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

We described two patients who were successfully resuscitated from out-of-hospital cardiac arrest. Their ECGs showed ST elevations in V1 and aVR, as well as diffuse ST depression. Their ST elevation in V1 was noted to be greater than in aVR. While one patient was found to have an occlusion of the right ventricular (RV) branch of the right coronary artery, the other was found to have an occlusion of a proximal non-dominant right coronary artery supplying the RV branch. Successful primary percutaneous coronary intervention was performed for each patient with angioplasty and implantation of a drug-eluting stent. Both patients made good physical and neurological recovery.
Adult ; Angioplasty ; Angioplasty, Balloon, Coronary ; Cardiopulmonary Resuscitation ; Coronary Vessels ; physiopathology ; Defibrillators ; Drug-Eluting Stents ; Electrocardiography ; Heart Ventricles ; physiopathology ; Hepatitis B ; complications ; Humans ; Male ; Myocardial Infarction ; diagnosis ; physiopathology ; Out-of-Hospital Cardiac Arrest ; therapy ; Percutaneous Coronary Intervention ; Resuscitation ; Singapore

Adult ; Anti-Inflammatory Agents ; therapeutic use ; Coronary Vasospasm ; complications ; physiopathology ; Coronary Vessels ; diagnostic imaging ; Electrocardiography ; Gas Gangrene ; complications ; therapy ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Male ; Pericarditis ; complications ; physiopathology

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

To explore the protective effects of right coronary artery ischemic preconditioning and post-conditioning on myocardial ischemia reperfusion injury in rabbit heart.
 Methods: A total of 30 rabbits were randomly divided into 4 groups: a control group (n=7), an ischemia reperfusion group (IR group, n=8), an ischemic preconditioning group (IPC group, n=8) and an ischemic post-conditioning group (IPO group, n=7). Venous blood samples were taken at pre-operation, 1 and 6 h post-operation, and the concentration of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin-T (cTn-T) were measured. The infarct area of cardiac muscle was calculated.
 Results: Compared with the IR group, the levels of CK-MB and cTn-T at 1 and 6 h post-operation in the IPC group and the IPO group were reduced (all P<0.05). Compared with the IR group, the infarct size in the IPC group and the IPO group was significantly decreased, with significant difference (both P<0.05) .
 Conclusion: Right coronary artery ischemic preconditioning and post-conditioning exert significant protective effects on the myocardial ischemia reperfusion injury in New Zealand rabbits.
Animals ; Coronary Vessels ; Creatine Kinase, MB Form ; blood ; Heart ; Ischemia ; Ischemic Postconditioning ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial ; Myocardial Infarction ; etiology ; pathology ; physiopathology ; prevention & control ; Myocardial Ischemia ; complications ; therapy ; Myocardial Reperfusion Injury ; prevention & control ; Myocardium ; Rabbits ; Troponin T ; blood

Coronary Vasospasm ; diagnosis ; Coronary Vessels ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis

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

Scutellarin (SCU), a flavonoid from a traditional Chinese medicinal plant. Our previous study has demonstrated that SCU relaxes mouse aortic arteries mainly in an endothelium-depend-ent manner. In the present study, we investigated the vasoprotective effects of SCU against HR-induced endothelial dysfunction (ED) in isolated rat CA and the possible mechanisms involving cyclic guanosine monophosphate (cGMP) dependent protein kinase (PKG). The isolated endothelium-intact and endothelium-denuded rat CA rings were treated with HR injury. Evaluation of endothelium-dependent and -independent vasodilation relaxation of the CA rings were performed using wire myography and the protein expressions were assayed by Western blotting. SCU (10-1 000 μmol·L(-1)) could relax the endothelium-intact CA rings but not endothelium-denuded ones. In the intact CA rings, the PKG inhibitor, Rp-8-Br-cGMPS (PKGI-rp, 4 μmol·L(-1)), significantly blocked SCU (10-1 000 μmol·L(-1))-induced relaxation. The NO synthase (NOS) inhibitor, NO-nitro-L-arginine methylester (L-NAME, 100 μmol·L(-1)), did not significantly change the effects of SCU (10-1 000 μmol·L(-1)). HR treatment significantly impaired ACh-induced relaxation, which was reversed by pre-incubation with SCU (500 μmol·L(-1)), while HR treatment did not altered NTG-induced vasodilation. PKGI-rp (4 μmol·L(-1)) blocked the protective effects of SCU in HR-treated CA rings. Additionally, HR treatment reduced phosphorylated vasodilator-stimulated phosphoprotein (p-VASP, phosphorylated product of PKG), which was reversed by SCU pre-incubation, suggesting that SCU activated PKG phosphorylation against HR injury. SCU induces CA vasodilation in an endothelium-dependent manner to and repairs HR-induced impairment via activation of PKG signaling pathway.
Animals ; Apigenin ; pharmacology ; Cell Adhesion Molecules ; drug effects ; Cell Hypoxia ; Coronary Vessels ; drug effects ; Cyclic GMP ; analogs & derivatives ; metabolism ; pharmacology ; Cyclic GMP-Dependent Protein Kinases ; Glucuronates ; pharmacology ; Microfilament Proteins ; drug effects ; NG-Nitroarginine Methyl Ester ; metabolism ; pharmacology ; Phosphoproteins ; drug effects ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; complications ; physiopathology ; Signal Transduction ; drug effects ; Thionucleotides ; metabolism ; pharmacology ; Vasodilation ; drug effects ; physiology

In women receiving evaluation for suspected ischemic symptoms, a "normal" diagnosis is five times more common than it is in men. These women are often labeled as having cardiac syndrome X, also known as microvascular angina (MVA). MVA is defined as angina pectoris caused by abnormalities of the small coronary arteries, and is characterized by effort chest pain and evidence of myocardial ischemia with a non-invasive stress test, although the coronary arteries can appear normal or near normal by angiography. MVA patients are often neglected due to the assumption of a good prognosis. However, MVA has important prognostic implications and a proper diagnosis is necessary in order to relieve the patients' symptoms and improve clinical outcomes. The coronary microvasculature cannot be directly imaged using coronary angiography, due to the small diameter of the vessels; therefore, the coronary microvascular must be assessed functionally. Treatment of MVA initially includes standard anti-ischemic drugs (beta-blockers, calcium antagonists, and nitrates), although control of symptoms is often insufficient. In this review, we discuss the pathophysiology, diagnosis, and treatment of MVA.
Cardiovascular Agents/therapeutic use ; Coronary Circulation ; Coronary Vessels/physiopathology ; Female ; Heart Function Tests ; Humans ; Male ; Microcirculation ; Microvascular Angina/diagnosis/drug therapy/*epidemiology/physiopathology ; Predictive Value of Tests ; Risk Factors ; Sex Distribution ; Sex Factors ; Treatment Outcome

Prinzmetal's variant angina describes chest pain secondary to reversible coronary artery vasospasm in the context of both diseased and non-diseased coronary arteries. Symptoms typically occur when the patient is at rest and are associated with transient ST-segment elevation. Acute episodes respond to glyceryl trinitrate, but myocardial infarction and other potentially fatal complications can occur, and long-term management can be challenging. Although it is not well understood, the underlying mechanism appears to involve a combination of endothelial damage and vasoactive mediators. In this case, a 35-year-old woman with myocardial infarction secondary to coronary artery vasospasm experienced recurrent chest pain. Coronary angiography revealed severe focal stenosis in the mid left anterior descending artery, which completely resolved after administration of intracoronary glyceryl trinitrate. The patient was discharged on nitrates and calcium channel blockers. The patient re-presented with another myocardial infarction, requiring up-titration of medical therapy.
Adult ; Angina Pectoris, Variant ; complications ; drug therapy ; Constriction, Pathologic ; drug therapy ; pathology ; Coronary Angiography ; Coronary Vasospasm ; Coronary Vessels ; physiopathology ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; complications ; drug therapy ; pathology ; Nitroglycerin ; therapeutic use ; Recurrence ; Vasodilator Agents ; therapeutic use