Objective:To study the correlation between the serum homocysteine level and the carotid artery atherosclerosis,and study the relationship between the serum homocysteine level and hyperlipoproteinemia which is one of the risk factor of atherosclerosis.Methods:A Total of 64 middle and aged patients were included.The serum homocysteine level was measured with ELISA method,carotid artery intimal-medial thickness(IMT)and plaque integration were measured by colour Doppler ultrasound meter.Results:The serum homocysteine level were positively correlated to artery IMT and arterial plaque integration(r=0.498,0.747,P0.001).The serum homocysteine level were no correlated to hyperlipoproteinemia.Conclusion:The serum homocysteine level may be an independent risk factor of the carotid atherosclerosis.
Objective To investigate the impacts of overweight and obesity on endothelial function in middle-aged persons. Methods 609 subjects aged 35-55 years without cardiovascular disease and other clinical diseases were included in this study. The caliber of brachial artery was measured at rest, during in creased flow and after sublingual nitroglycerin to evaluate endothelial function by using high resolution vascular ultrasound. And generalized adipose tissue depots [expressed as body mass index (BMI) and percentage of body fat (Fat%)], regional adipose tissue depots (waist and hip circumferences ) and adipose tissue distribution (waist-hip ratio) were measured. Results Flow-mediated dilatation was significantly impaired in the groups of overweight and obesity compared with that of normal weight group, and no difference was seen in male and female. The flow-mediated dilation in overweight or obesity ones were negatively correlated with Fat% (r=-0.221, P0.001) waist circumference(r=-0.195, P0.001) and waist-hip ratio (r=-0.148, P0.01) in male and with BMI (r=-0.192, P0.001) and Fat%(r=-0.287, P0.001) in female. There was no significant difference in nitroglycerin-induced dilatation in every groups and no correlativity with adipose tissue depots and distribution. Conclusion Overweight or obesity is a important factor of endothelial dysfunction and the latter is closely correlated with adipose tissue depots and distribution.
Newly emerging evidence showed that glucocorticoids could potentiate natriuretic peptides' action by increasing the density of natriuretic peptide receptor A, leading to a potent diuresis and a renal function improvement in patients with acute decompensated heart failure (ADHF). Therefore, glucocorticoid therapy may be used in patients with ADHF.One hundred two patients with ADHF were randomized to receive glucocorticoids or standard treatment. Change from baseline in serum creatinine (SCr) at day 7 and cardiovascular death within 30 days were recorded. The study was terminated early because of slow site initiation and patient enrolment.Glucocorticoid therapy seemed to be well tolerated. There was a remarkable SCr reduction after 7 days treatment. The change from baseline in SCr is -0.14 mg/dL in glucocorticoid group versus -0.02 mg/dL in standard treatment group (P < 0.05). Although sample size is limited, a cardiovascular death reduction at 30 days was observed in glucocorticoid group with odds ratio of 0.26 (3 deaths in glucocorticoid vs. 10 deaths in standard treatment group, P < 0.05). The survival benefit associated with glucocorticoid therapy persisted during the follow-up. Patient-assessed dyspnea and physician-assessed global clinical status were also improved in glucocorticoid group.Limited data indicate that glucocorticoid therapy may be used safely in patients with ADHF in short term. Glucocorticoid therapy did not cause heart failure deterioration. Further investigations are warranted.
Objective:To evaluate the efficacy and safety of interventional therapy for trilogy of fallot (F_3). Method:From 2004-08 to 2005-07, 18 patients of F3 who were 3-32(8.4±6.2)years old were treated with the percutaneous balloon pulmonary valvuloplasty (PBPV) and the occluder devices through the percutaneous procedure under fluoroscopy, angiography and transthoracic echocardiography (TTE), X-ray, electrocardiogram and echocardiography were performed to evaluate the efficacy in them immediately after surgery and at 6 months follow-up. Result: All of 18 patients were treated successfully, without the severe complications. After therapy, right ventricular systolic pressure decreased from (84±25) to (40±10) mmHg (1 mmHg=0.133 kPa)and systolic pressure gradient across the pulmonary valve decreased from (67±26) to (13.0±11.5) mmHg immediately ( P 0.01). The atrial septal defect diameter was 5-16 (9.2±7.4)mm by TTE. The diameter of the occluder selected was 8~20(13.0±9.2)mm. Slightly residual shunts were found in 2 cases, while no residual shunt was found in other 16 patients. Conclusion: Transcatheter interventional therapy for F3 is safe, easy and effective.
Abstract Glucocorticoids, produced in adrenal cortex, exert potent natriuretic and diuretic actions in the kidney. Recently, it has been found that glucocorticoids could upregulate the expression of natriuretic peptide receptor A (NPR-A), the primary receptor of atrial natriuretic peptide, in the hypothalamus of the rat. Consequently, systemic administration of glucocorticoid could block dehydration-induced water intake by activation hypothalamic NPR-A. We describe here glucocorticoids could inhibit sodium intake when administrated systemically in conscious, salt-depleted rats; an effect which was strong and long-lasting. The study provided further evidence for the actions of glucocorticoids on central nervous system, which together with their established renal actions coordinated to normalize extracellular fluid volume.
Objective:To investigate the correlation among codon 55, 192 gene polymorphisms of paraoxonase(PON)-1 and coronary heart disease (CHD) as well as its severity of stenosis in Chinese subjects.Method:One hundred and fifty-one patients with CHD and sixty-one subjects without CHD (according to the undergoing diagnostic Judkins selection coronary angiography) were enrolled. Genotype and allele frequency of PON-1 codon 55, 192 gene polymorphisms were assayed by polymerase chain reaction (PCR)-restriction fragment length polymorphisms (RFLP) technique. Coronary score of Gensini was estimated the severity of the coronary artery stenosis.Result:Frequency of L allele were 0.91 in the CHD group and 0.87 in the control group (χ2=6.66,P0.01). Frequency of B allele of PON-1 gene codon 192 in CHD group was significant higher than that in the control group (0.65 vs 0.29, χ2=45.07,P0.01). There was statistic significance among PON-1 gene codon 192 three genotypes in the CHD subgroup and the patients with genotype BB had the highest Gensini’s coronary score by Kruskal-Wallis H test (H=11.631, P0.01).Conclusion:There is no relationship between PON-1 gene codon 55 genotype and CHD possibly, but there is significant relationship between PON-1 gene codon 192 genotype and CHD. Frequency of allele B and alllele L in the CHD group was higher than in the control group. PON-1 gene codon 192 polymorphisms may influent on the severity of coronary stenosis.
ObjectiveTo explore the relationship between β3-adrenergic receptor (β3-AR) gene Trp64Arg mutation with early atherosclerosis in the simple obesity subjects. Methods295 overweight and obesity subjects were divided into two groups including peripheral obesity and central obesity according to the waist-hip ratio (WHR). 172 healthy subjects with normal body mass served as a control group. Geno-typing of the Trp64Arg mutation in the β3-AR gene and flow-mediated endothelium-dependent dilation (EDD) and other clinical parameters,such as fasting blood glucose (FBG),fasting insulin (FINS),plasma endothelin (ET) and nitric oxide (NO) were measured in all subjects. Homeostasis model assessment (HOMA) was applied to calculate HOMA-IR as an index of insulin resistance. ResultsEDD was reduced in both peripheral and central obesity groups compared with control group. The change was more obvious in central obesity subjects,whose level of NO also was lower than peripheral obesity and control subjects. The allelic frequency of the Trp64Arg mutation was similar among peripheral obesity,central obesity and control groups ( 17.17 , 25.26 and 18.89 ,respectively),which showed an upward tendency,but no significant differences were found in central obesity subjects compared with peripheral obesity and control subjects. EDD was significantly reduced in subjects with Trp64Arg and Arg64Arg genotypes compared with Trp64Trp genotype in central obesity group,but no significant difference were found between mutation and non-mutation subjects in peripheral obesity group. ConclusionEarly atherosclerosis in simple obesity subjects is correlative to total body fat and body fat distribution,the β3-AR gene Trp64Arg mutation also is an important factor participating in atherosclerosis.
Abstract Background: The role of glucocorticoids in body fluid control is full of controversy. It is well documented that glucocorticoids could produce potent and persistent diuresis in congestive heart failure. But, the diuretic effect was not reported in patients with euvolemia. Objective: To test the hypothesis that the diuresis induced by glucocorticoids is systemic volume dependent. Methods: The diuretic effect of glucocorticoids in rats with various systemic volume statuses (i.e. systemic volume depletion, euvolemia, and systemic volume overload, respectively) was recorded. Results: Glucocorticoids only produced potent and persistent diuresis in the rats with systemic volume overload. Conclusion: The diuresis induced by glucocorticoids was systemic volume dependent, which explained the phenomenon that glucocorticoids only have potent and persistent diuretic effect in congestive heart failure.
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