National Center for Cardiovascular Disease

Beijing, China

National Center for Cardiovascular Disease

Beijing, China
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Ou-Yang W.-B.,National Center for Cardiovascular Disease | Ou-Yang W.-B.,Peking Union Medical College | Wang S.-Z.,National Center for Cardiovascular Disease | Wang S.-Z.,Peking Union Medical College | And 16 more authors.
European Journal of Cardio-thoracic Surgery | Year: 2017

OBJECTIVES: To assess safety and effectiveness of symmetric and asymmetric occluders in perventricular device closure without cardiopulmonary bypass of perimembranous ventricular septal defects (pmVSDs). METHODS: The present retrospective study enrolled 581 patients who underwent perventricular device closure of pmVSDs under transoesophageal echocardiography guidance from May 2011 to April 2016, and outpatient electrocardiography and transthoracic echocardiography assessments at 1, 3, 6 and 12 months, and yearly thereafter. RESULTS: The overall success rate of device implantation was 92.6% (43 surgical conversions immediately). Between patients receiving symmetric (n = 353) and asymmetric (n = 185) occluders, there were no significant differences in age, weight and defect diameter distributions; however, both before discharge and at mean 28.6 ± 21.2 (range, 1-60)-month follow-up, the symmetric group had lower rates of trivial residual shunt (5.7% vs 11.4%, P = 0.018; and 0.8% vs 5.9%, P = 0.001) and bundle branch block (0.8% vs 5.4%, P = 0.002; and 0.6% vs 3.8%, P = 0.009); and at follow-up, the asymmetric group had lower residual shunt (47.6% vs 85.0%, P = 0.020) and similar branch block (30.0% vs 33.3%, P = 1.000) disappearance rates. There were no severe complications, i.e. aortic regurgitation,malignant arrhythmias, haemolysis or device dislocation. CONCLUSIONS: Perventricular device closure of pmVSDs appears safe and effective with symmetric and asymmetric occluders. However, the lower residual shunt disappearance and higher branch block incidence rates for asymmetric occluders would favour more proactive conversion to surgical repair immediately when residual shunt is present intraoperatively. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Ye Y.,Shanghai JiaoTong University | Li K.,Shanghai East Hospital | Liu J.,Shanghai JiaoTong University | Li M.,Nanjing Medical University | And 7 more authors.
Journal of Cardiology | Year: 2013

Familial hypercholesterolemia (FH) is an inherited disorder of blood lipid metabolism characterized by high serum low-density lipoprotein cholesterol levels and premature coronary artery disease. In this study, we used a system biology approach to identify co-expressed gene pairs that were potentially involved in the progression of FH and constructed a conserved co-expression network using these genes. A total of 4232 co-expressed relationships were identified and we verified the significance by random permutation. FH patients showed differences in lipoprotein and cholesterol metabolism in circulating monocytes and lymphocytes compared to healthy controls. We hope our study could aid in understanding of FH and could provide the basis for FH biomarker identification. © 2013 Japanese College of Cardiology.

Ye Y.-Z.,Shanghai JiaoTong University | Cao B.,Yangzhou University | Li M.-Q.,Nanjing Medical University | Wang W.,National Center for Cardiovascular Disease | And 7 more authors.
Lipids in Health and Disease | Year: 2012

Background: Administration of androgens decreases plasma concentrations of high-density lipid cholesterol (HDL-C). However, the mechanisms by which androgens mediate lipid metabolism remain unknown. This present study used HepG2 cell cultures and ovariectomized C57BL/6 J mice to determine whether apolipoprotein M (ApoM), a constituent of HDL, was affected by dihydrotestosterone (DHT). Methods. HepG2 cells were cultured in the presence of either DHT, agonist of protein kinase C (PKC), phorbol-12-myristate-13-acetate (PMA), blocker of androgen receptor flutamide together with different concentrations of DHT, or DHT together with staurosporine at different concentrations for 24 hrs. Ovariectomized C57BL/6 J mice were treated with DHT or vehicle for 7d or 14d and the levels of plasma ApoM and livers ApoM mRNA were measured. The mRNA levels of ApoM, ApoAI were determined by real-time RT-PCR. ApoM and ApoAI were determined by western blotting analysis. Results: Addition of DHT to cell culture medium selectively down-regulated ApoM mRNA expression and ApoM secretion in a dose-dependent manner. At 10 nM DHT, the ApoM mRNA levels were about 20% lower than in untreated cells and about 40% lower at 1000 nM DHT than in the control cells. The secretion of ApoM into the medium was reduced to a similar extent. The inhibitory effect of DHT on ApoM secretion was not blocked by the classical androgen receptor blocker flutamide but by an antagonist of PKC, Staurosporine. Agonist of PKC, PMA, also reduced ApoM. At 0.5 μM PMA, the ApoM mRNA levels and the secretion of ApoM into the medium were about 30% lower than in the control cells. The mRNA expression levels and secretion of another HDL-associated apolipoprotein AI (ApoAI) were not affected by DHT. The levels of plasma ApoM and liver ApoM mRNA of DHT-treated C57BL/6 J mice were lower than those of vehicle-treated mice. Conclusions: DHT directly and selectively down-regulated the level of ApoM mRNA and the secretion of ApoM by protein kinase C but independently of the classical androgen receptor. © 2012 Yi-zhou et al.; licensee BioMed Central Ltd.

Cao B.,Yangzhou University | Ye Y.Z.,Shanghai JiaoTong University | Rui J.,Nanjing Medical University | Li M.Q.,National Center for Cardiovascular Disease | And 3 more authors.
Lipids in Health and Disease | Year: 2013

Background: It has been reported that rs940494 and rs805296 SNPs of apolipoprotein M (apoM) gene may confer the risk in the development of type 2 diabetes (T2D) and coronary artery disease (CAD) in the Han Chinese. However, a recent study demonstrated that rs805297 polymorphism is significantly associated with reduced total high density lipoprotein (HDL) levels in rheumatoid arthritis patients. But the relationship between rs805297 SNP and CAD has not been explored. The aim of the present study was to elucidate whether the rs805297 mutant allele is implicated in CAD and links to changes in blood lipid levels in these patients. Methods. Three hundred CAD patients and three hundred and twelve non-CAD patients were subjected in the present study. All subjects were confirmed by the angiography. Plasma concentrations of apoM were semi-quantitatively determined by dot-blotting analysis, and total serum lipid levels were quantified using an automated RA-1000 (Technician, USA). The genotyping of rs805297 of apoM was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: Genotype and allele frequencies were not significant (P = 0.5798 and 0.3834, respectively) between cases and controls. Compared with the wild-type C/C genotype, carriers of the C/A and A/A genotypes did not have an increased risk of CAD, as determined by multiple logistic regression analysis, after adjustment for age, sex, BMI, history of smoking, hypertension and hypercholesterolemia. (CA, odds ratio = 0.49, 95% confidence interval 0.15-1.87, P = 0.462; AA, odds ratio = 0.51, 95% confidence interval 0.13-1.68, P = 0.534). The plasma concentration levels of apoM did not differ significantly among carriers of the three genotypes between two groups. Lastly, control subjects with A/A genotypes had lower total levels of HDL cholesterol than did those with C/C genotypes. Conclusions: The results presented here suggest that the rs805297 SNP is not associated with an increased risk of developing CAD, although it does independently correlate with dyslipidaemia in Han Chinese individuals. © 2013 Cao et al.; licensee BioMed Central Ltd.

Pan X.-B.,National Center for Cardiovascular Disease | Pan X.-B.,Peking Union Medical College | Ou-Yang W.-B.,National Center for Cardiovascular Disease | Ou-Yang W.-B.,Peking Union Medical College | And 16 more authors.
Journal of Interventional Cardiology | Year: 2015

Objective Demonstrate the benefits of percutaneous atrial septal defect (ASD) closure under guidance of transthoracic echocardiography (TTE) without fluoroscopy. Methods From February 2013 to April 2014, 127 consecutive patients with an isolated type II ASD were recruited to undergo percutaneous closure under either TTE (n = 60, TTE group) or TEE (n = 67, TEE group) guidance. The TTE group received local anesthesia or sedation with propofol, and the TEE group received general anesthesia with endotracheal intubation. Follow-up examinations were performed for both groups at 1 month, 3 months, 6 months, and 1 year after discharge and annually thereafter. Results The TTE group had a significantly shorter procedure time and respirator ventilation duration than the TEE group. The dose of propofol required, the cost, and the pharyngeal complication rate were significantly lower in the TTE group than in the TEE group. The median follow-up of 11.6 months was uneventful in all patients. Conclusions Percutaneous ASD closure with TTE guidance as the only imaging tool avoids fluoroscopy, endotracheal intubation, and probe insertion and is associated with a satisfactory procedural success rate and lower costs. This procedure is a safe and reliable treatment for ASD. © 2015, Wiley Periodicals, Inc.

News Article | December 13, 2016

When it comes to 3D printing organs for practicing difficult surgeries, texture can be as important as structure. Researchers across the globe have been using 3D printers to make custom models of brains, spines and hearts to practice difficult surgeries. But some have taken that research to the next level by designing printed organs that feel, move and bleed like the real thing. The slimy, squishy materials not only help doctors get a more realistic understanding of complex cases, they can help medical students develop muscle memory faster. The University of Rochester's Simulated Inanimate Model for a Physical Learning Experience (SIMPLE) project uses hydrogel to create 3D-printed organs that bleed when cut. "Very few surgical simulations are successful at recreating the live event from the beginning to the end," said Dr. Ahmed Ghazi, an assistant professor in the Department of Urology, in a statement. "What we have created is a model that looks, feels, and reacts like a live organ and allows trainees and surgeons to replicate the same experience they would face in the operating room with a real patient." In some of these cases, surgeons are trying out new methods or simply honing their skills on a routine surgery. But in others, patients' organs, skeleton or nerves are formed in an unusual way, and a surgeon wants to try several methods to see which would be the most successful and cause the least blood loss. "Surgeons are just like pilots," Ghazi said. "There will always be the first time a pilot takes a 747 up into the air and there will always be a first time a surgeon does a procedure from beginning to end on their own. While pilots have simulators that allow them to spend hours of training in a realistic environment, there really is no lifelike equivalent for surgeons." In Japan, a 3D-printed heart built by the National Center for Cardiovascular Disease in the city of Suita near Osaka was built to help doctors practice difficult cardiac surgeries, Japanese media outlet Shimpo Hebei Shimbun reported Wednesday. The heart model is customized to each patient through their CT and MRI scans, and surgeons are able to use the model to practice complicated surgeries ahead of time. Unlike most other models, the center's 3D-printed heart feels like a real organ, which helps surgeons get a lifelike experience when testing a procedure. Printing organs for practice is gaining popularity among hospitals around the globe. Hospitals like the Cleveland Clinic use 3D printing for practice on complex and rare surgical cases. And some researchers at various hospitals are working toward the day when 3D-printed functional organs could be used for transplants. The National Institutes of Health even offers a variety of heart models for organizations to 3D-print for practice or to show students. "Surgery is often like a Pandora's Box," said Ghazi in a statement. "You don't know what is inside until you open it up." Get six of our favorite Motherboard stories every day by signing up for our newsletter.

Wang J.-G.,National Center for Cardiovascular Disease | Fang W.,National Center for Cardiovascular Disease | Yang M.-F.,Capital Medical University | Tian Y.-Q.,National Center for Cardiovascular Disease | And 6 more authors.
Medicine (United States) | Year: 2015

The effects of left bundle branch block (LBBB) on left ventricular myocardial metabolism have not been well investigated. This study evaluated these effects in patients with coronary artery disease (CAD). Sixty-five CAD patients with complete LBBB (mean age, 61.8±9.7 years) and 65 without LBBB (mean age, 59.9±8.4 years) underwent single photon emission computed tomography, positron emission tomography, and contrast coronary angiography. The relationship between myocardial perfusion and metabolism and reverse mismatch score, and that between QRS length and reverse mismatch score and wall motion score were evaluated. The incidence of left ventricular septum and anterior wall reverse mismatching between the 2 groups was significantly different (P<0.001 and P=0.002, respectively). The incidences of normal myocardial perfusion and metabolism in the left ventricular lateral and inferior walls were also significantly different between the 2 group (P<0.001 and P<0.001, respectively). The incidence of septal reverse mismatching in patients with mild-to-moderate perfusion was significantly higher among those with LBBB than among those without LBBB (P<0.001). In CAD patients with LBBB, septal reverse mismatching was significantly more common among those with mild-to-moderate perfusion than among those with severe perfusion defects (P=0.002). The correlation between the septal reverse mismatch score and QRS length was significant (P=0.026). In patients with CAD and LBBB, septal and anterior reverse mismatching of myocardial perfusion and metabolism was frequently present; the septal reverse mismatch score negatively correlated with the QRS interval. © 2015 Wolters Kluwer Health, Inc.

Sun Y.,National Center for Cardiovascular Disease
Chinese Journal of Pathology | Year: 2014

Objective: To study the clinical and pathologic features of primary cardiac inflammatory myofibroblastic tumor.Methods: A total of 4 patients with primary cardiac inflammatory myofibroblastic tumor were encountered during the period from 1993 to 2013 in National Center for Cardiovascular Disease. The clinical features, imaging findings and outcomes of the 4 patients were evaluated. ALK protein expression and ALK gene status were studied using the archival tumor tissues.Results: There were 1 female and 3 male patients. The age of patients ranged from 5 months to 30 years (mean =16 years). The tumor was located in right ventricle (n = 2), right atrium (n = 1) or pericardium (n = 1). Histologic patterns included 2 cases of fibrous histiocytoma type, 1 case of granulomatous type and 1 case of sclerosing type. Immunohistochemical study showed that 2 cases expressed ALK protein. Fluorescence in-situ hybridization however did not reveal any ALK gene rearrangement.Conclusions: Inflammatory myofibroblastic tumor of the heart is rarely encountered and easily misdiagnosed. It carries distinctive clinical and pathologic features. ALK protein expression is helpful in arriving at the correct diagnosis.

Sun X.,National Center for Cardiovascular Disease | Sun Y.,National Center for Cardiovascular Disease | Wang G.,National Center for Cardiovascular Disease
Chinese Journal of Emergency Medicine | Year: 2014

Objective: To investigate the reliability of electrocardiographic (ECG) signal for the accurate assessment of myocardial ischemia in order to evaluate the clinical value of remote real-time ECG monitoring system based on GPRS in patients with acute ST-elevation myocardial infarction (STEMI). Methods: A total of 60 STEMI patients admitted between April 2008 and December 2010 were enrolled. All subjects were given the remote real-time ECG monitoring and routine 12 leads ECG monitoring at the same time. They were divided into remote ECG group and the 12 leads ECG group. The remote real-time ECG monitoring collects electrocardiosignal to imitate V1, V3, V5 lead and I lead. P wave duration, PR interval, duration of time limit of QRS wave and T wave, QT interval, and the P wave amplitude, QRS wave amplitude, R- (Q + S), T wave amplitude were measured, and the detectability rate of arrhythmia and the definited diagnosis rate of ST segment elevation in accordance with clinical manifestion were compared in each group with different parameters. The data were analyzed by t test, rank sum test, Pearson correlation analysis, Spearman's rank correlation and the chi-square test. Results: In STEMI patients, there were no statistical differences in time limits and amplitude of waves on ECG between the two groups (P > 0. 05), and the correlations between parameters of two groups were found to be close (P < 0. 01). There was no difference in the detectability rate of cardiac arrhythmia between two groups (P > 0.05), and no difference in the rate of correct diagnosis of elevated ST segment between two groups (P > 0. 05), except V1 lead (P < 0.05). Conclusions The sensitivity of the change in ST segment of the two groups is similar, and the remote real-time ECC monitoring can help determine the location of myocardial ischemia.

Fan G.,National Center for Cardiovascular Disease | Wang Z.,National Center for Cardiovascular Disease | Zhang L.,National Center for Cardiovascular Disease | Chen Z.,National Center for Cardiovascular Disease | And 5 more authors.
Zhonghua yi xue za zhi | Year: 2015

OBJECTIVE: To investigate the percentages of awareness, treatment and control and the prevalence of hypertension in north rural China.METHODS: An epidemiological study was conducted by stratified cluster random sampling in March 2013 within 4 out of 20 regions in north China. At least 1 250 residents aged over 35 years were recruited and there were 625 males and 625 females from 4 villages randomly selected from each region. The risk factors for hypertension such as blood pressure (BP), height, weight and past history of illness were collected.From 4 575 valid samples, there were 2 062 males and 2 513 females.Hypertension was defined as any subject with mean systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg or use of antihypertensive medication. All the relevant rates were standardized by gender and age group according to the figures of Third National Population Census.RESULTS: The standardized rates of hypertension in population aged over 35 years were 41.2% in Shunyi District, Beijing, 26.0% in Yuzhong County, Gansu Province, 25.2% in Jingyu County, Jilin Province and 22.8% in Dongfeng County, Jilin Province respectively. And significant differences existed among different regions (P < 0.001). The prevalence of hypertension in males was higher than that in females. The overall rates of awareness, treatment, control and control under treatment were 46.9%, 30.5%, 12.8% and 41.5% respectively in males versus 64.2%, 48.9%, 20.4% and 38.4% respectively in females. These rates were significantly higher in people with a family history of hypertension than those without one (P < 0.05). The prevalence of hypertension and the rates of awareness, treatment increased with the increase of BMI (P < 0.05) other than the rates of control and control with drugs.CONCLUSION: The prevalence of hypertension was of great difference between different rural areas in north China. The rates of awareness, treatment and control have remained at a low level.

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