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Xu B.,Peking Union Medical College | Dou K.-F.,Peking Union Medical College | Han Y.-L.,Shenyang Northern Hospital | Lu S.-Z.,Capital Medical University | And 12 more authors.
Chinese Medical Journal | Year: 2011

Background Available drug-eluting stents (DES) have achieved great success in reducing restenosis rates. Recently, investigators have demonstrated that the durable olymer carrier lays a significant role in DES-related hy ersensitive reaction and delays vessel healing. TIVOLI stent is a novel sirolimus-eluting coronary stent with biodegradable coating containing sirolimus and olylactic-co-glycolic acid (LGA) olymer. The resent study sought to evaluate the effectiveness and safety of the TIVOLI biodegradable- olymer-based sirolimus-eluting stent in treating atients with coronary artery disease. Methods A ros ective, multicenter clinical trial com aring TIVOLI biodegradable coated sirolimus-eluting stent with ENDEAVOR zotarolimus-eluting stent was conducted in 324 atients (TIVOLI grou: 168 atients; ENDEAVOR grou: 156 atients) at 12 centers in China to demonstrate the non-inferiority of in-stent late loss with TIVOLI stent com ared to ENDEAVOR stent in subjects with a maximum of two de novo native coronary artery lesions (lesion length ≤40 mm, reference vessel diameter 2.25-4.00 mm). The rimary end oint was angiogra hic in-stent late loss at 8-month. The secondary end oints were clinical outcomes at 2 years, including major adverse cardiac events (cardiac death, myocardial infarction, or target-lesion revascularization) and stent thrombosis. Results Angiogra hic late lumen loss at 8 months in the TIVOLI grou was su erior to the ENDEAVOR grou (in-stent (0.25±0.33) mm vs. (0.57±0.55) mm, diff (95% CI) -0.23 (-0.32, -0.14), <0.0001; in-segment (0.25±0.33) mm vs. (0.42±0.55) mm, diff (95% CI) -0.13 (-0.23, -0.02), =0.0083). The rate of in-stent binary restenosis at 8 months was reduced from 8.6% in the ENDEAVOR grou to 2.9% in the TIVOLI grou (=0.0229). Com ared to ENDEAVOR stent, TIVOLI stent resulted in a significant reduction in target-lesion revascularization (4.2% vs. 9.6%, =0.0495) at 2 years. The two-year major adverse cardiac events (MACE) rate was lower for the TIVOLI grou, but not significantly different (6.6% vs. 10.9%, =0.1630). Conclusions TIVOLI was su erior to ENDEAVOR stent with res ect to late lumen loss at 8 months, and it yielded both lower rates of angiogra hic binary restenosis at 8 months and target lesion revascularization (TLR) at 2 years. The MACE rate at 2 years was com arable in both grous.


Yang J.,University of South China | Luo J.,Guangdong Provincial Cardiovascular Institute | Biao D.,Guangdong Provincial Cardiovascular Institute | Wang S.Y.,Guangdong Provincial Cardiovascular Institute | And 2 more authors.
Advanced Materials Research | Year: 2014

This study aimed to investigate the Cytotoxic effects of TGFα-SAP on the inhibition of neointimal proliferation after rat common carotid arterial injury. Methods seventy rats were divided into two groups. The TGFα-SAP treated group was treated with local injection of TGFα-SAP (5μg/kg) after injury, and the control group was treated with saline. Rat arterial segment was investigated at 1, 3, 9, and 28 days after operation. Results Compared to the control group, the TGFα-SAP treated group shows a significant inhibition of intimal thickness. Conclusion The results indicated that TGFα-SAP can effectively inhibit neointimal proliferation following arterial injury. © (2014) Trans Tech Publications, Switzerland.


Luo J.,University of South China | Zeng O.,University of South China | Xiao T.,University of South China | Li F.,University of South China | And 5 more authors.
Applied Mechanics and Materials | Year: 2014

Objective: To investigate the effects of TGFα-SAP on the inhibition of neointimal hyperplasia of rat which suffered from common carotid arterial injury. Methods: Saporin and TGFα were conjugated by using N-succinimidyl-3 (2-pyridyldithio) propionate. seventy rats were divided into two groups at random, the TGFα-SAP treated group was treated with local injection of TGFα-SAP (5μg/kg) after injury, and the control group was treated with saline. PCNA analysis and TUNEL analysis were performed. Results: Compared to the control group, the TGFα-SAP treated group showed a significant inhibition of intimal thickness and exhibited a lower P/A ratio and a higher rate of apoptosis. Conclusion: TGFα-SAP, as a potential stent coating material, could inhibit neointimal hyperplasia by inhibiting the proliferation and promoting the apoptosis of smooth muscle cells in the neointima. © (2014) Trans Tech Publications, Switzerland.


Guo Y.,University of Sichuan | Tang J.,University of Sichuan | Du L.,University of Sichuan | Liu J.,University of Sichuan | And 3 more authors.
Canadian Journal of Cardiology | Year: 2012

Background: Postoperative hemorrhage following cardiopulmonary bypass in heart valve replacement patients may be caused by a mismatch of protamine and heparin. We hypothesized that a 2-titration-guided protamine dose would reduce protamine-heparin mismatch and bleeding in those patients. Methods: Patients scheduled for elective cardiac valve replacement surgery (N = 60) were randomly divided into 3 groups. All patients received 2 titrations: the first at termination of cardiopulmonary bypass and the second at 5 minutes after the initial dose of protamine. In the control group, the initial protamine dose was based on the heparin dose received; the supplemental protamine dose was empirically determined. In the single-titration group, the initial dose was based on the first titration, while supplemental dose was empirically determined. In the 2-titration group, both initial and supplemental doses were based on titrations. Bleeding volumes were recorded from the time of first protamine dose to 24 hours after surgery. Results: Most patients needed supplemental protamine according to second titrations. In the 2-titration group, 12 patients received supplemental protamine, whereas only 1 patient in the single-titration group and 6 in the control group received supplemental protamine (P = 0.003). The blood loss was significantly less in the 2-titration group (526 ± 131 mL) than in the control group (730 ± 385 mL; P = 0.019). Conclusions: A higher dosage of protamine based on 2 titrations reduced blood loss after surgery, supporting the hypothesis that inadequate dosage of protamine contributes to hemorrhage after valve replacement surgery. © 2012 Canadian Cardiovascular Society.


Rao F.,Guangdong Provincial Cardiovascular Institute | Rao F.,Guangdong General Hospital | Rao F.,Guangdong Academy of Medical science | Deng C.-Y.,Guangdong General Hospital | And 22 more authors.
Experimental Physiology | Year: 2013

New findings: • What is the central question of this study? Recent evidence indicates that T-type calcium channels may play an important role in the pathogenesis of atrial fibrillation. We previously reported that macrophage migration inhibitory factor (MIF), a pro-inflammatory cytokine, reduced L-type calcium channel expression in atrial fibrillation. The role of MIF in the regulation of atrial T-type calcium channels has not been previously investigated. • What is the main finding and its importance? In the present study, we report that MIF decreases the T-type calcium current in atrium-derived myocytes through impairment of channel function and activation of c-Src kinases, representing a potential pathogenic mechanism in atrial fibrillation. The T-type Ca2+ current (ICa,T) plays an important role in the pathogenesis of atrial fibrillation (AF). The present study sought to investigate the role of macrophage migration inhibitory factor (MIF), a pleiotropic cytokine, in the regulation of T-type Ca2+ channels (TCCs) in atrial myocytes. We used the whole-cell voltage-clamp technique and biochemical assays to study the regulation and expression of ICa,T in atrial myocytes. Gene levels of the α1G and α1H subunit of TCCs were decreased in human atrial tissue of patients with AF. In cultured atrium-derived myocytes (HL-1 cells), mouse recombinant MIF (20 or 40 nm, 24 h) suppressed peak ICa,T in a concentration-dependent manner, impaired the voltage-dependent activation of ICa,T and downregulated TCC α1G and α1H mRNA. The Src inhibitors genistein and PP1 significantly enhanced ICa,T. The reduction of ICa,T and TCC subunit mRNA induced by recombinant MIF could be reversed by genistein and PP1. The TCC α1G associated with Src in HL-1 cells and mouse cardiomycytes. Macrophage migration inhibitory factor is involved in the pathogenesis of AF, probably by decreasing the T-type calcium current in atrium-derived myocytes through impairment of channel function and activation of c-Src kinases, representing a potential pathogenic mechanism in atrial fibrillation. © 2012 The Authors. Experimental Physiology © 2012 The Physiological Society.


Jian X.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2012

To summarize the experience with surgical correction of tetralogy of Fallot in adults over 40 years of age. From November 1985 to July 2008, 9 male and 11 female patients aged 41-53 years (mean 46.3±3.5 years) underwent total surgical correction for tetralogy of Fallot. Twelve patients had preoperative NYHA class III cardiac function. The common comorbidities included infective endocarditis, cerebral abscess, cerebral infarction, renal dysfunction, and tricuspid insufficiency. Surgical corrections were carried out at the anatomical or physiological level. Nineteen patients received right ventriculotomy to relieve right ventricular outflow obstruction and for ventricular septal defect closure, and 1 patient had Fontan operation. Two patients died after the surgery for heart failure and ventricular fibrillation. The average cardiopulmonary bypass time, aortic clamp time, and postoperative ventilation time was 142.9±36.3 min, 89.9±25.1 min, and 72.0±17.5 h, respectively. Postoperative low cardiac output syndrome occurred in 5 cases, septic shock in 1 case, secondary renal failure in 1 case, and bleeding in 2 cases. Echocardiography showed a significant postoperative reduction of the mean right ventricular outflow tract velocity from 4.29±1.36 m/s to 2.13±0.83 m/s (P<0.01); the right ventricular longitudinal dimension exhibited no significant changes postoperatively (57.1±6.7 mm vs 55.1±7.0 mm, P=0.65). Surgical correction of the tetralogy of Fallot in patients over 40 years is highly risky and requires appropriate management of cardiac failure, careful myocardial protection, and thorough intracardiac lesion correction to decrease surgical complications.


Chen D.L.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2010

To study the relationship between angiotensin-converting enzyme 2 (ACE2) gene polymorphisms and the risk factor for essential hypertension (EH) with concurrent ischemic stroke in southern Chinese population. The G9570A polymorphism in ACE2 gene were detected in 139 patients with EH and stroke using polymerase chain reaction-restriction fragment length polymorphism. Detailed clinical and biochemistrical data of the patients, including the pulse pressure, high sensitivity C-reactive protein (hsCRP), intima-media thickness (IMT), high-density lipoprotein cholesterol (HDL-C) and uric acid levels, were collected to study the relationship between ACE2 gene and the risk factor of EH and stroke. The levels of hsCRP (OR=1.022), uric acid (OR=1.224), IMT and pulse pressure was positively correlated to the incidence of EH and stroke. The pulse pressure, hsCRP, IMT, and HDL-C levels in male stroke patients carrying A allele was significantly higher than those in patients carrying G allele (P<0.05). In female stroke patients, the pulse pressure, hsCRP, IMT, and HDL-C levels were also significantly different with regard to the genotype of ACE2 gene (P<0.05). The patients with EH and ischemic stroke carrying the A/AA allele of ACE2 gene have higher risks than those carrying other allele, and can be also more vulnerable to stroke recurrence.


Yan H.,Guangdong Provincial Cardiovascular Institute | Hou D.-Z.,Guangdong Provincial Cardiovascular Institute | Zhang B.,Guangdong Provincial Cardiovascular Institute | Dong T.-M.,Guangdong Provincial Cardiovascular Institute | And 3 more authors.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2016

OBJECTIVE: To investigate the risk factors and angiographic features of acute coronary syndrome (ACS) in women below 50 years of age.METHODS: A total of 131 women with ACS aged 50 years or younger were enrolled in this study as the case group, with another 425 women aged below 50 years with normal coronary angiographic findings as the control group. The risk factors and clinical and coronary angiographic features of ACS were analyzed.RESULTS: Compared with the control group, significantly higher frequencies of dyslipidemia, hypertension (especially diastolic hypertension), diabetes, or a positive family history for coronary artery disease (CAD) were found in ACS group (P<0.05) . The proportion of post-menopausal women and the menopausal ages were similar between the two groups (P>0.05), but the mean diastolic pressure was significantly higher in ACS group than in the control group (P<0.05). Among the menopausal women, the conventional risk factors for ACS were similar between the two groups with the exception of family history CAD, which was more frequent in ACS group. Serum total cholesterol and triglyceride levels were significantly higher in ACS group than in the control group (P<0.05), but the levels of high- and low-density lipoprotein cholesterol levels were comparable between them. Positive findings of urine protein were more frequent in ACS group. In ACS group, 54.2% of the patients had a single diseased artery, 29.6% had more than one diseased artery, and 16.0% had slightly diseased or even normal coronary arteries; the lesion was found most commonly in the left anterior descending artery.CONCLUSION: In women with ACS below 50 years of age, the risk factors of ACS included the conventional risk factors of CAD and a positive finding of urine protein. Menopause is not associated with an increased incidence of ACS. A substantial portion of these ACS patients can have slightly diseased and even normal coronary arteries.


PubMed | Guangdong Provincial Cardiovascular Institute
Type: Journal Article | Journal: Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2010

To study the relationship between angiotensin-converting enzyme 2 (ACE2) gene polymorphisms and the risk factor for essential hypertension (EH) with concurrent ischemic stroke in southern Chinese population.The G9570A polymorphism in ACE2 gene were detected in 139 patients with EH and stroke using polymerase chain reaction-restriction fragment length polymorphism. Detailed clinical and biochemistrical data of the patients, including the pulse pressure, high sensitivity C-reactive protein (hsCRP), intima-media thickness (IMT), high-density lipoprotein cholesterol (HDL-C) and uric acid levels, were collected to study the relationship between ACE2 gene and the risk factor of EH and stroke.The levels of hsCRP (OR=1.022), uric acid (OR=1.224), IMT and pulse pressure was positively correlated to the incidence of EH and stroke. The pulse pressure, hsCRP, IMT, and HDL-C levels in male stroke patients carrying A allele was significantly higher than those in patients carrying G allele (P<0.05). In female stroke patients, the pulse pressure, hsCRP, IMT, and HDL-C levels were also significantly different with regard to the genotype of ACE2 gene (P<0.05).The patients with EH and ischemic stroke carrying the A/AA allele of ACE2 gene have higher risks than those carrying other allele, and can be also more vulnerable to stroke recurrence.


Liu L.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2013

To evaluate the clinical effect of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death. According to ACC/AHA Guideline of ICD implantation (2005), 35 patients successfully received ICD/CRT-D implantation for primary prevention of sudden cardiac death in our hospital from January 2006 to December 2009. All the patients were followed up for a mean of 2 years. During the follow up, 11 (31.43%) patients experienced ventricular arrhythmic episodes, for which 16 defibrillation therapies and 75 anti-tachycardia pacing (ATP) therapies were delivered without mistaken shock or death. The incidence rate of NVM was 100%, that of PVT was 66.67%, Brugada syndrome 50%, HCM 25% and DCM 16.67%. Of these episodes, the incidence of VF episodes among PVC patients was 87.5% (14 beats), ventricular tachycardia PVC was 82.28% (65 times), 5 beats in NVM patients, 4 beats in HCM and Brugada syndrome patients, and 1 beat in DCM patients. No ICD implantation-related complication was detected, and no ventricular tachycardia induced syncope occurred in these cases. All patients showed improved quality of life after the implantation. ICD implantation can prevent malignant ventricular arrhythmia episodes, especially for PVT, NVM and Brugada syndrome in high risk SCD patients, demonstrating the value of implantation of ICD as a primary prevention in high-risk SCD patients.

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