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    • Endocardial and epicardial ablation of premature ventricular complex arising from the summit:ECG characteristics and long-term prognosis

      2023, 31(7):594-599.

      Keywords:summit area electrocardiography premature ventricular complex endocardial ablation epicardial ablation
      Abstract (281)HTML (0)PDF 4.43 M (492)Favorites

      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.

    • Elevated plasma remnant cholesterol associated with long-term adverse cardiovascular events in young patients with coronary artery disease

      2023, 31(12):1058-1066.

      Keywords:premature coronary artery disease remnant cholesterol major adverse cardiac events
      Abstract (192)HTML (0)PDF 8.73 M (590)Favorites

      Abstract:Aim To determine the relationship between remnant cholesterol (RC) and long-term cardiovascular risk in young patients with coronary artery disease (CAD). Methods 3 200 patients with CAD hospitalized from May 2013 to November 2015 were analyzed retrospectively. They were divided into three groups according to age:young group (<45 years old), middle-aged group (45~70 years old) and elderly group (≥70 years old); They are divided into high group and low group according to RC levels. The incidence of major adverse cardiovascular event (MACE) was statistically analyzed. KM method was used to evaluate the survival rate without MACE event, and Cox regression was used to evaluate the predictors of clinical endpoint. The dose-response relationship between RC and MACE risk was demonstrated using a restricted cubic spline (RCS) model. Results A total of 3 112 patients were followed up (97.25%), including 160 in young group, 2 390 in middle-aged group, and 562 in elderly group. The median follow-up time was 7.36 years. Among them, 864 cases (27.8%) experienced MACE events. KM curve showed that RC was not a predictor of long-term MACE in patients with CAD of all ages (P>0.05), nor was it a predictor of MACE in middle-aged and elderly groups (P>0.05). KM curve and Cox regression showed that RC was an independent predictor of long-term MACE in premature CAD patients, and the risk of MACE increased by 1.07 times for every 1 mmol/L increase in RC (HR=2.7,5%CI:1.35~3.17, P<0.01). Through calculation and verification, it was found that the optimal cutoff value of RC for predicting the occurrence of MACE in premature CAD patients was 0.94 mmol/L, and the risk of MACE in premature CAD patients with RC>0.94 mmol/L increased by 1.98 times (HR=2.8,5%CI:1.41~6.32, P<0.01); Conversely, the risk of MACE was reduced by 66% in premature CAD patients with RC<0.94 mmol/L (HR=0.4,5%CI:0.16~0.71, P<0.01). Conclusion RC is an independent predictor of long-term MACE occurrence in premature CAD patients (7.36 years). The optimal cutoff value of RC in this population is 0.94 mmol/L. Controlling RC below 0.94 mmol/L is able to reduce the risk of MACE by 66% in premature CAD patients.

    • Correlation between plasma miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p levels and premature coronary artery disease and its preliminary screening value

      2022, 30(8):681-690.DOI: 10.20039/j.cnki.1007-3949.2022.08.006

      Keywords:premature coronary artery disease novel biomarker miR-1228-5p miR-34a-5p miR-192-5pmiR-30a-3p
      Abstract (340)HTML (0)PDF 9.63 M (663)Favorites

      Abstract:Aim To investigate the correlation between plasma miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p levels and premature coronary artery disease (PCAD) and their early screening value as biomarkers. Methods According to inclusion criteria and exclusion criteria, 6 patients with clearly diagnosed PCAD were included as PCAD group and 6 heathy subjects as control group. Blood was collected from the PCAD group and the control group, and serum samples were extracted and stored. The miRNA levels in the serum of the two groups were detected using DNBseq platform, and the miRNA with significant differences were screened. According to inclusion and exclusion criteria, blood from 78 patients with PCAD, 75 patients with late-onset coronary artery disease and 69 healthy subjects were collected and the selected miRNAs were verified by qPCR. Coronary angiography reports of patients with PCAD were analyzed, and the severity of coronary artery disease was evaluated by Gensini score. Spearman correlation test was used to analyze the correlation between the degree of coronary stenosis and the miRNA. ROC curve was used to analyze the diagnostic value of plasma levels of miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p for PCAD, and multivariate Logistic regression was used to analyze the influencing factors of PCAD. Results DNBseq platform analysis showed 33 differentially expressed miRNAs, including 17 up-regulated miRNAs and 16 down-regulated miRNAs. The 5 miRNAs with the most significant difference levels were miR-1228-5p, miR-34a-5p, miR-192-5p, miR-424-3p and miR-30a-3p. qPCR results showed that compared with the control group, plasma miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p levels were increased by 1.7 times, 1.4 times, 0.7 times and 2.5 times in patients with PCAD (P<0.05). There was no significant difference in miR-424-3p level between the two groups (P>0.05). Spearman correlation analysis showed that plasma levels of miR-1228-5p and miR-34a-5p were positively correlated with the degree of coronary stenosis in patients with PCAD (r=0.307, P=0.004; r=0.238, P=0.036). ROC curve analysis showed that the areas under ROC curve for the diagnosis of PCAD by miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p were 0.3,0.2,0.731 and 0.798, respectively. The area under ROC curve of the combined diagnosis was 0.990, and 95%CI was 0.970~1.000. Conclusions The plasma levels of miR-1228-5p, miR-34a-5p, miR-192-5p and miR-30a-3p in patients with PCAD were significantly increased. The combined detection showed high accuracy in the diagnosis of PCAD, which is expected to be new biomarkers for preliminary screening of PCAD.

    • Research progress of the genetic variations in lipid metabolism related with premature coronary heart disease

      2021, 29(3):264-270.

      Keywords:premature coronary heart disease; atherosclerosis; lipid metabolism; genetic variation
      Abstract (694)HTML (0)PDF 3.48 M (742)Favorites

      Abstract:Premature coronary heart disease(pCHD)is a special type of cardiovascular disease. Recent research has demonstrated that pCHD possesses a strong genetic basis, genetic factors account for almost 50%~60% morbidity rate of pCHD, and lipid metabolism gene plays the most important role in it. Genetic variations of lipid metabolism can lead to the impediment of lipid synthesis and catabolism, as well as a series of disease characterized by atherosclerosis(As)and pCHD.This review aims to give a brief summary of the relationship between the genetic variations of lipid metabolism and pCHD.

    • Correlation between red blood cell distribution width,mean platelet volume and premature coronary artery disease

      2019, 27(10):881-886.

      Keywords:premature coronary artery disease red blood cell distribution width mean platelet volume Gensini score
      Abstract (811)HTML (0)PDF 3.82 M (1118)Favorites

      Abstract:Aim To investigate the distribution of red blood cell distribution width (RDW) and mean platelet volume (MPV) in patients with premature coronary artery disease(PCHD) and its relationship with the severity of PCHD, and to evaluate the diagnostic value of RDW and MPV for PCHD. Methods A total of 407 patients with suspected coronary artery disease(CHD) due to chest pain and male <55 years old and female <65 years old were enrolled in the study. All patients received coronary angiography (CAG), 309 cases of PCHD were confirmed and the remaining 98 cases were normal control group. The levels of RDW and MPV in the two groups and the subgroups of the PCHD were compared. The correlation between RDW and MPV and severity of coronary lesions (Gensini score) and independent risk factors for PCHD were analyzed. Results The levels of RDW and MPV in the PCHD group were significantly higher than those in the control group (P<0.05). RDW and MPV were higher in the acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP) groups than the control group (P<0.05); there was a positive correlation between RDW, MPV and Gensini scores in the PCHD group(r=0.246 and 0.199, P<0.05). Multivariate Logistic regression analysis showed that RDW and MPV were independent risk factors for PCHD(OR=3.3,5%CI:2.197~6.359, P<0.001; OR=1.3,5%CI:1.074~1.705, P=0.010). R0C curve analysis showed that the optimal cut-off value of RDW to diagnose PCHD was 12.25% with a sensitivity of 69% and specificity of 72%, and the optimal cut-off value of MPV to diagnose PCHD was 8.55 fl with a sensitivity of 91% and a specificity of 37%. Conclusions RDW and MPV are correlated to the clinical type of PCHD and the severity of PCHD. RDW and MPV are the independent risk factors for PCHD, which provides some value for the diagnosis of PCHD.

    • Current status of diagnosis and treatment of familial hypercholesterolemia in China

      2018, 26(8):851-857.

      Keywords:hypercholesterolemia premature coronary artery disease gene mutation lipid-lowering drug
      Abstract (1382)HTML (0)PDF 3.82 M (917)Favorites

      Abstract:Familial hypercholesterolemia (FH) is the most common monogenic disorder of lipid metabolism. The total cholesterol levels begin to rise during fetal stage, which leads to premature coronary heart disease. The diagnosis of FH is based on the serum concentration of low density lipoprotein cholesterol (LDLC), xanthomas, premature coronary heart disease and genetic test. While early detection and intervention are all crucial to the prognosis, the diagnosis rate and LDLC control rates after lipid-lowering drug treatment are extremely low in China.

    • Mechanism of high density lipoprotein against HUVEC apoptosis in patients with premature coronary heart disease

      2017, 25(7):671-678.

      Keywords:Premature coronary heart disease High density lipoprotein Oxidized low density lipoprotein Apoptosis Atherosclerosis
      Abstract (1230)HTML (0)PDF 8.75 M (1092)Favorites

      Abstract:Aim To investigate whether there is a difference between HDLPCHD and HDLhealth against human umbilical vein endothelial cells apoptosis in patients with premature coronary heart disease (PCHD) and the possible mechanism. Methods Blood samples of PCHD patients and healthy subjects were collected, and HDL was isolated from the blood samples. Human umbilical vein endothelial cells were treated for 24 hours with different concentrations of oxidized low density lipoprotein (ox-LDL), cell viability was detected by MTT, to identify the appropriate concentration of ox-LDL induced human umbilical vein endothelial cells cell apoptosis. Human umbilical vein endothelial cells were pretreated with different hours and different concentration of HDLhealth, then treated with the appropriate concentration of ox-LDL for 24 hours, cell viability was detected by MTT, to identify the optimal concentration and time of HDLhealth pretreated human umbilical vein endothelial cells. Human umbilical vein endothelial cells were pretreated with the optimal hours and the optimal concentration of HDLhealth and HDLPCHD, then treated with the appropriate concentration of ox-LDL for 24 hours, cell viability was detected by MTT. Annexin V-FITC/PI apoptosis detection kit was used for flow cytometry staining, Western blot was used to detect Caspase 3 and Caspase 9 protein expression, kit was used to detect the activity of reactive oxygen species (ROS), sub-fraction (HDL1-HDL10) distribution of HDLhealth and HDLPCHD were analyzed by Lipoprint System. Results Human umbilical vein endothelial cell survival rate was 60.34% after treatmented with 100 mg/L ox-LDL for 24 hours, which was significantly lower than that in the blank treatment group (P<0.05). Human umbilical vein endothelial cell survival rate was 82.01% after pretreated with 200 mg/L HDLhealth for 18 hours, which could significantly reduce the damage of ox-LDL to cells. 200 mg/L HDLhealth could significantly inhibit apoptosis of human umbilical vein endothelial cells, the expression of Caspase 3 and Caspase 9 and the production of ROS , which were induced by 100 mg/L ox-LDL. Human umbilical vein endothelial cell survival rate was 65.5% after pretreated with 200 mg/L HDLPCHD for 18 hours, and its effect was weaker than that of HDLhealth. 200 mg/L HDLPCHD could inhibit apoptosis of human umbilical vein endothelial cells, the expression of Caspase 3 and Caspase 9 and the production of ROS induced by 100 mg/L ox-LDL, but the effect was weaker than that of HDLhealth. The content of large particle (HDL1-HDL3) in HDLPCHD subgroup was lower than that in HDLhealth (28.5%±5.7% vs. 46.8%±15.2%), while the content of small particle (HDL8-HDL10) was higher than that of HDLhealth (21.4%±7.8% vs. 10.9%±5.4%). Conclusion Comparison to the HDLhealth, perhaps due to the large particle of HDLPCHD sub-fraction content (HDL1-HDL3) was lower than that of HDLhealth, while the small particle was higher than that of HDLhealth (HDL8-HDL10), resulting in antioxidant function weakened, inhibiting the apoptosis of endothelial cells induced by ox-LDL were decreased, thereby weakening or losing the role of anti-atherosclerosis.

    • Analysis Between Health-related Quality Life and Risk Factors in Non-diabetic Premature Coronary Heart Disease Man

      2015, 23(11):1141-1145.

      Keywords:Non-Diabetic Man Premature Coronary Heart Disease Health-Related Quality Life Risk Factor
      Abstract (968)HTML (0)PDF 1.23 M (1218)Favorites

      Abstract:Aim To investigate the correlation between health-related quality life (HRQL) and risk factors in non-diabetic premature coronary heart disease (CHD) man.Methods 215 non-diabetic man patients (age fewer than 50) were selected from cardiology department (Sun Yat-sen Memorial Hospital of Sun Yat-sen University) from January 2012 to January 2015. All subjects were diagnosed by coronary angiography and divided into two groups according to the percentage of coronary artery stenosis as follows: 104 cases with coronary artery stenosis above 50% (age 43.04±4.69, CHD group) and 111 cases with coronary artery stenosis less than 50% (age 42.92±4.30, Healthy control group). Clinical data and health-related quality information were collected and analyzed by SPSS 18.0.Results 1) Hypertension, hyperlipidemia, smoking, family history, diastolic blood pressure and systolic blood pressure were significantly higher in the CHD group than that of the healthy control group (P<0.05) 2) The proportion of low education, stress pressure and excess fatigue were significantly higher in the CHD group than that of the healthy control group (P<0.05) 3) Smoking, hypertension, high pressure and excess fatigue significantly increased the incidence of coronary heart disease in non-diabetic man patients after adjusting the relative risk factors, which included smoking, drinking, hypertension, hyperlipidemia, hyperuricemia, the family history of coronary heart disease, low education, stress pressure and excess fatigue. The odds ratio (OR) and 95% CI for smoking, hypertension, stress pressure and excess fatigue were 5.005 (2.096, 11.954), 3.704 (1.466, 9.355), 2.635 (1.309, 5.302), 2.594 (1.192, 5.648) respectively (P<0.05).Conclusion Our data suggest that smoking, hypertension, stress pressure and excess fatigue are the risk factors of premature CHD in non-diabetic man, and smoking is the most significant risk factor in this study.

    • Ideal Cardiovascular Health Behaviors and Factors in Patients with Premature Coronary Heart Disease

      2014, 22(12):1268-1272.

      Keywords:Premature CHD Ideal Cardiovascular Health Behaviors and Factors Prevention
      Abstract (1297)HTML (0)PDF 1.58 M (1315)Favorites

      Abstract:Aim To explore the ideal cardiovascular health behaviors and factors in patients with premature coronary heart disease (CHD),in order to provide guideline for primary prevention of premature CHD and early targeted treatment.Methods A total of 544 patients diagnosed with CHD by coronary angiography were selected from department of cardiology,Tangshan worker’s hospital from January 2013 to September 2013.We excluded subjects with a family history of CHD (n61) and those who had missing data on health factors or health behaviors (n24).Based on age,the subjects were divided into two groups: 229 patients with premature CHD (male aged ≤55 years,female aged ≤65 years) served as the case group,while 208 patients with late-onset CHD (male>55,female>65 years) served as the control group.A case-control study was conducted to analyze the ideal cardiovascular health factors and health behaviors in patients with premature CHD,such as age,gender,body mass index (BMI),history of smoking and drinking,healthy dietary intake,physical activity,history of hypertension,diabetes and dyslipidemia,family history of CHD and so on.Results ①As for percentage of males,systolic blood pressure,high density lipoprotein cholesterol (HDLC),low density lipoprotein cholesterol (LDLC) and triglyceride (TG),no statistically significant difference was found between the two groups (P>0.05).Total cholesterol levels,diastolic blood pressure,BMI and fasting blood glucose in premature CHD group were higher than those in the control group,which was significantly different (P<0.05)②The proportion of healthy dietary intake and physical activity was lower in premature CHD group,compared with that in late-onset CHD group (P<0.05)③Multiple logistic regression analysis on ideal cardiovascular health behaviors and factors showed that cigarette smoking,elevated fasting blood glucose and higher BMI as well as inadequate healthy dietary intake and physical inactivity were associated with premature CHD,and OR values were 1.46 (95%CI 1.02~2.28),2.17 (95%CI 1.22~3.86),2.59 (95%CI 1.68~4.00),2.78 (95%CI 1.90~4.08) and 3.68 (95%CI 2.54~5.34),respectively.Conclusion Cigarette smoking,elevated fasting blood glucose,BMI,inadequate healthy diet and physical inactivity may be associated with the incidence of premature CHD.

    • Correlation Study on Polymorphisms of the Endodermis Nitricoxide Synthase Gene and N5, N10 Methylene Tetrahydrofolate Reductase Gene in Han Patients with Premature Coronary Artery Disease in the Suwan Region

      2012, 20(5):463-468.

      Keywords:Endodermis Nitricoxide SynthaseN5, N10 Methylene Tetrahydrofolate ReductaseGene PolymorphismPremature Coronary Artery Disease
      Abstract (1204)HTML (0)PDF 1.37 M (1383)Favorites

      Abstract:AimTo investigate a potential association of the gene polymorphisms of endodermis nitricoxide synthase(eNOS) and N5, N10 methylene tetrahydrofolate reductase (MTHFR) gene with premature coronary artery disease (PCAD).MethodsThe polymorphisms of gene eNOS and MTHFR were measured by polymerase chain reaction and restriction fragment length polymorphism analysis(PCR-RFLP) in 131 patients with PCAD (PCAD group)and 131 non-coronary heart disease patients (control group), who were matched in age and sex.ResultsThe frequencies of eNOS G894T gene polymorphism (χ2=2.072, p=0.355) and its T allele (χ2=0.727, p=0.394) in PCAD group were not significantly different from those in control group.The frequencies of MTHFR C677T gene polymorphism T allele were significantly higher in PCAD group than those in control group(χ2=16.339, p=0.000).The frequencies of the three genotypes (CC, CT and TT) were significantly different between the two groups(χ2=14.290, p=0.001).Logistic regression analysis indicated that MTHFR 677C/T TT genotype was an independent risk factor in PCAD(p<0.05).ConclusionThe eNOS G894T polymorphism may have no association with the pathogenesis of PCAD in Han patients of Swnan region; the TT genotype of the MTHFR C677T gene may increase the risk of PCAD.The genetic polymorphism of MTHFR gene promoter is associated with the susceptibility to PCAD in Suwan Han nationality.

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