Coronary magnetic resonance angiography(MRA)is a technique that allows visualization of the coronary arteries by noninvasive means.This review summarizes results from several studies comparing the difference of coronary MRA with conventional coronary angiography,and finds it to be a diagnosis tool of coronary artery stenoses with a high degree of accuracy,especially with sites at the proximal and middle segments.Current limitations of two-dimensional and three-dimensional coronary MIRA are discussed,which prevents it to be sensitive enough as a screening tool.The development trends of coronary MRA are also been evaluated.(J Intervent Radiol,2007,16:139-142)

The clinical and electrocardiographic data of 35 cases with CAVB were analyzed. They could be divided into two groups: chronic (28 cases) and transcient(7 cases). The primary diseases of the patients in the chronic group were coronary heart disease(CHD) in 11 cases, a condition of unknown cause in 12, and miscellaneous diseases in 5.The clinical and ECG manifestations of the 12 cases with unknown cause were suggestive that the disorder was most likely to be primary degeneration of conduction bundles(PDCB). PDCB differed from CHD by the following:(1) In PDCB, there was neither history of chest pain nor factors vulnerable to CHD being found. No ischemic changes cound be found on the ECG of PDCB cases.(2) The duration of CAVB was longer in PDCB cases (mostly over 3 years) than in CHD cases (all under 2 years).(3) The onset of CAVB occurred at a younger age in PDCB(an average of 50.6 years) than in CHD(an average of 66.3 years).The difference between the two was significant(P

12 months in 31.3% (15/48). The graft lesions were found in 72.9% (35/48) of the patients, the worsened native lesions in 8.3% (4/48) and incomplete revascularization in 12.5% (6/48). Total occlusion was found in 33.3% (45/135) of the grafts and stenosis in 5.9% (8/135). LIMA total occlusion was 46.4% (13/28), stenosis was 8.6% (3/35) and competitive flow was 8.6% (3/35). Stenosis was found in 5.2% (5/97) of the SVG and total occlusion in 35.1% (34/97). Two of the five radial arteries were stenotic. Except for the chronic total occlusions, PCI treated the above problems with a high success rate. Conclusion Reoccurrence of angina is not uncommon after CABG. The causes are mainly due to the graft problem, and secondly due to worsened native lesion and incomplete revascularization. PCI can be used to treat the above problems except for the chronic total occlusions of the native vessels and graft.

ObjectiveTo observe the effects of anti-neurohormone drugs on ventricular remodelling and the plasma concentrations of neurohormone of patients with different grade heart function after myocardial infarction.MethodsAccording to ejection fraction of patients,103 consective patients with myocardial infarction were divided into two groups:normal heart function group:ejection fraction ranged from 50% to 70%.Abnormal heart function group:ejection fraction was less than 50%.All patients were given the same beta-receptor blocking agent and angiotensin-converting enzyme inhibitor and then were followed up 6 months.Heart function and the plasma concentrations of neurohormone were compared before and after anti-neurohormone drugs were given;at the same time,changes of heart function and the plasma concentrations of neurohormone were compared in statistical aspect between two groups.ResultsThe improvement of heart function and change of the plasma concentrations of neurohormone were significantly different in statistics before and after drugs were used.Besides,the patients with different grade heart function had significantly different changes of heart function and plasma concentrations of neurohormone.ConclusionAnti-neurohormone drugs can significantly reduce the level of the plasma neurohormone,improve heart function and inhibit heart remodeling.What’s more,there are better treatment effects in patients with heart failure.

Currently ischemic preconditioning is one of the most efficacious ways to treat ischemia reperfusion via triggering endogenously protective system. However, pharmacologic preconditioning has been produced due to the difficulty of performing ischemia preconditioning. Pharmacologic preconditioning, including both receptors and non-receptors, is actively investigated for the treatment of ischemia reperfusion.

AIM: To determine the effect of exogenous phosphocreatine (PCr) at different concentrations on transient outward potassium (Ito) current in rat ischemic ventricular mid-myocardial (M) cells and to explore the antiarrhythmia mechanism in the treatment of ischemic heart disease. METHODS: M cells were isolated enzymatically from left ventricular mid-myocardium of rats. Peak Ito current was recorded by patch-clamp technique in the whole-cell configuration when M cells were superfused with normal Tyrode solution,simple ischemic solution,and simulated ischemic solution containing PCr at concentrations of 5,10,20 and 30 mmol/L for 10 min. RESULTS: Peak Ito current density of M cells superfused with simple simulated ischemic solution was significantly reduced by (76.1±6.3)% (P<0.05) compared with M cells superfused with Tyrode solution. Ischemic solution containing 5,10,20 and 30 mmol/L PCr reduced peak Ito current density by (57.1±9.6)% (P<0.05),(40.3±10.3)% (P<0.05),(34.3±9.6)% (P<0.05) and (32.1±10.6)% (P<0.05),respectively. There was statistical difference among ischemic solution without PCr and containing PCr at concentrations of 5 and 10 mmol/L groups (P<0.05). No statistical difference among groups of 10,20 and 30 mmol/L PCr was observed (P>0.05). CONCLUSION: PCr reverses the inhibition of Ito current under ischemic condition in M cells,which may be the mechanism responsible for arrhythmia prevention in ischemic heart disease. PCr at concentrations of 0～10 mmol/L exerts significant dose-effect relationship.

Objective To investigate the safety and efficacy of protective measures(hydration treatment)during perioperative period of interventional therapy for renal function of gerontic patients with coronary artery disease(CAD)complicated by chronic renal insufficiency(CRI).Methods The relation between hydration therapies and the renal function of 168 CAD patients(≥60 years old)complicated by CRI were analyzed.These patients were divided into three groups:in the group A,patients underwent selective coronary angiography(SCA)with conventional treatment during interventional perioperative period(IPP);in the group B,patients underwent SCA and treated with the NaCl plus low dose NaHCO3 during IPP;in the group C,patients underwent percutaneous coronary intervention(PCI),and meanwhile treated with the same dose NaCl and NaHCO3 as the group B during IPP.Results Coronary interventions were successful in all 168 patients.Contrast medium associated nephropathy(CAN)was found in 30 patients,and incidences of the CAN were 17(27.4%)in the group A,3(7.5%)in the group B and 10(15.2%)in the group C,respectively.The accompanying diseases and characteristics of the patients also effected the incidence of CAN:the CAN incidence of patients with hyperlipidemia was significantly higher than that with normal cholesterol(P<0.001);patients with diabetes was significantly higher than that with normal serum glucose(P<0.001);patients with stenosis of renal artery was significantly higher than that with normal renal artery(P<0.001);patients with heart failure(grade Ⅲ～Ⅳ)was significantly higher than that with the grade Ⅰ～Ⅱ(P<0.001).Conclusion The hydration treatment with the NaCl plus low dose NaHCO3 during IPP can protect renal function and increase tolerance for gernotic CAD patients complicated by CRI during IPP,and improve prognosis.

This paper reported the results of balloon pulmonary valvuloplasty for 8 patients (single-balloon for 7 cases,double-balloon for 1 case).The meanpulmonary valve orifice in diameter (PVOD) was dilated from 8.4?2.2 preoperation to 16.4?1.5mm of postoperation,the systolic pressure in rightventricle (RV)was reduced from 16.9?5.3 to 9.1?3.8kPa,the pressure gradient from RV to pulmonary artery was reduced from 14.9?5.1 to 6.6?2.9 kPa,the cardiac index was increased from 3.2?0.3 to-5.1?0.7L/min m-2.The symptoms and heart murmur were nearly,subsided after treatment,the patients dischargd within 5 days after operation.PBPV is a nonoperative procedure with good efffect and.safety.

Objective To evaluate the immediate and long-term outcomes of left main bifurcation lesions using different stenting techniques.Methods 27 patients undergone unprotected left main coronary artery stenting had been analyzed.14 cases with simple stenting techniques and 13 cases with complex stenting techniques were involved.Results 40 coronary stents were deployed in 27 patients.The procedural success rate was 100%.No major adverse cardiac events(MACE)had developed in hospital.More true bifurcation lesions were involved in complex stenting group than in simple stenting group(84.6% vs 14.3%,P=0.0004),as well as multivessel lesions involved(100% vs 57.1%,P=0.0074).The residual ostial restenosis of left anterior descending artery(LAD)in complex stenting techniques group was more than that in simple stenting techniques group((4.29±4.25)vs(10.85±5.51),P=0.002).The residual ostial restenosis of left circumflex artery(LCX)in complex stenting group was less than that in simple stenting group((4.61±3.01)vs(13.63±11.21),P=0.009).The patients were followed up for 2～53 months.Angina pectoris recurred in 3 cases(11.1%)and target lesion revascularization(TLR)developed in 2 cases(7.41%).The total MACE happened in 2 cases(7.41%).There was no significant difference between complex stenting group and simple stenting group about symptom recurrence(7.1% vs 15.4%,P=0.59)and TLR(0 vs 15.4%,P=0.13).Conclusion Both simple and complex stenting techniques are feasible with better in-hospital and long-term outcomes.

BACKGROUND:The safety and efficacy of paclitaxel-eluting stents (Taxus DES) has been proved by international researchers in clinic investigations.Based on further inclusion criteria,the incidence of in-stent restenosis is still lower than that of bare-metal stent.OBJECTIVE:TO observe restenosis of Taxus DES and the effect on local vessels through applying the follow up of coronary angiography and to investigate the biocompatibility of stent and host.DESIGN:Following-up observation.SETTING:Department of Cardiology,General Hospital of Chinese PLA.PARTICIPANTS:A total of 297 patients who had undergone coronary Taxus DES implantation for coronary artery disease were selected from Cardiovascular Department of General Hospital of Chinese PLA from May 2003 to May 2005.There were 265 males and 32 females and their ages ranged from 36 to 76 years.All patients provided informed consent,and the experiment had got confirmed consent from local ethic committee.METHODS:All patients were implanted Taxus DES and received the follow up within 6 and 12 months.In addition,at 6 months after operation,coronary angiography was used to measure the reference vessel diameter (RVD) and the minimal lumen diameter(MLD),calculate diameter restenosis rate and observe late loss.MAIN OUTCOME MEASURES:Coronary angiography at 6 months after Taxus DES implantation and biocompatibility of stent and host.RESULTS:①Quantitative angiographic analysis(QCA):Angiographic follow-up showed that the late loss of in-stent was significantly higher than that of pro-in-lesion and dis-in-lesion(P＜0.05).②Coronary angiography in-stent restenosis:In 134 angiographic follow-up patients,a total of 14 patients experienced restenosis,and the incidence was 10.4%(14/134).The patterns of restenosis were diffuse in-stent in 7 patients and the rate of revascularization was 6.7%.③Stent aneurysm:Angiographic evidence of aneurysm was observed in one patient among follow-up cases,and the rate of which was 0.75% (1/134).④Clinic follow-up major adverse cardiac events(MACE):Among 297 patients,one patient was attracted sudden death 5 months after intervention (0.34%; 1/297),and one patient was suffered subacute thrombosis 5 days after stent implant (0.34%;1/297),and late thrombosis occurred in 2 patients.The general rate of MACE was 1.35%.CONCLUSION:①The late loss of Taxus DES mainly takes place in in-stent.The patterns of restenosis of Taxus DES are in majority of diffuse in-stent,and the incidence of MACE is low.②Taxus DES possibly results aneurysm in local vessels.The follow up indicates that Taxus DES has a good biocompatibility to patients.