ECG manifestations: noncoronary heart disease

The electrocardiogram reflects changes to the heart beyond those seen in acute myocardial infarction and acute coronary syndromes.Diseases of the pericardium and heart muscle such as pericarditis,myocarditis, and pericardial effusion have characteristic manifestations. Hypertensive heart disease is associated with a variety of changes on the electrocardiogram, as is valvular heart disease. Cardiac rhythm disturbances have been associated with the Brugada syndrome and the long QT syndrome, both of which have telltale findings on the electrocardiogram. The manifestations of dextrocardia, although rare, should be familiar to those who interpret electro-cardiograms. Transplanted hearts also feature classic changes, both in health and in stages of rejection. The various electrocardiographic manifestations of these noncoronary heart diseases are reviewed here.     

Coronary vasomotor and blood flow responses to isoflavone-intact soya protein in subjects with coronary heart disease or risk factors for coronary heart disease

Results in animals suggest favourable coronary vasomotor actions of isoflavones; however, the effects of isoflavones on the human coronary circulation have not been determined. In the present study, we therefore investigated the effects of short-term isoflavone-intact soya protein ingestion on basal coronary arterial tone and stimulated vasoreactivity and blood flow in patients with CHD (coronary heart disease) or risk factors for CHD. Seventy-one subjects were randomized, double-blind, to isoflavone-intact soya protein [active; n=33, aged 58+/-8 years (mean+/-S.D.)] or isoflavone-free placebo (n=38, aged 61+/-8 years) for 5 days prior to coronary angiography. In 25 of these subjects, stimulated coronary blood flow was calculated from flow velocity, measured using intracoronary Doppler and coronary luminal diameter before and after intracoronary adenosine, ACh (acetylcholine) and ISDN (isosorbide dinitrate) infusions. Basal and stimulated coronary artery luminal diameters were measured using quantitative coronary angiography. Serum concentrations of the isoflavones genistein, daidzein and equol were increased by active treatment (P<0.001, P<0.001 and P=0.03 respectively). Basal mean luminal diameter was not significantly different between groups (active compared with placebo: 2.9+/-0.7 compared with 2.73+/-0.44 mm, P=0.31). There was no difference in luminal diameter, flow velocity and volume flow responses to adenosine, ACh or ISDN between groups. Active supplement had no effect on basal coronary artery tone or stimulated coronary vasoreactivity or blood flow compared with placebo. Our results suggest that short-term consumption of isoflavone-intact soya protein is neither harmful nor beneficial to the coronary circulation of humans with CHD or risk factors for CHD. These results are consistent with recent cautions placed on the purported health benefits of plant sterols.     

The ebb and flow of heart disease. Circadian rhythms and coronary heart disease.

Circadian rhythms have been shown to influence morbidity and mortality associated with heart disease, and most heart attacks occur in the early morning. An awareness of this link can motivate clients to comply with 24-hour medication.     

冠状动脉病变与动态血压的相关性研究

目的探讨24 h动态血压与冠状动脉病变严重程度的相关性.方法 194例行冠状动脉造影的患者同时进行24 h动态血压监测.冠状动脉病变的严重程度用冠状动脉病变的血管支数表示.结果合并高血压组冠状动脉双支和三支血管病变的患病率显著高于未合并高血压组（P＜0.001）;与脉压＜60 mm Hg的患者相比,脉压≥60 mm Hg的患者冠状动脉双支和三支血管病变的患病率显著增高（P＜0.001）.结论脉压与冠状动脉病变严重程度密切相关,最高收缩压是预测冠状动脉病变与否的最佳参数.     

Metabolic and hormonal blood flow modeling in patients with coronary heart disease: In vitro and clinical study

The blood flow pattern investigations are of great importance in coronary blood flow destabilization pathogenesis understanding, and consequently in acute coronary event (ACE) risk stratification in patients with coronary heart disease. The aim of the study was to research the principal hormonal and metabolic blood flow regulative aspects and its structure in patients with ischemic heart disease and the contribution to cumulative ACE risk.A total of 182 patients with stable angina pectoris were included in the prospective study (2000–2006). Complex clinical examination, biochemical tests and blood tests were performed. Whole-blood (WB) viscosity, erythrocyte aggregation and deformation ability, WB suspension stability, and initial erythrocytes disaggregation parameter were studied. Dynamic characteristics of blood flow were obtained in the experiment.Received results allow marking the principle components of blood flow pattern with proven high prognostic value of ACE in patients with ischemic heart disease. ACE risk stratification program was developed.     

血清同型半胱氨酸浓度与冠心病相互关系的研究

目的探讨血清同型半胱氨酸（HCY）对冠状动脉粥样硬化性心脏病（CHD）的发生、发展、治疗及预后的影响。方法利用高效液相色谱（HPLC）法检测了30例受试对象血清中的HCY(CHD20例,正常对照组10例)。结果CHD组和对照组的血清总HCY水平分别为（16.50±7.90）μmol/L和（7.52±4.00）μmol/L,CHD患者的血清HCY水平明显高于正常对照组,有显著差异（P<0.01）。结论高同型半胱氨酸血症是CHD的独立风险因素。     

血清胆红素与冠心病关系探讨

目的对56例冠心病患者和60例健康人血清胆红素进行检测,旨在探讨血清胆红素与冠心病的关系.方法采用上海长征试剂于全自动生化分析仪上检测健康对照组与冠心病患者的血清胆红素和血脂,采用统计学t检验计算两组P值.结果冠心病组血清总胆红素及间接胆红素极显著低于正常对照组(P＜0.01),直接胆红素在两组亦有显著差异(P＜0.05).结论血清胆红素的浓度降低与冠心病存在一定的相关性.     

Lowering blood cholesterol to reduce coronary heart disease risk

Key recent findings provide definitive evidence that lowering blood cholesterol in humans reduces coronary heart disease risk. These research advances serve as the basis for national guidelines concerning the medical and public health implications of lowering blood cholesterol to prevent heart disease.     

冠心病与ABO血型的相关性研究

目的 研究冠心病(CHD)与ABO血型分布的关系.方法 选择我院2006-2010年冠心病患者3831例,采用血型群体分布方法,按年龄、性别等分组,进行ABO血型相关性分布的统计分析.结果 ASO血型分布在冠心病患者和对照组中存在显著性差异:A型x2=0.31(P>0.05),B型x2=15.72(P<0.01),O型x2=37.48(P<0.01),AB型x2=9.10(P<0.01),且其RR值分别为1.01、1.10、0.86、1.16.结论 冠心病患者与普通人群ABO血型分布存在显著性差异,其中B型和AB型为冠心病的危险因子,O型为冠心病保护因子.     

冠脉介入对冠心病患者血流及炎症因子的影响

目的观察和分析经皮冠状动脉介入(PCI)干预后冠状动脉血流及基质金属蛋白酶-9(MMP-9)、白细胞介素-6(IL-6)等炎症因子水平的变化。方法选取46例择期行PCI术的急性冠脉综合征(ACS)患者作为PCI组,选取22例行常规冠状动脉造影检查的患者作为CA组,对两组患者术前、术后外周血标本中以及PCI患者术中病变局部血标本中的MMP-9、IL-6水平和术后冠状动脉的校正的TIMI计帧数(c TFC)进行检测和比较。结果 PCI组患者使用造影剂量和术后c TFC均显著高于CA组(P0.05);PCI组患者术后外周血标本IL-6水平较术前显著升高(P0.05)且显著高于CA组(P0.05),PCI组患者术中病变局部血标本IL-6水平显著高于术前或术后的外周血标本(P0.05);PCI组患者的术中病变局部血标本的IL-6水平(r=0.589)、术中局部血标本与术前外周血标本MMP-9水平的差值(r=0.372)和术中局部血标本与术前外周血标本IL-6水平的差值(r=0.628)与患者的c TFC呈正相关(P0.05)。结论 PCI术可显著改善ACS患者的冠脉血流,局部PCI操作、血流再灌注等因素可引起病变局部血清炎症因子水平的上升,其变化幅度较外周血更加显著。     

肺静脉血流图鉴别二尖瓣血流图伪正常化的价值

目的 探讨肺静脉血流图鉴别二尖瓣血流图伪正常化的价值。方法 同时采用二尖瓣血流图和肺静脉血流图指标对41例正常人和91例冠心病患者左室舒张功能进行监测。结果 心肌梗死组二尖瓣血流图各指标正常,而肺静脉血流图异常,表现为心房收缩期肺静脉逆流峰A峰时限（AETp )延长,AETp与二尖瓣A峰时限（AET）之差＞0,与正常组比较差异有显著性意义;心绞痛组二尖瓣血流图和肺静血流图检测指标均异常,表现为E峰与A峰速度时间积分比值（EVTI／AVTI）降低,E峰与A峰最大流速比值（E／A）＜1,AETp延长,AETp－AET＜0,与正常组比较差异有显著性意义。结论 肺静脉血流图能鉴别二尖瓣血流图伪正常化：两指标联合应用可准确反映左室舒张功能受损的不同阶段。     

冠心病患者血小板膜糖蛋白CD_(62)P表达和血粘度的临床研究

目的　探讨血小板膜糖蛋白CD62 P表达及血粘度与冠心病的关系。方法　利用流式细胞仪和单克隆抗体技术测定 82例冠心病患者 (稳定型心绞痛 2 6例A组 ;不稳定型心绞痛 2 8例B组 ;急性心肌梗死2 8例C组和 2 8例健康人D组 )的CD62 P活性及血液流变学指标。结果　A组、B组、C组和D组的CD62 P阳性表达率分别为 3 6 2± 1 2 4 %、5 2 6± 1 4 9%、6 0 8± 1 75 %和 2 4 6± 0 81%。A组、B组和C组与健康人D组比较 ,差异均有显著意义 (P值均 <0 0 5 )。以上各组的血浆粘度分别为 1 31± 0 30、1 6 4± 0 2 2、2 19±0 35及 1 30± 0 18。B组、C组与对照组相比差异均有显著意义 (P值均 <0 0 5 ) ,CD62 P与血浆粘度和纤维蛋白原浓度呈正相关 (r =0 872 ,P <0 0 5 ;r =0 793,P <0 0 5 )。结论　CD62 P及血浆粘度均可能成为判断冠心病患者病情进展程度的良好指标     

Impact of photo hemotherapy on blood lipid composition in coronary heart disease

The serum lipid composition (total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and triglycerides) was studied in 47 patients with coronary heart disease (CHD) (Functional Classes II-IV) treated in the inpatient setting. A significant increase in the above parameters was found in 87% of the patients. During drug treatment, 28 patients received a course of photo hemotherapy (PHT), their blood was irradiated with blue light (Group 1). In another group, including 9 patients (Group 2), their blood underwent ultraviolet irradiation (UVI). A control group comprising 10 individuals received only drug treatment. In Group 1, there was a significant decrease in the levels of TC and LDL and an increase in the content of HDL. In Group 2, only the level of LDL decreased.     

Women and coronary heart disease

Coronary heart disease (CHD) is the leading cause of death in men and women in the United States. The incidence of CHD during midlife is lower in women than men, but the gap narrows with each decade. Because women have a longer life span than men, the absolute numbers of CHD deaths are roughly equal. Effective diagnosis of CHD in women requires the recognition of gender differences in presentation and pathogenesis. Women present with atypical symptoms and are less likely to have adequate primary prevention. This article discusses the differences between men and women in CHD and examines the assessment, diagnosis, and clinical management of CHD in women.     

冠心病与 ABO 血型关系研究的 Meta 分析

目的：系统评价冠心病与 ABO 血型分布的关系。方法计算机检索 Cochrane Library、PubMed、万方数据库、中国学术期刊数据库(CNKI)、中国生物医学文献数据库(CBM)至2014年1月31日,收集冠心病与 ABO 血型关系的病例对照研究及队列研究,按纳入和排除标准由2名评价者独立选择试验、提取资料,交叉核对并进行方法学质量评估后,使用 RevMan 5.2软件进行 Meta 分析。结果纳入17项研究,冠心病患者15988例。Meta 分析结果显示：①与对照组比较,冠心病患者中 A 血型的比例升高(OR =1.27,95% CI =1.09~1.48,P <0.01),O 血型的比例降低(OR =0.79,95% CI =0.68~0.91,P <0.01),B 血型(OR =1.04,95% CI =0.93~1.16,P >0.05)与AB 血型(OR =0.88,95% CI =0.70~1.09,P >0.05)比较差异无统计学意义;②与对照组比较,心肌梗死(MI)组O 血型的比例降低(OR =0.63,95% CI =0.45~0.86,P <0.01)。两组 A、B、AB 血型 MI 分布比较差异无统计学意义。结论 A 血型人群患冠心病的风险增加,而 O 血型则为冠心病与 MI 发病的保护因子。B 血型及 AB 血型与冠心病及 MI 的发病均无明显相关性。