Objective To study on the evaluation of haemodynamics in the normal and pulmonary hypertensive mouse hearts using pressure volume loops measured by electric catheter.Methods Compared the difference in haemodynamics between mice exposed to chronic hypoxia for 10 days,which causes hypoxia-induced pulmonary hypertension (experimental group,n =8),and mice raised under normal atmospheric pressure (control group,n =8).The right carotid artery was cannulated with a 1.2 F catheter and advanced into the ascending aorta,then punctured towards the right ventricular apex.A 1.2 F admittance pressure-volume catheter was introduced using a 20-gauge needle to obtain the pressure-volume measurements and calculate hemodynamic parameters.Results There were no significant differences in average by weight,ratio of right atrial weight to body weight,left atrial weight/body weight,left ventricular free wall and septum weight/body weight between the 2 groups(all P ＞ 0.05).The ratio of right rentricle/left rentricle and septum weight as well as right rentricular weight/body weight was increased in the experimental group and of significant difference when compared to the control.The mice in in the experimental group had a 61％ mean decrease in cardiac output,a 55％ decrease in ejection fraction,and a 63％ decrease in ventricular compliance(P ＜0.05).The increase in dP/dtmax-EDVand PRSWfound in the experimental group reflected significant increase in myocardial contractility.Increase in Ees was observed but without significant difference as compared to the control.Ea significantly increased in the experimental group resulting in significant decrease in Ees/Ea from (0.71 ±0.27) to (0.35 ±0.17) (P＜ 0.005).Conclusion This study demonstrates the feasibility of obtaining RV pressure-volume measurements in mice using electric catheter.These measurements provide insight into right ventricular-pulmonary artery interactions in healthy and diseased conditions.

Objective To evaluate the feasibility and therapeutic efficacy of prophylactic implantation of intraaortic balloon pump in patients with high-risk coronary artery disease.Methods 121 patients with high-risk coronary heart disease who received prophylactic implantation of intraaortic balloon pump in percutaneous coronary intervention were enrolled as the treatment group (Group A),and another 119 patients with high-risk coronary heart disease who had conventional coronary intervention were enrolled as the control group (Group B).The rates of intraoperative malignant arrhythmia (ventricular tachycardia,ventricular fibrillation),acute left heart failure,cardiogenic shock and sudden death were compared between the two group.NT-proBNP levels,left ventricular systolic function and the rates of major adverse cardiac events,within 30 days of PCI and after 1 year were compared between the two groups.Results The event rates of intraoperative malignant arrhythmia,acute left heart failure,cardiogenic shock,and sudden death in Group A was significantly lower than those in Group B (all P ＜ 0.05).Postoperative hematoma were found in 2 cases,aortic dissection in 1 case and thrombocytopenia in 1 case in Group A without significant difference as compared to Group B (P ＞ 0.05).Within 30 days after PCI,NT-proBNP levels and left ventricular diastolic diameter in Group A were lower than those in Group B while the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).The rates of major cardiac adverse events,including sudden cardiac death and severe heart failure were lower than those in Group B (all P ＜ 0.05).At 1 year after PCI,the NT-proBNP levels left ventricular diastolic diameter in Group A were lower than those in Group B with the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).There were no significant differences in the rates of major cardiac adverse events,including sudden cardiac death and severe heart failure after 1 year(all P ＞ 0.05).Conclusions For patients with high-risk coronary heart disease undergoing coronary intervention,prophylactic implantation of intraaortic balloon pump may decrease the incidence of intraoperative complications,reduce the incidence of cardiac death and severe heart failure within 30 days,and improve the left ventricular function after 1 year.Its role in reducing long term major cardiac adverse events after 1 year still needs more clinical trials for funther justification.

Objective By comparing the efficacy and complication rates of the 8-mm-tip cryoablation catheter with the normal electrode ablation catheter in the treatment of atrioventricular nodal reentrant tachycardia,this study investigated the efficacy and feasibility of ablation with the 8-mm-tip cryoablation catheter.Methods This is a retrospective case-control study including 122 patients with AVNRT treated with CRYO (n =56) using an 8-mm-tip cryoablation catheter or RF ablation (n =66) from June 2014 to May 2016.The procedure success rate,the recurrence rate,atrioventricular block incidence,procedure time and the difference between the X-ray fluoroscopy dose were compared between the 2 groups.Results The procedure success rate was comparable between the 2 groups(100％ for CRYO vs.98.5％ for RF,P ＞0.999)and no AVB was found in both groups.The CRYO group needed shorter procedural time [(66.29±4.72)min vs.(70.00 ± 7.50) min,P =0.001] and less X-ray exposure [(674.14 ± 126.12) mSv vs.(837.52 ± 138.38) mSv,P ＞ 0.001] than the RF group.Conclusions 8-mm-tip cryoablation catheter cryoablation for atrioventricular nodal reentrant tachycardia is as safe and effective as compared to conventional radiofrequency ablation with potential advantages.

Objective To explore the efficacy and safety of ticagrelor plus cilostazol of different dosage in the treatment of low-weight patients after PCI.Methods A total of 148 consecutive ACS patients (body weight ≤ 65 kg) past PCI and with aspirin intolerance were enrolled and randomly divided into four groups.Patients given cilostazol 50mg twice daily plus clopidogrel 75 mg daily were named as the CC50 mg group.Patients in the CC100 mg group were given cilostazol 100 mg twice daily plus clopidogrel 75 mg daily.The TCS0 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90mg twice daily and the TC100 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90 mg twice daily.All patients were followed up clinically for 6 months.The clinical endpoints were MACEs and bleeding events.Platelet aggregation at 7 and 30 days after treatment the incidence of clinical endpoints during followup were compared between the four groups.Results Patients in the TC100mg group had the lowest platelet aggregation rates tested on both the 7th and 30th day after treatment among all the 4 groups.After 6 months of follow up,the MACEs rate was not significantly different between the four groups (P =0.930).Bleeding events rates in the TC100 mg group the highest among the 4 but without groups significant differences.Conclusions In ACS patients with low body weight ≤ 65 kg) past PCI and with aspirin intolerance,cilostazol 50mg twice daily plus ticagrelor is a safe and efficacious therapeutic regimen.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.

The safety and effectiveness of catheter ablation in coronary sinus using radiofre-quency energy was studied in 16 dogs. Radiofrequency energy(1229?711 J) was applied between electrode catheter placed inside coronary sinus and a chest wall patch. Thirteen dogs were killed approximately half an hour after ablation and three 3 to 4 weeks. Lesion of abltion area were 3. 2?1. 8mm in length, 2. 2?1. 7mm in width and 2. 1?1. 0mm in depth. Microscopic examination showed well circumscribed area of coagultion necrosis (acute period)and fibrosis (chronic period). The coronary atery and mitral apparatus were not involved,nor was the endocadium. No arrhyth-mias except occationally atrial or ventricular premature beats were observed. No hemodynamic changes and rupture of coronary sinus occurred in any dog. Large amount of radiofrequency energy can be safely applied to the coronary sinus. The location of the lesions produced suggests that this technique may be useful for interruption of left-sided atioventricular pathways of patients.

The plasma levels of atrial natriuretic factor (ANF), angiotension II (AII, vaso-pressin (VP) and endogenous digitalis-like factor (EDLF) were determined in 23 patients with mi-tral stenosis before and after percutaneous balloon mitral valvuloplasty (PBMV). Before PBMV, the plasma levels of ANF and EDLF were elevated in all patients with lower level of All than nor-mal. After the procedure, with a concomitant decrease of left atrial pressure, the plasma ANF de-creased at 15 minutes (from 317. 4?96. 2 to 164. 9?56. 8ng/L , P

Transcatheter atrioventricular (AV) junction ablation with radiofrequency energy was performed in five patients with AV nodal reentrant tachycardia. Disappearance of ventriculoa-trial condcution in all patients was showed and no dual pathway was observed in four patients, in whom three patients occurred first degree AV block after ablation. No tachycardia was showed in all patients in the electrophysiology test and in follow-up of 1. 5-12. 5 months. The results sug-gested that the application of radiofrequency energy may be a suitable and safe therapeutic mothed for modification of AV nodal conduction in patients with AV nodal reentrant tachycardia.

Transcatheter electrical ablation was performed in 5 patients, none of them showed clinical effectiveness for treatment of antiarrhythmic drugs, with recurrent sustained ventricular tachycardia (VT). The localization of ventricular ectopic focus mainly depended upon the results of pace mapping. Energy used for each transcatheter electrical ablation (TEA) was usually 150-250J and the total energy was 550J to 800J respectively for each patient. No recurrence of VT was ob-served in 4 cases during 19 to 41 (mean 26. 8) months of follow-up period, two of them without adminstration of drug. Sustained VT relapsed during the 4th months after ablation in one case, however, heart rate during VT was much slower than before. Our experience suggests that long-term effectiveness of TEA for treatment of drug-resist VT is inspiring.

The resting 12 lead electrocardiograms (ECG) of 45 patients with Wolff-Parkinson-White syndrome and 30 normal persons were assessed by five criterias for locating the accessory pathway. Golden criteria was established by site of accessory pathway confirmed during epicardial mapping and absent accessory pathway from normal person. Compared five criterias of EGG with golden criteria, the idiosyncrasy of every criteria was 100% and the sensitivity of Rosenbaum's cri-terias, Gallagher's, WHO's, Lindsay's, Reddy's were respectively 93. 3% , 71. 1% , 64. 4% , 60% , 53. 3%. The preliminary feature for locating the accessory pathway of ECG was put forward from advantages of five criterias and observation of this report data.