Objective To investigate the effect of delayed PTCA and stenting for infarct related artery on the chronic phase of left ventricular remodelling and cardiac events in patients with acute myocardial infarction. Methods Fifty two patients with primary acute myocardial infarction were divided into PTCA group ( n =27) and non PTCA group ( n =25). Twenty seven patients underwent PTCA and coronary stenting with an average of 12 days after the acute onset. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and cardiac events in each group were followed up. Results There were no significant differences in preoperation and postoperation for LVEDV and LVESV in the PTCA group, on the contrary a significant increase for before and after follow up for LVEDV and LVESV in the non PTCA group( P 0.05). Conclusions Delayed PTCA and stenting for infarct related artery would inhibit ventricular enlargement and delay chronic phase of left ventricular remolding. Moreover, cardiac events were significantly reduced in patients with acute myocardial infarction after delayed PTCA and stenting.

Objective To investigate the incidence and clinical significance of “no flow” (NF) phenomena after primary percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (AMI). Methods ninety nine consecutive AMI patients underwent primary PCI were devided into NF group (18 cases) and non NF group (81 cases). The incidence of NF, clinical characteristics, blush grade, ST T segment elevation, peak CPK, left ventricular function and cardiac events were analysed. Results Eighteen patients demonstated NF, the incidence of NF was 18.2%. Compared with non NF, previous MI、diabetes、anterior MI and multivessel disease were more frequently observed in the cases with NF ( P 0.05). Conclusions The incidence NF after primary PCI in the treatment of AMI is 18.2%. The patients with NF show malperfusion in the myocardial microcirculation, larger infarct size, ventricular dysfunction and poor prognosis.

Objective To compare primary PCI with venous thrombolysis on the clinical effect in patients with AMI. Methods One hundred and thirty two consecutive patients with acute myocardial infarction during thirteen months were divided into primary PCI group( n =75) and venous thrombolysis group(n=57).The reperfusion rate and cardiac events during in hospital and follow up were recorded in two groups. Results The reperfusion rate of venous thrombolysis was 57.9% and 96% in primary PCI group( P

0.05, all statistically insignificant. Conclusions: Primary PCI was equally effective for the treatment of one vessel and multivessel AMI patients.

Objective To analyse reperfusion arrhythmias in AMI patients treated by direct PCI. To investigate prevention and treatments so as to elevate operation achievement ratio.Methods One hundred and seventy six AMI patients underwent direct PCI; of the 176 patients, 56 presented reperfusion arrhythmias. Observations were made in the context of the different arrhythmias, relation between the time onset of the arrhythmias after reperfusion, relation of infarct size number of the involved vessels and the infarct size to the arrhythmias. Results PCI performed with six hours after AMI showed much higher incidence of arrhythmias than PCI performed six to twenty four hours after AMI (P0.05).Conclusions Reperfusion arrhythmias were commonly seen in AMI patients treated by direct PCI. Early prevention and detection with appropriate treatment is the key to elevate survival rate leading to a better prognosis.

OBJECTIVEThis study investigated the effect of catheter-based renal sympathetic denervation (RDN) in pigs with rapid pacing induced heart failure.

METHODSHeart failure was induced by rapid right ventricular pacing in 12 pigs and pigs were randomly divided into RDN group (n = 6): pacing+RDN at 7 days post pacing; control group (n = 6): pacing only. Echocardiography examination (LVEF, LVEDD and LVESD) was performed before pacing and at 1 and 2 weeks post pacing. Serum biochemical markers including renin, aldosterone and creatinine were also measured at baseline, 1 and 2 weeks after pacing. Repeated renal artery angiography was performed at 1 week after RDN. All pigs were sacrificed to examine the heart and renal pathology and renal artery sympathetic nerve staining at 2 weeks post pacing.

RESULTSLVEF decreased 1 week after rapid pacing from (60.5 ± 6.0)% to (35.3 ± 9.8)%. LVEF was significantly higher [(42.8 ± 5.9) % vs. (33.4 ± 9.7)%, P = 0.001 8] while LVESD was significantly lower [(28.4 ± 3.7) mm vs. (33.0 ± 2.0) mm, P = 0.001 6] in the RDN group than in the control group at 2 weeks post pacing. At 2 weeks after pacing, plasma concentrations of renin and aldosterone were significantly lower in RDN group compared to the control group (all P < 0.05) . Kidney function and blood pressure were comparable between the two groups at 2 weeks post pacing. There were no signs of renal damages such as renal artery stenosis, dissection and thrombus in all pigs after 2 weeks pacing. Sympathetic neurons of adventitia were injured in RND group.

CONCLUSIONRDN could significantly improve cardiac function and attenuate left ventricular remodeling via inhibiting renin-angiotensin-aldosterone system in this pacing induced pig heart failure model.

Animals ; Cardiac Pacing, Artificial ; adverse effects ; Catheter Ablation ; methods ; Disease Models, Animal ; Female ; Heart Failure ; etiology ; surgery ; Kidney ; innervation ; Male ; Swine ; Sympathectomy ; methods