Objective:To investigate the relationship of von Willebrand factor cleaving enzyme(ADAMTS-13), ratio of mean platelet volume to platelet count (MPV/P), intelectin-1 (ITLN-1) and thrombolysis in myocardial infarction (TIMI) blood flow classification in acute myocardial infarction patients who performed percutaneous coronary intervention(PCI) and the value of predicting postoperative major cardiovascular adverse events (MACE).Methods:A total of 126 patients with acute myocardial infarction treated with PCI in Yuechi County People′s Hospital from January 2019 to January 2021 were selected and divided into MACE group (25 cases) and no MACE group (101 cases) according of the prognosis. The levels of ADAMTS-13, MPV/P and ITLN-1 were compared between the two groups, the correlation of above index and TIMI blood flow classification and the value of predicting postoperative MACE were analyzed.Results:The levels of ADAMTS-13 and ITLN-1 in the MACE group were lower than those in the MACE group, and the level of MPV/P was higher than that in the MACE group: (132.59 ± 43.05) μg/L vs. (186.33 ± 58.17) μg/L, (255.36 ± 80.24) mg/L vs. (342.65 ± 91.18) mg/L, (0.06 ± 0.02) fl/( × 10 9/L) vs. (0.04 ± 0.01) fl/( ×10 9/L), there were statistical differences ( P<0.05). The results of Spearman correlation analysis showed that the levels of ADAMTS-13 and ITLN-1 were positively correlated with TIMI blood flow classification ( r = 0.692, 0.622, P<0.01) , the level of MPV/P was negatively correlated with TIMI blood flow classification ( r = -0.665, P<0.01). The area under the curve of ADAMTS-13, MPV/P combined with ITLN-1 in protecting the MACE was 0.872. Conclusions:ADAMTS-13, MPV/P and ITLN-1 are related to the TIMI blood flow classification and MACE in patients with acute myocardial infarction after PCI, and the combined detection can be used as a reliable predictor of MACE.

Objective Previous studies have shown that vitamin D deficiency is closely related to cardiac remodeling. How?ever, the underlying mechanisms have not been fully elucidated. Moreover, oxidative stress plays an important role on the pathologies of cardiac remodeling. The aim of this study was to explore the influence of VD deficiency on cardiac oxidative stress and the potential sig?nal pathway. Methods The male C57 mice ( 3 weeks old) were randomly divided into three groups: vitamin D deficiency ( VDD ) group ( vitamin D deficiency feed for 10 weeks) , vitamin D deficiency ( VDA) group ( vitamin D sufficiency feed for 10 weeks) and VDD+calcitriol ( CAL) group ( vitamin D deficiency feed for 10 weeks and then vitamin D sufficiency feed and calcitriol treatment for 10 weeks) . Results There were significant differences between the VDD group and the VDA group in the left ventricular end?diastolic diameter and left ventricular mass index (3.82±0.125 mm vs 3.748±0.092 mm, P<0.05) (119.30±8.54 vs 97.60±3.65, P<0.05). The number of myocardial cells stained with 8?OHDG was higher in the VDD group compared with the VDA group ( 65. 4 ± 2. 3 vs 21. 8 ± 1. 6, P<0.05) whereas was lower after calcitriol supplement. Furthermore, the expression of thioredoxin interacting protein (TXNIP) was sig?nificantly up?regulated and the ratio of p?ASK?1/ASK?1, cytochrome C release, and caspase3 activation were increased in the VDD group . Conclusion VDD can lead to cardiac oxidative injury and the up?regulation of TXNIP and the activation of ASK?1 related apoptotic signal cascade may be involved in this procedure.

Objective:To investigate the value of the Holter monitoring in silent myocardial ischemia (SMI).Methods: Sixty-eight patients with silent myocardial ischemia had the Holter monitoring.Results:Sixty-eight cases were detected 263 times of the SMI, Among them 05:00-12:00 highest incidence occurs 156 times total, 52.88% of the total number; second highest incidence of the time period of 18:00-22:00, total occurred 97 times, the total number of of 32.88%; 22:00-05:00 totaling occurred 46 times, the total number of 15.59%. There are a total of 187 predisposing factors array times, 63.34% of the total number. Heart rate greater than 100 bpm, SMI total array occurred 175 times, 59.32% of the total number; heart rate>65 bpm and

Objective To evaluate the influence of C-reactive protein (CRP),insulin resistance (IR) and epicardial fat volume (EFV) on the extent of coronary atherosclerosis in patients with different body mass index(BMl).Methods One hundred and three patients with coronary artery disease were involved in current study who underwent 64-slice dual source CT and percutaneous coronary angiography.Measurements of height,weight,waist circumference (WC) were recorded,and BMI was calculated.All patients were divided into obesity group (n =45) and non-obesity group (n =58) based on BMI.EFV were calculated through 64-slice dual source CT.Blood samples were collected for biochemical examination.Gensini score were adopted to quantify the severity of coronary artery stenosis.The relationship between Gensini score and EFV,CRP and homeostasis model assessment-insulin resistance(HOMA-IR) index were statistical analyzed by SPSS16.0 software.Results The level of CRP,WC,EFV and BMI in obesity group were (11.0 ± 5.8) mg/L,(96.1 ± 7.0) cm,(122.7 ± 43.3) cm3,(27.9 ± 2.9) kg/m2 respectively,significantly higher than those in non-obesity group ((6.5 ± 3.4) mg/L,(86.4 ± 7.6) cm,(92.9 ± 39.5) cm3,(22.4 ± 1.9) kg/m2) and the differences were significant (t =2.24,6.74,3.64,11.74,and P ＜ 0.05).CRP were positively correlated with EFV (r =0.404,0.364,P ＜0.05) in both obesity and non-obesity group,While HOMA-IR were only associated with BMI in obese group(r =0.322,P ＜0.05).Gensini score in non-obesity groups were positively related with EFV and CRP (r =0.358,0.315,P ＜ 0.05),while in obesity groups were positively related with EFV,CRP and HOMA-IR(r =0.348,0.297,0.384; P ＜ 0.05).The associations between Gensini score and CRP were not significant in obesity group after adjusting BMI and WC.Multiple linear regression analysis showed that EFV and diabetes mellitus were independent risk factors of patient Gensini score.Conclusion Coronary atherosclerosis is positively related with EFV and CRP in all patients.While,coronary atherosclerosis is influenced by BMI,WC and HOMA-IR in obese group.EFV is an independent risk factor of coronary atherosclerosis.

Objective Epicardial fat volume ( EFV) was a risk factor for coronary heart disease ( CHD) , but there is little research regarding the relationship of EFV with insulin resistance ( IR) and CHD in patients with metabolic syndrome ( MS) .The aim of the article was to explore the effect of EFV in patients with MS on CHD and IR . Methods Patients with MS treated by percutane-ous coronary angiography ( CAG) in our hospital from February 2013 to August 2013 were recruited in this study .The data of height , weight, waist circumference(WC) and hip circumference(HP) were recorded.EFV were measured by MSCT.Fasting blood samples were collected for blood biochemical test . Results EFV in patients with MS was in positive relation with IR index (IRI)(r=0.335, P<0.001) and CHD (r=0.321, P<0.05), and the correlation still remained when the influences of WC and body mass index (BMI) were excluded.Logistic regression analysis showed that EFV was an independent risk factor for CHD (P<0.05), while linear regression analysis indicated EFV , BMI and LDL-C were the risk factors for IRI .ROC curves analysis proved EFV and BMI had diag-nosis value for IRI, and the areas under curve of EFV were 0.755 and 0.679 (P<0.05) respectively. Conclusion EFV is an in-dependent risk factor for CHD and IRI in patients with MS , and EFV has an advantage over BMI in the diagnosis value of IRI .

Objective To explore the disparity of severity of cardiac dysfunction and recovery among different glycometabolic patients in the early phase of acute myocardial infarction (AMI) . Methods Consecutive 111 AMI patients without known diabetes underwent continuous glucose monitoring. Patients with different glycometabolic status were compared in terms of cadiac dysfunction and recovery at admission and 3month follow up. Results Compared to patients with normglycemia and transient hyperglycemia, patitents with persistent hyperglycemia were more likely to grade Killip Ⅱ or above,which were 13.3% (4/30) ,33. 3% ( 12/36) ,55. 6% (25/45), 20. 0% ( 6/30), 41.7% ( 15/36 ) and 93.3% (42/45) ( Ps ＜ 0. 01 ). In-hospital left ventricular ejection fraction (LVEF), mitral valve protodiastolic E peak velocities (E) and its ratio to late diastolic (E/A) decreased significantly ( LVEF :0. 52 ± 0. 02,0. 48 ± 0. 01 and 0. 37 ± 0. 02; E: [0. 65 ± 0. 41]m/s,[0.55 ± 0.02] m/s and [0.39 ±0. 12]m/s;E/A:1. 15 ±0.08,1.02 ±0.06 and 0.61 ±0.02,respectively) ( Ps ＜ 0. 01 ), whereas LVESV and WMSI increased significantly ( LVESV: [25.83 ± 0. 51] ml,[31.26 ± 1.23] ml, [37, 72 ± 1.01] ml; WMSI: 1.5 ± 0. 3,1.8 ± 0. 2 and 2. 6 ± 0. 4, respectively) ( Ps ＜ 0. 01 )There months after AMI,patitents with persistent hyperglycemia were more likely to grade NYHA Ⅱ or above compared to patients with normglycemia and transient hyperglycemia [67.5% (27/40), 10.0% (3/30) and 11.8% (4/34),respectively] (P ＜0. 01 ). Echocardiographic recovery was observed in each group,but less in persistent hyperglycemia patients. Conclusion Cardiac function of patients with persistent hyperglycemia suffered more severely from AMI and difficult to recover.

One hundred and eleven patients with acute myocardial infarction and without known diabetes mellitus who underwent continuous glucose monitoring were divided into normoglycemia(n = 30),transient hyperglycemia(n = 36),and persistent hyperglycemia(n = 45)groups.Compared with other two groups,higher mean blood glucose,standard deviation of blood glucose,largest amplitude of glycemic excursions,mean amplitude of glycemic excursions,and absolute mean of daily differences were observed in the patients with persistent hyperglycemia group(all P<0.01),who were more likely to be female with the history of hypertension and old myocardial infarction(all P<0.05).It was shown that the levels of aspartate aminotransferase,creatine phosphokinase(CK),CK-MB,total cholesterol,triglyceride,low-density lipoprotein cholesterol,HbA1C,and C reactive protein levels were higher in these patients(P<0.01).

Objective To approach the effect of hyperglycemia on admission on the prognosis in female pa-tients with acute myocardial infarction (AMI) during hospital stay. Methods 171 female AMI patients without a history of diabetes mellitus from January 1998 to December 2007 were divided into 3 groups according to the blood glucose level on admission. Group Ⅰ included 69 cases with blood glucose <6. 1 mmol/L,group Ⅱ included 49 cases with blood glucose between 6.1 and 7.8 mmol/L,and group Ⅲ included 53 cases with blood glucose >7.8 mmoL/ L. The basic clinical profile, infarct sites, the incidence rates of the main complications and the mortality of the pa-rhythmia among group Ⅲ ,group Ⅰ and group Ⅱ were significantly different ( the incidence rate of cardiac failure was 30.43% (21/69) ,32.65% (16/49) and 58.49% (31/53), the incidence rate of cardiogenic shock was 5.80% (4/69) ,8.16% (4/49) and 24.53% (13/53) ; the incidence rate of severe arrhythmia was 24.64% (17/69) ,30. 61% (15/49) and 54.72% ( 29/53), respeetivley in group Ⅰ, group Ⅱ and group Ⅲ, P < 0.05 for each). The in-hospital mortality in group Ⅲ (28.30% (15/53) ) was remarkably higher than group Ⅰ ( 13.04% (6/69)) ,with significant difference ( P < 0.05 ). Conclusions Elevated blood glucose level on admission is associated with s markedly increased risk of cardiac failure,severe arrhythmia,cardiogenic shock and mortality during hospital stay in female patients suffering from AMI.

Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.

Acute aortic dissection is the most lethal one among the diseases involving the aorta.This article reviewed the operative indications,methods,curative effects and clinical prospect of Endovascular Graft Exclusion (EVGE) for aortic dissection .The indications for EVGE are DeBakeyⅢB type aortic dissections with the intimal tear. EVGE is a minus invasive method with a firmly curative effects, and its clinical prospect will be very bright.