BACKGROUND Individuals diagnosed with gastrointestinal tumors are at an increased risk of developing cardiovascular diseases.Among which,ventricular arrhythmia is a prevalent clinical concern.This suggests that ventri...BACKGROUND Individuals diagnosed with gastrointestinal tumors are at an increased risk of developing cardiovascular diseases.Among which,ventricular arrhythmia is a prevalent clinical concern.This suggests that ventricular arrhythmias may have predictive value in the prognosis of patients with gastrointestinal tumors.AIM To explore the prognostic value of ventricular arrhythmias in patients with gastrointestinal tumors receiving surgery.METHODS We retrospectively analyzed data from 130 patients undergoing gastrointestinal tumor resection.These patients were evaluated by a 24-h ambulatory electrocardiogram(ECG)at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2020.Additionally,41 general healthy age-matched and sexmatched controls were included.Patients were categorized into survival and non-survival groups.The primary endpoint was all-cause mortality,and secondary endpoints included major adverse cardiovascular events(MACEs).RESULTS Colorectal tumors comprised 90%of cases.Preoperative ambulatory ECG monitoring revealed that among the 130 patients with gastrointestinal tumors,100(76.92%)exhibited varying degrees of premature ventricular contractions(PVCs).Ten patients(7.69%)manifested non-sustained ventricular tachycardia(NSVT).The patients with gastrointestinal tumors exhibited higher PVCs compared to the healthy controls on both conventional ECG[27(21.3)vs 1(2.5),P=0.012]and 24-h ambulatory ECG[14(1.0,405)vs 1(0,6.5),P<0.001].Non-survivors had a higher PVC count than survivors[150.50(7.25,1690.50)vs 9(0,229.25),P=0.020].During the follow-up period,24 patients died and 11 patients experienced MACEs.Univariate analysis linked PVC>35/24 h to all-cause mortality,and NSVT was associated with MACE.However,neither PVC burden nor NSVT independently predicted outcomes according to multivariate analysis.CONCLUSION Patients with gastrointestinal tumors exhibited elevated PVCs.PVCs>35/24 h and NSVT detected by 24-h ambulatory ECG were prognostically significant but were not found to be independent predictors.展开更多
Background:Abnormal myocardial voltage-gated sodium channel 1.5(Nav1.5)expression and function cause lethal ventricular arrhythmias during myocardial ischemia–reperfusion(I/R).Protein inhibitor of activated STAT Y(PI...Background:Abnormal myocardial voltage-gated sodium channel 1.5(Nav1.5)expression and function cause lethal ventricular arrhythmias during myocardial ischemia–reperfusion(I/R).Protein inhibitor of activated STAT Y(PIASy)-mediated caveolin-3(Cav-3)small ubiquitin-related modifier(SUMO)modification affects Cav-3 binding to the Nav1.5.PIASy activity is increased after myocardial I/R,but it is unclear whether this is attributable to plasma membrane Nav1.5 downregulation and ventricular arrhythmias.Methods:Using recombinant adeno-associated virus subtype 9(AAV9),rat cardiac PIASy was silenced using intraventricular injection of PIASy short hairpin RNA(shRNA).After two weeks,rat hearts were subjected to I/R and electrocardiography was performed to assess malignant arrhythmias.Tissues from peri-infarct areas of the left ventricle were collected for molecular biological measurements.Results:PIASy was upregulated by I/R(P<0.01),with increased SUMO2/3 modification of Cav-3 and reduced membrane Nav1.5 density(P<0.01).AAV9-PIASy shRNA intraventricular injection into the rat heart down-regulated PIASy after I/R,at both mRNA and protein levels(P<0.05 vs.Scramble-shRNA+I/R group),decreased SUMO-modified Cav-3 levels,enhanced Cav-3 binding to Nav1.5,and prevented I/R-induced decrease of Nav1.5 and Cav-3co-localization in the intercalated disc and lateral membrane.PIASy silencing in rat hearts reduced I/R-induced fatal arrhythmias,which was reflected by a modest decrease in the duration of ventricular fibrillation(VF;P<0.05 vs.Scramble-shRNA+I/R group)and a significantly reduced arrhythmia score(P<0.01 vs.Scramble-shRNA+I/R group).The anti-arrhythmic effects of PIASy silencing were also evidenced by decreased episodes of ventricular tachycardia(VT),sustained VT and VF,especially at the time 5–10 min after ischemia(P<0.05 vs.Scramble-shRNA+IR group).Using in vitro human embryonic kidney 293 T(HEK293T)cells and isolated adult rat cardiomyocyte models exposed to hypoxia/reoxygenation(H/R),we confirmed that increased PIASy promoted Cav-3 modification by SUMO2/3 and Nav1.5/Cav-3 dissociation after H/R.Mutation of SUMO consensus lysine sites in Cav-3(K38R or K144R)altered the membrane expression levels of Nav1.5 and Cav-3 before and after H/R in HEK293T cells.Conclusions:I/R-induced cardiac PIASy activation increased Cav-3 SUMOylation by SUMO2/3 and dysregulated Nav1.5-related ventricular arrhythmias.Cardiac-targeted PIASy silencing mediated Cav-3 deSUMOylation and partially prevented I/R-induced Nav1.5 downregulation in the plasma membrane of cardiomyocytes,and subsequent ventricular arrhythmias in rats.PIASy was identified as a potential therapeutic target for life-threatening arrhythmias in patients with ischemic heart diseases.展开更多
Patientcharacteristics Patients in this study consisted of eight consecutive patients with frequent premature ventricular complexes(PVCs) or both PVCs and ventricular tachycardia(VT)who had been referred for catheter ...Patientcharacteristics Patients in this study consisted of eight consecutive patients with frequent premature ventricular complexes(PVCs) or both PVCs and ventricular tachycardia(VT)who had been referred for catheter ablation and whose arrhythmia was mapped to one of the right ventricular(RV)papillary muscles(PAPs).The control group consisted of 10 consecutive patients who were referred for ablation of symptomatic idiopathic展开更多
Objective:To explore and analyze the clinical effect of low-dose Betaloc combined with amiodarone in treating ventricular arrhythmia.Methods:70 patients with ventricular arrhythmia who were admitted to the Department ...Objective:To explore and analyze the clinical effect of low-dose Betaloc combined with amiodarone in treating ventricular arrhythmia.Methods:70 patients with ventricular arrhythmia who were admitted to the Department of Cardiology of our hospital between August 2022 and August 2023 were selected as research subjects.They were divided into two groups using the coin-tossing method:the combination group(n=35)and the reference group(n=35).The combination group was treated with low-dose Betaloc and amiodarone,and the control group was treated with low-dose Betaloc alone.The treatment efficacy,cardiac function indicators,and related tested indicators of the two groups were compared.Results:The total efficacy of the treatment received by the combination group was much higher than that of the control group(P<0.05).Besides,after treatment,the cardiac function indicators such as left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),and cardiac index(CI)of the patients in the combination group were significantly better than those of the reference group(P<0.05).Furthermore,the high-sensitivity C-reactive protein(Hs-CRP),N-terminal prohormone of brain natriuretic peptide(NT-proBNP),adiponectin(APN),and other related test indicators of the patients in the combination group were significantly better than those of the reference group(P<0.05).Conclusion:Low-dose Betaloc combined with amiodarone has a noticeable effect in treating ventricular arrhythmia and deserves to be widely promoted.展开更多
Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to i...Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to investigate the characteristics of the ablation of VAs and the factors influencing the long-term success rate in our center.Methods Totally,2751 consecutive patients(mean ages 44±15 years,male/female 58.6%/41.4%)with VAs underwent radiofrequency ablation in Guangdong Provincial People’s Hospital from 2013 to 2018 were analyzed.Baseline data were retrieved from the medical record system.Long-term follow-up data were obtained by telephone interview.We mainly recorded the patient’s last post-ablation holter,and the symptoms after ablation.Multivariable regressions were applied to assess the relationship between the long-term success rate and the influence factors.Results Through the baseline data of 2751 patients,we found that the acute success rate of ablation was 95.1%.The average follow-up time was 16±5 months(ranging from 1 to 80).In all,304 patients(11%)lost follow-up,while 2447 patients(89%)were successfully followed.The long-term success rate of ablation was 82.56%.By means of multivariable regression analyses,it was discovered that cardiovascular diseases,such as coronary heart disease(OR:0.568,95%CI:0.327-0.987),hypertension(OR:1.554,95%CI:1.100-2.198),were independently associated with the long-term success rate,as well as ablation approaches(OR:0.212,95%CI:0.082-0.550).Lower ablation success rates of the patients whose VAs were originated from some uncommon region,like left ventricular papillary muscle,Summit,etc.were observed.Conclusions Ablation approaches,concomitant cardiovascular diseases,and ablation targets were related to the long-term clinical outcome of VAs ablation.展开更多
Objective:To explore and analyze the clinical effect of small and medium doses of Betaloc combined with amiodarone in the treatment of ventricular arrhythmia.Methods:60 patients with ventricular arrhythmia that were t...Objective:To explore and analyze the clinical effect of small and medium doses of Betaloc combined with amiodarone in the treatment of ventricular arrhythmia.Methods:60 patients with ventricular arrhythmia that were treated in the Department of Cardiology of our hospital from May 2018-May 2023 were selected for this study,and they were divided into a research group(n=30)and a reference group(n=30).The study group was treated with small doses of Betaloc and amiodarone,while the reference group was treated with conventional treatment.The total efficacy of medication,QRS interval,standard deviation of normal-to-normal(NN)intervals(SDNN),root mean square of successive differences between normal heartbeats(RMSSD),standard deviation of the average NN intervals(SDANN),and incidence of adverse reactions were compared between the groups.Results:The effectiveness of medication in the study group was significantly higher than that in the reference group(P<0.05).Besides,there was no statistically significant difference(P>0.05)in the QRS interval and SDNN between the two groups before treatment.After treatment,the QRS interval and SDNN of the study group were significantly lower than those of the reference group(P<0.05).Before treatment,there was no significant difference in RMSSD and SDANN between groups(P>0.05).After treatment,RMSSD and SDANN in the study group were significantly better than those in the reference group(P<0.05),and the difference was statistically significant.The incidence of adverse reactions in the study group was significantly lower than that in the reference group(P<0.05),and the difference was statistically significant.Conclusion:Small doses of Betoprolol and amiodarone is more effective in the treatment of ventricular arrhythmia,which has the value of popularization and application.展开更多
BACKGROUND: V entricular arrhythmia(VA) is one of the most common complications of myocardial infarction(MI), and ventricular tachycardia and fi brillation are the main causes for sudden cardiac death. This study aime...BACKGROUND: V entricular arrhythmia(VA) is one of the most common complications of myocardial infarction(MI), and ventricular tachycardia and fi brillation are the main causes for sudden cardiac death. This study aimed to explore the effect of ramipril on the occurrence of VA and its mechanism after MI in rabbits.METHODS: Twenty-four New Zealand rabbits purchased from the Wuhan Laboratory Animal Research Center were divided into three groups: sham-operated(SHAM) group(n=8), MI group(n=8) and MI with ramipril(RAM) group(n=8). Rabbits in the SHAM group received a median sternotomy without ligation of the left ventricular coronary artery. Rabbits in the MI and RAM groups received a median sternotomy followed by ligation of the left coronary artery. The successful anterior MI was confi rmed by elevation of the ST segment with more than 0.2 mV in lead II and III. After MI, rabbits in the RAM group were fed with intragastric ramipril(1 mg/kg per day) for 12 weeks. Before and 12 weeks after MI in the three groups, ventricular tachycardia or fi brillation(VT/VF) episodes and MAP in cadiocytes of the epicardium, mid-myocardium and endocardium were recorded by a multichannel physiograph. Student's t test and ANOVA were used for statistical analysis.RESULTS: VT/VF episodes were decreased more markedly in the RAM group than in the MI group after 12 weeks(2.6±0.8 vs. 12.4±2.9, P<0.05). Twelve weeks after MI, the duration of repolarization for 90%(APD90) of three-tier ventricular myocytes in the MI group was longer than that before MI(258.2±21.1 vs. 230.1±23.2, 278.0±23.8 vs. 245.8±25.4, 242.6±22.7 vs. 227.0±21.7, P<0.05). However, the APD90 was not signif icantly different at 12 weeks before and after MI in the RAM group(P>0.05). Moreover, the transmural dispersion of repolarization(TDR) was increased more markedly 12 weeks after MI in the MI group than in the SHAM and RAM groups(36.2±10.2 vs. 18.7±6.2, 24.9±8.7, P<0.05). But the TDR was not signifi cantly different between the RAM and SHAM groups(18.7±6.2 vs. 24.9±8.7, P>0.05).CONCLUSION: Ramipril may reduce the incidence of malignant ventricular arrhythmia via improvement of transmembrance repolarization heterogeneity after MI.展开更多
BACKGROUND:Calcium calmodulin-dependent kinase II(CaMKII) can be more active in patients with left ventricular hypertrophy(LVH),which in turn causes phosphorylation of ryanodine receptors,resulting in inactivation and...BACKGROUND:Calcium calmodulin-dependent kinase II(CaMKII) can be more active in patients with left ventricular hypertrophy(LVH),which in turn causes phosphorylation of ryanodine receptors,resulting in inactivation and the instability of intracellular calcium homeostasis.The present study aimed to determine the effect of CaMKII-ryanodine receptor pathway signaling in rabbits with left ventricular hypertrophy and triggered ventricular arrhythmia.METHODS:Forty New Zealand rabbits were randomized into four groups(10 per group):sham group,LVH group,KN-93 group(LVH+KN-93),and ryanodine group(LVH+ryanodine).Rabbits in the LVH,KN-93,and ryanodine groups were used to establish a left ventricular hypertrophy model by the coarctation of the abdominal aorta,while those in the sham group did not undergo the coarctation.After eight weeks,action potentials(APs) were recorded simultaneously in the endocardium and epicardium,and a transmural electrocardiogram(ECG) was also recorded in the rabbit left ventricular wedge model.Drugs were administered to the animals in the KN-93 and ryanodine groups,and the frequency of triggered APs and ventricular tachycardia was recorded after the rabbits were given isoprenaline(1 μmol/L) and high-frequency stimulation.RESULTS:The frequency(animals/group) of triggered APs was 0/10 in the sham group,10/10 in the LVH group,4/10 in the KN-93 group,and 1/10 in the ryanodine group.The frequencies of ventricular tachycardia were 0/10,9/10,3/10,and 1/10,respectively.The frequencies of polymorphic ventricular tachycardia or ventricular fibrillation were 0/10,7/10,2/10,and 1/10,respectively.The frequencies of triggered ventricular arrhythmias in the KN-93 and ryanodine groups were much lower than those in the LVH group(P<0.05).CONCLUSIONS:KN-93 and ryanodine can effectively reduce the occurrence of triggered ventricular arrhythmia in rabbits with LVH.The CaMKII-ryanodine signaling pathway can be used as a new means of treating ventricular arrhythmia.展开更多
<strong>Objective:</strong> To explore the predictive ability of Tp-ec, Q-Tc, Tp-e/Q-T and HRV on malignant arrhythmia during hospitalization. <strong>Method:</strong> 100 patients with maligna...<strong>Objective:</strong> To explore the predictive ability of Tp-ec, Q-Tc, Tp-e/Q-T and HRV on malignant arrhythmia during hospitalization. <strong>Method:</strong> 100 patients with malignant ventricular arrhythmia were included as the experimental group, another 100 patients without malignant ventricular arrhythmia were included as control group. The differences of Tp-ec, Q-Tc, Tp-e/Q-T and HRV were compared between the two groups. Multivariate logistic regression analysis was used to study variables and establish prediction model. ROC curve was used to evaluate the predictive ability and best predictive value of each index for malignant ventricular arrhythmia in hospital. <strong>Result:</strong> Compared with the control group, Tp-ec, Q-Tc, Tp-e/Q-T and HRV in the experimental group were significantly increased, (P < 0.001), HRV was decreased significantly. Multivariate logistic regression showed that the increase of Tp-ec, Q-Tc, Tp-e/Q-T and the decrease of HRV were the risk factors of malignant ventricular ventricular arrhythmia in hospital (OR = 11.169, 1.788, 1.001, 0.780), and bulid prediction model Z = -254.827 + 0.203 * Tp-ec + 0.581 * Q-Tc + 878.066 * Tp-e/Q-T-0.248 * SDNN. ROC curve showed that the area under the curve (AUC) of TP EC, Q-Tc, Tp-e/Q-T, HRV and predictive model for the diagnosis of malignant ventricular ventricular arrhythmia in hospital were 0.988, 0.905, 0.973, 0.901, 0.993, the best critical values were 100.365 ms, 447.078 ms, 0.239, 100.500, 181.792. <strong>Conclusion:</strong> The decrease of Tp-ec, Q-Tc, Tp-e/Q-T and HRV were the risk factors of malignant ventricular arrhythmia, and has predictive value for malignant ventricular arrhythmia in hospital. The prediction model combined with Tp-ec, Q-Tc, Tp-e/Q-T and HRV can improve the prediction ability of variables on malignant ventricular arrhythmia in hospital.展开更多
BACKGROUND Herbal medicine has a long history of use in the prevention and treatment of disease and is becoming increasingly popular globally.However,there are also widespread concerns about its safety.Among them,the ...BACKGROUND Herbal medicine has a long history of use in the prevention and treatment of disease and is becoming increasingly popular globally.However,there are also widespread concerns about its safety.Among them,the cardiotoxicity of aconitine has been described.CASE SUMMARY We report a case of a 61-year-old male with aconitine poisoning presenting with malignant arrhythmia and severe cardiogenic shock,which was successfully managed with aggressive advanced life support and heart transplantation.CONCLUSION This is the first case wherein in vivo cardiac pathology was obtained,confirming that aconitine caused acute myocardial necrosis.展开更多
Objective To evaluate the clinical significance of QT dispersion (QTd, QTcd) in dilated cardiomyopathy (DCM). Methods QTd and QTcd were measured on simultaneously recording 12 lead electrocardiograms (ECGs) in 60 DCM ...Objective To evaluate the clinical significance of QT dispersion (QTd, QTcd) in dilated cardiomyopathy (DCM). Methods QTd and QTcd were measured on simultaneously recording 12 lead electrocardiograms (ECGs) in 60 DCM patients and compared with 60 healthy subjects. Results The values of QTd and QTcd in DCM were significantly higher than those in control group (P<0 01). With subgroup analysis, QTd and QTcd in patients with cardiac sudden death (CSD) were longer than those in survivors and those died of progressive heart failure (P<0 05), patients with ventricular tachycardia (VT) or with severe heart failure than those without (compared with patients with ventricular premature beats [VPB], P<0 05, compared with patients without ventricular arrhythmia [VA], P<0 01) or with mild heart failure (P<0 01). The values of QTd and QTcd in patients with VPB were greater than those in patients without VA(P<0 05). There were significant differences in the rates of VT, CSD and heart failure between the groups of QTd>110 ms and QTd≤110 ms(P<0 01 or P<0 05), in contrast to ejection fraction(EF) and fractional shortening (FS)(P>0 05). Conclusion The values of QTd and QTcd increased in DCM patients were susceptive index for monitoring maligant VA in DCM, also important prognostic markers of CSD. QTd was correlated with NYHA functional class but not with EF and FS.展开更多
基金Supported by the Sixth Affiliated Hospital of Sun Yat-sen University Clinical Research-1010 Program,No.1010PY(2023)-06the National Nature Science Foundation of China,No.81400301+1 种基金the Fundamental Research Funds for the Central Universities,No.19ykpy10Guangzhou Health Science and Technology Project,No.20231A010068.
文摘BACKGROUND Individuals diagnosed with gastrointestinal tumors are at an increased risk of developing cardiovascular diseases.Among which,ventricular arrhythmia is a prevalent clinical concern.This suggests that ventricular arrhythmias may have predictive value in the prognosis of patients with gastrointestinal tumors.AIM To explore the prognostic value of ventricular arrhythmias in patients with gastrointestinal tumors receiving surgery.METHODS We retrospectively analyzed data from 130 patients undergoing gastrointestinal tumor resection.These patients were evaluated by a 24-h ambulatory electrocardiogram(ECG)at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2020.Additionally,41 general healthy age-matched and sexmatched controls were included.Patients were categorized into survival and non-survival groups.The primary endpoint was all-cause mortality,and secondary endpoints included major adverse cardiovascular events(MACEs).RESULTS Colorectal tumors comprised 90%of cases.Preoperative ambulatory ECG monitoring revealed that among the 130 patients with gastrointestinal tumors,100(76.92%)exhibited varying degrees of premature ventricular contractions(PVCs).Ten patients(7.69%)manifested non-sustained ventricular tachycardia(NSVT).The patients with gastrointestinal tumors exhibited higher PVCs compared to the healthy controls on both conventional ECG[27(21.3)vs 1(2.5),P=0.012]and 24-h ambulatory ECG[14(1.0,405)vs 1(0,6.5),P<0.001].Non-survivors had a higher PVC count than survivors[150.50(7.25,1690.50)vs 9(0,229.25),P=0.020].During the follow-up period,24 patients died and 11 patients experienced MACEs.Univariate analysis linked PVC>35/24 h to all-cause mortality,and NSVT was associated with MACE.However,neither PVC burden nor NSVT independently predicted outcomes according to multivariate analysis.CONCLUSION Patients with gastrointestinal tumors exhibited elevated PVCs.PVCs>35/24 h and NSVT detected by 24-h ambulatory ECG were prognostically significant but were not found to be independent predictors.
基金supported by grants from the National Natural Science Foundation of China(81770824,81270239)。
文摘Background:Abnormal myocardial voltage-gated sodium channel 1.5(Nav1.5)expression and function cause lethal ventricular arrhythmias during myocardial ischemia–reperfusion(I/R).Protein inhibitor of activated STAT Y(PIASy)-mediated caveolin-3(Cav-3)small ubiquitin-related modifier(SUMO)modification affects Cav-3 binding to the Nav1.5.PIASy activity is increased after myocardial I/R,but it is unclear whether this is attributable to plasma membrane Nav1.5 downregulation and ventricular arrhythmias.Methods:Using recombinant adeno-associated virus subtype 9(AAV9),rat cardiac PIASy was silenced using intraventricular injection of PIASy short hairpin RNA(shRNA).After two weeks,rat hearts were subjected to I/R and electrocardiography was performed to assess malignant arrhythmias.Tissues from peri-infarct areas of the left ventricle were collected for molecular biological measurements.Results:PIASy was upregulated by I/R(P<0.01),with increased SUMO2/3 modification of Cav-3 and reduced membrane Nav1.5 density(P<0.01).AAV9-PIASy shRNA intraventricular injection into the rat heart down-regulated PIASy after I/R,at both mRNA and protein levels(P<0.05 vs.Scramble-shRNA+I/R group),decreased SUMO-modified Cav-3 levels,enhanced Cav-3 binding to Nav1.5,and prevented I/R-induced decrease of Nav1.5 and Cav-3co-localization in the intercalated disc and lateral membrane.PIASy silencing in rat hearts reduced I/R-induced fatal arrhythmias,which was reflected by a modest decrease in the duration of ventricular fibrillation(VF;P<0.05 vs.Scramble-shRNA+I/R group)and a significantly reduced arrhythmia score(P<0.01 vs.Scramble-shRNA+I/R group).The anti-arrhythmic effects of PIASy silencing were also evidenced by decreased episodes of ventricular tachycardia(VT),sustained VT and VF,especially at the time 5–10 min after ischemia(P<0.05 vs.Scramble-shRNA+IR group).Using in vitro human embryonic kidney 293 T(HEK293T)cells and isolated adult rat cardiomyocyte models exposed to hypoxia/reoxygenation(H/R),we confirmed that increased PIASy promoted Cav-3 modification by SUMO2/3 and Nav1.5/Cav-3 dissociation after H/R.Mutation of SUMO consensus lysine sites in Cav-3(K38R or K144R)altered the membrane expression levels of Nav1.5 and Cav-3 before and after H/R in HEK293T cells.Conclusions:I/R-induced cardiac PIASy activation increased Cav-3 SUMOylation by SUMO2/3 and dysregulated Nav1.5-related ventricular arrhythmias.Cardiac-targeted PIASy silencing mediated Cav-3 deSUMOylation and partially prevented I/R-induced Nav1.5 downregulation in the plasma membrane of cardiomyocytes,and subsequent ventricular arrhythmias in rats.PIASy was identified as a potential therapeutic target for life-threatening arrhythmias in patients with ischemic heart diseases.
文摘Patientcharacteristics Patients in this study consisted of eight consecutive patients with frequent premature ventricular complexes(PVCs) or both PVCs and ventricular tachycardia(VT)who had been referred for catheter ablation and whose arrhythmia was mapped to one of the right ventricular(RV)papillary muscles(PAPs).The control group consisted of 10 consecutive patients who were referred for ablation of symptomatic idiopathic
文摘Objective:To explore and analyze the clinical effect of low-dose Betaloc combined with amiodarone in treating ventricular arrhythmia.Methods:70 patients with ventricular arrhythmia who were admitted to the Department of Cardiology of our hospital between August 2022 and August 2023 were selected as research subjects.They were divided into two groups using the coin-tossing method:the combination group(n=35)and the reference group(n=35).The combination group was treated with low-dose Betaloc and amiodarone,and the control group was treated with low-dose Betaloc alone.The treatment efficacy,cardiac function indicators,and related tested indicators of the two groups were compared.Results:The total efficacy of the treatment received by the combination group was much higher than that of the control group(P<0.05).Besides,after treatment,the cardiac function indicators such as left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),and cardiac index(CI)of the patients in the combination group were significantly better than those of the reference group(P<0.05).Furthermore,the high-sensitivity C-reactive protein(Hs-CRP),N-terminal prohormone of brain natriuretic peptide(NT-proBNP),adiponectin(APN),and other related test indicators of the patients in the combination group were significantly better than those of the reference group(P<0.05).Conclusion:Low-dose Betaloc combined with amiodarone has a noticeable effect in treating ventricular arrhythmia and deserves to be widely promoted.
文摘Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to investigate the characteristics of the ablation of VAs and the factors influencing the long-term success rate in our center.Methods Totally,2751 consecutive patients(mean ages 44±15 years,male/female 58.6%/41.4%)with VAs underwent radiofrequency ablation in Guangdong Provincial People’s Hospital from 2013 to 2018 were analyzed.Baseline data were retrieved from the medical record system.Long-term follow-up data were obtained by telephone interview.We mainly recorded the patient’s last post-ablation holter,and the symptoms after ablation.Multivariable regressions were applied to assess the relationship between the long-term success rate and the influence factors.Results Through the baseline data of 2751 patients,we found that the acute success rate of ablation was 95.1%.The average follow-up time was 16±5 months(ranging from 1 to 80).In all,304 patients(11%)lost follow-up,while 2447 patients(89%)were successfully followed.The long-term success rate of ablation was 82.56%.By means of multivariable regression analyses,it was discovered that cardiovascular diseases,such as coronary heart disease(OR:0.568,95%CI:0.327-0.987),hypertension(OR:1.554,95%CI:1.100-2.198),were independently associated with the long-term success rate,as well as ablation approaches(OR:0.212,95%CI:0.082-0.550).Lower ablation success rates of the patients whose VAs were originated from some uncommon region,like left ventricular papillary muscle,Summit,etc.were observed.Conclusions Ablation approaches,concomitant cardiovascular diseases,and ablation targets were related to the long-term clinical outcome of VAs ablation.
文摘Objective:To explore and analyze the clinical effect of small and medium doses of Betaloc combined with amiodarone in the treatment of ventricular arrhythmia.Methods:60 patients with ventricular arrhythmia that were treated in the Department of Cardiology of our hospital from May 2018-May 2023 were selected for this study,and they were divided into a research group(n=30)and a reference group(n=30).The study group was treated with small doses of Betaloc and amiodarone,while the reference group was treated with conventional treatment.The total efficacy of medication,QRS interval,standard deviation of normal-to-normal(NN)intervals(SDNN),root mean square of successive differences between normal heartbeats(RMSSD),standard deviation of the average NN intervals(SDANN),and incidence of adverse reactions were compared between the groups.Results:The effectiveness of medication in the study group was significantly higher than that in the reference group(P<0.05).Besides,there was no statistically significant difference(P>0.05)in the QRS interval and SDNN between the two groups before treatment.After treatment,the QRS interval and SDNN of the study group were significantly lower than those of the reference group(P<0.05).Before treatment,there was no significant difference in RMSSD and SDANN between groups(P>0.05).After treatment,RMSSD and SDANN in the study group were significantly better than those in the reference group(P<0.05),and the difference was statistically significant.The incidence of adverse reactions in the study group was significantly lower than that in the reference group(P<0.05),and the difference was statistically significant.Conclusion:Small doses of Betoprolol and amiodarone is more effective in the treatment of ventricular arrhythmia,which has the value of popularization and application.
基金supported by a grant from the Natural Science Foundation of Hubei(2007ABA288)
文摘BACKGROUND: V entricular arrhythmia(VA) is one of the most common complications of myocardial infarction(MI), and ventricular tachycardia and fi brillation are the main causes for sudden cardiac death. This study aimed to explore the effect of ramipril on the occurrence of VA and its mechanism after MI in rabbits.METHODS: Twenty-four New Zealand rabbits purchased from the Wuhan Laboratory Animal Research Center were divided into three groups: sham-operated(SHAM) group(n=8), MI group(n=8) and MI with ramipril(RAM) group(n=8). Rabbits in the SHAM group received a median sternotomy without ligation of the left ventricular coronary artery. Rabbits in the MI and RAM groups received a median sternotomy followed by ligation of the left coronary artery. The successful anterior MI was confi rmed by elevation of the ST segment with more than 0.2 mV in lead II and III. After MI, rabbits in the RAM group were fed with intragastric ramipril(1 mg/kg per day) for 12 weeks. Before and 12 weeks after MI in the three groups, ventricular tachycardia or fi brillation(VT/VF) episodes and MAP in cadiocytes of the epicardium, mid-myocardium and endocardium were recorded by a multichannel physiograph. Student's t test and ANOVA were used for statistical analysis.RESULTS: VT/VF episodes were decreased more markedly in the RAM group than in the MI group after 12 weeks(2.6±0.8 vs. 12.4±2.9, P<0.05). Twelve weeks after MI, the duration of repolarization for 90%(APD90) of three-tier ventricular myocytes in the MI group was longer than that before MI(258.2±21.1 vs. 230.1±23.2, 278.0±23.8 vs. 245.8±25.4, 242.6±22.7 vs. 227.0±21.7, P<0.05). However, the APD90 was not signif icantly different at 12 weeks before and after MI in the RAM group(P>0.05). Moreover, the transmural dispersion of repolarization(TDR) was increased more markedly 12 weeks after MI in the MI group than in the SHAM and RAM groups(36.2±10.2 vs. 18.7±6.2, 24.9±8.7, P<0.05). But the TDR was not signifi cantly different between the RAM and SHAM groups(18.7±6.2 vs. 24.9±8.7, P>0.05).CONCLUSION: Ramipril may reduce the incidence of malignant ventricular arrhythmia via improvement of transmembrance repolarization heterogeneity after MI.
基金supported by a grant from Surface Project of Natural Science Foundation of Fujian Province(2008J0075)
文摘BACKGROUND:Calcium calmodulin-dependent kinase II(CaMKII) can be more active in patients with left ventricular hypertrophy(LVH),which in turn causes phosphorylation of ryanodine receptors,resulting in inactivation and the instability of intracellular calcium homeostasis.The present study aimed to determine the effect of CaMKII-ryanodine receptor pathway signaling in rabbits with left ventricular hypertrophy and triggered ventricular arrhythmia.METHODS:Forty New Zealand rabbits were randomized into four groups(10 per group):sham group,LVH group,KN-93 group(LVH+KN-93),and ryanodine group(LVH+ryanodine).Rabbits in the LVH,KN-93,and ryanodine groups were used to establish a left ventricular hypertrophy model by the coarctation of the abdominal aorta,while those in the sham group did not undergo the coarctation.After eight weeks,action potentials(APs) were recorded simultaneously in the endocardium and epicardium,and a transmural electrocardiogram(ECG) was also recorded in the rabbit left ventricular wedge model.Drugs were administered to the animals in the KN-93 and ryanodine groups,and the frequency of triggered APs and ventricular tachycardia was recorded after the rabbits were given isoprenaline(1 μmol/L) and high-frequency stimulation.RESULTS:The frequency(animals/group) of triggered APs was 0/10 in the sham group,10/10 in the LVH group,4/10 in the KN-93 group,and 1/10 in the ryanodine group.The frequencies of ventricular tachycardia were 0/10,9/10,3/10,and 1/10,respectively.The frequencies of polymorphic ventricular tachycardia or ventricular fibrillation were 0/10,7/10,2/10,and 1/10,respectively.The frequencies of triggered ventricular arrhythmias in the KN-93 and ryanodine groups were much lower than those in the LVH group(P<0.05).CONCLUSIONS:KN-93 and ryanodine can effectively reduce the occurrence of triggered ventricular arrhythmia in rabbits with LVH.The CaMKII-ryanodine signaling pathway can be used as a new means of treating ventricular arrhythmia.
文摘<strong>Objective:</strong> To explore the predictive ability of Tp-ec, Q-Tc, Tp-e/Q-T and HRV on malignant arrhythmia during hospitalization. <strong>Method:</strong> 100 patients with malignant ventricular arrhythmia were included as the experimental group, another 100 patients without malignant ventricular arrhythmia were included as control group. The differences of Tp-ec, Q-Tc, Tp-e/Q-T and HRV were compared between the two groups. Multivariate logistic regression analysis was used to study variables and establish prediction model. ROC curve was used to evaluate the predictive ability and best predictive value of each index for malignant ventricular arrhythmia in hospital. <strong>Result:</strong> Compared with the control group, Tp-ec, Q-Tc, Tp-e/Q-T and HRV in the experimental group were significantly increased, (P < 0.001), HRV was decreased significantly. Multivariate logistic regression showed that the increase of Tp-ec, Q-Tc, Tp-e/Q-T and the decrease of HRV were the risk factors of malignant ventricular ventricular arrhythmia in hospital (OR = 11.169, 1.788, 1.001, 0.780), and bulid prediction model Z = -254.827 + 0.203 * Tp-ec + 0.581 * Q-Tc + 878.066 * Tp-e/Q-T-0.248 * SDNN. ROC curve showed that the area under the curve (AUC) of TP EC, Q-Tc, Tp-e/Q-T, HRV and predictive model for the diagnosis of malignant ventricular ventricular arrhythmia in hospital were 0.988, 0.905, 0.973, 0.901, 0.993, the best critical values were 100.365 ms, 447.078 ms, 0.239, 100.500, 181.792. <strong>Conclusion:</strong> The decrease of Tp-ec, Q-Tc, Tp-e/Q-T and HRV were the risk factors of malignant ventricular arrhythmia, and has predictive value for malignant ventricular arrhythmia in hospital. The prediction model combined with Tp-ec, Q-Tc, Tp-e/Q-T and HRV can improve the prediction ability of variables on malignant ventricular arrhythmia in hospital.
基金Supported by Dongguan Science and Technology of Social Development Program,No.202050715001213.
文摘BACKGROUND Herbal medicine has a long history of use in the prevention and treatment of disease and is becoming increasingly popular globally.However,there are also widespread concerns about its safety.Among them,the cardiotoxicity of aconitine has been described.CASE SUMMARY We report a case of a 61-year-old male with aconitine poisoning presenting with malignant arrhythmia and severe cardiogenic shock,which was successfully managed with aggressive advanced life support and heart transplantation.CONCLUSION This is the first case wherein in vivo cardiac pathology was obtained,confirming that aconitine caused acute myocardial necrosis.
文摘Objective To evaluate the clinical significance of QT dispersion (QTd, QTcd) in dilated cardiomyopathy (DCM). Methods QTd and QTcd were measured on simultaneously recording 12 lead electrocardiograms (ECGs) in 60 DCM patients and compared with 60 healthy subjects. Results The values of QTd and QTcd in DCM were significantly higher than those in control group (P<0 01). With subgroup analysis, QTd and QTcd in patients with cardiac sudden death (CSD) were longer than those in survivors and those died of progressive heart failure (P<0 05), patients with ventricular tachycardia (VT) or with severe heart failure than those without (compared with patients with ventricular premature beats [VPB], P<0 05, compared with patients without ventricular arrhythmia [VA], P<0 01) or with mild heart failure (P<0 01). The values of QTd and QTcd in patients with VPB were greater than those in patients without VA(P<0 05). There were significant differences in the rates of VT, CSD and heart failure between the groups of QTd>110 ms and QTd≤110 ms(P<0 01 or P<0 05), in contrast to ejection fraction(EF) and fractional shortening (FS)(P>0 05). Conclusion The values of QTd and QTcd increased in DCM patients were susceptive index for monitoring maligant VA in DCM, also important prognostic markers of CSD. QTd was correlated with NYHA functional class but not with EF and FS.
