Objective To study the clinical and angiographic features in ST Segment Elevation Myocardial Infarction (STEMI) patients with spontaneous reperfusion. Methods A total of 519 patients with STEMI underwent Primary percutaneous coronary intervention (PCI) from January 2006 to December 2009 in Anzhen Hospital were enrolled. All patients were divided into the spontaneous reperfusion group (TIMI flow gradeⅢ ) and the non-spontaneous reperfusion group (TIMI flow grade 0-Ⅱ ) according to the TIMI flow grade before primary PCI. The incidence rate of spontaneous reperfusion through coronary angiography before primary PCI was observed, and the clinical relevant factors and angiographic lesion features of spontaneous reperfusion were analyzed. Results There were significant differences in age, CTnI peak value, high thrombus burden, and lesion location in distant LAD (P=0.000, 0.000, 0.002, 0.000, and 0.003, respectively) between the two groups. But there were no significant differences in gender, hypertension, diabetes mellitus, smoking history, hyperlipemia, angina pectoris history, culprit vessel distribution, lesion distribution in LCX and RCA, and collateral circulation between the two groups (Pgt;0.05 for all). Conclusion Compared to the patients without spontaneous reperfusion, patients with spontaneous reperfusion are younger in age, lower in CTnI peak value, and heavier in thrombosis burden, with culprit lesions mostly located in the distant LAD.
【摘要】 目的 用老年大鼠建立一種與人類發病年齡相符的穩定可重復的急性心肌梗死動物模型。 方法 Wistar大鼠經戊巴比妥鈉麻醉后，氣管切開插管，連通呼吸機，開胸后結扎左冠狀動脈前降支。分不同時間點測血流動力學后取出心臟行病理組織學觀察。 結果 成功建立老年大鼠心肌梗死模型并進行病理組織學驗證。 結論 建立老年大鼠心梗模型是可靠的，有助于指導臨床實踐。【Abstract】 Objective To develop a steady and repeatable acute myocardial infarction model in old rats in accordance to human age. Methods Wistar rats were anaesthetized with sodium phenobarbital. After tracheotomy intubation, respiration machine was linked. Left anterior thoracotomy was performed to ligate the left anterior descending coronary artery. After hemodynamic parameters were obtained at various time points, hearts of the rats were taken for pathologic and histological examinations. Results The model of acute myocardial infarction in old rats was established successfully and proved by pathologic and histological staining. Conclusion It is reliable to establish the myocardial infarction model in old rats, which is helpful in guiding clinical practices.
Objective To investigate the clinical characteristics of acute myocardial infarction ( AMI) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods Clinical data of 16 elderly patients with AECOPD and AMI from may 2007 to December 2009 were reviewed. Meanwhile, 128 elderly AECOPD patients without AMI were analyzed as control. Results Neither the AMI group nor the control group had typical precordial pain, conscious disturbance, andhypotension. Compared with the control group, the main symptoms of the AMI group were worsening of chest tightness and dyspnea( 16 /16 vs. 4/128, P lt;0. 01) ,most of which accompanying fever( 11/16 vs. 6/128, P lt;0. 05) and anorexia ( 10/16 vs. 23 /128, P lt; 0. 05) . The incidence of patches-like shadow on chest X-rayincreased ( 16 /16 vs. 62/128, P lt;0. 05) , PaO2 ( mm Hg) decreased ( 43. 72 ±3. 64 vs. 82. 26 ±11. 41, P lt;0. 001) , the red blood cell count ( ×1012 /L) increased ( 6. 43 ±0. 42 vs. 4. 11 ±1. 24, P lt; 0. 05) , the concentration of total cholesterol ( mmol /L) increased ( 6. 51 ±0. 84 vs. 3. 93 ±1. 14, P lt; 0. 05) , the needfor invasive mechanical ventilation increased ( 13/16 vs. 11 /128, P lt; 0. 05) , the days in hospital were prolonged ( 35 ±13 vs. 11 ±3, P lt; 0. 01) , the cost ( 1000 RMB) increased( 32 ±11 vs. 7. 6 ±2. 8, P lt;0. 01) , and the mortality also increased ( 2/16 vs. 3 /128, P lt;0. 01) . Conclusion AMI should be alerted in the case of sudden exacerbation of chest tightness and dyspnea in elderly patients with AECOPD.
Objective To investigate the effects of granulocyto-colony stimulating factor (G-CSF) on the mobil ization of endothel ial progenitor cells (EPCs) in the rats with myocardial infarction (MI), to observe the density of neovascularization and the mRNA expressions of vascular endothel ial growth factor (VEGF) and its receptor (Flk-1) in the border area of MI. Methods Thirty-six adult male rats (weighing 250-280 g) were divided randomly into control group, MI group, and G-CSF group. In MI group and G-CSF group, the models of MI were establ ished by left anterior descenting coronary artery l igation and were treated with intraperitoneal injection of sal ine (0.3 mL/d) or G-CSF [30 μg/(kg?d)] for 5 days. In control group, after open chest operation, chest was closed without treatment. The level of EPCs was surveyed and the plasma concentrations of VEGF and C-reaction protein (CRP) were measured at 7 days. The mRNA expressions of VEGFand its receptor Flk-1 in the border area of infarct myocardium were determined through RT-PCR. Results Compared withcontrol group, the number of circulating white blood cell (WBC) and EPCs levels, and the serum concentrations of VEGF and CRP were all significantly increased in MI group and G-CSF group (P lt; 0.05); when compared with MI group, the number of circulating WBC and EPCs levels, and the serum concentrations of VEGF were increased and the concentration of CRP was decreased in G-CSF group (P lt; 0.05). Compared with control group, the mRNA expressions of VEGF and Flk-1, and the density of neovascularization in the border area of infarct myocardium were increased in MI group and G-CSF group, whereas those in G-CSF group were significantly augmented compared with MI group (P lt; 0.05). Conclusion In the rats with MI, G-CSF could promote EPCs mobil ization, increase the mRNA expressions of VEGF and Flk-1, and augment the density of neovascularization in the border area of infarct myocardium.
Objective
To estimate the incidence of post-myocardial infarction depression among Chinese acute myocardial infarction (AMI) patients by meta-analysis and to provide references for the management of AMI patients.
Methods
We searched databases including PubMed, The Cochrane Library (Issue 6, 2016), CNKI, CBM, WanFang Data and VIP from January 2000 to July 2016, to collect literature regarding the incidence of post-myocardial infarction depression among patients with AMI. Two reviewers independently screened literature, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed by using Comprehensive Meta Analysis (CMA) 2.0 software.
Results
Totally, 22 cross-sectional studies were included, involving 2 986 AMI patients, of which1 239 were post-myocardial infarction depression patients. The overall incidence of post-myocardial infarction depression among the AMI patients was 42.7% (95%CI 36.3% to 49.4%). There was no statistical differences observed when the studies were stratified by sex, regions, scales and years (allP values>0.05).
Conclusion
In China, the incidence of post-myocardial infarction depression is high and rising year by year roughly among AMI patients. The status should be paid more attention.
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....
A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.
An 84-year-old severe aortic stenosis patient admitted with acute heart failure was reported. Transcatheter aortic valve replacement (TAVR) was proposed. The patient was at high risk of the left coronary artery occlusion in preoperative and intraoperative evaluation. Coronary artery protection was performed by pre-embedded coronary artery guide wire and stent during the TAVR. The left coronary artery was partially blocked by valve leaflet after 23 mm self-expanding aortic valve was released. Coronary revascularization was not performed as the coronary blood flow was not affected. However, the patient suffered acute myocardial infarction with hypotension on the third day after TAVR. Emergency angiography showed that left coronary artery was more blocked than before and the condition improved after left main coronary stent implantation. This case suggested that aggressive coronary revascularization should be considered for high risk of coronary artery obstruction during TAVR, especially for partial obstruction of coronary artery.
