Primary Prevention of Sudden Cardiac Death in Heart Failure: Will the Solution Be Shocking?

Sudden cardiac death (SCD) may occur in as many as 40% of all patients who suffer from heart failure. This review describes the scope of the problem, risk factors for SCD, the effect of medications used in heart failure on SCD and the potential effect of the implantable cardioverter-defibrillator in primary prevention.     

可疑青光眼患者视野指数与眼底血管变化的关系

目的探讨可疑青光眼者眼底血氧饱和度的基本特征及其与视野指数的关系。方法采用横断面研究设计,对可疑青光眼者及正常对照者应用视网膜血氧饱和度测量仪测量眼底血氧饱和度,同时进行中心30°阈值视野检测;统计分析平均视网膜光敏感度（ MS）、平均视野缺损度（MD）及丢失方差（LV）三个视野指数,以及视网膜血氧饱和度,并进行相关分析。结果可疑青光眼者与正常者MD存在统计学差异（P ＜0．05）;可疑青光眼者平均视网膜动脉血氧饱和度及视网膜鼻下支动脉血氧饱和度与正常者比较存在统计学差异（P ＜0．05）;可疑青光眼者视野检测的MD与NIA存在相关性,（r ＝0．368,P ＝0．045）。结论可疑青光眼者眼底血管可能发生了相应的变化,视网膜血氧饱和度状况与视野指数间存在一定联系。     

Temporal effect of Guanxin No. 2 on cardiac function, blood viscosity and angiogenesis in rats after long-term occlusion of the left anterior descending coronary artery

AIM: Cardiac infarction is one of the main causes of death in both developing and developed countries over past decades. Currently available approaches for treating patients with this disease are not satisfactory. Traditional Chinese medicines have been increasingly paid attention to. The aim of this study was to characterize the dynamic protective effects of Guanxin No. 2 decoction (GX II) on cardiac dysfunction combined with the blood viscosity and myocardial hypertrophy parameters in myocardial infarction (MI) rats. METHODS: Male Sprague-Dawley rats (180-200 g) were randomly divided into three groups: sham-operated, coronary artery ligation (CAL), and CAL plus GX II (GX II, 10.0 g raw materials/kg/d, bid, p.o.). The experiment was carried out at 4 time points as the 3rd, 7th, 14th, and 28th day after ligation. RESULT: It was found that on the one hand, GX II could significantly improve the heart function, and remarkably decrease infarct size and inhibit ventricular remodeling. On the other hand, GX II showed some unique effects such as angiogenesis which was induced in the left ventricular tissue. This result was consistent with the finding of an augmented vascular endothelial growth factor (VEGF) expression in this area. CONCLUSIONS: The studies demonstrated that GX II exerted extensively beneficial cardioprotective effect on CAL rats, it might stimulate angiogenesis of ischemic region to compensate blood supply to the heart via upregulated VEGF expression.     

不同采集模式门控心肌显像对左室功能参数测定的影响

目的 比较16帧和8帧采集模式下99Tcm-MIBI门控心肌显像对测定左室舒张末期容量(EDV)、收缩末期容量(ESV)、左室射血分数(LVEF)的影响.方法 91例患者,在相同条件下分别进行每个心动周期为16帧和8帧的门控采集.采用GS Quant软件分别计算出两种采集方法的EDV、ESV、LVEF,并进行比较.结果 (1)16帧和8帧门控采集对左室功能测定的重复性好,变异系数(CV)均小于2%.(2)16帧和8帧门控采集测定的EDV、ESV和LVEF分别为(68.2±20.5) ml、(20.9±11.9) ml和(71.3±9.2)%,(74.9±21.9) ml、(26.2±13.9) ml和(66.9±9.5)%.16帧测定的EDV、ESV值较8帧测定的小(P＜0.01),但其测定的LVEF 值较8帧高(P＜0.01).结论 16帧和8帧采集的门控心肌显像测定的EDV、ESV和LVEF值有很好的相关性.     

Short-Term Left Ventricular Reverse Remodeling after Transcatheter Aortic Valve Replacement in Children

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Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects

Objective

To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI).

Left ventricular thrombi after short-term high-dose anticoagulants in acute myocardial infarction

To examine the effect of short-term, high-dose anticoagulationon the subsequent occurrence of left ventricular (LV) thrombiafter a first anterior wall acute myocardial infarction (AMI),21 patients received placebo and 21 high-dose anticoagulantsduring the first 10 days of the acute infarction. They werestudied with cross-sectional echocardiography 10 days and 1-3and 6 months post infarction. At 1 month, 6 of 7 thrombi presentin the placebo group at 10 days were still visible. No thrombiwere detected at 10 days in the anticoagulation group, but 6patients had developed a LV thrombus at 1 month. These 12 patientswith LV thrombi were subsequently treated with oral warfarinfor 2 months, after which all thrombi had disappeared. Warfarinwas then discontinued, and a thrombus had recurred in 5 patientsafter 6 months. Apical akinesis at 10 days a predictor for thrombuswith a sensitivity and specificity of 100% and 72.2% respectively. Three of the 13 patients with LV thrombi suffered stroke incontrast to none without thrombi (P=0.025). We conclude that after discontinuation of short-term high-doseanticoagulation therapy in anterior AMI, LV thrombi may developrapidly and lead to embolic complications, particularly in patientswith persisting apical akinesis.     

Effects of transmembrane region variability on cell surface expression and allorecognition of HLA-DP3

The functional relevance of polymorphisms outside the peptide binding groove of HLA molecules is poorly understood. Here we have addressed this issue by studying HLA-DP3, a common antigen relevant for functional matching algorithms of unrelated hematopoietic stem cell transplantation (HSCT) encoded by two transmembrane (TM) region variants, DPB1^*03:01 and DPB1^*104:01. The two HLA-DP3 variants were found at a overall allelic frequency of 10.4% in 201 volunteer stem cell donors, at a ratio of 4.2:1. No significant differences were observed in cell surface expression levels of the two variants on B lymphoblastoid cell lines (BLCL), primary B cells or monocytes. Three different alloreactive T cell lines or clones showed similar levels of activation marker CD107a and/or CD137 upregulation in response to HLA-DP3 encoded by DPB1^*03:01 and DPB1^*104:01, either endogenously on BLCL or after lentiveral-vector mediated transfer into the same cellular background. These data provide, for the first time, direct evidence for a limited functional role of a TM region polymorphism on expression and allorecognition of HLA-DP3 and are compatible with the notion that the two variants can be considered as a single functional entity for unrelated stem cell donor selection.