Objective To analyze risk factors of acute ST-segment elevation myocardial infarction (STEMI) in young and middle-aged women.Methods Fifty women(18-50 years old) with acute STEMI from January 2014 to January 2015 in Beijing Anzhen Hospital,Capital Medical University were enrolled as observation group.One hundred and fifty same age healthy women were enrolled as control group.Age,blood pressure,heart rate,hypertension history,diabetes history,hyperlipidemia history,smoking history,serum levels of uric acid,total cholesterol,triacylglycerol,low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol(HDL-C) were analyzed.Results Heart rate,serum uric acid and triacylglycerol in observation group were significantly higher than those in control group [(75 ± 12)times/min vs (69 ± 11)times/rin,300(256,380) mmol/L vs 268(221,302) mmol/L,1.5 (1.1,2.0) mmol/L vs 1.3 (0.8,1.7) mmol/L] (P ＜ 0.05),HDL-C in observation group was significantly lower than that in control group[(1.01 ± 0.21) mmol/L vs (1.16 ± 0.26) mmol/L] (P ＜ 0.05);histories of hypertension,diabetes,hyperlipidemia in observation group were significantly higher than those in control group[54.0％ (27/50) vs 36.7％ (55/150),34.0％ (17/50) vs 8.7％ (13/150),70.0％ (35/50) vs 53.3％ (80/150)] (P ＜ 0.05).Univariate logistic regression analysis showed that heart rate,histories of hypertension,diabetes,hyperlipidemia,serum uric acid and HDL-C were risk factors of acute STEMI (P ＜ 0.05).Multivariate logistic regression analysis showed that heart rate [odds ratio (OR) =1.043,95％ confidence interval (CI):1.004-1.084,P =0.029],history of diabetes (OR =3.342,95％ CI:1.340-8.338,P =0.010) and serum uric acid(OR =1.006,95％ CI:1.001-1.011,P =0.015) were independent risk factors of acute STEMI;HDL-C was an independent protective factor of acute STEMI (OR =0.114,95％ CI:0.016-0.807,P =0.030).Conclusions High heart rate,history of hypertension and high serum level of uric acid are independent risk factors of acute STEMI in young and middle-aged women;high serum level of HDL-C is an independent protective factor of acute STEMI.

目的:探讨导管室上游应用替罗非班对中高危非ST段抬高急性冠状动脉综合征(NSTACS)患者血运重建术后凝血纤溶系统的影响.方法:80例中高危NSTACS患者均择期接受冠状动脉介入术(PCI)治疗,分为上游组(PCI前应用替罗非班,n=38例)和下游组(PCI开始时应用替罗非班,n =42例),观察术前及术后24小时血浆凝血酶原时间(PT)、D二聚体、纤维蛋白原(FBG)和纤溶酶原激活物抑制物-1(PAI-1),观察两组靶血管血流灌注及院内、30天主要心血管不良事件和出血事件.结果:与基线水平比较,两组患者术后血清PAI-1水平均显著低于基线水平[上游组(11.8±3.2)vs.(9.7±2.7)ng/L,P=0.003;下游组(11.0±1.1) vs.(10.1 ±1.6)ng/L,P=0.020],上游组术后PAI-1水平显著低于下游组[(9.7±2.7)vs.(10.1 ±1.6)ng/L,P=0.039].两组术前术后PT、DD和FBG未见明显差异(P＞0.05),两组患者出血事件差异有统计学意义(P＞0.05).上游组术后靶血管TMPG分级＜3的比例明显低于下游组(P =0.023);两组患者院内和30天心血管不良事件未见有意义统计学差异(P＞0.05).结论:替罗非班可通过调节纤溶系统,改善接受PCI治疗的中高危NSTSCA患者血栓高负荷状态,部分改善靶血管的血流灌注,导管室上游应用效果或更显著,且未见明显增加出血事件.

Objective To observe the influence of preoperative tirofiban administration on the inflammatory reactions in patients with middle-high risk of non-ST-segment elevation acute coronary system (NSTEACS). Methods The patients (n=80 and aged from 18 to 75) planed to have percutaneous coronary intervention (PCI) were chosen from May 2009 to Jul. 2010, and divided into 2 groups. The pre-PCI group (n=38) was given tirofiban in loading dose (10 g/kg injected within 3 min) at first and (12±2) h before coronary angiography and then given intravenous drip of tirofiban (0.15 g/kg/min) for 24 h after PCI. The control group (n=42) was given tirofiban in loading dose (10 g/kg injected within 3 min) after guiding catheter placed and then given intravenous drip of tirofiban (0.15 g/kg/min) for 24 h after PCI. The incidence of major adverse cardiovascular events (MACE) was compared between 2 group during hospital stay and 30 d after discharge. The levels of high-sensitivity C-reactive protein (hs-CRP), soluble CD40 ligand (sCD40L), cardiac troponin I (cTnI) and creatine kinase MB (CK-MB) were detected befor and after PCI. Results In pre-PCI group, the levels of CK-MB, hs-CRP and sCDL40 decreased after PCI [(22.91±11.76) U/L vs. (14.69±15.72) U/L], [(16.50±7.76) mg/L vs. (10.91±13.16) mg/L], [(18.92± 8.90) g/L vs. (12.65±10.99) g/L, all P<0.05]. Compared with control group, sCDL40 decreased in pre-PCI group after PCI [(14.23±8.91) g/L vs. (12.65±10.99) g/L, P<0.05]. The difference in incidence of endpoint events had no statistical significance (P=0.860) between 2 groups. Conclusion The early administration of tirofiban before PCI can inhibit the inflammatory reactions and relieve acute myocardial impairment.

Objective To study the effect of tirofiban on endothelin function in non-ST elevation acute coronary syndrome(NSTACS)patients before PCI.Methods One hundred NSTACS patients who underwent PCI were divided into pre-PCI group(n=50)and pro-PCI group(n=50).Their vascular perfusion,major adverse cardiovascular events(MACE),serum ET-1and NO levels were recorded before and 24 hafter PCI.Results The TIMI myocardial perfusion grade(TMPG)3 was significantly higher in pre-PCI group than in pro-PCI group after PCI(P=0.037).The baseline serum ET-1level was significantly higher while the baseline serum NO level was significantly lower in pre-PCI group than in pro-PCI group after PCI(70.1±32.8μg/L vs55.9±29.5μg/L,P=0.028;47.8±23.9μmol/L vs 70.6±20.6μmol/L,P=0.035).The serum ET-1level was significantly lower while the serum NO level was significantly higher in pre-PCI group than in pro-PCI group after PCI(55.9±29.5μg/Lvs 63.7±47.7μg/L,P=0.044;70.6±20.6μmol/L vs 53.2±40.2μmol/L,P=0.038).No significant difference was found in MACE between the two groups after PCI(P0.05).Conclusion Tirofiban improves myocardial perfusion by protecting the endothelial function but does not reduce the early MACE in NSTACS patients after PCI.

Objective To analyze the clinical effect of upstream application of tirofiban in patients with moderate-high risk non-ST acute coronary syndrome (NSTACS).Methods Totally 182 patients with NSTACS who received elective percutaneous coronary intervention(PCI) from May 2009 to July 2010 were randomly divided into observation group (80 cases) given upstream application of tirofiban (before PCI) and control group(102 cases) given tirofiban from the onset of PCI.The characteristics of coronary lesions,stenting implantation,flow perfusion of the culprit vessel (CV),creatine kinaseand cardiac troponin Ⅰ (cTNI) in serum,major adverse cardiovascular events (MACE) in hospital and 30 days after PCI,haemorrhage were observed and compared between the two groups.Results The access site,degree of stenosis,proportion of multivessel lesion,proportion of chronic occlusion lesion,proportion of long lesion (＞ 20 mm),proportion of bifurcation lesion,proportion of thrombotic lesion,stent number,stent diameter,stent length had no statistical differences between the two groups (P ＞ 0.05).The pre-and postoperative thrombolysis in myocardial infarction (TIMI) flow grade and preoperative TIMI myocardial perfusion grade (TMPG) showed no significantly differences between the two groups (P ＞ 0.05);the proportion of TMPG ＜ 3 in observation group was significantly lower than that of control group [6.2％ (5/80) vs 15.7％ (16/102)] (P ＜ 0.05).The level of serum creatine kinase and cTNI 48 h after operation were significantly decreased compared with those before operation in observation group[(5 ±4) U/L vs (21 ± 10) U/L,(0.8 ±0.4) μg/L vs (4.0 ± 1.7) μg/L] and control group [(9 ± 3) U/L vs (20 ± 11) U/L,(1.1 ± 0.9) μg/L vs (4.6 ± 1.8) μg/L],also being significantly different between the two groups (P ＜ 0.05).No MACE occurred in both groups.No significant difference of incidence of haemorrhage was found between the two groups (P ＞ 0.05);after stopping or reducing the dose of tirofiban,the haemorrhage symptom disappeared and no serious haemorrhage was observed.Conclusion Upstream using of tirofiban may improve myocardial perfusion of CV,without increasing the incidence of haemorrhage in patients with moderate-high risk NSTACS receiving PCI.

<正>患者男,57岁。主因劳力性胸闷、胸痛、气促10余年,加重1年余入院。患者于10余年前无明显诱因出现胸闷、胸痛、气促症状,以活动后症状明显,在当地医院就诊,以"冠心病"口服"冠心宁、欣康"等药物治疗,症状有所缓解。近1年来停药后症状复发,且发作次数频繁,伴有背痛、出汗,与活动无明显关系,安静状态下亦有发作,持续十余分钟可以自行缓解。有高血压病史1年余,血压最高达150/100mm

Objective To evaluate the long-term clinical outcomes after implacement of drug-eluting stent in patients with unprotected left main coronary artery(ULMCA) disease.Methods PCI with DES was performed in 211 consecutive patients with ULMCA disease between september 2006 and march 2010,with the long-term clinical outcomes studied.Results Of the 211 ULM patients,145(68.7%)were with unstable angina and 75.4% of the cases were with distal ULM,multivessel coronary disease were noticed in 151(71.6%) cases.Single stent was applied in 119(74.8%) for distal ULM patients.All patients were followed up for an average of(28.9±11.8) months.Major adverse cardiac or cerebrovascular events(MACCE) were seen in 38(18.0%) patients.There were 9(4.3%) cases of deaths,10(4.7%) of myocardial infarction(MI),23(10.9%) of target vessel revascularization,and 3(1.4%) of cerebrovascular events.MACCE occurrence rates were similar between distal and no-distal ULM patients(Log-rank P=0.62).No significant statistical differences existed in MACCE occurrence rate between single-stent and two-stent technology in treating distal ULM(Log-rank P=0.795).Compared with non-diabetic ULM patients,the rate of MACCE was significantly higher in ULM patients with complicated type-2 diabetes(Log-rank P=0.026).Conclusion The present study demonstrates that PCI with drug-eluting stent implacement is a safe and effective method in treatment of unprotected left main coronary artery disease.Diabetes mellitus is among the independent predictors of MACCE following coronary stenting in ULM patients.

BACKGROUND:The Syntax score was recently developed as a comprehensive, angiographic tool grading the complexity of coronary artery disease (CAD). It aims to assist in patient selection and risk stratification of patients with extensive CAD undergoing revascularization. However, the prognostic value of the Syntax score in patients undergoing percutaneous coronary intervention (PCI) has not been validated. The aim of this study was to evaluate its role in predicting long-term incidences of major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing PCI for 3-vessel disease.METHODS:Two hundred and three consecutive patients with de novo 3-vessel CAD undergoing PCI with sirolimus-eluting stents were studied. Their angiograms were scored according to the Syntax score. The patients were divided into tertiles according to the Syntax score: lowest Syntax score tertile (Syntax score ≤ 22), intermediate Syntax score tertile (Syntax score of 23 to 32), and the highest Syntax score tertile (Syntax score ≥ 33). During the 1-year follow-up, the MACCE-free survival curves were estimated by the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relation between the Syntax score and the incidence of MACCE. Performance of the Syntax score was studied with respect to predicting the rate of MACCE by receiver operator characteristic (ROC) curves with an area under the curve.RESULTS:The overall Syntax score ranged from 6 to 66 with mean ± standard deviation of 27.9 ± 12.6 and a median of 26. At 1 year, the Syntax score significantly predicted the risk of MACCE (HR 1.07/U increase, 95%CI 1.04 to 1.11, P < 0.001). The rate of MACCE was significantly increased among patients in the highest Syntax score tertile (17.9%) as compared with those with the lowest Syntax score tertile (1.4%, P < 0.001) or intermediate Syntax score tertile (6.2%, P = 0.041). After the adjustment for all potential confounders, the Syntax score remained a significant predictor of the rate of MACCE (adjusted HR 1.12/U increase, 95%CI 1.05 to 1.20, P < 0.001). The Syntax score accurately predicted MACCE with an area under the receiver operator curve of 0.77 (95%CI 0.65 to 0.90, P < 0.001). A Syntax score of 29.5 was identified as the optimal cutoff to predict MACCE with a sensitivity of 82.4% and specificity of 65.6%.CONCLUSION:The Syntax score predicts the risk of MACCE in patients with 3-vessel disease undergoing PCI.

Objective To evaluate the long-term clinical outcome after implanting drug-eluting stent in the aged with unprotected left main coronary artery(ULMCA)disease.Materials and Methods PCI with DES was performed in 211 patients having ULMCA disease,including 83 elderly patients and 128 young and middle-aged patients.The clinical characters and long-term follow-up were studied.Results There were higher Syntax Score,higher ratios of chronic total occlusion and multi-vessel disease in the aged ULMCA(P0.05).Major adverse cardiac or cerebrovascular events(MACCE)occurred in 21 aged patients and in 17 young and middle-aged patients(Log rank,P=0.034).No significant difference were found in the incidences death,myocardial infarction(MI)and target-vessel revascularization(TVR).Compared with non-diabetic ULM patients,the rate of MACCE was significantly higher in type-2 DM ULM patients(Log rank,P=0.037).Conclusion The ULM aged patients have more severe coronary lesion,PCI with Drug-Eluting stent implantation in the ULM aged patients is safe and feasible and has favorable outcomes.Diabetes mellitus is the independent predictor about MACCE following coronary stenting in the ULM aged patients.

Objective To observe the effects of type 2 diabetes mellitus (DM) on the long-term clinic outcomes in the unprotected left main artery(ULM) lesion patients after implanting drug-eluting stent. Methods The clinical characters of unprotected left main artery lesion patients combining type 2 diabetes mellitus were analyzed and to study the long-term clinical effects of DM on implanting drug-eluting stent in ULM lesion patients. Results Compared with none-DM group, the ULM lesion patients with DM(DM-ULM) group were older witth less male and higher rates of hypertension, stroke and SYNTAX score[(23.1 ± 10.2) vs (33.9 ± 14.6) ;P =0.010]. With Logrank analysis, compared with the control group, the DM-ULM group had higher incidence of major adverse cardiac or cerebrovascular events(MACCE) [20(16. 7%) vs 18(32.6%)], myocardial infarction (MI)[1 (0. 7%) vs 9(20.1%)] and hard end points [6(6. 5%) vs 13(26. 3%)] (P ＜0.05). There were no differences of targetvessel revascularization, death, stroke and cardiac death(P＞ 0.05) between the 2 groups. Conclusion DM is the independent predicting factor of long-term MACCE, MI and adverse clinical endpoints.

Objective To compare the clinical feature and revascularization status in the aged with different types of acute myocardial infarction.Methods The patients with acute myocardial infarction were ddivided into two groups:ST-elevation myocardial infarction(STEMI) group and non-ST-elevation myocardial infarction(NSTEMI) group.The clinical and coronary angiographic characteristics and revascularization status were compared.Results In the STEMI group,the proportion of males,rate of typical chest pain,peak value of CK and CK-MB were higher than those in NSTEMI group(P0.05);but in NSTEMI group,the patients were elder,the rates of hypertension, hyperlipemia and diabetes were higher(P0.05).Multi-vessel diseases of coronary artery, long stenotic lesion,≥90%severe stenosis of infarction-related artery(IRA),collateral circulation of IRA were more prevalent in the NSTEMI group(P0.05,P0.01).The rate of IRA total obstruction was significantly lower in the NSTEMI group than in the STEMI group(P0.01).During hospital stay,the rate of revascularization in the NSTEMI group was lower than that in STEMI group(P0.01),but the rate of MACCE was same between the two groups.Conclusion Compared with the aged with STEMI,the NSTEMI group has more clinical complications,more severe coronary lesions,less revascularization.

目的比较西罗莫司药物洗脱支架和金属裸支架治疗冠心病患者的远期安全性。方法选择北京安贞医院2000年1月至2004年8月置入金属裸支架的冠心病患者505例,与2004年1月至2005年1月置入西罗莫司洗脱支架的984例冠心病患者进行历史性对照分析,比较两组患者支架术后随访2年的死亡、支架内血栓、非致死性心肌梗死发生率。结果两组患者在合并吸烟、高血压、高血脂、糖尿病所占比例及冠状动脉病变支数方面差异均无统计学意义。西罗莫司洗脱支架组患者平均年龄较大、分叉病变比例高、置入支架平均直径小且平均支架长度较长。临床随访2年,两组患者生存率、支架内血栓、非致死性心肌梗死及死亡/非致死性心肌梗死发生率方面差异均无统计学意义（分别为99.3%、1.3%、1.1%、1.8%和98.3%、1.7%、1.7%、3.5%,P＞0.05）。结论西罗莫司洗脱支架和金属裸支架在冠心病患者中应用的远期安全性相似。

Objective To compare the long-term outcomes of complete and incomplete revascularization in patients with multivessel coronary disease(MVD).Methods Totally 540 consecutive MVD patients were enrolled in this study Among them 247 patients underwent complete revascularization(CR)and 293 underwent incomplete revascularization(IR).The long-term follow-up outcomes were analyzed.Results The number of mean lesion,the rates of triple vessel disease,left main artery lesion,chronic total obstruction,and bifurcation lesion,and the degree of lesions were significantly higher in IR group than in CR group.The rates of ejective fraction(EF)after percutaneous coronary intervention(PCI)were significantly lower and the rates of revascularization and major adverse cardiac events(MACE)were significantly higher in IR group than in CR group.Logistic regression analysis showed IR was the predictive factor of MACE and revascularization(P0.05),but not of long-term death or recurrent myocardial infarction.Conclusion Compared with IR,CR can achieve better long-term clinical outcome in MVD patients.Incomplete revascularization is the predictive factor of MACE and revascularization.

Objective To study the safety and efficacy of percutaneous coronary intervention(PCI) through radial artery and femoral artery approach in aged female patients with coronary heart disease. Methods Retrospective analysis of clinical data of 332 patients older than 75 years was done.The patients were divided into 2 groups:radial artery group and femoral artery group.Results Of the 332 patients,96 received PCI treatment.The rate of 3-vessel lesion was 39.7% and 47.4% and the rate of bifurcation lesion was 60.3% and 52.6% in radial artery group and femoral artery group respectively.Compared with radial artery group,the operation time was longer, peripheral vessel injury was significantly increased (P < 0.05),the postoperative observation time and bed-rest time were significantly prolonged,incidences of pseudoaneurysm and lower limb venous thrombosis were signifieantly increased,and incidence of punctured artery occlusion was significantly decreased (P < 0.05) in femoral artery group.Conclusions Radial approach PCI in senile women with coronary heart disease reduced the vascular complications in high-risk population. PCI improves the long-term survival rate of patients and can be done in the elderly with low mortality rate and acceptable long-term outcomes.

目的:评价高龄冠心病患者冠状动脉介入治疗的安全性和临床效果。方法:96例高龄冠心病患者,经冠状动脉造影检查冠状动脉狭窄≥75%而行支架植入术,观察生化指标,比较桡动脉、股动脉途径介入治疗的疗效。结果:高龄冠心病患者合并高血压、糖尿病比例分别为76.1%,39.6%。术后B型钠尿肽、花生四烯酸、二磷酸腺苷较术前改善(P<0.05)。冠状动脉造影显示桡动脉、股动脉入径组钙化病变、分叉病变比例分别为51.7%/60.3%,52.6%/52.6%,桡动脉入径组外周血管损伤较股动脉入径组低(6.89%∶23.7%)(P<0.01),手术时间、术后观察时间较股动脉入径组短(P<0.05或<0.01)。结论:高龄患者选择桡动脉介入术可减少局部血管并发症,冠状动脉血运重建术可显著提高老年患者远期生存率和生活质量,近期治疗风险小,病死率低。

AIM: To study the clinical characteristics and pathological changes in coronary artery in patients with recurrent myocardial ischemia after coronary artery bypass grafting(CABG).METHODS: Data were retrospectively reviewed in 247 patients who had recurrent myocardial ischemia after CABG and underwent percutaneous coronary intervention(PCI).Patients were divided into two groups: diabetes mellitus(DM) group and non-DM groups.RESULTS: The ratio of recurrent myocardial ischemia was higher and PBG and HbAl were significantly higher in DM group(P0.05).A significant difference was observed in blood vessel changes and types of PCI stent(P0.05).Long-term ratio of the AMI was higher in DM group(11.9%) compared with that in non-DM group(5.1%)(P0.05) and the revascularization rate was also higher in DM group(22.4%) than the rate(15.3%) in non-DM group(P0.05).CONCLUSION: Recurrent myocardial ischemia after CABG is high in patients with diabetes mellitus along with severe coronary vessel involvement and complications.

Objective To establish the bladder cancer line stable expressing enhanced GFP gene and observe its biological characteristics.Methods KU-7 cell line was transfected by enhance GFP(EGFP) gene in liposome-mediated gene transfer and selected by G418.The expression of EGFP in infected cells was observed by fluorescence microscopy and detected by flow cytometry.Multiple biological behaviors,such as the growth curve and cell adherent rate were compared between the infected and uninfected cells.EGFP expression in subcutaneous tumors was assessed in vivo.Results After being transduced,bladder cancer KU-7 cells with the EGFP gene displayed a stable and long-term EGFP expression under the nonselective conditions in vitro.Their biological behaviors,such as the growth curve and cell adherent rate were not different compared to untransfected parental cells in vitro.In subcutaneous tumors,EGFP was stable and highly expressed.Conclusion The bladder cancer cell line stable expressing EGFP has been successfully established.

OBJECTIVE:To observe the angiographic characteristics and the long-term clinical outcomes following coronary stenting in non-diabetic (non-DM) and type 2 diabetic (DM) patients with coronary artery disease.METHODS:This cohort study enrolled 1172 consecutive patients with coronary heart disease underwent elective coronary stenting (249 type 2 DM and 923 non-DM). The angiographic characteristics and the long-term clinical follow-up results were compared between non-DM and DM patients.RESULTS:The follow-up period was (39.2 +/- 6.4) months (6 - 83 months), follow-up rate was 90.3% in DM and 91.0% in non-DM group (P > 0.05). Compared with non-diabetic patients, there were significantly higher incidences of 2-vessel (P = 0.029) and 3-vessel (P = 0.013) diseases of coronary artery, severe stenosis lesion (P = 0.012), chronic total obstructive lesion (P = 0.044) and long lesion (P = 0.001), in-stent restenosis (ISR, P = 0.000) and revascularization (P = 0.000) and MACE (P = 0.000) in DM patients. COX multiple factorial analysis showed that DM is independent risk factor for ISR (P = 0.000), revascularization (P = 0.001) and MACE (P = 0.003).CONCLUSIONS:CHD patients with type 2 DM are associated with multi- and more severe vessel lesions. Type 2 DM is also an independent risk factor for increased ISR, revascularization and MACE post stenting.

Objective To investigate the effect of simvastatin on heme oxygenase (HO) -1expression and ventricular remodeling in rats with non-ischemic heart failure. Methods Seventy eight male Wistar rats were randomized into three groups: normal control group (n = 18), model group and simvastatin group (n= 60). Male Wistar rats in model and simvastatin group were given adrimycin(ADR) in an accumulated dose of 15 mg/kg for two weeks (2.5 mg /kg, peritoneal injection, three times per week), and 8 rats were dead. The survival rats (n= 52) were then randomly divided into two groups: model group (n=26) and simvastatin group (n=26), and 6 rats were dead in model group, while 7 dead in simvastatin group at the end of the study. Then rats in simvastatin treatment group(n=19)were given simvastatin 20 mg·kg-1·d-1 by gavage for four weeks,and rats in model group (n=20) and in control group (n=18) were treated with 5% glucose by gavage.At the forth week, another 9 rats were selected into the study and given ADR with an accumulated dose of 15 mg/kg for two weeks. The hemodynamics, mRNA expression of HO-1 in myocardium, left ventricular function as well as hydroxyproline were measured at the end of the sixth week. Results At the sixth week, compared with control group, systolic (+) and diastolic (-) function of the left ventricule (±LVdp/dtmax) of rats in model group and simvastatin group were reduced significantly, and the reduction amplitudes of + LVdp/dtmax and -LVdp/dtmax were 28.2%, 11.9% and 33.0%,27.9%,4, respectively (F = 4.899,3. 890, all P<0.01). The + LVdp/dtmax of rats in simvastatin group was higher than that in model group (F= 2.461, P<0.05). The content of myocardium hydroxyproline was elevated from the end of the second week [(485.0±52.9)g/kg vs. (364.0±41.6)g/kg,F=0.441 ,P<0.01]. At the end of the sixth week, the content of myocardium hydroxyproline of model group elevated continuously [(572.9±75.4) g/kg vs. (485.0±52.9)g/kg, F=0.654,P<0.05], but not for simvastatin group [(475.9±86.5) g/kg vs. (485.0±52.9)g/kg, P>0.05]. The mRNA expression of HO-1 in myocardium 'in model group was higher than that in control group [(0.6217±0.1229) vs. (0.2475±0.1053), F = 0.128, P < 0.01]. The mRNA expression of myocardium HO-1 was increased further by simvastatin treatment [(0.7860±0.1133) vs. (0.6217±0.1229),F=3.622,P<0.05]. Conclusions Compared with control group, the myocardial HO-1expression of heart failure rats is increased. Simvastatin treatment enhances the myocardium HO-1 expression further and alleviates myocardial injury and the degree of heart failure.

OBJECTIVE:Fabry' s disease is a rare X-linked recessive disease. Its cardiac manifestations are not well recognized.METHODS:The data of 3 patients from different Chinese kindreds with Fabry's disease and cardiac manifestations who seeked medical advice in our department in 2007 were analyzed. The age, sex, family history, main symptoms, ECG and echocardiographic findings were recorded for all the patients. The diagnostic criteria of Fabry's disease was based on alpha-galactosidase (alpha-GAL) quantity in white blood cells.RESULTS:All of the patients were female. Their age was from 41 to 57. Two of them had the typical symptoms of Fabry's disease in their young age. All of them had family history of the disease and cardiac symptoms. ECG showed ST-T change and echocardiography showed hypertrophy of left ventricule of different degrees. Their alpha-galactosidase level in white blood cells was lower than normal. The alpha-galactosidase level in patient 1 was the lowest. Her cardiac symptoms were most serious in the three patients and she had involvement of other organs.CONCLUSION:Patients with Fabry's disease may have cardiac manifestations. Family history, typical symptoms in young age and the characteristics of multisystemic disorder are helpful clues to the diagnosis.