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Protective Role of Hydrogen Sulfide on Neonatal rat Myocardial Cells by Hypoxia-Reoxygenation Injury

Chinese Circulation Journal.2009;24(3):227-230. doi:10.3969/j.issn.1000-3614.2009.03.019

Objective:To investigate the direct effect of different concentrations of hydrogen sulfide(H_2S)on neonatal rat myocardial cells by hypoxia injury during different time point,and the indirect effect of reoxygenation injury in order to analyze the protective role of H_2S on myocardial cells subjected to hypoxia/reoxygenation injury. Methods:Primary cultured myocardial cells from neonatal rats were randomly divided into 9 groups:Normal control group,Hypoxia NaHS 0 μmol/L group,100 μmol/L group,200 μmol/L group,400 μmol/L group and those groups subjected to hypoxia for 24 h,48 h and 72 h. Hypoxia/reoxygenation NaHS 0 μmol/L group,100 μmol/L group,200 μmol/L group,400 μmol/L group and those groups subjected to hypoxia for 24 h,48 h,72 h and then reoxygenation for 2 h. The number of survival cells were counted and the activity of lactate dehydrogenase(LDH)were measured respectively at each time point. Results:At the same time point of 24 h,48 h,72 h hypoxia,the number of survival cells increased and the activity of LDH decreased in hypoxia NaHS treatment groups as compared with Hypoxia NaHS 0 μmol/L group(P<0.01). The protective role of Hypoxia NaHS 200 μand 400 μmol/L groups were better than NaHS 100 μmol/L group at 24 h of time poit(P<0.05～0.01). The number of survival cells by hypoxia/reoxygenation increased and the leakage of LDH from reoxygenation cells decreased in hypoxia/reoxygenation NaHS treatment groups as compared with hypoxia/reoxygenation NaHS 0 μmol/L group(P<0.01).Conclusion:NaHS 100 to 400 μmol/L had the protective effects on myocardial cells by hypoxia/reoxygenation injury. NaHS 200 to 400 μmol/L might offer the best protective effects on myocardial cells by hypoxia injury at 24 h.

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Transvenous Cryoablation Versus Radiofrequency Catheter Ablation for Treatment of Atrioventricular Nodal Reentrant Rachycardia

Linzhi LI ; Zhiyu LING ; Zengzhang LIU ; Li SU ; Qiang SHE ; Yuehui YIN

Chinese Circulation Journal.2009;24(3):206-209. doi:10.3969/j.issn.1000-3614.2009.03.013

Objective:To compare the efficacy and safety between cryoablation(Cryo)and radiofrequency (RF)ablation in patients with atrioventricular nodal reentrant tachycardia(AVNRT). Methods: A total of 83 patients with AVNRT underwent electrophysiological treatment in our hospital from October 2006 to March 2009 were studied. Patients were divided into two groups according to their own choices. Cryo group (n=41) and RF group (n=42). The clinical characteristics,success rate,procedural time and ablative time were compared between two groups. Results:The procedural time and ablative time in Cryo group was significantly longer than those in RF group (119.14±40.16 min vs.85.86±28.24 min,P=0.001; 1118.91±620.62 s vs.370.97±279.23 s,P<0.001). The acute success rate was achieved in 40/41(97.6%)patients in Cryo group,and 42/42(100.0%) in RF group. Transient AV-block was encountered in 6 (15%) patients in the Cryo group and 5 (11.9%) in RF group (P=0.681). There was no complete atrial-ventricular(AV)conduction block at the end of procedures. There was no recurrence of AVNRT in either Cryo group nor in RF group during 11.6±5.5 months of follow up period.Conclusion:Cryoablation was as effective and safe as RF ablation for AVNRT. Cryo-energy was one kind of alternative ablation energy for AVNRT.

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Feasibility and Stability of Right Ventricular Outflow Tract Pacing Under Current Technology

Ruohan CHEN ; Keping CHEN ; Fangzheng WANG ; Wei HUA ; Shu ZHANG

Chinese Circulation Journal.2009;24(3):202-205. doi:10.3969/j.issn.1000-3614.2009.03.012

Objectives: To assess the feasibility and stability of right ventricular outflow tract (ROVT) pacing under current technology by comparing the results of ROVT pacing with the traditional right ventricular apex (RVA) pacing. Methods: A total of 42 patients (at mean age of 63.5±10.4 years) without structural heart disease were randomly divided into two groups. RVA pacing group (n=14),and RVOT pacing group(n=28). An active fixation lead was implanted in all patients whose pacemaker could automatically measure the pacing threshold every day. The operation time,X-ray exposure time and lead parameters detected during the operation were collected to evaluate the feasibility of RVOT pacing. The complications related to lead and implantation procedure and the trend of threshold change during the follow-up time were used to assess the stability of RVOT pacing.Results: There were no statistic differences between RVA pacing group and RVOT pacing group in terms of operation time,X-ray exposure time and lead parameters. In RVOT group,the change of threshold during acute period was similar to those in RVA group (P=0.23). Chronic pacing threshold was also comparable between two groups,mean threshold at 6 months follow-up time was 0.55±0.11V and 0.54±0.09V at 0.4 pulse width in RVA group and RVOT group respectively (P=0.787).Conclusion: RVOT pacing was feasible and stable in operation time and lead characteristics compared with the conventional RVA pacing under current pacing technology.

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Intermedial to Long Term Surgical Management in Aortic Valve Insufficiency After Ventricular Septal Defect Repair

Zhiqiang LI ; Xiangdong SHEN ; Yinglong LIU ; Hansong SUN ; Xiaodong ZHU

Chinese Circulation Journal.2009;24(3):224-226. doi:10.3969/j.issn.1000-3614.2009.03.018

Objective:To explore the intermedial to long term surgical management in aortic valve insufficiency(AI)after ventricular septal defect(VSD)repair.Methods:A total of 22 consecutive patients with AI after VSD repair in our hospital from January 1996 to December 2007 underwent surgical treatment were enrolled in this study. Valve perforation was mainly pathological changes. Aortic valve replacement was performed in 13 patients and aortic valvuloplasty was done in 9 patients.Results:One patient died after the operation.Post operative X-ray and echocardiogram revealed that both cardio-thoracic ratio(0.57±0.07 vs. 0.52±0.04 P<0.05)and left ventricular end diastolic diameter(54.5±10.2 mm vs. 46.7±5.8mm P<0.05)decreased markedly. 3 patients suffered from mild aortic regurgitation after valvuloplasty.Conclusion:The iatrogenic injury of aortic valve during VSD repair could be corrected satisfactorily by valve replacement or valvuloplasty.

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Operative and Mid-Term Results of 107 Corrected Congenital Transposion of Great Arteries

Zhongdong HUA ; Shengshou HU ; Xiangbin PAN ; Xiangdong SHEN ; Shoujun LI ; Jun YAN ; Yinglong LIU ; Qingyu WU ; Xu WANG

Chinese Circulation Journal.2009;24(3):221-223. doi:10.3969/j.issn.1000-3614.2009.03.017

Objective:To retrospectively analyze the results and mid-term outcomes of 107 patients with corrected congenital transposition of great arteries(CCTGA)who underwent surgical treatment.Methods:A total of 107 CCTGA patients with surgical treatment from January 1996 to October 2005 in our hospital were studied.There were 72 male and 35 female,with the mean age of 11.5±8.4years and mean body weight of 31.6±4.7kg. Among the cohort,81 were levocardia,23 dextrocardia,and 3 medocardia.Initial surgical procedure included single ventricle repair in 14 cases,conventional biventricular repair in 75 and biventricular anatomical repair in 18 cases. 99(93%)patients were followed up with the mean time of 47.8 months.Results:The early operative mortality rate was 4.76% in different procedures.The death rate with single ventricle repair was 0%,conventional biventricular repair 4%,atrial-arterial double switch 0%,atrial-ventricular double switch 40%. The risk factors for operative mortality were lesions with double outlet left ventricle combined with pulmonary stenosis(P<0.01)and Rastelli procedure(P<0.05). 12 patients(12.6%)died during the follow up period,among them,10(83.3%)were in conventional repair group,2(16.7%)in single ventricle repair group,and no death in double switch group. The risk of death during the follow up period of time were conventional biventricular repair,Rastelli procedure and tricuspid regurgitation.Conclusion:Conventional biventricular repair had a disappointing outcome in both operation and in long-term of follow up time. Patients suitable for single ventricular repair had fair short-and mid-term outcomes. Atrial-arterial double switch procedure had good operation and long-term results.

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Preliminary Study of Microarray Gene Expression Profiles in Chronic Congestive Heart Failure due to Rheumatic Heart Disease

Xiaobo LIAO ; Xinmin ZHOU ; Jinfu YANG ; Jianming LI ; Hao TANG ; Yuan ZHAO ; Dongxu HU

Chinese Circulation Journal.2009;24(3):217-220. doi:10.3969/j.issn.1000-3614.2009.03.016

Objective:To analyze gene expression profiling of left ventricular myocardium in patients with chronic congestive heart failure(CHF)caused by rheumatic heart disease(RHD)with the normal controls in order to identify CHF associated target genes. Methods:The gene expression profiles of left ventricular myocardium from patients with CHF by RHD and normal controls were obtained from six human whole-genomic oligonucleotide microarrays(Affymetrix HG U133 Plus 2.0 GeneChip). GeneSpring software was used to identify the differentially expressed genes in both groups,and bioinformatic analysis was applied to analyze the target genes associated with CHF. Real-time PCR was carried out to validate the expression of three target genes. Results:We identified 102 target genes associated with CHF which were classified into 7 gene clusters. Microarray results were further confirmed by real time PCR for three genes. ATF3 was markedly down-regulated,IGFBP2 and NPPB were notably up-regulated in the left ventricular myocardium samples from CHF patients. Conclusion:A lot of differentially expressed genes,obtained by using the whole-genomic expression profiling technology,might be a contributory factor for the initiation and progression of CHF and it helpful for the understanding of underlying pathophysiological implications. Further investigation on these genes would provide a strategy to identify genetic markers and molecular events associated with CHF caused by RHD.

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Anesthesia of Children with Grave Congenital Heart Diseas es during Cardiac Catheterization and Ventriculography——369 Cases Review

Yun WANG ; Dongya ZHANG ; Weiqin HUANG

Chinese Circulation Journal.2001;16(1):56-57.

Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

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The Experience of Using Fresh Autologous Pericardium in Cardiac O peration

Zonglin SHEN ; Zhihong LIU ; Shangyi JI

Chinese Circulation Journal.2001;16(1):53-55.

Objective:To introduce the experience of using the fresh autologous pericard ium in cardiac operation. 　　Methods:Fresh autologous pericardium unprepared by 0.5% glutardaldehyde was used in cardiac operations in 321 patients.It was used not only in repair of at rial septal defect and ventricular septal defect,but also in operations of many complicated congenital heart diseases,such as tetralogy of Fallot,double outlet of right ventricle,atrioventricular canal,single atrium anomalous pulmonary veno us connection,Ebstein's anomaly,tricuspid atresia,pulmonary atresia,single vent ricle,complete transposition of the great ateries.Autologous pericardium was als o used for enlargement aortic root in rheumatic heart disease and repairing of a trial septium after resection of the left atrial myxoma. 　　Results:Twenty patients (6.1%) died within 30 days after operation.The resi dual shunt was found in one patient with tetralogy of Fallot and three patients with ventricular septal defect.Two hundred and fourty-three patients (75.7%) w ere followed-up.No patient had hemolysis,embolism,infectious endocarditis,patch calciflcation or other complications concerned with the use of the autologous p ericardium after operation. 　　Conclusion:The fresh autologous pericardium is a good material for repairing cardiac defects.

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mRNA Expression of c-myc Gene in the Hyperacute Rejection of Xe notransplantation

Qiang MENG ; Qingyu WU

Chinese Circulation Journal.2001;16(1):67-69.

Objective:To research expression and function of c-myc gene in hyperacute r ejection of xenotransplantation. 　　Method:Through the model of hyperacute rejection of xenotransplantation wit h isolated rat heart perfused with human plasma,we detected c-myc mRNA expressi on and cell localization with in situ hybridization in hyperacute rejection. 　　Result:c-myc mRNA increased expression in the endothelium cell of heart.Th e value of signal is 450.09±409.99.The value of signal of group of control is 1 74.40±51.50(p＜0.05)。　　Conclusion:From these study findings,it would appear that hyperacute rejecti on is associated with the elevation of c-myc mRNA expression.

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Detection and Significance of Antibody Against Human Myocardial Mitochondria in Virus Myocarditis and Dilated Cardiomyopathy

Jiandong DING ; Xiang WU ; Yong GU

Chinese Circulation Journal.2001;16(1):38-40.

Objectives:The present study in vestigated the presence and significance of serum antibody against human myocardial mitochondria in patients with virus myocarditis (VMC) and dilated cardiomyopathy (DCM). 　　Methods:The human myocardial mitochondtia were used as antigen to detect serum autoantibody by immuno-dot blot in 29 VMC patients,24 DCM patients,33 patients with other cardiac (OCD) and 20 healthy blood donor (HBD).The antigen molecular weight was detected by Western blot. 　　Results:①Positive autoantibody against human myocardial mitochordria was found in 41.4% in VMC and 41.7% in DCM patients,which were much higher than 6.1% in OCD or 0% in HBD patients.②Cardiac troponin T was elevated in 43.8% of autoantibody-positive VMC and DCM patients,which was much higher than 12.0% in autoantibody-negative VMC and DCM patients (p＜0.05).③The antigen molecular weight of human myocardial mitochondria was 30KD. 　　Conclusions:①The presence of autoantibody against supports that concept that is responsible for the development of VMC and DCM.Autoantibody is one of the factors that give rise to cardiac injury.The antibody detection may serve as a diagnostic index for VMC and DCM.②The specific antigen is probably human myocardial adenine nucleotide translocator.

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