OBJECTIVETo study the association of red blood cell distribution width (RDW) and lipoprotein-associated phospholipase A2 (LP-PLA2) with the degree of coronary artery stenosis in patients with coronary artery disease (CAD) and the value of RDW combined with LP-PLA2 detection in accurate evaluation of coronary artery stenosis.

METHODSA total of 224 patients including 119 non-CAD cases and 105 CAD cases admitted in our hospital between June, 2013 and June, 2014 were enrolled in this study. The patients' baseline clinical data were collected and venous blood samples were obtained for detecting WBC, RDW-CV and LP-PLA2. The Gensini score of the CAD patients was calculated based on coronary angiographic findings.

RESULTSCompared with the non-CAD patients, CAD patients had significantly higher RDW-CV (P=0.009) and LP-PLA2 (P=0.004) levels. The CAD patients with high Gensini scores had also significantly higher RDW-CV (P=0.001) and LP-PLA2 (P<0.001) levels than those with low scores; RDW-CV and LP-PLA2 were significantly correlated with the Gensini score, and the area under curve of their combined detection was 0.931.

CONCLUSIONCombination of RDW and LP-PLA2 can improve the diagnostic accuracy of the degree of coronary artery stenosis in patients with CAD.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; blood ; Coronary Angiography ; Coronary Artery Disease ; diagnosis ; Coronary Stenosis ; diagnosis ; Erythrocyte Count ; Erythrocytes ; cytology ; Humans

BACKGROUND: The non-invasive differentiation of ischemic and nonischemic acute heart failure (AHF) not resulting from acute myocardial infarction is difficult and has therapeutic and prognostic implications. The aim of this study was to assess whether resting myocardial contrast echocardiography (MCE) can detect coronary artery disease (CAD) in patients with decreased left ventricular (LV) systolic function and global hypokinesis presenting with AHF. METHODS: Twenty-one consecutive patients underwent low-power real-time MCE based on color-coded pulse inversion Doppler. Standard apical LV views were acquired during contrast IV infusion of Definity(R). Following transient microbubbles destruction, the contrast replenishment rate (beta), reflecting myocardial blood flow velocity, was derived by plotting signal intensity vs. time and fitting data to the exponential function: y (t) = A (1 - e(-beta(t-t0))) + C. RESULTS: Of the 21 (mean age 56.6 +/- 13.6 years) patients, 5 (23.8%) demonstrated flow-limiting CAD (> 70% of luminal diameter narrowing). The mean +/- standard deviation of LV ejection fraction was 29.6 +/- 8.6%. Quantitative MCE analysis was feasible in 258 of 378 segments (68.3%). There were no significant difference in "beta" and "Abeta" in patients without and with CAD (0.48 +/- 0.27 vs. 0.45 +/- 0.25, p = 0.453 for beta and 2.99 +/- 2.23 vs. 3.68 +/- 3.13, p = 0.059 for Abeta, respectively). No contrast-related side effects were reported. CONCLUSION: Resting quantitative MCE analysis in patients with AHF was feasible, however, the parameters did not aid in detecting of CAD.
Blood Flow Velocity ; Coronary Artery Disease* ; Coronary Disease ; Diagnosis ; Echocardiography* ; Heart Failure* ; Humans ; Microbubbles ; Myocardial Infarction ; Phenobarbital ; Pilot Projects*

Adult ; Blood Viscosity ; Coronary Disease ; blood ; Diabetes Mellitus ; blood ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional

OBJECTIVETo evaluate the relationship between periodontitis and the traditional risk factors of coronary heart disease (CHD), as well as the role in the mechanisms responsible for high-sensitivity C-reactive protein (hsCRP) in the relationship of peridontitis and CHD.

METHODSA periodontal examination was conducted on a total of 356 subjects, and community periodontal index of treatment needs (CPITN) was obtained from each subject. Periodontal status was categorized into TN < or =2, TN=3, TN=4 three groups according to the CPITN indexes. Fasting venous blood samples were collected from all the three group subjects, the serum hsCRP concentration and serological changes used in diagnosing CHD routinely were determined, and software of SPSS 16.0 were used to analyzed the relationship of periodontal, hsCRP concentration and routinely CHD serological indexes.

RESULTSIn the groups of TN < or =2, TN=3 and TN=4, the hsCRP level was (1.10 +/- 1.16), (1.86 +/- 2.34), (2.25 +/- 2.75) mg x L(-1), respectively. Compared with Group TN < or =2, the concentration of hsCRP in Group TN=3 and TN=4 were higher (OR = 1.24, OR = 1.31, respectively). Compared with group hsCRP < 3.0 mg x L(-1), more calculus and deep periodontal pockets were found in the Group hsCRP > or = 3.0 mg x L(-1) (P < 0.05).

CONCLUSIONThe serum hsCRP level is correlated with the severity of periodontal disease.

C-Reactive Protein ; chemistry ; Coronary Disease ; Humans ; Periodontal Index ; Periodontitis ; blood ; diagnosis ; Risk Factors

Blood Circulation ; Coronary Disease ; diagnosis ; physiopathology ; Humans ; Integrative Medicine ; Societies, Medical

OBJECTIVETo study the relationship among peripheral leucocytes, coronary artery stenosis and Chinese medicine syndromes in patients with coronary heart disease (CHD).

METHODSThe Chinese medicine syndromes of 189 CHD patients were differentiated into six types: the turbidity-phlegm blood-stasis type (A), the qi-deficiency blood-stasis type (B), the cold-congealing blood-stasis type (C), the qi-stagnancy blood-stasis type (D), the qi-deficiency phlegm-stasis type (E) and the turbidity-phlegm blocking laterals type (F). Coronary angiography and peripheral leucocyte counting were performed simultaneously for determining the degree of blood-stasis by scoring (BSS), and the outcome of coronary angiography was evaluated depending Gensini scoring system. All data obtained were analyzed statistically.

RESULTSThe highest BSS, that means the highest degree of coronary artery stenosis, was shown in patients of Chinese medicine type C, following with type A, B and D in order, the lowest level was found in the non-blood-stasis groups, namely, patients of Chinese medicine type E and F. Peripheral count of leucocytes were correlated with the BSS and Gensini score, count of mononuclear cell was individually correlated with BSS, and that of neutrophil was individually correlated with Gensini score.

CONCLUSIONSBSS and distribution of peripheral leucocytes were different in CHD patients of various Chinese medicine types, count of peripheral mononuclear cell is individually correlated with BSS, and that of neutrophil is individually correlated with Gensini score.

Adult ; Aged ; Coronary Artery Disease ; blood ; diagnosis ; pathology ; Coronary Stenosis ; blood ; diagnosis ; pathology ; Female ; Humans ; Leukocyte Count ; Leukocytes ; Male ; Medicine, Chinese Traditional ; Middle Aged

Aortic Valve Stenosis ; blood ; diagnosis ; etiology ; Child ; Coronary Artery Disease ; blood ; diagnosis ; etiology ; Coronary Vessels ; diagnostic imaging ; pathology ; Echocardiography ; Female ; Humans ; Hyperlipoproteinemia Type II ; blood ; complications ; diagnosis ; genetics ; Lipoproteins, LDL ; blood ; Triglycerides ; blood

BACKGROUND: Hypertension is a common, chronic disease that poses as a main risk factor of coronary artery disease. Therefore, it requires accurate diagnosis. This study attempted to examine the problem of misclassification and accurate diagnosis of hypertension in primary care settings and to consider the relationship between variability of blood pressure and number of measurements. METHODS: Among the 168 patients with initially high blood pressure who visited health screening center of one university hospital from May to November, 1999, 97 persons who corresponded to the following conditions were chosen for this study. We classified hypertension as stage 1 and 2. The subjects were not previously diagnosed as hypertensive and had no past history of use of antihypertensive medication. Blood pressure was measured according to 1999 WH0/1SH Hypertension Guideline, and two or more measures were performed at each visit on five separate occasions at one week intervals RESULTS: The mean of initial blood pressure was 169.6 mmHg in systole, 96.3 mmHg in diastole. The mean of subsequent blood pressure was 165.0 mmHg, 146.1 mmHg, 143.4 mmHg, 138.7 mmHg in systole and 92.5 mmHg, 88.4 mmHg, 87 mmHg, 85.1 mmHg in diastole, which showed the tendency to be lower. In both systole and diastole, the mean differences between first and second measurements, second and third measurements were significant, but insignificant between third and forth measurements, and forth and fifth measurements. We divided systolic and diastolic pressures into two subgroups according to stage 1,2 classification of hypertension. In stage 1 subgroup, the means of blood pressures were lower from 151.3mmHg to 135.4 mmHg in systole, from 95.1 mmHg to 85.3 mmHg in diastole, but there were not significant. In stage 2 subgroup, the mean blood pressure was lower from 169.7 mmHg to 142.5mmHg in systole, from 105.4 mmHg to 87.8 mmHg in diastole, and the mean differences between first and second measurements, second and third measurements were significant, but not significant between third and forth measurements, and forth and fifth measurements. CONCLUSION: Blood pressure tends to be checked significantly lower until subsequent third measurements, but not thereafter. We think that more studies to find out how many blood pressure measurements are needed for diagnosing hypertension in consideration of patient's blood pressure level and risk factors.
Blood Pressure* ; Chronic Disease ; Classification ; Coronary Artery Disease ; Diagnosis* ; Diastole ; Humans ; Hypertension* ; Mass Screening ; Primary Health Care ; Risk Factors ; Systole

BACKGROUND AND OBJECTIVES: The measurement of the coronary flow velocity reserve (CFR) using transthoracic Doppler echocardiography (TTDE) has been reported to be useful for assessing the physiological significance of left anterior descending coronary artery (LAD) stenosis. This study was performed to evaluate the usefulness of CFR by TTDE for diagnosis of restenosis following revascularization procedures. SUBJECTS AND METHODS:Patients who were scheduled for follow-up coronary angiography following percutaneous intervention, or coronary bypass, surgery for a LAD lesion were enrolled. Prior to the follow-up coronary angiography, flow velocities in the distal LAD were measured by TTDE, both at rest and during the intravenous infusion of adenosine. CFR was defined as the ratio of the hyperemic to the basal peak diastolic velocities. Angiographic restenosis was defined as a diameter stenosis of more than 50% of the normal value by a quantitative coronary angiography. Of 142 consecutive patients, measurement of the CFR was possible in 95% (n=135), with 39 patients having a myocardial infarction in the LAD territory. The remaining 96 patients were used as the subjects ofin this study. RESULTS: The diameter stenosis was 41+/-26%, with angiographic restenosis found in 33 patients (34%). The mean CFR by TTDE was 2.5+/-1.1. CFR <2.0 was used to diagnose restenosis, with a sensitivity and specificity of 79% (26/33) and 89% (56/63), respectively. CONCLUSION: The noninvasive measurement of the CFR with TTDE is highly feasible, and can be a useful diagnostic modality for restenosis of a LAD following a revascularization procedure.
Adenosine ; Blood Flow Velocity ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Echocardiography, Doppler* ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Myocardial Infarction ; Reference Values ; Sensitivity and Specificity

Arterial Occlusive Diseases ; diagnosis ; etiology ; Coronary Disease ; complications ; diagnosis ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged