Objective To explore the possibility of dynamic pulse pressure (DPP) being used to predict cardiovascular events in old men with normotension. Methods During May 1995 to September 2001, a 24h DPP monitoring was carried out on 858 old men with normotension (60-91 years old, BP60 mmHg, respectively. The first attack of cardiovascular event was recorded. Results In the 3 groups of subjects, the incidence of total cardiovascular events (100 persons per year) was 3.7, 5.8, and 9.1 respectively (log-rank test, P=0.000 9, 0.000 2, 0.000 0). After adjustment for the other risk factors including age, hypertension history, diabetes and previous cardiovascular disease, it has been found that the data of dynamic pulse pressure is of a significant value for predict cardiovascular events (P

Objective To determine the related facuors of side branch occlusion after stent implantion in the main branch of biburcation lesions.Methods We retrospectively analyzed 121 bifurcation lesions in 92 patients who accepted percutaneous coronary interventional therapy in our hospital from 2005 September to 2006 January.We employed quantitive coronary angiography analysis after stenting in the main branch and then evaluated the factors related to side branch stenosis.Results After stenting in the main branch of bifurcation lesions,four factors were found to be involved in causing side branch stenosis,which included:the plaque burden of both branches,the angle of bifurcation and the diameter of the side branch.The plaque burden of both branches was positively correlated but the biburcation angle and the diameter of the side branch were correlated to the formation of side branch stenosis.The severity of side branch stenosis after PCI could be represented by the regression equation:Y=0.48A-11.4B-0.23C+0.22D(Y:the degree of side branch stenosis after main branch stenting,unit:%;A:degree of pre-procedural side branch stenosis;B:diameter of the side brance;C:biburcation angle;D:the degree of pre-procedural main branch stenosis).Conclusion In bifurcation lesions,side branch stenosis after stenting in the main branch is related to plaque burden of both branches,diameter of the side branch and the bifurcational angle.Serious plaque burden in both branches,small side branch and sharper biburcation angle are more likely to cause side branch occlusion after main branch stenting.

Objective To analyze the clinical characteristics of patients with cardiac amyloidosis.Methods The clinical data of 14 patients with cardiac amyloidosis were retrospectively analysed.Results The patients with cardiac amyloidosis had characteristics of large atriums and hypertrophic ventricular walls in echocardiography.And they also had low limb lead voltage in ECG.The ratio of(SV5+RV1)and left ventricle crossing area of all patients were obviously lower than 1.5.Biopsy behaved staining of congo red.And most patients had renal,dermatic and gastrointestinal involvements.Conclusion The patients of cardiac dysfunction with the characteristics of restrictive cardiomyopathy in echocardiogram and feature of low limb lead voltage in ECG,have the possibility of cardiac amyloidosis and need to prove it through biopsy.(SV5+RV1)/CSA may be a promising method for screening cardiac amyloid.

Objective To study the anticoagulant activity of hirulog. Methods Rabbits blood samples were collected before and after injecting hirulog. Thrombin clot time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured to investigate the dose-effect and time-effect relationship of hirulog and compared the efficacy with heparin. Results TT, PT and APTT of rabbits blood samples were prolonged remarkably by hirulog, and the action duration was about 60 min, that was similar to heparin. Conclusion Hirulog showed obvious anticoagulant effects with clear dose-effect relationship.

This study examined the effects of endovascular irradiation on cell proliferation and apoptosis after overstretch balloon angioplasty in a normolipemic swine model of restenosi. Twenty five swine underwent oversized balloon angioplasty in the LAD and/or LCX,and in 13 of them the procedure was followed immediately by endovascular radiation using a guide wire with 3 cm long 192 Ir line source to deliver 20Gy to overdilated segments. All the animals were killed at 3 and 30 days. Cell proliferation was estimated by immunostaining for proliferation cell nuclear antigen (PCNA). Apoptosis was identified by the terminal uridine nick end labeling(TUNEL). The results showed that endovascular radiation significantly reduced the pcna positive cells compared with controls 3 days and 30 days after initial injury. There were no quantitative differences in the amount of TUNEL labeling cells among irradiated and control vessels in any region examined 3 days and 30 days after balloon injury. Endovascular radiation may reduce restenosis by inhibiting the cell proliferation, not by enhancing cell apoptosis.

Objective To evaluate the potential protective effects of erythropoietin (EPO) in combination with granulocyte-colony stimulating factor (G-CSF) on hypoxia cardiomyocytes. Methods After left ventricular cardiomyocytes were isolated from neonate rat, the cells were inoculated in a cultural atmosphere of 95%N2 and 5%CO2 for 24 h to establish hypoxia cardiomyocytes model. The protective effects of EPO and G-CSF at different concentrations were evaluated for the optimal concentration. Then the protective effects of EPO in combination with G-CSF were investigated under the optimized concentrations. The survival, apoptotic and necrotic rates of cardiomyocytes were assessed by flow cytometry. Results The mortality and ratio of apoptotic cells to total necrotic cell were higher in hypoxia cardiomyocytes than normal cells significantly (26.73% vs 5.63%,70.05% vs 37.83%, P0.05), and the combination group was much better than EPO and G-CSF alone groups (P

Objective To evaluate the angiographic effect in patients treated with Taxus DES implantation in clinical practice. Methods Two hundred and ninty-seven patients were treated with Taxus DES implantation and 134 patients underwent angiographic follow-up from 5 to 15 months. Results Angiographic follow-up the in-stent late loss was higher than pro-in-lesion and dis-in lesion late lumen loss(0.37 vs 0.18 vs 0.12mm,P

Objective To evaluate the safety and efficacy of stenting in unprotected left main coronary artery lesions.Methods From December 2001 to April 2006,43 patients with mean ages of 62.79?11.26(45-86)years underwent unprotected left main coronary artery stenting.There were 4 cases(9.3%)with previous history of myocardial infarction,30 cases(69.8%)with hypertension and 5 cases(11.6%)with diabetes mellitus.Results Altogether 56 coronary stents were deployed in 43 patients.Isolated LMCA stenosis was found in 4 cases(9.3%),and in 39 patients(90.7%)there was multivessel disease in combination.There was ostial lesion in 11 cases(25.6%),and with mid shaftlesion in 6 cases(13.9%).Bifurcation lesion was found in remaining patients.Stents were successfully implanted into LMCA in 43 cases without complication during the procedure.In-hospital MACE developed in 2 cases(4.7%),including 1case of TLR(2.3%)and 1 death(2.3%).The patients were followed up for 2-53 months.MACE developed in 4 cases(9.5%),all were TLR.There were no significant difference in the rate of in-hospital and follow-up MACE,as well as recurring symptom among sites of the lesion.The cardiac event-free survival was 93.3% 6 months after PCI,89.4% 9 months after PCI,and 84.5% one year after PCI.Conclusion With the improvement of PCI strategies and intervention devices,coronary stenting can be safely applied for the treatment of LMCA lesions with satisfactory in-hospital and long-term outcomes in the experienced center.

The aim of this study was to investigate factors contributing to left ventricular dysfunction (LVD) in patients who had survived acute myocardial infarction(AMI). Retrospective regression analysis was performed for all the hospitalized patients with AMI who underwent coronary angiography from 1988 to 1998. 155 patients met the entry criteria. Seven patients(4 5%) died of cardiac events after discharge during the ten years′ follow up. In the multivariate logistic regression analysis and stepwise selection, the following factors appeared to be the significantly independent predictors of the LVD after AMI : age, hypertension, hyperlipidemia, LVEF during the first admission, size of infarction, the number of vessel disease, thrombolytic therapy, PTCA. In the COX regression and stepwise selection, the following factors appeared to be significantly independent predictors of the LVD after AMI : hyperlipidemia, LVED during the first admission, size of infarction, the number of vessel disease, thrombolytic therapy , PTCA. The probability of LVD increased with time. Patients with advanced age, hypertension, hyperlipidemia, large infarction, multivessel disease, reduced LVEF after AMI, no thrombolysis and PTCA are prone to develop LVD.

Totally 896 medical records were statistically analyzed from Jan. 1, ] 998 to Dec. 31 , 2001. There were 65 cases (7. 3%,65/896) of ischemic cardiomyopathy .of which 38 cases (58. 5% .38/65) were myocardial infarction in small area, 27 cases(41. 5% ,27/65) were in large area. The causes of ischemic cardiomyopathy were lack of blood supply in cardiac cells for a long time and pathological changes in branches of coronary artery. If myocardial infarction in small area occurred,the blood vessels should be opened again in acute period, and the risk factors must be prevented and treated.