Renshen Decoction is derived from the Synopsis of the Golden Chamber and is also known as Lizhong Pills or Lizhong Decoction, with the effects of warming the middle, dispelling cold, tonifying Qi, and strengthening the spleen, primarily treating spleen-stomach deficiency-cold syndrome. In modern clinical practice, Lizhong Pills and Lizhong Decoction are more frequently used, while Renshen Decoction is less common. Currently, this decoction is often applied in the treatment of gastric ulcers, infantile rotavirus diarrhea, chronic nephritis, autoimmune diabetes, allergic rhinitis, and other conditions, but reports on its use for coronary heart disease and angina pectoris are limited. Research has shown that in the original text, chest impediment(chest pain and stuffiness) includes not only coronary heart disease but also conditions such as coronary microcirculation disorders, X syndrome, coronary artery bridge, cardiomyopathy, heart valve disease, heart failure, chronic obstructive pulmonary disease, pulmonary heart disease, pulmonary arterial hypertension, hypotension, arrhythmia, and other diseases characterized by chest tightness. The name Renshen Decoction focuses on Panax ginseng without mentioning "Lizhong", indicating that its primary target is not the middle energizer but rather the deficiency of vital Qi and the collapse of the heart vessel. "Qi counterflow from the hypochondrium and rushing up to chest" encompasses acute inferior myocardial infarction combined with gastrointestinal irritation, and diseases with chest tightness as the main clinical manifestation combined with slow arrhythmias associated with vagus nerve excitement, nausea, and vomiting. Renshen Decoction is formulated for the deficiency-induced chest impediment, corresponding to the complication stage of coronary heart disease in modern clinical practice, which includes acute myocardial infarction with hypotension, cardiogenic shock, heart failure, and bradyarrhythmia. This differs from the excess-induced chest impediment addressed by Zhishi Xiebai Guizhi Decoction in the same article. The chest impediment treated by Renshen Decoction includes both the acute critical stage of cardiovascular diseases and the recovery phase of major illnesses. Pathophysiologically, the syndrome associated with Renshen Decoction may be closely related to ischemia, heart failure, hypotension, shock, and bradycardia. In terms of formula differentiation, Renshen Decoction must be distinguished from Zhishi Xiebai Guizhi Decoction and Chaihu Jia Longgu Muli Decoction. Renshen Decoction represents the ancient "Cardiac Triple Therapy".
Humans ; Drugs, Chinese Herbal/administration & dosage* ; Coronary Disease/physiopathology* ; Heart Failure/physiopathology* ; Hypertension, Pulmonary/physiopathology* ; Hypotension/physiopathology*

OBJECTIVE: To study the clinical features of children with recurrent Kawasaki disease (KD). METHODS: PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, and Weipu Data were searched for case-control studies on the clinical features of initial and recurrent KD. The articles were screened according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the Meta analysis. Effect models were selected based on the results of heterogeneity test, and then pooled RESULTS: A total of 9 case-control studies were included, with 12 059 children with KD in total, among whom 206 children had recurrent KD (127 boys/61.7%; 79 girls/38.3%). The results of the Meta analysis showed that compared with the initial KD onset, the children with recurrent KD had a shorter duration of fever ( CONCLUSIONS Current evidence shows that children with recurrent KD tend to have a shorter duration of fever and a lower incidence of swelling of the hands and feet. KD recurrence is more common in boys. Current evidence does not show an increased risk of developing coronary artery lesions in children with recurrent KD.
Child ; Chronic Disease ; Coronary Vessels/pathology* ; Edema/etiology* ; Female ; Fever/etiology* ; Humans ; Male ; Mucocutaneous Lymph Node Syndrome/physiopathology* ; Recurrence

OBJECTIVE: To evaluate the level of blood pressure control in patients with coronary heart disease (CHD) of China in order to provide guidance for the prevention and treatment of CHD. METHODS: The patients with CHD were retrospectively collected from 2011~2014 in PLA General Hospital and Hainan Branch Hospital. Then analyzed the difference of blood pressure compliance rate between different surgical methods percutaneous coronary intervention (PCI), coronary artery bypass grafting(CABG), secondary preventive drugs(aspirin, clopidogrel, nitrates, trimetazidine, nicorandil, hypotensor, hypoglycemic, lipid-lowering drugs) and lifestyle(smoking, drinking, exercise). RESULTS: ①Effects of surgical methods on blood pressure:Male's systolic blood pressure (SBP) and diastolic blood pressure(DBP) in the CABG group were lower in the PCI group and control group, and female's DBP in the CABG group were lower in the PCI group. ②Usage rate of secondary prevention drugs:usage rate of trimetazidine, calcium antagonist, β-blockers, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor antagonist (ARB) in hypertension group were higher than in normal blood pressure group. ③ Lifestyle condition:compliance rate of blood pressure in the smoking group was lower than that in the non smoking group. And there was no significant difference in blood pressure compliance rate among whether drinking and doing exercise or not. CONCLUSIONS Blood pressure control in patients with CHD was still not satisfied. Compared with PCI, CABG may be more beneficial in the control of blood pressure in patients with CHD. Smoking cessation and improving the usage rate of secondary preventive drugs are still the main means of blood pressure control.
Blood Pressure ; China ; Coronary Artery Bypass ; Coronary Disease ; drug therapy ; physiopathology ; surgery ; Female ; Humans ; Life Style ; Male ; Percutaneous Coronary Intervention ; Retrospective Studies ; Treatment Outcome

PURPOSE: Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients. MATERIALS AND METHODS: Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort. RESULTS: The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046). CONCLUSION: Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.
Aged ; Aorta ; Biomarkers ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Coronary Artery Disease/diagnostic imaging/*physiopathology ; Diabetes Mellitus/*physiopathology ; Diabetic Nephropathies/physiopathology ; Echocardiography ; Female ; Humans ; Kidney Failure, Chronic/*physiopathology ; Male ; Middle Aged ; Pulse Wave Analysis ; Regression Analysis ; Risk Factors ; Systole/physiology

Adult ; Atherosclerosis ; diagnosis ; Chest Pain ; Coronary Aneurysm ; diagnosis ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; Coronary Vessel Anomalies ; diagnosis ; Coronary Vessels ; diagnostic imaging ; physiopathology ; Electrocardiography ; Humans ; Male ; Risk Factors ; Troponin I ; metabolism ; Vascular Diseases ; congenital ; diagnosis

Sudden cardiac death （SCD）, most commonly seen in coronary heart disease, is a kind of sudden death caused by series of cardiac parameters, which usually combines with myocardial infarction. However, some SCDs （including early myocardial infarction） happen suddenly and cause death in a very short time. In these circumstances, typical morphological changes are lack in macroscopic or microscopic fields, which make such SCDs become the emphasis and difficulty in the present research. SCD caused by myocardial infarction and abnormalities of cardiac conduction system （CCS） is related to atherosclerosis of coronary artery closely. This paper reviews cardiac dysfunction caused by myocardial infarction and diseases of CCS from morphology and molecular biology, and explores potential relationship between them. This paper aims to provide clues to the mechanism of myocardial infarction related sudden death and possible assistance for forensic diagnosis of SCD.
Coronary Disease ; Death, Sudden, Cardiac/etiology* ; Heart Conduction System/physiopathology* ; Humans ; Myocardial Infarction/physiopathology*

BACKGROUNDThere are limited data on longer-term outcomes (>5 years) for patients with unprotected left main coronary artery (ULMCA) disease who underwent percutaneous coronary intervention (PCI) in the drug-eluting stents (DES) era. This study aimed at comparing the long-term (>5 years) outcomes of patients with ULMCA disease underwent PCI with DES and coronary artery bypass grafting (CABG) and the predictors of adverse events.

METHODSAll consecutive patients with ULMCA disease treated with DES implantation versus CABG in our center, between January 2003 and July 2009, were screened for analyzing. A propensity score analysis was carried out to adjust for potential confounding between the two groups.

RESULTSNine hundred and twenty-two patients with ULMCA disease were enrolled for the analyses (DES = 465 vs. CABG = 457). During the median follow-up of 7.1 years (interquartile range 5.3-8.2 years), no difference was found between PCI and CABG in the occurrence of death (P = 0.282) and the composite endpoint of cardiac death, myocardial infarction (MI) and stroke (P = 0.294). Rates of major adverse cardiac and cerebrovascular events were significantly higher in the PCI group (P = 0.014) in large part because of the significantly higher rate of repeat revascularization (P < 0.001). PCI was correlated with the lower occurrence of stroke (P = 0.004). Multivariate analysis showed ejection fraction (EF) (P = 0.012), creatinine (P = 0.016), and prior stroke (P = 0.031) were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age (P = 0.026) and EF (P = 0.002) were independent predictors in the CABG group.

CONCLUSIONSDuring a median follow-up of 7.1 years, there was no difference in the rate of death between PCI with DES implantation and CABG in ULMCA lesions in the patient cohort. CABG group was observed to have significantly lower rates of repeat revascularization but higher stroke rates compared with PCI. EF, creatinine, and prior stroke were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age and EF were independent predictors in the CABG group.

Aged ; Coronary Artery Bypass ; Coronary Artery Disease ; physiopathology ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Stroke Volume

OBJECTIVETo investigate the effects of treadmill exercise on central hemodynamics in patients with coronary artery disease.

METHODSSixty-eight consecutive patients below 60 years of age with the diagnosis of coronary artery disease (CAD) between July, 2013 and April, 2014 underwent treadmill exercise test following the standard Bruce protocol. Ninety-seven individuals without CAD served as the control group. Central hemodynamics of the subjects, including the central aortic blood pressure (cSBP), augmentation index (AI) and augmentation pressure (AP), were examined before and after the exercise.

RESULTScSBP increased significantly after acute exercise in both groups (P<0.001). Immediately after treadmill exercise, AI showed no significant changes in CAD patients (P=0.561) but decreased significantly in the control subjects (P<0.001). AI before exercise and cSBP after exercise were significantly higher in CAD group than in the control group (P=0.009 and 0.009, respectively). Stepwise regression analysis showed that the maximal heart rate after exercise was the main factor that affected cSBP increment in CAD group (P=0.012), and the occurrence of ischemia after exercise was associated with a lower cSBP increment (P=0.048).

CONCLUSIONAI does not decrease significantly after acute exercise in patients with CAD, suggesting that AI is closely associated with coronary artery blood perfusion after exercise and may serve as a potential target for improving ischemic threshold during rehabilitation of the patients.

Blood Pressure ; Case-Control Studies ; Coronary Artery Disease ; physiopathology ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Middle Aged

Objective To explore the impact of myocardial bridge-mural coronary artery (MB-MCA) on myocardial blood supply. Methods The imaging data of 74 patients with the isolate MB in the left anterior descending artery undergoing 256-slice CT coronary angiography and myocardial perfusion imaging (MPI) were retrospectively analyzed. The subjects were divided into incomplete and complete MB types. The length of MB and the systolic stenosis degree of MCA were measured.The type and length of MB and the systolic stenosis degree of MCA (according to Noble grade) were compared between the normal and abnormal MPI groups. The clinical characteristics including age, gender, body mass index, hypertension, dyslipidemia, diabetes mellitus, and smoking history were also reviewed. Results There were 38 incomplete MB cases and 13 complete MB cases in the normal MPI group,and 5 and 18 in the abnormal MPI group (χ=18.134,P=0.000). The MB length in the normal and abnormal MPI group were (14.7±3.7) mm and (15.5±4.5) mm (t=0.804,P=0.424). However, the systolic stenosis degree of MCA showed significant difference (χ=17.839,P=0.000). The clinical characteristics were not significantly differentt between the normal and abnormal MPI groups (P>0.05). Conclusions The MB type and the systolic stenosis degree of MCA can affect myocardial perfusion.Patients with complete MB and the moderate-to-severe systolic stenosis degree of MCA are more susceptible to myocardial ischemia. However, the MB length is not correlated with myocardial ischemia.
Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; physiopathology ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hypertension ; Myocardial Bridging ; physiopathology ; Myocardial Ischemia ; physiopathology ; Myocardial Perfusion Imaging ; Myocardium ; Retrospective Studies ; Tomography, X-Ray Computed

Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH.
Adolescent ; Biomarkers ; metabolism ; Bone and Bones ; Child ; Coronary Disease ; blood ; Disease Progression ; Female ; Goiter ; complications ; Humans ; Hypothyroidism ; blood ; diagnosis ; therapy ; Male ; Migraine Disorders ; physiopathology ; Pregnancy ; Pregnancy Complications ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Treatment Outcome