] after reformat,especially among the very high-risk patients [17.9%(12/68) vs.21.6%(11/52),P>0.05].Conclusions The blood-lipid report reformat did not improve the patient behaviors and knowledge of the prevention and treatment of dyslipidemia because of poor treatment rate and medication compliance.The combination of patient education and thorough blood-lipid report reformat may help to increase the attainment rate of dyslipidemia therapy.