Objective: To explore the effect of apelin on angiotensin II (Ang II)-induced cardiomyocyte hypertrophy and intracellular signal transduction mechanism in experimental rats.
Methods: The cardiomyocyte from 1 to 3 days neonatal rats were cultured with Ang II to induce the cardiomyocyte hypertrophy, and the cells were treated by apelin at different concentrations. The [3H] Leucine incorporation, cardiomyocyte surface area and total protein expression were analyzed to evaluate the degree of cardiomycyte hypertrophy. The protein expressions of intracellular BNP, β-MHC, nuclear factor 3 of activated T cells (NFATc3), calcineurin, phospho-calcineurin, calmodulin kinase II (CaMK II) and phospho-CaMK II were assessed by Western blot analysis. The mRNA expressions of BNP andβ-MHC were examined by RT-PCR.
Results: Apelin may inhibit Ang II induced cardiomyocyte hypertrophic response in a dose-dependent manner, the maximum inhibition was achieved at Ang II 1000 nmol/L. Meanwhile, apelin may inhibit Ang II-induced elevations of intracellular resting free calcium level, mRNA expressions of BNP andβ-MHC, protein expressions of NFATc3, phospho-calcineurin, CaMK II and phospho-CaMK II in a dose-dependent manner.
Conclusion: Apelin may inhibit Ang II-induced cardiomyocyte hypertrophy in experimental rats which might be related to Ca2+-dependent calcineurin signal pass ways.

Objective To study the characteristics and the related risk factors of coronary artery changes in the elderly patients of coronary heart disease complicated with diabetes mellitus. Methods According to WHO diagnostic standards of diabetes, coronary heart disease(CHD) complicated with diabetes mellitus(65 patients) was indicated as CHD+DM group, and the coronary heart disease without diabetes(68 patients) was indicated as CHD group. All patients were examined by coronary angiographic semiquantitative(CAG), and blood pressure, oral glucose tolerance test, level of blood sugar, insulin, lipid, BUN and Cr were measured. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis were evaluated by AHA standards. The related risk factors in coronary artery disease were analysed by pluralism straight line statistics. Results The coronary multivessel changes(75 4% vs 38 2%, P

Objective: To observe the safety and efifcacy of excimer laser coronary atherectomy (ELCA) for treating the patients with coronary chronic total occlusion (CTO). Methods: A total of 3 coronary CTO patients treated by ELCA in our hospital from 2015-01 to 2016-11 were analyzed. The patients received guide steel wire gone through occlusion segment under the guidance of offside coronary angiography; drug-eluting stent implantation was conducted after ELCA treatment. The operative success rate with complication was observed and the occurrence of MACE was followed-up. Results: The device performing and interventional therapy were succeed in all 3 patients. No coronary dissection, perforation, slow relfow and thrombosis were occurred during the operation; no angina, myocardial infarction, target vessel revascularization and death were observed by follow-up study. Conclusion: Application of ELCA combining drug-eluting stent implantation was safe and effective for treating the patients with coronary CTO.

Objective To investigate the relationship between glucose tolerance change and the coronary artery lesion in the patients with coronary heart disease. Methods One hundred and ninety three patients with coronary artery disease were divided into 3 groups according to WHO(1985) and American Diabetes Association (1997) standard of diabetic diagnoses: (1) normal glucose tolerance (NGT) group 122 cases; (2) impaired glucose tolerance (IGT) group 39 cases; (3) type 2 diabetes mellitus (DM) group 32 cases. All patients were examined by the coronary angiographic semiquantitative (CAG) and 75 g oral glucose tolerance test. Blood glucose, insulin, triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL C) were determined. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis was evaluated according to American Heart Association standard. The risk factors of coronary artery lesion were analysed by pluralism stepwiss regression analysis. Results The coronary multivessel changes and the severity of coronary artery stenosis and calcification were more frequent in IGT group than those in NGT group (66.5% vs 35.1%, 8.9?3.6 vs 6.5?3.9, 6.3?3.6 vs 3.9?4.1 respectively, P

Objective To assess the condition of left ventricular outflow tract obstruction (LVOTO) under resting conditions and physiological exercise in hypertrophic cardiomyopathy (HCM) patients.Methods A total of 60 patients with HCM and left ventri cular outflow tract gradient (LVOTG) ＜ 50 mm Hg (1 mm Hg =0.133 kPa) at rest were enrolled consecutively,and LVOTG at rest and exercise were measured by echocardiography.Of 51 patients with gradients ＜ 30 mm Hg at rest,26 were latent LVOTO with exercise peak value LVOTG ≥ 30 mm Hg,25 were non LVOTO with exercise peak value LVOTG ＜ 30 mm Hg,and 9 were resting obstruction with LVOTG 30-49 mm Hg.The morphological characteristics of different types of obstruction were analyzed.Results Patients with latent LVOTO were more likely to have SAM(73.1％ vs 8.0％),narrow of LVOT(46.2％ vs 4.0％),higher resting gradients [(16.9 ±7.2) mm Hg vs (7.1 ± 4.3) mm Hg] and mitral regurgitation grade at rest than patients with non-obstructive (all P values ＜ 0.05).The distribution of septal hypertrophy were different in the two groups (P ＜ 0.05).Multivariate logistic regression analysis showed independent predictors of latent LVOTO were SAM (OR 6.431,95 ％ CI 2.323-291.112,P =0.002) at rest and distribution of septal hypertrophy (OR 0.011,95％ CI 0.001-0.179,P =0.008).Conclusions Approximately half of patients with nonobstructive HCM at rest have latent LVOTO.SAM and distribution of septal hypertrophy may be useful to identify patients with latent obstruction.

Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.

Objective To compare the long-term effect of three different drng-eluting stents (DES) for in-stent restenotic lesions. Methods From April 2004 to June 2006, 390 consecutive patients undergoing DES implantation including 187 Cypher (group C), 89 Taxus (group T) and 114 Firebird (group F) with resulting in-stent restenotic lesions were studied. A mean of 2 year clinical and 7-month angiographic follow-up was carried out. Results Baseline characteristics indicated that there were more unstable angina cases in T group and less left main disease and more triple vessel disease cases in F group. A mean of 2-year follow-up results showed no difference of major adverse cardiac events (MACE) rate among the three groups (23.0% vs 22.5% vs 13.2% , P = 0. 081) and no difference of cardiac death, non-fatal myocardial infarction (MI) and target vessel revascularization rate(1.1% vs 4. 5% vs 1.8% , P = 0. 210, 5.9% vs 2. 2% vs 2. 6% ,P =0. 226 and 2. 9% vs 2. 2% vs 0. 9% , P =0. 509). There was no difference of total stent thrombosis or its components among the three groups (total: 4. 8% vs 3.4% vs 2. 6%, P=0. 605, early: 0. 5% vs 0 vs 0. 9% ,P =0. 560, late: 1.6% vs 1.1% vs 0. 9% ,P =0. 849 and very late: 2. 9% vs 2. 2% vs 0. 9% , P =0. 509) according to Academic Research Consortium (ARC) standard definitions (definite + probable). 7-month angiographic follow-up indicated that there was a lower trend of both in-stent and in-segment trestenosis rate in C and F groups (17.9% vs 29. 4% vs 13.6% ,P = 0. 214 and 21.8% vs 35.3% vs 15.9%, P =0. 132) and in-stent and in-segment late loss was significantly smaller inCand F groups [(0.31±0.12) mm vs(0.75±0.24) mm vs(0.31±0.13) mm, P=0.000 and (0.33±0.18)mm vs (0.61±0.23)mm vs (0.31±0.14)mm, P=0.001]. Conclusions Results from this 2-year follow-up, single-center study showed comparable effectiveness and safety of Cypher, Taxus and Firebird DES for in-stent restnotic lesions, but Cypher and Firebird had better effect in reducing restenosis.

Objective To analyze the correlation between septal branch characteristics and the prognosis of alcohol septal ablation ( ASA ) in patients with hypertrophic obstructive cardiomyopathy . Methods The clinical , echocardiographic , angiographic and procedural characteristics were analyzed retrospectively in 55 patients.Good prognosis was defined as left ventricular outflow tract gradient decreased by 50%at long term follow-up.The characteristics of septal branch were analyzed in terms of QCA .Results There were no differences in the length of the ablated septal branch , sizes of the adjacent branches , distances between the septal branch and the ostia of the coronary arteries and the volume of alcoholo consumed ( all P>0.05).Compared with poor prognosis group (n =27), the diameter of the ablated septal branches were significantly larger in the good prognosis group ( n=28 ) [ ( 1.75 ±0.36 ) mm vs.( 1.48 ±0.41 ) mm, P=0.012].The distance between the ablated branch and its adjacent branch was farer in the good prognosis group [(18.80 ±10.20)mm vs.(13.04 ±6.65)mm, P=0.020].In multivariate analysis, the diameter of the ablated branch (OR 9.258,95%CI 1.427-60.069, P=0.020)and the distance between the ablated septal branch and its adjacent septal branch (OR 1.102,95% CI 1.002-1.213, P =0.046) were found to be independent risk factors for good prognosis of ASA .Conclusions The diameter of the ablated septal branch and the distance between its adjacent septal branch are associated with better prognosis of ASA .

Objective: To summarize the characteristics of arrhythmia with the relevant factors affecting its prognosis in patients of apical hypertrophic cardiomyopathy (AHCM). Methods: A total 283 AHCM patients with echocardiography or cardiac magnetic resonance (CMR) conifrmed diagnosis in our hospital from 2005-01 to 2012-08 were summarized. The patients were divided into 2 groups: With arrhythmia group, n=103 and Without arrhythmia group,n=180. The endpoint event was followed-up by clinical and telephone visits in both groups and the relevant risk factors affecting AHCM prognosis were investigated by Cox regression analysis. Results: There were 269 patients ifnished the follow-up investigation, 98 in With arrhythmia group, 171 in Without arrhythmia group, and the death rate was 4.08% vs 1.17%, the occurrence of endpoint event was 18.37% vs 5.58%respectively. Cox regression analysis indicated that age (HR=23.051, 95% CI 1.08-1.068,P<0.005), left atrial diameter (HR=4.113, 95%CI 1.002-1.119,P=0.043) and NT-proBNP (HR= 18.653, 95% CI 3.433-26.650,P<0.005) were the independent risk factors affecting prognosis in AHCM patients. Conclusion: Arrhythmia is one of the common presentations of AHCM, it does not have much impact on survival, while it may cause ventricular ifbrillation and increase the occurrence of cardiovascular events.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.