During 5/2000 - 5/2001, the nuclear medicine depar. of Cho Ray hospital implemented the scintigraphic application of myocardial blood irrigation for 144 cases (93 with 99 mTc-MIBI, 33 with 201 TI and 14 with 99m Tc MIBI combined with 201 TI). The results from angiography have shown that the sensitivity and specificity of scintigraphy in the diagnosis of the coronary arterial pathology was 92% and 71.4%, respectively. The scintigraphy for myocardial blood irrigation was a sensitive, noninvasive and valuable method of diagnosis of the coronary arterial pathology
Cardiomyopathies ; Angiography ; blood ; Irrigation

This study determined the levels of serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecular-1 (sVCAM-1) in patients with different types of Keshan disease (KD), examined the relationship between Coxsackie B virus-specific IgM antibody (CBV-IgM) and sICAM-1 or sVCAM-1 in KD patients, and investigated the role of these adhesion molecules in the pathogenesis of KD and their clinical implications. The levels of serum sICAM-1, sVCAM-1 and CBV-IgM were measured by using enzyme-linked immunosorbent assay in 22 patients with chronic Keshan disease (CKD), 27 with latent Keshan disease (LKD) and 28 healthy controls. The subjects in different groups were adjusted for sex and age. Echocardiography was adopted to determine left ventricular ejection fraction (LVEF) in 22 patients with CKD. The results showed that CKD patients had significantly higher levels of sICAM-1 and sVCAM-1 than LKD patients and healthy controls (P<0.01 for all). And there was significant difference in the levels of the 2 adhesion molecules between LKD patients and healthy controls (P<0.05). A negative correlation was found between LVEF and sICAM-1 or sVCAM-1 in CKD patients. The percentage of CBV-specific IgM positive individuals in KD patients was significantly higher than that of healthy controls. In CVB-specific IgM positive patients, the levels of serum sICAM-1 and sVCAM-1 were significantly greater than those in CBV-specific IgM negative counterpart. It was concluded that the increase in the levels of sICAM-1 and sVCAM-1 suggests the progression of inflammation in KD. sICAM-1 and sVCAM-1 can promote the development of myocardial pathology and lead to poor myocardial function. The increased serum sICAM-1 and sVCAM-1 in KD patients may be related to CBV infection.
Cardiomyopathies/*blood ; Cardiomyopathies/etiology ; Cardiomyopathies/*virology ; Coxsackievirus Infections/*complications ; Enterovirus B, Human ; Intercellular Adhesion Molecule-1/*blood ; Selenium/blood ; Vascular Cell Adhesion Molecule-1/blood ; Young Adult

OBJECTIVETo summarize experience of perioperative anesthetic management for patients undergone excision of pheochromocytoma and complicated with catecholamine cardiomyopathy.

METHODSPerioperative anesthetic management for surgical treatment of three cases of pheochromocytoma complicated with catecholamine cardiomyopathy was described and discussed according to literature reports.

RESULTSThe catecholamine cardiomyopathy of the three cases presented with left ventricular hypertrophy, congestive cardiac failure and acute myocardial infarction. After removal of the pheochromocytoma under general anesthesia, a prolonged hypotension occurred in all of the three cases. In order to maintain stable hemodynamics, large dose of catecholamine was required after surgery. All of the three patients were survived and discharged.

CONCLUSIONSIt is suggested that myocardial dysfunction may be another important factor for the prolonged hypotension after removal of the tumor. Meticulous preoperative assessment of heart function is of primary importance for the management of anaesthesia during surgical procedures.

Adrenal Gland Neoplasms ; blood ; surgery ; Adult ; Anesthesia, General ; Cardiomyopathies ; blood ; etiology ; Catecholamines ; blood ; Female ; Heart Failure ; blood ; etiology ; Humans ; Male ; Pheochromocytoma ; blood ; surgery

OBJECTIVETo investigate the instigating effect of "shock heart" on injury to liver, kidney and intestine at early stage of severe burn in rat.

METHODSFifty-six healthy male Wistar rats were enrolled in the study and randomly divided into normal control (n=8, without treatment, NC) and burn (n=48, inflicted with 30% TBSA full-thickness scald, B) groups. The rats in B group were intraperitoneally injected with Ringer's lactate solution (4 ml x kg(-1) x 1% TBSA(-1) 30 minutes after burn following the Parkland formula, and they were observed at 0.5, 1.0, 3.0, 6.0, 12.0, 24.0 post-burn hour (PBH), with 8 rats at each time point. The parameters concerning myocardial mechanics, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure( LVEDP), +/-dp/dt max were recorded. The volume of blood flow in liver, kidney and intestine were detected. The serum contents of cTnI, TBA, 32-MG, DAO were determined.

RESULTSIn B group, LVSP and +/- dp/dt max decreased at 1.0 PBH, SBP, DBP and MAP decreased at 3.0 PBH ,all parameters of myocardial mechanics, decreased at 6.0 PBH and still lower than those in NC group at 24.0 PBH (P < 0.01). The volume of blood flow in liver, kidney and intestine in B group were markedly decreased at 1.0 PBH, and gradually decreased during 1.0-12.0 PBH, which were still lower than those in NC group at 24.0 PBH (P < 0.05 or P < 0.01). Compared with that in NC group (1.71 +/- 0.07 microg/L), the serum content of cTnI in B group were increased at 0.5 PBH (2.22 +/- 0.08 microg/ L, P < 0.01), and peaked at 12.0 PBH (7.07 +/- 0.44 microg/L), and persisted at high level (4.57 +/- 0.30 microg/L) at 24.0 PBH. The serum contents of TBA at 3.0 PBH, beta2-MG at 1.0 PBH, DAO at 1.0 PBH was obviously higher than those in NC group (P < 0.05 or P < 0.01), which all showed ascending tendency during 1.0-12.0 PBH.

CONCLUSIONMyocardial damage is earlier than other organs after severe burn, which is significantly correlated with the parameters of other organs damage and their blood flow volume. Shock heart may be one initiate factor to induce the damage of liver, kidney and intestine and decrease of their blood flow volume after severe burn.

Animals ; Blood Pressure ; Burns ; blood ; physiopathology ; Cardiomyopathies ; etiology ; Kidney ; blood supply ; Liver ; blood supply ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Shock ; physiopathology ; Ventricular Function

OBJECTIVETo study the relationship between insulin resistance and myocardial injury in children with critical diseases in light of the fact that such children usually suffer from noticeable insulin resistance and myocardial injury.

METHODSSixty-three children with critical diseases who were admitted between March 2010 and June 2011 were enrolled to comprise a case group. Fasting blood glucose, serum insulin, myocardial enzyme, and troponin I (CTnI) levels were measured. The insulin resistance index (HOMA-IR) was calculated. The children were classified into two groups: insulin resistance (HOMA-IR>1.0; n=30) and non-insulin resistance (HOMA-IR≤1.0; n=33). Thirty healthy children served as the control group.

RESULTSHOMA-IR, lactate dehydrogenase (LDH), aspartate aminotransferaseaspartate transaminase (AST), creatine kinase (CK), isoenzymes of creating kinase (CK-MB), α-hydroxybuty rate dehydrogenase (α-HBDH) and CTnI in the insulin resistance group were higher than those in the non-insulin resistance and the control groups (all P<0.05). The non-insulin resistance group also showed obviously higher levels in terms of LDH, AST, CK, CK-MB, α-HBDH, and CTnI than the control group (P<0.05). In the insulin resistance group, there exists a positive correlation between HOMA-IR and such indicators as LDH, CK, CK-MB, AST, α-HBDH and CTnI (r=0.697, 0.739, 0.781, 0.642, 0.381, 0.792 respectively; all P<0.05).

CONCLUSIONSInsulin resistance makes myocardial injury more serious; HOMA-IR can serve as a forecast indicator for the degree of myocardial injury.

Aspartate Aminotransferases ; blood ; Cardiomyopathies ; etiology ; Child ; Child, Preschool ; Creatine Kinase, MB Form ; blood ; Critical Illness ; Female ; Humans ; Insulin Resistance ; L-Lactate Dehydrogenase ; blood ; Male ; Troponin I ; blood

Acute Disease ; Adult ; Cardiomyopathies ; blood ; chemically induced ; diagnosis ; Creatine Kinase ; blood ; Female ; Humans ; Male ; Organophosphate Poisoning ; Pesticides ; poisoning ; Troponin I ; blood

OBJECTIVE: To investigate the myocardial fibrotic indices in patients with ischemic cardiomyopathy (ICM), and explore the mechanism of myocardial fibrosis. METHODS: The concentration of serum procollagen type III aminoterminal peptide (P III P), procollagen type IV aminoterminal peptide (P IV P), lamnin (LN), and hyaluronic acid (HA), as well as plasma angiotension II (AngII), aldosterone (ALD), and transforming growth factor beta 1 (TGFbeta1) in 46 ICM patients and 37 normal controls were measured by radioimmunoassay (RIA). The correlations between the plasma levels of AngII, ADL, TGFbeta1, and serum levels of P III P, P IV P, LN, and HA were analyzed. RESULTS: Compared with normal controls, the concentrations of serum P III P, P IV P, LN, HA, and plasma AngII, ADL, and TGfbeta1, significantly increased in ICM patients. AngII, ALD, and TGFbeta1 levels were positively correlated with the indices of myocardial fibrosis. CONCLUSION The myocardial fibrosis exists in ICM patients and the serum concentrations of P III P, P IV P, LN, and HA may be an indirect index of myocardial fibrosis. AngII, ADL, and TGFbeta1 levels play important roles in myocardial fibrosis.
Aged ; Cardiomyopathies ; pathology ; Collagen Type III ; blood ; Coronary Artery Disease ; pathology ; Female ; Fibrosis ; pathology ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Male ; Middle Aged ; Myocardium ; pathology

BACKGROUND AND OBJECTIVES: Angiotensin converting enzyme inhibitor is known to be effective in the prevention of left ventricular remodeling following myocardial infarction. However, little data is available concerning the clinical effects of angiotensin (AT) receptor blocker in ischemic cardiomyopathy. This study evaluated the clinical effects of the concomitant use of losartan with low doses of hydrochlorthiazide in cases of ischemic cardiomyopathy. SUBJECTS AND METHODS: A combined agent of 50 mg of losartan potassium with 12.5 mg of hydrochlorthiazide (HCTZ) was administrated once daily over a 12-week period to 29 patients (M:F=26:3, 61.4+/-8.7 years) who were diagnosed with ischemic heart failure (ejection fraction lower than 50% by echocardiography) at Chonnam National University Hospital. RESULTS: Clinical symptoms of dyspnea in the 29 patients improved from 2.08+/-0.49 to 1.15+/-0.38 as measured by New York Heart Association class. The systolic and diastolic blood pressure did not change significantly following treatment (116.5+/-18.0/77.0+/-11.9 mmHg vs. 118.7+/-15.1/78.1+/-11.1 mmHg). The ejection fraction following administration of Losartan/HCTZ increased from 40.3+/-8.1% to 46.7+/-10.8% (p=0.001). Losartan/HCTZ was well tolerated in all patients without significant adverse effects or laboratory changes. CONCLUSION: A fixed combination of losartan and low dose hydrochlorthiazide is effective in patients with ischemic heart failure.
Angiotensins ; Blood Pressure ; Cardiomyopathies ; Diuretics ; Dyspnea ; Heart Failure* ; Heart* ; Humans ; Jeollanam-do ; Losartan* ; Myocardial Infarction ; Peptidyl-Dipeptidase A ; Ventricular Remodeling

OBJECTIVE: To investigate the nucleolus expression in the diabetic cardiomyopathy. METHODS: The rats were divided into a control group and a type II diabetic cardiomyopathy group (model group). In the model group, rats were fed with high-fat and high-sugar food (rats were intravenously injected with 60 mg/kg chain urea with cephalosporins in the 5th and 6th weeks in mice). The level of blood glucose was determined at the end of 8th week and the level of fasting blood glucose was examined at the end of 20th week. The ratio of the heart mass and body mass was calculated, and the pathological changes in myocardial morphology were observed. The immunohistochemical method and Western blot were used to detect the expression level of myocardial nucleolin. RESULTS: The level of fasting blood glucose was significantly increased in the diabetic model group than that in the control group (P<0.05). Rats in the model group were found hypertrophic cardic cells, with fracture, dissolusion, and disordered arrangement. Immunohistochemical staining and Western blot showed the protein levels of myocardial nucleolin in the model group were obviously higher than those in the control group (P<0.05). CONCLUSION Nucleolin may play a role in the pathogenesis and development of the diabetic cardiomyopathy.
Animals ; Blood Glucose ; Diabetes Mellitus, Experimental ; metabolism ; Diabetic Cardiomyopathies ; metabolism ; Myocardium ; pathology ; Phosphoproteins ; metabolism ; RNA-Binding Proteins ; metabolism ; Rats

OBJECTIVE: To investigate the epidemiology and independent risk factors of septic cardiomyopathy. METHODS: A prospective study was conducted. Patients with sepsis in intensive care unit (ICU) of Subei People's Hospital of Jiangsu Province, Yangzhou University, Fuxing Hospital, Capital Medical University and Beijing Electric Power Hospital from May 2016 to August 2019 were enrolled. All patients received standardized treatments according to the Surviving Sepsis Campaign (SSC) guidelines. Blood were collected within 24 hours of admission to ICU, and plasma histone H4, cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by enzyme linked immunosorbent assay (ELISA). Transthoracic echocardiography was performed to record the ultrasonic parameters within 24 hours after admission. Sequential organ failure assessment (SOFA) score, usage of vasopressor drugs, and the prognosis of ICU were recorded. Patients were divided into two groups according to whether cardiomyopathy occurred or not, and the differences of each index between the two groups were compared. The correlation between plasma histone H4 and SOFA score, cTnI, NT-proBNP were investigated. Multivariate binary Logistic regression was used to determine the risk factors for septic cardiomyopathy. The predictive value of histone H4 in septic cardiomyopathy was shown by the receiver operating characteristic (ROC) curve. RESULTS: 121 patients were included in this study, and there were 60 patients (49.6%) with septic cardiomyopathy. Thirty-six patients died, with an ICU mortality of 29.8%. (1) Correlation analysis showed that plasma histone H4 in patients with septic cardiomyopathy was positively correlated with cTnI, SOFA score and NT-proBNP (r value was 0.512, 0.403 and 0.274, respectively, all P < 0.01). (2) Compared with the non-cardiomyopathy group, the plasma histone H4, cTnI, usage of vasopressor drugs, SOFA score and ICU mortality in the cardiomyopathy group were significantly increased [histone H4 (mg/L): 0.26 (0.23, 0.30) vs. 0.22 (0.17, 0.27), cTnI (μg/L): 0.21 (0.17, 0.30) vs. 0.18 (0.14, 0.22), usage of vasopressor drugs: 83.3% (50/60) vs. 65.6% (40/61), SOFA score: 11 (9, 12) vs. 9 (8, 10), ICU mortality: 40.0% (24/60) vs. 19.7% (12/61), all P < 0.05]. Multivariate binary Logistic regression analysis showed that high histone H4 level [odds ratio (OR) = 6.502, 95% confidence interval (95%CI) was 1.203-78.231, P = 0.044] and usage of vasopressor drugs (OR = 2.622, 95%CI was 1.034-6.849, P = 0.042) were independent risk factors for septic cardiomyopathy. (4) ROC curve analysis showed the cut-off of histones H4 for predicting septic cardiomyopathy was 0.24 mg/L, the area under the curve was 0.684 (P < 0.01), with the sensitivity of 65.2%, and specificity of 68.9%. CONCLUSIONS Septic cardiomyopathy had a high incidence. Higher plasma histone H4 and the usage of vasopressor drugs were independent risk factors for septic cardiomyopathy.
Cardiomyopathies ; Histones/blood* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Prognosis ; Prospective Studies ; ROC Curve ; Retrospective Studies ; Risk Factors ; Sepsis