Objective To evaluate the impact of triglyceride(TG) on the severity and the extent of coronary artery stenosis.Methods Ninety-three cases of young patients(below 45 years old, with or without hypertriglyeeridemia)underwent pereutaneous coronary intervention(PCI)were retrospectively analyzed.The patients were divided into three groups according to TG levels:I group(TG<1.70 mmol/L,36 cases),II group(1.70 mmol/L≤TG≤2.25 mmol/L,19 cases),III group(TG>2.25 mmol/L,38 cases).The severity of coronary artery stenosis and the extent Was compared among the three groups.Results In all patients, the male and the smoker occupied the overwhelming majority[94.62%(88/93),83.87%(78/93)].Total cholesterol(TC),non-high density lipoprotein cholesterol(HDL-C)in III group were higher than those in I group with statistical significance(P=0.006,0.003).There were no significant difference among the three groups in low density lipopmtein cholesterol(LDL-C),HDL-C,fasting blood glncose(P=0.648,0.795,0.247).There were no significant difference among the three groups in extent of coronary artery and severity of coronary artery stenosis(P=0.241,0.879).Conclusions There is no significant difference among the three groups in severity of coronary artery stenosis and extent of coronary artery.Hypertriglyeeridemia ian't the determiner on severity of coronary heart disease.

The prevalence of obstructive pulmonary disease (COPD) and chronic heart failure (CHF) increased gradually with age. The coexistence of COPD and CHF was very common but often neglected. To avoid overlooking COPD in patients with known CHF, pulmonary function tests should be routinely obtained. Likewise, to avoid overlooking CHF in patients with known COPD, left ventricular function should be routinely assessed. Plasma brain natriuretic peptide was a useful index to differentiate COPD exacerbation from CHF decompensation in patients presenting with acute dyspnea. Skeletal muscle metabolic alterations and its atrophy were the common mechanisms which resulting in deterioration of function capacity in elderly patients with CHF and COPD. Contrary to the conventional belief, long-term beta adrenergic blockers should be given to elderly patients with CHF and COPD. Exercise training reverses rapidly progress of skeletal muscle metabolic alterations and atrophy and promotes independence and life quality in elderly patients.

Objective To investigate the effect of miRNA-1 on the cardiomyocyte apoptosis in rats. Methods MicroRNA-1 mimics was transfected into the cultured H9c2 cell line (miRNA-1 group). Cells transfected with random miR-NA fragment was used as negative control group. The cell apoptosis was evaluated by FCM assay. MTT assay was used to de-tect the cell viability. The expression level of miRNA-1 was detected by real-time PCR. The expression levels of Bcl-2 mRNA and protein were detected by real-time PCR and Western blot assay. Results Compared with normal and negative control groups, the expression level of miRNA-1 was significantly higher in H9c2 cardiomyocytes, the apoptosis rate was in-creased, the cell vitality and Bcl-2 expression level were significantly decreased after transfection of miRNA-1 mimics. Conclusion miRNA-1 mimics can up-regulate miRNA-1 level, inhibit proliferation and induce cardiomyocyte apoptosis.

Objective To investigate the risk factors and prognosis of no-reflow phenomenon in patients after percutaneous coronary intervention(PCI).Methods Retrospectively analyzed 524 patients with acute coronary syndrome after PCI of which 427 patients had detailed record.Angiographic no-reflow phenomenon was designated as TIMI≤2 flow without mechanical obstruction of embolism,thrombus,dissection and spasm.Normal flow designated as TIMI 3 flow.Using random count table of Excel,70 patients were randomized from 393 patients with coronary flow TIMI 3 after PCI as the control normal flow group.Results The no reflow group enrolled 34 patients.Compared with the normal flow group,their incidence of AMI and diabetes,the blood insulin level and mean leukocyte count were significantly higher.The incidence of MACE in and out of hospital was higher in the no reflow group than the normal flow group.Within the no reflow group,the EF decreased while the LVEDD increased significantly PCI.Conclusion History of diabetes,blood insulin level and leukocyte count may be the risk factors of no-reflow.On the other hand,the no reflow phenomenon maybe a prognostic factor of MACE,ventricular remodeling and heart function for patients after PCI.

Objective To investigate the clinical autopsy results of patients died of cardiovascular disease or other disease complicated with cardiac damage. Methods Complete autopsy was performed on 86 cases with uncertain cause of death. Through integrating clinical diagnosis and treatment with gross autopsy findings and microscopic observations, 86 autopsies were determined the major cause of death. Results In 86 autopsies, 69 cases were heart disease. Differences between pathological diagnosis and clinical diagnosis were compared. Twenty-seven cases were cardiac deaths, with diagnosis accrodance rate of 81. 5%. Fortytwo cases died of non-cardiac disease but complicated with heart disease or involving the heart which accelerated the death in patients, with accordance rate of 78.6%. Conclusion Scientific and correct performance of autopsy was important to determine the causes of death, to promote development of related disciplines and to improve the diagnosis and treatment of the diseases.

Objective To investigate the effects of homocysteinemia (HHcy) and hypertension on left ventricular re?modeling. Methods A total of 275 patients with coronary heart disease were divided into four groups including H-type hy? pertension group (n=96), non-H-type hypertension group (n=44), HHcy+non-hypertension group (n=53) and control group (n=65) based on their blood pression levels and plasma HHcy levels. The serum levels of glucose (Glu), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL) were compared between groups. The left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST) and left ventricular mass index (LVMI) were observed in four groups. The proportion of patients with left ventricular remodeling was also compared between four groups. The influence fac?tors of left ventricular remodeling were analysed. Results There were no significant differences in biochemical parameters except Hcy level between frour groups. The values of LVMI, left ventricular wall thickness and the proportion of patients with left ventricular remodeling were significantly higher in H-type hypertension group than those of other three groups ( P<0.05). The Hcy level was positively correlated with LVMI and left ventricular wall thickness. Logistic regression analysis showed that HHcy and hypertension were the risk factors of left ventricular remodeling (OR=7.443, 7.754 and 9.948,P<0.05). The risk factors of left ventricular remodeling were higher in patients with both HHcy and hypertension than those in patients with HHcy or hypertension. Conclusion Homocysteine and higher systolic pressure are independent risk factors for left ventricular remodeling and they have a synergistic effect on leading to left ventricular remodeling.

Objective To study the correlation between normal level of thyroid hormone and gensini coronary scor-ing system. Methods Coronary heart disease patient who were treated with Cardio-angiography (CAG) (n=231) were divid-ed into 4 groups based on gensini coronary score. All the patients were examined with indexes include total triiodothyronine (TT3), total thyronine(TT4), free thyronine(FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH). And correla-tion between thyroid hormone level and gensini coronary scoring system was studied by Spearman correlation analysis and Multiple regression analysis. Results No significant difference was found in the levels of TT3, TT4, FT4, Cholesterol(CHO) and Triglyceride(TG) between the all 4 groups (P>0.05). FT3 and HDL-C decreased with the increase of extent of coronary artery lesions(P<0.01), and AGE and LDL-C raised with the coronary artery lesions extent (P<0.05). Gensini coronary scoring system was linearly negatively correlated with FT3, HDL-C and positively correlated with age and LDL-C. Age, FT3,HDL-C,LDL-C was independently correlated to Gensini score. Conclusion The lower level of FT3 is an indepen-dent risk factor for CHD.

Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera?tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col?lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P<0.05).(1)In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction(POCD)were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper?ative depression in patients underwent CABG.(2)In PCI group, ratio of female gender, blood pressure, incidence of Diabe?tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa?tients underwent revascularization is high. Female is the dependent risk factor in both CABG group and PCI group. Com?pared with PCI, CABG had greater influence on development of depression in postoperative patients.

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.

ObjectiveTo investigate the effects of tirofiban on microvascular flow in infarction zone after coronary reperfusion in pigs with acute myocardial infarction (AMI),and to explore its mechanism of decreasing microvessel obstruction (MO) and the relationship with inflammatory factors. MethodsChinese mini pigs were randomized into control group and tirofiban treatment group.Acute myocardial infarction was induced by balloon occluding the medium segment of the left anterior descending artery for 90 min,and then reperfusion was created by withdrawing the balloon.The infarct myocardium and MO area were detected with delayed enhancement multi-slice spiral CT (DE-MSCT),the serum levels of IL-6 and IL-10 were measured with enzyme linked immunosorbent assay (ELISA).The pigs were killed, the heartwere excised and stained with 2, 3, 5-triphenyltetrazolium chloride (TTC). Results6 pig models were successfully established in each group.4 pigs in control group and 3 pigs in tirofiban treating group experienced MO.The MO volume was increased at every time after reperfusion in both groups,while the MO volume was significantly reduced in tirofiban treatment group compared with control group at 1 h [(9.6 ± 3.1) ％ vs.(4.8 ±0.7)％],24 h[(13.4±3.3) ％ vs.(5.8±-1.2)％],48 h[(15.1±3.8)％ vs.(6.4±1.2)％] and 72 h [(15.9±4.6) ％ vs.(6.6±0.8)％ after reperfusion (t=6.99,13.76,14.21,11.38,all P＜0.05).Compared with the baseline,the levels of serum IL-6 and IL-10 in both groups were increased at 30 min after AMI.In tirofiban treatment group,the level of serum IL-6 was significantly lower and serum IL-10 was higher than those in control group (P＜0.05 and P＜0.01) from 10 min to 72 h after reperfusion. Conclusions Tirofiban may lessen the MO area in infarction zone of AMI after reperfusion,which may be ascribed to its anti-inflammation besides anti-platelets.