Effect of verapamil on splanchnic haemodynamics in a portal hypertensive rat model

To elucidate the effects of verapamil on splanchnic haemodynamics in rats with portal hypertension, verapamil was given at a low dose (0.2 mg/kg) and a high dose (2 mg/kg) to the rat model after portal vein ligation. Approximately 10% decrease in arterial pressure was caused by the low dose of verapamil, with significant decreases in cardiac output and portal venous inflow as well as reduced portal pressure; these were all indicative of a rise in portal vascular resistance. In contrast, the marked fall in both arterial pressure and cardiac output in the high dose, accompanied by a significant decrease in the portal pressure and the unchanged portal venous inflow, suggested a reduction in portal vascular resistance. This study shows that the acute effects of verapamil on portal hypertension may vary with the dosage used. These results also demonstrate that, since the therapeutic efficacy and safety of verapamil is only in a very limited range of dose, caution should be taken in its clinical use in the treatment of cirrhosis with portal hypertension.     

Total paracentesis in non-alcoholic cirrhotics with massive ascites: Mid-term effects on systemic and hepatic haemodynamics and renal function

Single total paracentesis (4.8–11 L) was performed in 23 patients with hepatitis B surface antigen (HBsAg)-positive cirrhosis and massive ascites and its effects on systemic and hepatic haemodynamics and renal function were examined over 5 days. Severe hypotension occurred in six (26.1%) patients from 6 to 54 h after paracentesis. In the remaining 17 patients, compared to the baseline, there was an increase in the cardiac output (6.1 ± 0.3 vs 6.7 ± 0.3 L/min, P <0.001) and a decrease in right atrial pressure (8.8 ± 0.8 vs 4.3 ± 0.7 mmHg, P <0.001), systemic vascular resistance (1160 ± 61 vs 976 ± 50 dyne·s·cm ^?5, P <0.001), and wedged hepatic venous pressure 30 min after completion of paracentesis. After 5 days, right atrial pressure, systemic vascular resistance and wedged hepatic venous pressure returned to baseline, while the cardiac output dropped to a level lower than the baseline (5.7 ± 0.7 L/min, P<0.05). Hepatic venous pressure gradient had returned to baseline after 5 days. Serial tests of serum creatinine level showed an increase from day 3 (1.34 ± 0.14 vs 1.04 ± 0.10 mg/dL, P <0.05). On day 5, creatinine clearance (55.7 ± 5.4 vs 41.9 ± 5.3 mL/min, P <0.05) and effective renal plasma flow (351 ± 32 vs 293 ± 29 mL/min, P <0.05) were decreased, compared to the baseline. Based on these data, infusion of a volume expander may be necessary for total paracentesis to avoid systemic haemodynamic complications in non-alcoholic cirrhosis.     

甾体激素 Ⅲ.海可吉宁醋酸酯的脱氢及有关合成

研究了应用“分散的二氧化硒”在含吡啶的氯苯中作用于海可吉宁醋酸酯(Ⅰ)以制备9(11)-脫氫海可吉宁醋酸酯(Ⅱ)的方便方法,收率达到75—8.9%理論。并用(Ⅱ)制得5α-孕甾-9(11),16-二烯-3β-醇-20-酮醋酸酯,作为甾体激素合成的中間体。     

白花蛇舌草的化学成分研究Ⅰ.

自茜草科(Rubiaceae)植物白花蛇舌草[Oldenlandia diffusa(Willd.)Roxb.]的乙醇提出物中分得七个結晶性物貭,其中四个是根据熔点、紅外光譜、衍生物等性貭,分別証明为三十一烷、豆甾醇、烏索酸、土当归酸;另外三个結晶的熔点分別为138—139℃,167—168℃,211—212℃(分解),尚在鉴定中。     

The Impact of Age on the Electroanatomical Characteristics and Outcome of Catheter Ablation in Patients with Atrial Fibrillation

Age and Atrial Fibrillation. Background: Previous studies have indicated that atrial fibrillation (AF) in patients over the age of 60 at diagnosis is a risk factor for a substantial increase in cardiovascular events. However, information about the impact of age on the atrial substrate and clinical outcome after catheter ablation of AF is limited. Methods: This study included 350 patients (53 ± 12 years, 254 males) who underwent circumferential pulmonary vein isolation (CPVI) of AF, guided by a NavX mapping system. The subjects were divided into three groups according to their age, as follows: Group I: age ≤50 (n = 141), Group II: age = 51–64 (n = 149) and Group III: age ≥65 years old (n = 60). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system before ablation. Several parameters, including the gender, AF duration, and left atrial (LA) diameter were analyzed. Results: The younger age group had a significantly smaller LA diameter (Group I vs Group II vs Group III, 36.89 ± 7.11 vs 39.16 ± 5.65 vs 40.77 ± 4.95 mm, P = 0.002) and higher LA bipolar voltage (2.09 ± 0.83 vs 1.73 ± 0.73 vs 1.86 ± 0.67 mV, respectively, P = 0.024), compared with the older AF patients. The LA bipolar voltage exhibited a significant reduction when the patients became older, however, that did not occur in the right atrium. The incidence of an AF recurrence was higher in the older age group than in the younger age groups. A subgroup of patients with lone AF was analyzed and age was found to be an independent predictor of the AF recurrence after receiving the first CPVI in the multivariable model (P < 0.05). Conclusions: Age has a significant impact on the LA substrate properties and outcome of the catheter ablation of AF. (J Cardiovasc Electrophysiol, Vol. 21, pp. 966‐972, September 2010)