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.

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.

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 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 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 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 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.

To investigate the association between HbA1C level and severity of coronary artery lesion in non-diabetic patients with coronary heart disease. This study was a retrospective and controlled study in a single center. 302 patients were enrolled. Coronary arterial lesion was confirmed by coronary angiography carried out in Tianjin Chest Hospital between January 2008 and November 2011. The patients enrolled should be non-diabetic with normal fasting blood glucose and HbA1C levels. The patients were divided into 3 groups according to the HbA1C levels, Group 1 (≤5. 5%, n=92),Group 2(5. 6%-5. 8%, n=94),Group 3(5. 9%-6. 4%, n=116), and the SYNTAX scores between the groups were compared. The predictive value of HbA1C in groups with intermediate and high SYNTAX score was identified by Logistic regression analysis while common risk factors such as sex, age, hypertension, lipid, and fasting glucose were adjusted. The SYNTAX score from Group 1 to Group 3 had statistically significantdifference(P<0.01). Simpleregressionwasusedtocalculatethecorrelationcoefficient(r=0.335,P<0. 01). Binary Logistic regression was used to confirm that HbA1C level was also associated with intermediate and high SYNTAX score(OR=5. 089, P<0. 05). In non-diabetic patients, the HbA1C level is associated with the severity of the lesion of coronary artery. The results indicate that a higher level of HbA1C seems to be an independent predictor to the prevalence of complex coronary lesions.

Objective To investigate the incidence of depression of coronary artery bypass grafting before and after surgery in patients with coronary heart disease and the impact of depression on patients undergoing coronary artery bypass grafting.Methods 345 patients treat with CABG were divided into depression and non depression groups based on Serf-rating depression scale(SDS).Compare the change of different degree of depression occurrence rate before and after surgery.All patients were followed up for 24 months after procedure for the occurrence major adverse cardiovascular events(MACE),then make the non MACE survival analysis and Cox regression.Results Baseline data of BMI(body mass index) and history of hypertension,cerebrovascular disease was statistically significant difference between groups.Depression in patients after CABG was significantly higher than that before procedure(40.9％ vs 24.3％,P ＜0.05).The MACE rate was significantly higher in patients with post-procedure depression than that in patients without depression(16.5％ vs 5.2％,P ＜0.01),and the incidences of myocardial infarction and target lesion revascularization were also significantly higher in depression patients than in non-depression patients(6.8％ vs 2.1％,6.6％ vs 1.6％,P ＜ 0.05).There was no significant difference on accumulative mortality between two groups(3.3％ vs 1.6％,P =0.315).The survival analysis curve of Kaplan-Meier show the incidences of non MACE survival rate was significantly lower in depression patients than in non-depression patients (P ＜0.001).There was no significant difference on death survival analysis(P =0.309).Depression,old myocardial infarction and LVEF(left ventricular ejection fraction)were independent risk factors for MACE.Conclusion The proportion was higher in patients with post-procedure and pre-procedure who have different degree of depression,the MACE rate was significantly higher in patients with postprocedure depression than in patients without depression.Depression is dangerous factors for prognosis of patients with coronary artery bypass grafting.

Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.