1.Radio-nuclear Imaging Study on Coronary Collateral Circulation and Myocardial Viability in Patients With Chronic Total Occlusion of Left Anterior Descending Artery
Shuheng LI ; Wei FANG ; Xiaoxin SUN ; Yueqin TIAN ; Rui SHEN ; Feng GUO ; Qi WANG ; Zuoxiang HE
Chinese Circulation Journal 2017;32(4):343-347
Objective: To assess the effect of coronary collateral circulation (CCC) on myocardial viabilityin patients with chronic total occlusion of left anterior descending (LAD) artery. Methods: A total of 101 consecutive patients with confirmed diagnosis of total LAD occlusion in our hospital were enrolled. Rest 99mTc-MIBISPECT myocardial perfusion and 18F-FDG PET were performed, in addition all patients received coronary angiography (CAG) at 3 months front and back. Both images were reconstructed in the same machine and QPS software was used to obtain the summed rest score (SRS), abnormal resting total perfusion defect (TPD), viable and non-viable myocardium, LVEDV, LVESV and LVEF in relevant patients. Based on CAG result, the patients were divided into 2 groups: CCC group, n=39 and No CCC group, n=62; according to existing old myocardial infarctionand location of LAD occlusion, the patients were further divided into 4 subgroups. The above parameters were compared among different groups. Results: There were 86 male and 15 female patients with the mean age at (59.92±11.43) years. Relevant parameters in CCC group and No CCC groupwere as in SRS: (21.23±9.68) vs (28.56±8.76), TPD: (30.03±13.69) %vs (40.37±12.50) %, viable myocardium: (21.77±13.12) % vs (13.66±9.23) %, non-viable myocardium (8.28±8.58) %vs (27.40±12.97) %, all P<0.05; in LVEDV: (109.82±30.01) ml vs (173.71±57.69) ml, LVESV: (62.82±22.39) ml vs (122.53±51.66) ml, LVEF: (43.85±8.46) % vs (31.03±8.30) %, all P<0.05. Conclusion: Our preliminary study found that CCC could maintain left ventricular rest perfusion, myocardial viability and protect cardiac function in patients with chronic total LAD occlusion.
2.Bio-effects of salusins on isolated rat heart and neonatal cardiomyocytes
Fang YU ; Jing ZHAO ; Jinghui YANG ; Lin CHANG ; Shuheng WANG ; Chaoshu TANG
Chinese Journal of Pathophysiology 1989;0(06):-
AIM: To investigate the bio-effects of salusins on rat heart and cardiomyocytes. METHODS: The cardiac function was determined by multipurpose polygraph in isolated rat heart treated with various concentrations of salusin-? or salusin-?. [ 45Ca 2+] and [3H]-Leu incorporation were determined in cultured neonatal rat cardiomyocytes with ?-liquid scintillation counter. RESULTS: 10 -12-10 -7mol/L salusin-? and salusin-? had no effects on isolated rat cardiac function. However, salusin-? and salusin-? stimulated [ 45Ca 2+] uptake and [3H]-Leu incorporation. The [ 45Ca 2+] uptake induced by salusins were inhibited by nicardipine, and were synergistically increased by endothelin-1. The [3H]-Leu incorporation induced by salusin-? and salusin-? was inhibited by nicardipine, FK506 (a special inhibitor of carcineulin), PD 98059 (inhibitor of MAPK) and chelerthine (inhibitor of PKC). The effects of salusin-? on [ 45Ca 2+] uptake was stronger than those of salusin-?. But there were no statistical difference in [3H]-Leu incorporation between salusin-? and salusin-?. CONCLUSIONS: Salusin-? and salusin-? did not affect directly cardiac function in rat hearts. But salusins improved calcium uptake and protein synthesize in neonatal rat cardiomyocytes. Those effects of salusins were related with calcium channel, carcinuelin, MAPK and PKC signal pathways. Salusins may be the regulatory factors for myocardium growth and hypertrophy.
3.Pain Management with fentanyl transdermal and morphine subcutaneous injection for the patients with advanced liver cancer pain after intervention therapy
Hengmei ZHU ; Guihua LU ; Shuheng FANG ; Lili XU
Journal of Pharmaceutical Practice 2017;35(1):75-77
Objective To evaluate the effects of fentanyl transdermal combined with morphine subcutaneous injection in the management of advanced liver cancer pain after intervention .Methods 166 patients who suffered from advanced liver canc-er and received intervention therapy in our hospital were divided into two groups .89 patients belong to the fentanyl transdermal combined with morphine subcutaneous injection treatment group .77 patients belong to the morphine subcutaneous injection treatment group .The pain score and the remission rate of the two groups were compared and analyzed statistically .Mean-while ,the side effects of each group were recorded .Results Pain score in the group with fentanyl transdermal and morphine treatment was significantly lower than morphine mono therapy .12 hours after intervention therapy ,(1 .97 ± 0 .56 for combina-tion treatment vs 3 .23 ± 1 .49 for morphine only group ,P<0 .05) .24 hours after intervention therapy ,(1 .63 ± 0 .44 for com-bination vs 4 .19 ± 1 .68 for morphine only group ,P<0 .01) .Similarly ,the remission rate of the fentanyl transdermal combined with morphine subcutaneous injection group improved significantly ,(92 .1% vs 76 .6% P<0 .05) 12 hours after intervention therapy ,and(97 .8% vs 70 .1% ,P<0 .05) 24 hours after intervention therapy .Conclusions The addition of fentanyl trans-dermal to morphine subcutaneous injection treatment significantly improve the pain remission rate for the patients with advanced liver cancer pain 72 hours after intervention therapy .
4.Evaluation of relationship between myocardial injury and left ventricular mechanical dyssynchrony using 99 Tcm-MIBI myocardial perfusion SPECT and 18 F-FDG myocardial metabolic PET imaging
Shuheng LI ; Yueqin TIAN ; Xiaoxin SUN ; Feng GUO ; Hailong ZHANG ; Zuoxiang HE ; Wei FANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2017;37(10):623-626
Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.