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简介：ObjectivesThepurposeofthisstudywastodetermineiftheultrasonicintegratedbackscatterandechointensitycouldbeusedinclinicaldiagnosisofacutemyocardialinfarction.MethodsandResultsWithin2weeksafteracutemyocardialinfarction,35patientsunderwentultrasonictissuecharacterizationfromthepapillaryshort-axisview.Thecyclicvariationofintegratedbackscatterandechointensityofthreedifferentmyocardialregionsperfusedbyleftanteriordescendingcoronaryartery,leftcircumflexcoronaryandrightcoronaryweremeasured.Thevalueofcyclicvariationofintegratedbackscatterandintegratedbackscatterandechointensity≤halfofthehighestvalueofthreedifferentmyocardialregionsonasameviewweredefineasthecriteriafordiagnosingacutemyocardialinfarction,andtheresultswerecomparedwithcoronaryangiography.ThesensitivityofdiagnosingacutemyocardialinfarctionbybothUltrasonictissuecharacterizationwithintegratedbackscatterandechointens

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：ObjectivesTostudythestatusoffibrinolyticinhibitioninpatientsofacutecoronarysyndrome(ACS)complicatedwithtypeⅡdiabetesmellitus(NIDDM)andtoevaluatetheeffectoffibrinolyticinhibitiontotheclinicalprognosis.MethodsTypeⅡdiabetesmellituswasdefinedbyADA1997/WH01998criteria.Thesubjectsweredividedintotreatmentgroupsthatincluded39patientsofACSwith20casesofacutemyocardiacinfarction(AMI),36patientsofACS+NIDOMwith20casesofAMI.Twentycasesofhealthypeoplewererandomizedtocontrolgroup.Theplasmaleveloftissuetypeplasminogenactivator(t-PA),plasminogenactivatorin-hibitortype-1(PAI-1)andplasmaD-dimerweredetectedbyusingelisatechnique.TheindexofstatueinfibrinolysiswasdetectedwiththeplasmalevelofD-dimerandtherateofPAI-1/D-dimerinpercentage.ThisindexwasusedtoevaluatethefibrinolyticinhibitionandtheclinicaloutcomeinallthepatientswithAMIintreatmentgroups.TheclinicaloutcomeinpatientswithAMIconsistedoftherateofreperfusion,theincidencesofreinfarction,severi-ousarrhythmia,pumpfailureanddeathintheearlyperiodofAMI.ResultsTheplasmalevelofPAI-1andD-dimerwashigherinthetwotreatmentgroupsthanthatinthecontrolgroup(P<0.01).TheplasmalevelofPAI-1significantlyhigherinACS+NIDDMpatientsthanthatinACS(P<0.05),buttheplasmalevelofD-dimerraisedfrombasiclevelwassignificanflylowerinACS+NIDDMthanthatinACS(P<0.05).TherateofPAI-1/D-dimerinpercentagewassignificantlyhigherinACS+NIDDMthanthatinACSorincontrolgroup(P<0.01).ForAMIpatientsintwotreatmentgroups,therateofreperfusionafterthethrorabolytictherapywassignifi-candylowerinACS+NIDDMthanthatinACS(P<0.01).TherateofincidencesinpumpfailurewassignificantlyhigherinACS+NIDDMthanthatinACStoo(P<0.05).Themorbidityofseveriousarrhythmia,re-infarctionandthemortalitywerealsohigherinACS+NI

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简介：Inheritedcardiomyopathiesaremajorcausesofmorbidityandmortalityandincludeagroupofcardiacdisorderssuchashypertrophiccardiomyopathy(HCM),dilatedcardiomyopathy,arrhythmogenicrightventriculardysplasia/cardiomyopathy(ARVD/C),leftventricularnoncompaction(LVNC),andrestrictivecardiomyopathy(RCM).Thesediseaseshaveasubstantialgeneticcomponentandpredisposetosuddencardiacdeath.Sincethefirstgenewasidentifiedasadisease-causinggeneforHCMovertwodecadesago,morethaneightygeneshavebeenidentifiedtobeassociatedwithinheritedcardiomyopathiesandgenetictestinghasbecomeprevalentinmakingclinicaldiagnosis.Withtheadventofnext-generationsequencingtechnology,geneticpaneltestingofinheritedcardiomyopathieshasbecomefeasibleandcostefficient.Inthisreview,wesummarizetheindividualcardiomyopathieswiththeemphasisoncardiomyopathygeneticsandgenetictesting.

简介：Inclinicalpractice,avarietyofsyndromesareassociatedwithcardiovasculardiseaseandhavecharacteristicfindings.Mostofthemareanautosomaldominantgeneticdisorderandhavedifferenttypesofcardiovascularabnormalities,includingelectrocardiographicconductiondefects,arrhythmias,cardiomyopathy,vascularandvalvulardiseases,cardiacseptaldefects,andpulmonaryproblems.Thereisagrowingneedforphysicianstopaymoreattentiontothesesyndromes.

简介：ObjectivesToinvestigatetheclinicalmanifestationsofhypertrophiccardiomyopathy(HCM),andtofindouttheclinicalcluestoavoidmisdiagnosisandprovidereferenceforfutureclinicaldiagnosisandtreatment.MethodsAretrospectiveanalysisof42consecutivepatientswithHCMhospitalizedinourhospitalbetweenJanuary1995andDecember2002wasexplored.BasedonthefamilyhistoryofHCM,clinicalmanifestations,electrocar-diogram,echocardiogram,coronaryangiographyandleftventriculography,theclinicalcharacteristicsbetweenHCMpatientswithleftventricularoutflowtractobstruction(HOCM)andHCMpatientswithoutobstruction(HNOCM)werecompared.Thecausesofmisdiagnosisandlosingdiagnosiswereanalysis.Results13patientswereinHOCMgroupand29patientswereinHNOCMgroup.MorepatientswithsyncopewereinHOCMgroupthaninHNOCMgroup(6/13vs.2/29,P<0.05).PatientswithejectivemurmurwereinHOCMgrouponly(P<0.01).Leftventricularoutflowtractpressuregradient(LVOTPG)onlyobservedinHOCMgroup(P<0.01).Ventriculartachycardiawasseeninbothgroups.28outof42patients(66.67%)hadmisdiagnosis,and4outof42patients(9.53%)hadlosingdiagnosis.Thus,coronaryheartdisease(CHD)hadthehighestrateofmisdiagnosis.Therewere20CHDpatients(71.43%)among28patientswithmisdiagnosis.Hypertensionwasin3,congenitalheartin2,cerebro-embolismin2,andmyocarditisin1.ConclusionsForapatientwithfamilyhistoryorsuddendeathhistoryofHCM,unexplainedsyncopeepisodes,chestpain(angina),especiallyinyoung,anejectionmurmuralongtheleftsternumborder,thepresenceofnarrowanddeepQwaves,orinversionofgiantTwavesinV3-V6,atrialfibrillationand/orcerebra-embolismechocardiogramshouldbegiven.CAGandLVGarenecessaryonlyiftheresultofechoisnegative,andthepatientswithsuspectedHCMorCHD.

简介：ObjectivesToinvestigatetheclinicalfeatureofacutepulmonaryembolism.MethodsRetrospectiveclinicalanalysiswasperformedaccordingtothedataof38casesofpulmonaryembolism.ResultsThereweregrounddiseasesandpredisposingfactorsin36casesofpulmonaryembolismamong38cases,theratiowas94.7%,amongthetotalpredisposingfactors,tumor,cardiovasculardisease,venousthrombosisoflowerextremity,smokingandlong-termbedwerecommon.Therewasnospecificityinclinicalfeature,physicalsignandroutchestXray,electrocardiography,andtheirappearanceswerediversified.Therewerespecificityandsensitivityinechocardiogram(UCG)andD-dimertosomeextent.But,thefinaldiagnosismustdependonsomespecialexaminations,suchasselectivepulmonaryarteriography,CTPA,MRAandsoon.ConclusionsThespecialexaminationsmustbedonetomakeadefinitediagnosistoconfirmpulmonaryembolismwhenthehighriskfactorsandgrounddiseasesareexisting.Itisnecessarytosomecaseswhentheclinicalfeaturecannotbeexplainedbyotherdiseases.

简介：A70-year-oldmanisseenforevaluationofaheartmurmurheardbyhisprimarycareprovider.Thepatientplaysdoublestennistwiceperweekandclaimstobeasymptomatic.–Medication:amlodipineforhypertension.–Physicalexamination(PE):pulse82bpm;bloodpressure140/90mmHg.–Neck:neckveinsflat.Carotidsdelayed.–Chest:clear.–Cardiovascular:grade2/6latepeakingsystolicejectionmurmur.–Extremities:normalpulses.–Echocardiogram:heavilycalcifiedaorticvalve.Peakjetvelocity4.6m/s.Aorticvalvearea0.7cm2.Rightventricularsystolicpressurenotobtainable.

简介：OjbectiveTofindtheindependentpredictorsforrestenosisaftercoronarystenting.MethodsQuantitativeangiographywasperformedon60cases(67successfullydilatedlesions)afterangio-plastyover6-monthsfollow-up,andbothunivariateandmultivariatelogisticregressionanalysisweredonetoi-dentifythecorrelationsofrestenosiswithclinicalfactors.ResultsThetotalrestenosisratewas31.3%(21of67lesions),andaccordingtounivariateanalysisthepatientswhounderwentcoronarystenting≥3.5mmhadalowerrateofrestenosis(P<0.01).Collateralcirculationtotheobstructionsite,highmaximalinflationpressure,smokingandthelessminimallumendiameterafterPTCAmadetherateofrestenosishigherower(P<0.05).Multivariatelogisticregressionanalysisshowedthatcoronarystenting≥3.5mmhadalowrateofrestenosis,buthighmaximalinflationpressureandsmokingmadetherestenosisratehigher.ConclusionCoronarystentsize,maximalinflationpressureand.smokin

简介：BackgroundTheprognosticvalueofserumC-reactiveprotein(CRP)inpatientswithinfectiveendocarditis(IE)isnotwellelucidated.ThisstudyaimedtoevaluatetheusefulnessofCRPinpredictingtheoutcomeofIE.MethodsTwohundredninty-sixpatientsfrom2009to2012intheDepartmentofCardiologyatGuangdongGeneralHospitalwerescreenedanddividedintosurgicalandconventionaltreatmentgroups.CRP,whitebloodcell(WBC),erythrocytesedimentationrate(ESR)andotherclinicaldatawereobtainedwithfollow-upfor12months.ResultsTwohundredthirty-sixpatientswereassignedtoreceivesurgerytreatmentwhile60patientsreceivedconventionaltreatment.Inthesurgerygroup,thelevelofCRPinthedeathpatientswassignificantlyhigherthanthatinthesurvivalpatients(P<0.001).TheareaunderthecurveofROCwasabout0.749(SE0.064,P=0.005,95%CI,0.624-0.874)andthecut-offpointofCRPwas23.8mg/L.Inconventionalgroup,therewassignificantdifferencebetweendeathandsurvival(P<0.001).TheareaunderthecurveofROCwasabout0.701(SE0.095,P=0.032,95%CI,0.515-0.888)andthecut-offpointsofCRPwas65.6mg/L.TherewerenosignificantdifferencesinWBCandESRbetweensurgeryandconventionalgroups.ConclusionAmoreaggressivesurgicalinterventionresultsinabetteroutcomeoverconventionaltreatmentandCRPcouldbeservedasapredictivemarkerforadverseoutcomeinIEpatients.

简介：Introduction,Anomalouscoronaryarteriesarefoundin0.1%–1.3%ofpatientsundergoingcoronaryangiography.AnomalouscoronaryarteriesareararebutimportantcauseofCP,arrhythmia,MI&suddencardiacdeath;andaretreatable.Angiographicevaluationcanbechallenging;misdiagnosiscanoccurinupto50%ofcases.Sometimestheseanomaliesaremissedbecauseoftheinexperienceoftheoperator.AnomalousCoronaryArteriescanbeassociatedwithcongenitalheartdiseaseorcanbeanisolatedanomaly.

简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

简介：ObjectiveFortycasesofIAMIwereexaminedwithcoronaryangiographyinordertostudytherelationshipofthevesselswiththeECGofIAMI.MethodsForcoronaryangiographyJudkin’smethodwasused;IAMIwasdiagnosedbythe1979WHO’sstandardofISHDandECGwasseparatelymeasuredbytwodoctors.ResultsMostofIAMIwithpolybranchcoronaryoritscollateraldisease(32.5%and42.5%)andonly10cases(25%)withsinglebranchcoronarydisease,whoseECGswereuntypical.ConclusionIAMIwithsingle-branchcoronarydiseasemightexpressasmildsymptomsandhavenotypicalECGchange.WhiletypicalECGchangeemerges,thecoronaryarteryalwaysshowedpoly-branchdiseaseorcollateralbranchobstructionandthediseasewouldbeadvanced.ItisimportanttopaymoreattentiontothecasesofIAMIwithoutclassicECGchangesoastogivediagnosisandtreatmentthemintime.

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简介：Toinvestigatetherelationshipbetweenthechronotropicincompetenceandangiographicseverityofcoronaryarterydisease,andtheclinicalvalueofinappropriatechronotropicresponsesinexercise.MethodsCoronaryangiographywasperformedin130patientssuspectedordiagnosedascoronaryheartdisease(CHD),andangiographicseverityofcoronaryarterydiseasewasquantitatedbyDukescoreandGensiniscore.Thepatientsweredividedinto4groups:non-CHDgroup(39cases),CHDgroupwithonlyonecoronaryarteryinvolved(CHD1,30cases),CHDgroupwithtwocoronaryarteriesinvolved(CHD2,31cases)andCHDgroupwiththreecoronaryarteriesinvolved(CHD3group,30cases).Amonthbeforecoronaryangiography,symptom-limitedbicycleergometorexercisehadbeenaccomplished,thechronotropicresponsehadbeenmeasuredandexpressedasratioofheartratereserve(HRR)andthemaximalage-predictedheartrateachieved(rHR).ResultsAnalysisofvarianceshowedthatrHRandHRRweremuchsignificantlylower(allP<0.01)inCHD2group(rHR0.793±0.078,HRR0.626±0.110)andCHD3group(rHR0.775±0.065,HRR0.586±0.125)thanthatinnon-CHDgroup(rHR0.888±0.062,HRR0.798±0.105)andCHD1group(rHR0.857±0.084,HRR0.735±0.146).rHRwassimilarbothbetweennon-CHDgroupandCHD1group(P>0.05)andbetweenCHD2groupandCHD3group(P>0.05).HRRhasnodifferencebetweenCHD2groupandCHD3group(P>0.05),butwassignificantlydifferentbetweennon-CHDgroupandCHD1group(P<0.05).TherewasasignificantlynegativecorrelationbetweenrHR,HRRandDukescore(r=-0.554,-0.578,respectively,allP<0.01),Gensiniscore(r=-0.453,-0.467,respectively,allP<0.01).CHDproportionreached75%inpatientswhohadpositiverHR(orHRR)andnon-STdepression.Diagnosticvalue[sensitivity0.868(P<0.01),0.846(P<0.01),specificity0.462,0.462,accuracy0.746(P<0.05),0.731,positivepredictivevalue0.790,0.786,negativepredictivevalue0.600,0.563,respectively]ofrHR<85%orHRR<72%whichwereusedasan

简介：BackgroundFlavonoidsfromfruits,vegetablesandplantshavebeenwidelystudiedontheireffectsofimprovinglipidemia,anti-inflammation,anti-plateletaggregationandanti-oxidativeactivities.However,wedon'tknowifflavonoidsfromrapebeepollenhavethesameeffectsinpatientswithdyslipidemia(DL),type2diabetesmellitus(T2DM),andcerebralinfarction(CI).MethodsThestudyinvolvedwithpatientsselectedanddividedinto4groups,30casesofDL,ofT2DM,ofCIandhealthcontrol(HC)foreach.Fortymgflavonoidsfromrapebeepollenadministratedorallytwiceadayfortwomonths.Bloodsugar(BG),totalcholesterol(TC),triglyceride(TG),highdensitylipoprotein-cholesterol(HDL-C),lowdensitylipoprotein-cholesterol(LDL-C),whiteblood-cellcounts(WBC),plateletcounts(PLT),high-sensitivityC-reactiveprotein(hsCRP)andmalondialdehyde(MDA)wereanalyzedinfourgroupsbeforeandaftertakingflavonoidsfortwomonths.Results(1)BasiclevelsofTC,BG,WBC,PLTandhsCRPingroupsofT2DM,CI,andTGandMDAingroupsofDL,T2DMandCIweresignificantlyhigherthanthoseinHC(P<0.05-0.001).(2)ThelevelsofTG,WBC,PLT,hsCRPandMDAweresignificantlydecreased,whileHDL-Cwasremarkablyincreasedaftertakingflavonoidsfortwomonths(P<0.05-0.001)ingroupofDL,T2MD,andCI.TheseindexeswerenotdifferentinthegroupofHCaftertakingflavonoids(P>0.05).ConclusionsTheresultscouldindicatemetabolicdisturbance,inflammation,andhighoxidativestressinpatientswithdyslipidemisa,type2diabetesmellitus,andcerebralinfarction.Theflavonoidsfromrapebeepollenmayhaveeffectsofantioxidantactivity,improvinglipids,andanti-inflammationonthesepatients.

简介：Heartfailure(HF)isacomplexclinicalsyndromethatresultsfromanystructuralorfunctionalimpairmentofventricularfillingorejectionofblood.HFisoneofthemostimportantandsevereendstagesofmanycardiovasculardiseases.EpidemiologicalstudiesofHFhavefocusedmainlyontheprevalence,incidence,mortality,fatality,anddistributionandtemporaltrendsoftheseindicatorsamongdifferentpopulations.ThisreviewhighlightsimportantepidemiologicalstudiesofHFinChina.

简介：Cardiovasculardisease(CVD)istheleadingcauseofdeathandamajorhealthcarechallengeglobally.Coronaryarterydisease(CAD)isaprimaryunderlyingpathologicalprocessinthemajorityofcardiovasculardiseasecases.Magneticresonanceimaging(MRI)canplayapotentiallyimportantroleinthemanagementofCADasanoninvasiveimagingmodalitywithoutionizingradiation,althoughitsearlypromisehasnotbeendeliveredbecauseofseveralcrucialtechnicallimitations.However,recentinnovationsinMRIhavereopenedthedoor,withtremendousopportunitiesformultiparametricassessmentofCADincludingluminalstenosis,plaqueburdenandcomposition,anddiseaseactivitiessuchasinflammationandhemorrhage.NovelMRIacquisitionandreconstructionstrategiesnowoffermuchincreasedspatialresolutionandimagequalityandshortenedexaminationtimescomparedwithconventionalapproaches.RecentclinicalexperiencesofcoronaryMRIindicatedthepotentialtoimprovethecurrentmanagementofcoronaryatherosclerosis,suchasidentifyingthepatientsatthehighestriskandevaluatingtherapeuticresponses.InthisreviewwediscussthelatesttechnicaladvancesandclinicalinsightsincoronaryMRI.