Abstract:Aim To analyze the 12-lead surface ECG of premature ventricular complex (PVC) originating from the summit to identify some ECG characteristics that may accurately determine the ablation target. Methods Between June 2018 and February 2021, a total of 36 patients with PVC arising from the summit underwent percutaneous radiofrequency catheter ablation (RFCA) in the coronary venous circulation or opposite left ventricular endocardial sites. The 12-lead ECG recordings about these patients were analyzed. Results 25 patients successfully ablated from the endocardial approach (endocardial group), 11 patients successfully ablated from the coronary venous circulation (epicardial group). The intrinsicoid deflection (ID) was smaller in the endocardial group than that in the epicardial group, and the difference was statistically significant (P＝0.022). The maximum deflection index (MDI) was smaller in the endocardial group than that in the epicardial group, and the difference was statistically significant (P＝0.020). The duration of the negative pseudodelta wave was shorter in the endocardial group compared to the epicardial group, the difference was statistically significant (P＝0.004). After follow-up 6～36 months, the RFCA success rate was 100% (11/11) in the epicardial group, 1 case in the endocardial group was lost, and the RFCA success rate was 87.5% (21/24) in the remaining 24 patients. Subgroup analysis of the endocardial group showed when the duration of the negative pseudodelta wave ≥25 ms, the RFCA success rate was 62.5% (5/8), and when the duration of the negative pseudodelta wave ＜25 ms, the RFCA success rate was 100% (16/16). The duration of the negative pseudodelta wave ＜25 ms had sensitivity and specificity of 94% and 72%, for the identification of successful ablation in the adjacent endocardium. Conclusion The negative pseudodelta wave of PVC originating from the summit ＜25 ms was closely related to the success rate of RFCA.

Abstract:Aim To investigate carotid atheroscelerotic lesions in the population ≥ 45 years of age in Dongying area. Methods Carotid artery ultrasound was performed in a total of 10 182 residents aged 45 or above. All residents were selected from 5 districts of Dongying urban and rural areas using cluster random sampling method. The carotid intima-media thickness (IMT), the plaque and vascular stenosis were recorded. Results The overall detection rate of carotid atheroscelerotic lesions was 74.8%, among which, the detection rates of simple IMT thickening, plaque formation, single plaque, multiple plaques, single carotid artery involvement, multiple carotid arteries involvement, carotid artery stent (CAS) implantation, and restenosis post CAS were 20.3%, 55.9%, 20.8%, 33.5% , 21.6%, 53.1%, 0.12%, and 0.03%. The detection rates of carotid artery mild stenosis (<50%), moderate stenosis (50%~69%), severe stenosis and occlusion (70%~100%) were respectively 73.6%, 1.0%, and 0.2%. The prevalence of carotid atheroscelerotic lesions, plaque formation, multiple plaques and multiple carotid arteries involvement in urban population were higher than that in rural population(P<0.05). There were significant differences between rural and urban population in the constituent ratio of carotid artery stenosis(P<0.05). The detection rates of carotid atheroscelerotic lesions, simple IMT thickening, plaque formation, multiple plaques, multiple carotid arteries involvement, and CAS implantation were higher in males than in females(P<0.05). Conclusion The incidence of carotid atherosclerosis in the population of Dongying area is high, the detection rate of the urban population is higher than that in rural population.

Abstract:Aim To observe the effect of Salvianolic acid B(SalB) on atherosclerotic plaque stabilization in diabetic atherosclerosis animal models prepared from apolipoprotein E(ApoE) gene knock-out mice treated by intraperitoneal injection of STZ and high fat diet.Methods Fifty two-month female ApoE gene knock-out mice were injected with STZ and fed with high fat diet for 12 weeks.Then fasting blood glucose(FBG) level was measured and forty diabetic atherosclerosis mice were selected for the following treatment experiment.Diabetic atherosclerosis mice were randomly divided into four groups.Each group was fed with same high fat diet and intragastrically administrated with different drugs for 8 weeks,named model group(distilled water),SalB high dose group(160 mg/(kg·d)),SalB medium dose group(80mg/(kg·d)) and Lovastatin group(2.3 mg/(kg·d)).Then frozen sections and paraffin sections of mice aortas were made.The lipid core area,thickness of fibrous cap,incidence of plaque erosion and the number of neovascularization in atheromatous plaque were measured by Sudan III staining,MASSON staining and immunohistochemistry staining. Results Compared with the model group,both the level of FBG and total cholesterol(TC) in the SalB high dose group and Lovastatin group reduced significantly(P<0.05).Compared with the model group,both the level of triglyceride(TG) and low density lipoprotein cholesterol(LDLC) in the SalB medium dose group,SalB high dose group and Lovastatin group reduced significantly(P<0.05),whereas the level of high density lipoprotein cholesterol(HDLC) increased significantly(P<0.05).Compared with the model group,lipid core area,the number of neovascularization in atheromatous plaque and the incidence of plaque erosion in the SalB medium dose group,SalB high dose group reduced significantly(P<0.01),whereas average thickness of fibrous cap became thicker significantly(P<0.01).Conclusions SalB may stabilize the diabetic atherosclerotic plaques by increasing average thickness of fibrous cap and decreasing lipid core area,incidence of plaque erosion and neovascularization in atheromatous plaque.

Abstract:Aim To investigate the relationship between adiponectin gene polymorphisms and the occurrence of atherosclerotic cerebral infarction(ACI),blood pressure as well as the lipid concentrations in Chinese Han population of Hunan area.Methods 163 healthy individuals and 161 ACI patients were recruited in this study.The genotypes of adiponectin were detected with polymerase chain reaction(PCR) and digested by specific restriction enzymes.Results Adiponectin polymorphisms existed in Chinese Han population of Hunan area,with the allele frequencies 0.783/0.217 for 45T/G in the whole study population,and 0.697/0.303 for 276G/T,respectively.There was no significant difference of genotype and allele frequency between ACI patients and controls for 45T/G polymorphisms(P>0.05).However,the frequency of T allele and TT genotype in adiponectin 276G/T polymorphisms were significantly higher in ACI group compared with that in control group(P<0.05).Also,T allele carriers had a significantly higher level of triglyceride(TG) than subjects with GG genotype.Conclusions 45T/G polymorphism of adiponectin might has no significant correlation with ACI in Chinese Han population of Hunan area,whereas 276G/T polymorphism might be associated with the development of ACI through a participation in the lipid metabolism.

Abstract:Aim To investigate the current epidemiological characteristics of blood lipid levels among rural hypertensive patients in Liaoning province and to provide scientific basis for the prevention and treatment of dyslipoproteinemia.Methods A cross-sectional survey was conducted during 2004～2006,through cluster multistage and random sampling to a resident(≥5 years) groups of 6 412 individuals(2,805 men,3,607 women) aged ≥35 years old with hypertension in the countryside of Liaoning province and blood chemical analyses were performed at a central,certified laboratory so as to understand the prevalence of dyslipoproteinemia based on criteria of the prevention and treatment of dyslipoproteinemia in 2006 in China,SPSS11.5 of statistical software was used for data analysis.Results(1)The average level of blood lipids(TC,HDLC,LDLC and TG)had higher levels in hypertensive women than that in hypertensive men(p<0.001).(2)The prevalence of isolated hypercholesterolemia(TC≥6.21 mmol/L),low HDLC concentration(HDLC<1.03 mmol/L),increased LDLC concentration(LDLC≥4.16 mmol/L),isolated hypertriglyceridemia(TG≥2.26 mmol/L) was 16.9%,8.8%,4.4%,and 19.8%.(3)The prevalence of TC increased with the increased stage of blood pressure and it showed a significant difference among 3 stages.In contrast,the prevalence of HDLC decreased with the increased stage of blood pressure and it was also significant(p<0.05);however,we didnt see a trend between LDLC and the stage of blood pressure and TG and the stage of blood pressure.Conclusion The prevalence of dyslipidemia was relatively high among rural hypertensive patients in Liaoning province,it is very important to prevent and control dyslipidemia for us.

Abstract:Aim To observe the anti-atheromatous effects of fenofibrate in cholesterol-fed rabbits. Methods 10 male New Zealand white rabbits were fed with high cholesterol diet for 8 weeks,and then were randomly divided into two groups: high cholesterol group maintained cholesterol diet for 4 weeks;fenofibrate treatment group maintained the same cholesterol diet besides supplementing with fenofibrate30 mg/(kg·d)] for 4 weeks.And control group was fed with normal diet for 12 weeks.Before and after feeding,serum tumor necrosis factor-α(TNFα) levels of all rabbits were measured.After feeding,the aortas were harvested for observing the formation of atherosclerotic plaques.TNF-α mRNA expression in adipose tissue was evaluated by reverse transcription-polymerase chain reaction(RT-PCR). Results High cholesterol group and fenofibrate treatment group showed higher serum levels of total cholesterol and low density lipoprotein cholesterol than those of control group(p<0.001),but there were no difference between the two groups(p<0.05).As compared with the high cholesterol group,aortic atherosclerotic area(52.8%±6.9% vs 76.3%±8.6%,p<0.01),intimal thickness of the aorta(28.45±5.68 μm vs 76.18±11.25 μm,p<0.05),serum TNF-α levels(2.11±0.26 ng/L vs 3.86±0.33 ng/L,p<0.05) and TNF-α mRNA expression in adipose tissue (0.31±0.05 vs 0.56±0.07,p<0.05) were significantly decreased in fenofibrate treatment group. Conclusions The study indicates that fenofibrate manifests an anti-atheromatous effect independent of the hypolipidemic effect in cholesterol-fed rabbits and decreasing serum TNF-α level may be one of its possible mechanisms.

Abstract:Aim To compare the expression of matrix metalloproteinase-2(MMP-2)and MMP-9 in atherosclerotic plaques of diabetic and non-diabetic patients and to investigate the potential role of MMP-2 and MMP-9 expression in unstabilizing plaques of diabetic patients. Methods Specimens of arteries were obtained from 23 diabetic patients and from 17 autopsy cases with acute coronary syndromes. 126 tissue blocks of late-stage lesions were classified into diabetic group (n=74)and non-diabetic group (n=52). Forty blocks were selected randomly from each group and serial sections were stained immunohistochemically with anti-human MMP-2 and MMP-9 monoclonal antibody. Microscope Image Analyzer was used for relatively quantitative analysis. Results In the diabetic arteries, intense staining was shown around the plaque core, especially in the plaque shoulder and thinned fibrous cap. MMP-2 integrated optical density(IOD) of diabetic group (69 014±14 459) was strikingly higher than that of the non-diabetic group (57 004±16 171). Threshold area of MMP-2 was significantly elevated (p<0.05) in samples from diabetic group (13.0%±2.7%) compared with samples from non-diabetic group with atherosclerosis (11.1%± 3.3% ). IOD of MMP-9 was also significantly higher (p<0.01) in diabetic group (102 485±20 431) than in the non-diabetic group (75 280±13 106). Conclusion The expression of MMP-2 and MMP-9 in atherosclerotic plaques of diabetic group is significantly higher than that of non-diabetic group. MMP-2 and MMP-9 accumulation, which play an important role in unstabilizing plaques, may promote atherosclerotic plaque disruption in diabetic patients.

Abstract:Aim To evaluate the effect of recombinant human vascular endothelial growth factor 165(VEGF165) on progression of atherosclerotic plaque in rabbits. Methods Fifteen rabbits were randomly fed with normal diet or high cholesterol diet. Albumin or VEGF165 was administered by a single-intramuscular injection(2 μg/kg)to rabbits fed with cholesterol diet begining three weeks before therapy. Subsets of rabbits from control group, high cholesterol group and VEGF group underwent perfusion-fixation and harvesting of the thoracic aorta for morphometric and immunohistochemical analysis at 42 days. Results In control group, high cholesterol group and VEGF group, significant difference was shown in comparing mean plaque area (0% vs. 1.81%±0.61% vs. 24.12%±3.58%), plaque circumference (0% vs. 6.05%±1.62% vs. 25.71%±1.97%) and maximal plaque thickness (0 vs. 0.06 mm±0.002 mm vs. 0.16 mm±0.007 mm)respectively. There were significant differences(p<0.05) in neovascularization density (number of CD34-positive cell, 0 vs. 12.35±2.02 vs. 61.15±7.55 cells/ mm 2 ) in control group, high cholesterol group and VEGF group at 42 days. Transmission electron microscopy showed intimal vessels were associated with lesion and the capillary lumen contain lymphocytes. There was positive correlation between CD34 positive area and plaque area (r=0.989, p<0.001)in VEGF group. Conclusions Vascular endothelial growth factor 165 increased the rate and degree of atherosclerotic plaque formation in the thoracic aorta in a cholesterol-fed rabbit model.

Abstract:Aim To acquaint with atherosclerosis(As) progress of apolipoprotein E~-knockout(ApoE~-) mouse in different periods and explore the influence of different diets on As progressof ApoE~-mice. Methods 40 ApoE~-mice with 6 week age,20 mice among them were given west food diet and 20 mice were given common diet,4 mice were randomly chosen in each group at the period of 15,19,24,28 and 36 weeks and sacrificed for pathological determination. Results As of ApoE~-mouse gradually aggravated with time passing, undergone a typical pathological course from fatty streak to atheromatous plaque;As of ApoE~-mice with high fat diet were more severe than As of ApoE~-mouse with common diet. Conclusions ApoE~-mouse was a reliable model for As research;west food diet could accelerate As pathological progress of ApoE~-mouse.

Abstract:Aim To evaluate the efficacy of intravascular ultrasound (IVUS) in patients undergoing renal artery intervention therapy. Methods 15 consecutive patients with significant renal artery stenosis (luminal narrowing of renal artery > 50%) underwent IVUS, before and after renal artery stenting. All patients underwent renal artery stenting, the sizes of the stent were chosen according to the results of IVUS. Results IVUS revealed 13 hard plaques with 2 severe calcification and 2 soft plaques in 15 patients; 12 lesions were found with negative remodeling, 3 with positive remodeling. The mean cross sectional areas of external elastic membrane and lumen were 119.7±23.1 mm 2 and 34.5±9.3 mm 2. The mean plaque area was 85.2±26.0 mm 2. All patients underwent renal artery stenting with 100% successful procedure rates. Conclusions IVUS has superiority in determining the lesion characteristics, defining the stenosis, calculating the luminal dimension and inserting the stent.