Objective\ To analyze the experiences of emergent or urgent coronary artery bypass grafting(CABG) for patients with acute myocardial infarction(AMI). Methods\ From May, 1996 through December, 1999, 9 patients with AMI underwent emergent CABG including eight males and one female, with mean age 61 years, and year range 44 70. The localization of the AMI was anterior in 4 and inferior in 5. The interval between the onset of AMI and CABG was within 24 hours in 7 cases, 10 days in 1 case and 14 days in 1 case....
ObjectiveTo investigate the effect and significance of early coronary artery bypass graft (CABG) on the expression level of ionophorous protein at infracted border zone (IBZ) in dog with acute myocardial infarction.
MethodsThe anterior descending coronary artery of all thirty healthy mongrel dogs were ligated into myocardial infarction model, whose successful criteria was that the regional myocardium supplied by ligated coronary artery became darker. Coronary artery bypass surgery performed at different time points after myocardial infarction (in the 1st week, the 2nd week, the 4th week, the 6th week respectively) was as an experimental group. While myocardial infarction without coronary artery bypass surgery was set up as a control group. Myocardial tissue without ligation of coronary artery was as a normal group. After 8 weeks, myocardial specimens were cut out in the experimental group and the control group. The local expression levels of ionophorous proteins such as Cav1.2, Kv4.3 and KchIP2 mRNA were detected by means of reverse transcription- polymerase chain reaction (RT-PCR) at normal myocardium and IBZ of the experimental group and the control group.
ResultsFour dogs in every experimental group and all dogs in the control group survived to the end of the study. Three myocardial ion channel proteins expression in the control group were lower than those of the normal group or the experimental group significantly (P<0.01). Cav1.2 mRNA expression in the experimental group in the 4th week or the 6th week was lower than that in the normal group significantly (P<0.05). Kv4.3 and KchIP2 mRNA expression in the experimental group in the 4th week or the 6th week were lower than those in the normal group and the experimental group significantly in the 1st week or the 2nd week (P<0.05).
ConclusionEarly CABG surgery for acute myocardial infarction could lessen the changes of expression level of ionophorous protein at infracted border zone (IBZ) of dog with acute myocardial infarction. Especially, CABG surgery among two weeks could improve expression level of ionophorous protein, and reduce the effect of ischemia for ionophorous protein and myocardial electrophysiology at IBZ.
The Essential of ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction was introduced, including epidemology, initial management in the emergency department and hospital management.
Abstract: Objective To investigate the effect of autologous bone marrow mesenchymal stem cells (MSCs) transplantation on cardiac function and their proliferation and differentiation in the post-infarct myocardium in rabbits. Methods Twenty New Zealand rabbits were randomly divided into two groups, the autologous bone marrow mesenchymal stem cells group (MSCs group,n=10) and control group (n=10). Myocardial infarct model was set up by ligation of the left anterior descending (LAD), two weeks after establishment of the infarct model,either 400μl of cell suspension (total cells 1×106) labled by 1,1’-dioctadecyl3,3,3’,3’-tetramethyl indocarbocyanine perchlorate (Dil) or a comparable volume of L-DMEM medium were autologously transplanted into several different points of the periphery of the scar respectively. To evaluate the heart function, echocardiography were performed before modeling,two weeks after modeling, 2 and 4 weeks after the cells transplantation for asurements of left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD), tocalculate left ventricular eject fraction(LVEF) and left ventricular fractional shortening (LVFS). Meanwhile the myocardial contrast echocardiography (MCE) were performed for evaluating the blood perfusion of the post-infarct myocardium. Eight weeks after the transplantation, the animalswere undergoing euthanasia, specimens were acquired for pathology. Results Echocardiography indicated that:The LVEF and LVFS between two groups were fundamentally the same before modeling,two weeks after modeling respectively (0.72±0.08 vs. 0.71±0.04,0.56±0.11 vs. 0.55±0.09; 0.35±0.06 vs. 0.35±0.04, 0.24±0.08 vs. 0.23±0.03, Pgt;0.05), but those were improved significantly in group MSCs when compared with control group at two weeks and four weeks after the cells transplantation(0.71±0.05 vs. 0.60±0.05，0.72±0.07 vs. 0.62±0.08 and 0.34±0.03 vs. 0.29±0.01， 0.35±0.06 vs. 0.27±0.05 respectively,Plt;0.05). There were no differences in LVESD and LVEDD between two groups in any time points(Pgt;0.05). MCE showed the blood perfusion of the infarct myocardium were improved two and four weeks after the cell transplantation. Pathology indicated that Dil positive cells were survived in MSCs transplanted hearts, stained positively for αsarcomeric actin and desmin eight weeks after cell transplantation, HE slides indicated that the capillary density in all the cells transplanted hearts were much higher when compared with control group (38.6±7.6/mm2 vs. 21.4±3.9/mm2，Plt;0.05). ConclusionMSCs can differentiate into cardiomyocytes, improve myocardial perfusion and cardiac function when transplanted into ischemic myocardium.
The aim of this study is to analyze the concordance between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO in patients with myocardial infarction. Sixty-four patients with coronary artery disease (CAD) and myocardial infarction were enrolled in the study.. Each patient underwent at least two of the above mentioned studies within 2 weeks. LVEF、 EDV and ESV values were analyzed with dedicated software. Statistical evaluation of correlation and agreement was carried out EDV was overestimated by 18F-FDG PET compared with GSPECT [(137.98±61.71) mL and (125.35±59.34) mL]; ESV was overestimated by 18F-FDG PET (85.89±55.21) mL and GSPECT (82.39±55.56) mL compared with ECHO (68.22±41.37) mL; EF was overestimated by 18F-FDG PET (41.96%±15.08%) and ECHO (52.18%±13.87%) compared with GSPECT (39.75%±15.64%), and EF was also overestimated by 18F-FDG PET compared with GSPECT. The results of linear regression analysis showed good correlation between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO (r=0.643-0.873, P=0.000). Bland-Altman analysis indicated that 18F-FDG PET correlated well with ECHO in the Left ventricular function parameters. While GSPECT correlated well with 18F-FDG PET in ESV, GSPECT had good correlation with Echo in respect of EDV and EF; whereas GSPECT had poor correlation with PET/ECHO in the remaining left ventricular function parameters. Therefore, the clinical physicians should decide whether they would use the method according to the patients' situation and diagnostic requirements.
The application of stem cell therapy for ischemic heart disease has aroused widespread interest. There have been many experimental studies concerning a variety of tissue stem cells such as bone marrow，blood，skin and skeletalmuscle stem cells，and their origins, differentiation and protein expressions are compared. In recent years，it is found that adipose-derived stromal cells （ADSCs） have potential advantages over other types of stem cells in that they are widely available and easily harvested through a simple liposuction procedure，and have a high regenerative capacity and therapeuticpotential for myocardial infarction. This review describes molecular and biological properties of ADSCs，their differentiationpotential，and regenerative and therapeutic potential for myocardial repair.
