Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

BACKGROUND:A number of studies have shown that bone marrow mesenchymal stem cells can survive in the infarcted myocardium and improve cardiac function. OBJECTIVE:To investigate the effects of al ogeneic rat bone marrow mesenchymal stem cells on heart failure in acute myocardial infarction models of rats and possible mechanisms. METHODS:Rat bone marrow mesenchymal stem cells were isolated from the bone marrow of 39 male Wistar rats by density gradient centrifugation with Percol . After ligating anterior descending coronary artery, 39 female Wistar rats were randomly divided into three groups:control group (Dulbecco’s modified Eagle’s medium, n=12), mesenchyma stem cells group (n=15) and mononuclear cells group (n=12). Eight weeks later, hemodynamics and left ventricular function were measured. Histopathological and immunohistochemical examinations were performed. RESULTS AND CONCLUSION:Compared with the control group, left ventricular end diastolic pressure, left ventricular relative weight, the col agen volume fraction of type I and type III in the infarction zone of the left ventricle were al significantly decreased, in contrast to ±dp/dtmax,-dp/dtmax/left ventricular systolic pressure, body weight and vascular density in infarction zone were al significantly increased both in mesenchymal stem cells group and mononuclear cells group. There were no significant differences between two treatment groups except for interventricular septal thickness and vascular density in non-infarction zone. 5-Bromo-2'-deoxyuridine positive cells were observed in the infarction area of mesenchyma stem cells group but no positive cells in mononuclear cells group. Some bal-like cellmasses were found positively stained with desmin and cardiac troponin T. Results have suggested that embedded bone marrow mesenchymal stem cells survived in exogenous host hearts. The therapy of mononuclear cells and mesenchymal stem cells could limit the left ventricular remodeling after acute myocardial infarction and improve left ventricular function through angiogenesis inducing and col agen deposition decreasing.

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 evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method.Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy,treated with resection of pituitary tumor,in PLA General Hospital,from 2005 to 2011,were collected and analyzed.Comparative analysis of cardiac function were made in these patients before and after the surgery,also with the postoperative recovery status,using echocardiography and other noninvasive detection means to detect the growth hormone ( GH),left ventricular end-diastolic diameter (LVEDD),septal thickness (ST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF) values.Results After the resection of pituitary tumor,the LVEDD,ST,LVPWT,LVEF levels were all significantly better than that before the surgery.Before the surgery the GH,ST,LVPWT,LVEF levels were 93.89 μg/L,11.13 mm,43.92％ and 10.53 mm,while those after the surgery were 5.16 μg/L,10.64 mm,49.28％ and 8.87 mm.The difference of the GH level before and after the surgery was correlated with the difference of ST,LVEDD and LVEF in a linear manner.Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy,and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.

Objective Biochemical indicators such as N-terminal pro-brain type natriuretic peptide(NT pro-BNP)and high-sensitivity Creactive protein(hsCRP)predict mortality in acute coronary syndrome(ACS).However,little is known about the relationship of these factors with severity of coronary artery stenosis in patients with.Methods Three hundred and thirty-one subjects including 246 unstable angina pectoris patients and 85 myocardial infarction patients were recruited and classified into two groups:single-vessel disease group(1-vessel disease,n=93)and multiple-vessel disease group(≥2-vessels disease,n=238)according to selective coronary angiography.Plasma levels of NT pro-BNP and hsCRP were measured and severity of coronary stenosis was determined by Gensini score.Results NT pro-BNP but not hsCRP level was higher in patients with myocardial infarction than in patients with unstable angina pectoris.The patients with multiple-vessel disease had significantly higher NT pro-BNP level but not hsCRP compared with those with single-vessel disease.NT pro-BNP levels increased significantly as left ventricle(LV)function decreased,and only NT proBNP but not hsCRP level was related to Gensini score of severity of coronary stenosis in ACS.Conclusion NT proBNP but not hsCRP level is related to severity of coronary artery stenosis in patients in ACS.

ObjectiveTo study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction. Methods130 patients with myocardial infarction were divided into anti-aldosterone group (spironolactone 20～40 mg/d + enalapril 10～20 mg/day, n=61) and control group (enalapril 10～20 mg/d, n=69). The echocardiogram and Doppler tissue imaging (DTI) were performed at enrolling time, and 6, 12 months after treatment. ResultsIn the anti-aldosterone group, the average mitral systolic wave (s) was significantly increased 6 months after treatment （P<0.05） to the enrolling time. LVEF and LVEDD improved 12 months after treatment （P<0.05）. In the control group, the average mitral systolic wave, LVEDD and LVEF did not significantly improve (P>0.05). Ratio of peak early to late diastolic filling velocity (e/a) was no significantly different between the anti-aldosterone group and the control group. ConclusionThe combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months, but cannot to the diastolic function.

ObjectiveTo investigate the relationship between thyrotropin (TSH) levels and B-type natriuretic peptide (BNP) in elderly patients with diastolic heart failure (DHF). MethodsPlasma levels of TSH and BNP were measured in 93 elderly patients diagnosed DHF clinically. ResultsThe BNP was (1011.07±238.27) pg/ml and (769.36±169.55) pg/ml in patients with high TSH level（>5.5 μIU/ml, n=46) and normal TSH level (0.35～5.5 μIU/ml, n=47) (P<0.05), respectively. ConclusionHigh TSH levels might promote the plasma BNP secretion in elderly patients with diastolic heart failure.

Objective To investigate the influence of age on recent prognosis of elderly inpatients with acute myocardial infarction (AMI).Methods A total of 2535 inpatients with AMI were divided into different age groups.The influences of age and coexistent diseases on prognosis in AMI patients were analyzed retrospectively.Results The hospital mortality and 30-day mortality were higher in patients aged ≥80 years compared with patients aged 65-79 years and patients aged 60-64 years(χ2 =46.378,P<0.01 ;χ2 = 44.534, P<0.01).In 60-64 years old patients with AMI, the prevalences of old myocardial infarction (OMI), renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group (all P<0.05).In 65-79 years old patients with AMI, the prevalences of OMI, hypertension, diabetes,cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).In 80-94 years old patients with AMI, the prevalences of OMI, diabetes, cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).The prevalences of OMI, hypertension, diabetes, cerebrovascular disease,respiratory insufficiency were significantly increased in 80-94 years old death group versus 60-64 and 65-79 years old death group(all P<0.05).Conclusions The mortality rate of elderly patients with AMI is increased with age and atypical angina pectoris should be paid more attention in these patients.

Objective To investigate the effect of hepatocyte growth factor (HGF) on mitral regurgitation caused by acute myocardial infarction in canines.Methods The acute myocardial infarction model was established by ligating proximal left anterior descending coronary artery (LAD) with 13 hybrid canines. The myocardial infarction model was successfuly established in 12 animals and those were randomly divided into the HGF-group and control group with 6 animals in each group. Canines of the HGF-group were injected with pc-DNA3-HGF 1 ml (about 300 μg) at the margin of infarcted myocardial and animals of the control group were injected with equal volume saline. The data were measured through echocardiography in the 1st, 4th and 8th week after ligation as following parameters: left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area. Left ventricular myocardium specimens were obtained in the 8th week after ligation and stained with hematoxylin and eosin for histological examination or with picrosirius red staining to assess the collagen content.Results Compared with the control group, LVEF in the HGF-group increased in the 4th week after ligation; LVEF significantly improved and LVESV decreased in the 8th week after ligation ( P<0.05). In the 8th week after ligation, left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area in the HGF-group were lower than that in the control group. In the HGF-group, neovascularization and fewer scars were observed histologically. Compared with the control group, the HGF-group showed higher capillary density in margin of infarcted area by factor Ⅷ-related immunohistochemistry staining ( P<0.01).Conclusion HGF gene can improve cardiac function and relieve mitral regurgitation after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, diminishing myocardiolysis and scarring.

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.