OBJECTIVETo discuss the clinical epidemiology features and change trend of aortic dissection (AD).

METHODSRetrospective analysis of consecutive 339 patients with AD over 10 years in Guangdong Cardiovascular Institution. Hospital records and prognosis were compared between two five-year periods.

RESULTS339 cases with AD were hospitalized during the past 10 years. The mean age was 55.7 +/- 11.2. The male/female ratio was 4.75 to 1. Hypertension was present in 71.7% of all patients. Heavy smoking history was elicited in 52.2% of all the patients. Type I dissection were identified in 32.3% of all the cases, type II in 5.1%, and type III in 62.6%. In-hospital mortality of acute type A dissection was 35.3%, acute type B dissection 8.0%. In two five-year periods, the total number of cases increased by 165%, among which type I was the fastest, increased by 270%. Changes of mean age and male/female ratio were not significant. For acute AD, changes of prognosis in one year improved, but did not reach statistical significance.

CONCLUSIONSThis study provides insight into current regional profiles of AD. The number of hospitalized patients with AD is increasing dramatically. The mean age of the first-attack is much younger and the male ration is much higher than that reported by other regional researchers. Limited by sample size, one year prognosis of acute AD dissection improved, but did not reach statistical significance. These data support the urgent need for further improvement in prevention and treatment of AD.

Adult ; Aged ; Aneurysm, Dissecting ; diagnosis ; epidemiology ; Aortic Diseases ; diagnosis ; epidemiology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo summarize prevalence rate and region distribution of congenital heart disease (CHD) in 12-month-old and younger infants among four regions of Guangdong province, China.

METHODSData from Guangdong CHD monitoring network including 34 monitoring units covering different geographic regions were analyzed. Professional training on screening and diagnosing CHD was provided to each work group member to improve the diagnosis level. CHD infants under or aged 12 months detected in the monitoring unit were included. CHD was diagnosed by fetus and infants echocardiography.

RESULTSFrom July 2004 to December 2010, 383 281 perinatal were registered and 3263 cases of CHD were detected in the 34 member units of Guangdong CHD monitoring network [total prevalence rate of CHD: 0.851% (3263/383 281), male prevalence rate: 0.868% (1799/207 347), female prevalence rate:0.828% (1456/175 843)].Stillbirth CHD prevalence rate was significantly higher than livebirth CHD prevalence rate [10.627% (676/6361) vs. 0.686% (2587/376 920), P < 0.01]. The total prevalence of CHD was significantly higher in Pearl River Delta region [0.906% (2826/311 823)] than in other regions [0.611% (437/71 458), P < 0.01]. Ventricular septal defect [39.93% (1033/2587) in livebirth] was the most dominant CHD, followed by patent ductus arteriosus [29.84% (772/2587)] and secundum atrial septal defect [13.76% (356/2587)].

CONCLUSIONSThe present data indicate that the prevalence of CHD in Guangdong is at the medium-upper level of the country associated with high stillbirth rate. The dominant type of CHD is ventricular septal defect. CHD prevalence is higher in the Pearl River Delta region than in other regions.

China ; epidemiology ; Female ; Heart Defects, Congenital ; epidemiology ; Humans ; Infant ; Male ; Prevalence

OBJECTIVETo analyze the differences of risk factors on congenital heart defect (CHD)between floating population and permanent residents in Guangdong.

METHODSA multicenter case-control study was carried out to investigate the risk factors of CHD in floating population and in permanent residents. Data was from 34 Guangdong CHD Monitoring Network centers during the year of 2004 to 2011. Exposed information related to the parents at pre-pregnancy and early pregnancy periods, was collected, using the same questionnaire survey methodology in the two populations. Possible risk factors were analyzed by univariate analysis and multivariate non-conditional logistic regression(ENTER method)methods. Risk factors were compared between the two populations.

RESULTSTotally, 855 CHD cases and their controls from the floating population, as well as 1673 cases and their controls from the permanent residents were included in this study. Age of the children under study was defined from 28th week of gestation to 1 year old postnatal. In the floating population, specific risk factor for CHD appeared as:maternal passive smoking in early pregnancy, while the specific protective factor as high family income. However, the specific risk factors would include: having diseases as maternal diabetes mellitus or syphilis, living in a newly (within half a year) decorated house or with fetal macrosomia in the permanent residents. High education level showed as a risk factor in floating population, however contrarily, as protective factor to the permanent residents. Except for the factors related to having fever of the mother and infant with low birth weight, factors as having history of deliveries more than two, with maternal virus infection, exposure to chemical agent and negative bearing history etc., have higher OR values in floating population than in the permanent residents.

CONCLUSIONSignificant differences of risk factors for CHD were noticed between floating population and the permanent residents, which have their individual specific risk factors. Most of the ORs appeared higher in floating population than in the permanent residents.

Case-Control Studies ; China ; epidemiology ; Female ; Heart Defects, Congenital ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Transients and Migrants

OBJECTIVETo evaluate the association between resting heart rate (HR) and all-cause death and coronary heart disease (CHD) events in the Chinese cohort.

METHODSData were obtained from the PRC-USA Cooperative Study on Cardiovascular and Cardiopulmonary Epidemiology. Baseline screen surveys were conducted in 1983 and 1984 from people aged 35 to 59 years living in urban or rural areas of Beijing and Guangzhou. Follow-up visits were performed for end point events of all-cause death and first CHD events every two years till 2005. Resting HR was determined from 5 consecutive intervals between R waves on the 12-lead electrocardiogram.

RESULTSA total of 9856 (4805 males) people were included in the study and the mean follow up duration was 16.2 years. There were 1523 deaths, including 200 CHD events during the follow up period. Mean resting HR was 67.9 beat per minute (bpm) in men and 71.6 bpm in women respectively which had a trend to increase with aging. Cox Proportional Hazards model indicated the relative risk of all-cause death increased constantly with the increase of HR percentile after control of age, fasting glucose, serum cholesterol, serum triglyceride, body mass index, systolic blood pressure and diastolic blood pressure. With HR 60-89 bpm as control group, the relative risk and 95% confidence interval in group HR < 50 bpm, 50 - 59 bpm, 90 - 99 bpm and > or = 100 bpm were 0.76 (0.49 - 1.17), 0.87 (0.75 - 1.02), 1.33 (1.06 - 1.68), 1.48 (1.03 - 2.14) respectively. However there was no significant correlation between HR and CHD events in studied population.

CONCLUSIONThe risk of total death increased significantly in people with HR > or = 90 bpm suggesting higher resting heart rate might be an independent risk factor for all-cause death in the Chinese population.

Adult ; Cause of Death ; China ; epidemiology ; Coronary Disease ; epidemiology ; mortality ; Female ; Follow-Up Studies ; Heart Rate ; Humans ; Male ; Middle Aged

OBJECTIVETo analyze the changes in the cardiac function after St. Jude Regent mechanical valve replacement and assess the prosthesis-patient matching.

METHODSFrom October 2007 to March 2009, 44 patients received implantation of 17 mm St. Jude aortic prostheses in our hospital. The patients were followed up for clinical symptoms, signs, electrocardiogram (ECG), echocardiogram and cardiac functions, and the results were compared with those of randomly selected 44 patients receiving 21 mm St. Jude aortic prostheses.

RESULTSIn 17 mm St Jude Medica Regent valve group, 8 patients presented with ECG ST segment changes, 3 complained of chest tightness, 3 had occasional chest pain and discomfort, and 8 had grade II and 4 grade III cardiac function. In 21 mm St Jude Medical Regent valve group, 6 patients had ECG ST segment changes, 2 complained of chest tightness, 2 reported occasional chest pain and discomfort, 11 had grade II and 2 grade III cardiac function. No significant differences were found in these indices between the two groups (P=0.32). Compared with those before operation, the two groups showed significant improvements in the left ventricular end-diastolic diameter, left ventricular posterior wall thickness, left ventricular mass index, and aortic pressure gradient (P<0.05). A significant increase in the left ventricular ejection fraction occurred 6-12 months after operation, but without statistical difference between the two groups (P>0.05).

CONCLUSIONFor underweight patients (<60 kg) and those with small body surface area (<1.6 cm(2)), 17 mm St. Jude Medical Regent valve prosthesis may produce good therapeutic effect, and some indices are even close to those after placement of 21 mm St. Jude Medical Regent valve prosthesis. No obvious prosthesis-patient mismatch occurs after the placement of the 17 mm valve prosthesis and aortic valve ring expansion is not necessary.

Adolescent ; Adult ; Aortic Valve ; diagnostic imaging ; surgery ; Aortic Valve Stenosis ; diagnostic imaging ; surgery ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Treatment Outcome ; Ultrasonography ; Young Adult

OBJECTIVETo summarize the experience with surgical treatment of constrictive pericarditis.

METHODSA retrospective analysis of the post-operative clinical data was conducted in 128 surgical patients with chronic constrictive pericarditis.

RESULTSTwo early postoperative death occurred in this group due to severe low cardiac output syndrome, with the mortality rate of 1.57%. The postoperative complications included low cardiac output syndrome (13.2%), arrhythmia (7.02%), acute renal insufficiency (3.9%), respiratory insufficiency (3.1%), wound infection (2.3%), postoperative chest bleeding (1.6%) and cerebral infarction (0.78%). Relapse occurred in one case because of incomplete pericardial resection.

CONCLUSIONSConstrictive pericarditis should be confirmed as soon as possible with actively surgery, and the extent of pericardial resection should be decided according to the individual conditions. Complete untethering of the diseased pericardium should be performed with active prevention of postoperative complications.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Pericarditis, Constrictive ; surgery ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the risk factors of congenital heart defects (CHD) in fetal and infants born from 2004 to 2011 in Guangdong province.

METHODSBabies with CHD aged from 28th week of gestation to 1 year old postnatal from July 1 2004 to December 31 2011 were registered in Guangdong CHD monitoring network with 34 participating units. Totally 2568 CHD cases were included, and 1: 1 matched with a normal control cohort by gender, living district and birth date (time span within 3 months).Exposed information of mother and father at pre-pregnancy and early pregnancy was collected. Post collinearity diagnostics analysis, univariate analysis results were included in a multivariate analysis model with forward stepwise conditional logistic regression.

RESULTSMultivariate conditional logistic regression analysis showed that high risk factors for CHD included low birth weight infant (OR = 5.34, P < 0.01), macrosomia (OR = 1.67, P < 0.05), low per capita income (0-1200 yuan, OR = 1.68, P < 0.01), exposure to chemical agent at early pregnancy (OR = 19.72, P < 0.01), floating population (OR = 2.13, P < 0.01), abnormal reproductive history (OR = 3.18, P < 0.01), exposure to passive smoking (OR = 2.59, P < 0.01), suffering from fever (OR = 3.74, P < 0.01), equal to or more than twice parity (OR = 1.45, P < 0.01), living in a newly (within six months)-decorated-apartment (OR = 2.74, P < 0.01), suffering from virus infection (OR = 2.08, P < 0.01), rural residence (OR = 1.33, P < 0.01), living in an apartment within 50 meters of major traffic road (OR = 1.52, P < 0.01), syphilis infection at early pregnancy (OR = 13.06, P < 0.05) and father's drinking habit at pre-pregnancy (OR = 1.57, P < 0.05).

CONCLUSIONNumerous risk factors for CHD in fetal and infants of Guangdong province are indicated by our results, comprehensive intervention should be considered in pre-pregnancy and early pregnancy to reduce the risk of CHD.

China ; epidemiology ; Female ; Heart Defects, Congenital ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Matched-Pair Analysis ; Pregnancy ; Risk Factors