Objective To observe the effects of taurine on ventricular remodeling of rats with acute myocardial infarction (AMI) though the establishment of rat AMI model by ligating the left anterior descending coronary branch. Methods Sixty 8-week-old male Wistar rats were randomly divided into four groups: sham group, AMI group, small-dose and high-dose taurine group, with 15 rats in each. Rats in the AMI group and taurine groups received ligation of the anterior descending coronary branch to establish an animal model of AMI. Meanwhile, rats in the sham group were subjected to sham coronary ligature. From the next day of the operation, rats in the taurine groups were dosed orally per day with taurine 300 mg/kg or 400 mg/kg for 8 weeks, respectively. Echocardiographic images were acquired before and 8 weeks after the operation, to get the indexes such as left ventricular end systolic diameter (LVIDs), left ventricular end diastolic diameter (LVIDd), left ventricular posterior wall end diastolic thickness (LVPWd), left ventricular ejection fraction (LVEF), fractional shortening (FS), mitral inflow velocity E (E), mitral inflow velocity A (A), and E/A ratio, and all the measurements above were expressed as the average of 6 consecutive cardiac cycles. After the animals were executed, cardiac mass and left ventricular mass were measured, and cardiac mass index (CMI) and left ventricular mass index (LVMI) were calculated. Brain natriuretic peptide (BNP) in all groups were measured by enzyme-linked immunosorbent assay before and 8 weeks after the operation. Results In comparison with the AMI group, CMI, LVMI, LVIDd and LVIDs of the small-dose and high-dose taurine groups were lower, and LVPWd, LVEF, FS and E/A were higher (P<0.05). Plasma BNP level in the AMI group and two taurine-treated groups were higher than that in the sham group, and it was the highest in the AMI group (P<0.05). Conclusion Taurine has a protective effect on ventricular remodeling in rats with AMI, and the protective effect is dose-dependent.
Objective To investigate the correlation between glycosylated hemoglobin A1c (HbA1c) and severity of coronary artery lesions in young men with acute myocardial infarction (AMI). Methods Total 278 young men with AMI less than 45 years old were retrospectively studied, and all of them were admitted to hospital from January 2009 to December 2011, and had undergone coronary angiography. According to the results of coronary angiography, the patients were divided into three groups based on the number of artery lesions: the single group (156 cases), the double group (64 cases) and the triple group (58 cases). The relationship between the severity of coronary artery lesions and the following factors were observed: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum uric acid (UA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking history, drinking history and family history of early coronary artery disease. Results a) HbA1c levels were gradually raised in all the three groups, but the single group (6.39±1.67%) was significantly lower than the double group (6.91±1.63%) and the triple group (7.41±2.12%), with significant differences (Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in both the ST-segment elevation AMI (6.42±1.68% vs. 7.17±1.86%, Plt;0.05) and the non-ST-segment AMI (5.57±0.37% vs. 8.56±2.83%, Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in patients with diabetes millitus (8.31±1.83% vs. 8.59±2.02%, Plt;0.05) and in patients without diabetes millitus (5.56±0.33% vs. 5.74±0.37%, Plt;0.05); b) There were significant differences in SBP, TC, HDL-C, LDL-C and drinking history between the single group and the other two groups (all Plt;0.05), and there were significant differences in DBP and TG between the single group and the double group (all Plt;0.05); and c) The results of logistic regression analysis showed that, LDL-C (OR=1.790), HbA1c (OR=1.287) and SBP (OR=1.042) were the independent risk factors (all Plt;0.05) for multiple lesions in coronary arteries of young men with AMI. Conclusion Glycosylated hemoglobin A1c is an independent risk factor for multiple lesions in coronary arteries of young men with AMI.
Objective To summarize the efficacy and clinical experiences of emergent coronary artery bypass grafting (E-CABG) in patients with acute myocardial infarction (AMI) and to discuss the operative opportunity and procedures. Methods We retrospectively analyzed the clinical data of 21 patients with AMI undergoing E-CABG in Sun Yatsen Cardiovascular Disease Hospital between June 1999 and December 2009. Among the patients, there were 14 males and 7 females with their age ranged from 24 to 81 years (63.9±12.4 years). Six patients were operated within 6 hours after the onset of AMI, 7 patients were operated from 6 hours to 3 days after the onset of AMI, and 8 patients were operated from 3 days to 30 days after the onset of AMI. Eight patients had the cardiogenic shock after AMI, one had rupture of ventricular septum and cardiogenic shock, two had rupture of coronary artery after percutaneous transluminal coronary angioplasty, eight had unstable angina and frequent ventricular arrhythmia, one had ventricular fibrillation and cardiac arrest, and one had cardiac trauma. Ten patients were treated with intraaortic balloon pump (IABP). Conventional CABG was performed for 12 patients, off-pump CABG for 5 patients, and on-pump-beating CABG for 4 patients. Results Five patients died after E-CABG with a mortality of 23.8% which was obviously higher than the overall CABG mortality (23.8% vs. 3.1%, χ2=21.184, P＜0.05). There were respectively 2, 2 and 1 deaths with a mortality of 33.3%, 28.6% and 12.5% respectively for operations within 6 hours, 6 hours to 3 days and 3 to 30 days after the onset of AMI. The mortality of those patients who were operated within 3 days after AMI was obviously lower (P＜0.05). The primary causes of death were low cardiac output syndrome, perioperative acute myocardial infarction after CABG and sapremia. There was one death each for patients operated with off-pump and on-pump-beating CABG. Sixteeen patients were discharged from the hospital. The follow-up was from 6 months to 10 years. There were 6 late deaths among which 5 died of cardiac failure accompanied by pulmonary infection, one died of noncardiac factor. Ten patients survived at present, and the quality of life among 5 patients was unsatisfactory. Conclusion The mortality of E-CABG is obviously higher in patients operated within 3 days of AMI. With the support of IABP, if the operation can be carried out 3 days after the onset of AMI, the surgical success rate will be greatly improved by adopting proper offpump and onpumpbeating procedures.
ObjectivesTo evaluate the efficacy and safety of newer-generation antidepressants for patients with myocardial infarction (MI) and depression.MethodsPubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI, WanFang Data, and VIP databases were searched from inception to December 2017 to collect randomized controlled trials (RCT) on newer-generation antidepressants for patients with MI and depression. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsTen RCTs involving 552 participants were included. The results showed that the antidepressant group was superior to the placebo or treatment group in terms of the improvement of depressive symptoms (SMD=–1.38, 95%CI –1.93 to –0.82, P<0.000 01), and incidence of angina (RR=0.42, 95%CI 0.25 to 0.71,P=0.001), recurrent MI (RR=0.43, 95%CI 0.22 to 0.83, P=0.01), and re-hospitalization for cardiac reasons (RR=0.51, 95%CI 0.28 to 0.92, P=0.03). However, there were no significant differences between two groups on all-cause mortality (RR=0.45, 95%CI 0.18 to 1.11, P=0.08), cardiovascular mortality (RR=0.53, 95%CI 0.16 to 1.73, P=0.29) and incidence of heart failure (RR=0.75, 95%CI 0.39 to 1.43, P=0.38). Subgroup analysis revealed that the type of antidepressants could affect the improvement of depression outcome. Citalopram and fluoxetine might be the most effective drugs for patients with MI and depression.ConclusionsNewer-generation antidepressants are effective for treatment of depressive symptoms in patients with MI and depression, with no significant impact on all-cause mortality and cardiovascular mortality. Moreover, antidepressants can reduce the incidence of angina, recurrent MI, and re-hospitalization for cardiac reasons in patients suffering from MI and depression. Due to limited quantity and quality of included studies, more high quality studies are required to verify above conclusions.
The Medical Administration and Hospital Administration of the National Health Commission released the "2021 China Chest Pain Center Quality Control Report" in January 2022. This report analyzes the construction ratio of chest pain centers in the second-level and above medical institutions nationwide in 2021 and the construction of standard and basic chest pain centers, mainly from the way of coming to the hospital, symptom onset to first medical contact time, door to wire time, reperfusion therapy ratio, in-hospital mortality, proportion of discharges with medication recommended by the guidelines and average length and cost of hospital stay of ST-segment elevation myocardial infarction patients to comprehensively describe the current status of the construction of the national chest pain centers. This article interprets the report in detail by reviewing relevant literature.
ObjectiveTo investigate the surgical methods and efficacy of myocardial infarction combined with ventricular septal perforation.MethodsThe clinical data of 60 patients with myocardial infarction combined with ventricular septal perforation admitted to the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from 2009 to 2018 were retrospectively analyzed. There were 39 males and 21 females, aged 63.3±8.3 years.ResultsAmong the 60 patients, 43 (71.7%) patients were perforated in the apex, 11 (18.3%) in the posterior septum and 6 (10.0%) in the anterior septum. There were 24 (40.0%) patients of single coronary artery disease. Fourteen (23.3%) patients received intra-aortic balloon counterpulsation before surgery. The waiting time from ventricular septal perforation to surgery was 48.3 (3-217) d. All patients underwent ventricular septal perforation repair, among whom 53 (88.3%) patients received ventricular aneurysm closure or resection, and 49 (81.7%) patients received coronary artery bypass graft with an average of 2 distal anastomoses during the same period. Perioperative complications in the hospital included 8 (13.3%) deaths, 8 (13.3%) heart failure, 5 (8.3%) ventricular fibrillation, 3 (5.0%) pericardial tamponade, and 11 (18.3%) secondary thoracotomy and 11 (18.3%) residual shunt. Except for 8 patients who died in the hospital, the other 52 cured and discharged patients were followed up. The median follow-up time was 4.9 years. The 2-year and 5-year survival rate of the patients was 95.8%, and the 8-year survival rate was 89.0%. Major adverse cardiovascular events incidence was 19.2%, including 3 (5.8%) deaths, 5 (9.6%) heart failure, 2 (3.8%) myocardial infarction, and 4 (7.7%) cerebrovascular events.ConclusionFor patients with ventricular septal perforation after myocardial infarction, surgery is an effective treatment method. Although the perioperative mortality rate is high, satisfactory long-term results can be achieved by carefully choosing the operation timing and methods.
The purpose of this study is to investigate the effects of self-assembling peptide GFS-4 on three-dimen-sional myocardial cell culture and tissue repair of myocardial infarction. The circular dichroism (CD) spectrum was used to detect secondary structure of GFS-4, and atomic force microscope (AFM) was used to analyze the microstructure of self-assembly. The nanofiber scaffolds self-assembled by GFS-4 were used as the three-dimensional culture material to observe the growth effect of cardiomyocytes. The model of myocardial infarction was established and the effect of GFS-4 on myocardial infarction was studied. The results indicated that self-assembling peptide GFS-4 could form mainly β-sheet structure that can form dense nanofiber scaffolds after 24 hours’ self-assembling. The myocardial cells had a favorable growth status in GFS-4 nanofiber scaffold hydrogel when cells treated in three-dimen-sional cell culture. The experiment of repairing myocardial infarction in vitro proved that peptide GFS-4 hydrogel scaffold could alleviate tissue necrosis in a myocardial infarction area. As a new nanofiber scaffold material, self-assembling peptide GFS-4 can be used for three-dimensional cell culture and tissue repairing in myocardial infarction area.