Objective To analyze the correlation between the change in carotid intima / media membrane (I/M) ratio and renal atherosclerosis in experimental rabbit carotid atherosclerosis models.Methods Forty-eight rabbits were randomly divided into the blank group,the control group and the model group by the random number table method,with 16 rabbits in each group.The blank group was not given any intervention,which was given basal feed.The control group was given high-fat diet of 120 g/d.The model group was given 7 d of high-fat diet and then the rabbits were changed into bilateral carotid atherosclerosis models through carotid intima air drying after 12 h of fasting (without fasting water).The bilateral operative carotid arteries and renal artery specimens of all rabbits were obtained to analyze the I/M ratio after routine paraffin embedding,sectioning and HE staining.Serum levels of triglyceride (TG),total cholesterol (TC) and C-reactive protein (CRP) were determined at the end of the experiment.Urinary microalbumin /urine creatinine (UACR) was analyzed and correlation analysis was performed.Results HE staining under light microscope was normal in the carotid artery and renal artery of rabbits in the blank group.In the control group,there was slight intimal hyperplasia in the carotid artery and slight hyperplasia and stenosis in the renal artery,without obvious lipid deposition.In the model group,there was obviously proliferated and thickened carotid intima,a large number of foam cells accumulated in the intima,extensively proliferated intima of the renal artery and seriously narrowed vessels,and thickened intima was accumulated foam cells at high magnification.Compared with the blank group,the carotid artery,renal artery I/M ratio in the control group and model group were significantly increased,serum TG,TC,CRP and UACR were significantly increased,and he carotid artery,renal artery I/M ratio and serum TG,TC,CRP and UACR in the model group were significantly highter than those of control group,the differences were statistically significant (P ＜ 0.05).The I/M ratio of carotid artery in rabbit carotid atherosclerosis models was positively correlated with the I/M ratio of renal artery,CRP and UACR (P ＜0.05),but there was no significant correlation with TG or TC (P ＞ 0.05).Conclusion Carotid atherosclerosis can promote the occurrence of renal atherosclerosis,which may be related to inflammatory reactions,vascular endothelial cell injury and renal vascular diseases.

Object: To explore the electrocardiographic characteristics of ventricular arrhythmias (VAs) originating from tricuspid annulus region. Methods: Present study included 169 consecutive patients undergoing catheter ablation of VAs from tricuspid annulus origin in our department from August 2007 to September 2016. Based on the origin sites, the patients were divided into two subgroups, the free wall group (81 cases) and septal wall group (88 cases). Based on the location, patients in the free wall group were classified into anterolateral (22 cases), lateral (26 cases) and posterolateral (33 cases) subgroups. Patients in the septal group were classified into anteroseptal (10 cases), midseptal (71 cases) and posteroseptal (7 cases) subgroups. We analyzed the electrocardiographic features of these patients and in 87 patients with PVCs/VT originating from right ventricular outflow tract. Results: (1) A positive R wave inⅠ, aVL, V(5)-V(6) leads were found among most of patients, only few cases originating from tricuspid annulus anteroseptum group and tricuspid annulus anterolateral group demonstrated qr or qs pattern in aVL lead. 97.53% (79/81) patients demonstrated rS pattern in V(1)-V(3) leads with VAs originating from tricuspid annulus free wall, and 9/10 patients demonstrated rS pattern in V(1) lead with VAs originating from anteroseptum, and 97.44% (76/78) patients demonstrated QS pattern in V(1) lead with VAs originating from midseptum and posteroseptum. Precordial lead transition zone was on or behind V(3) for tricuspid annulus free wall group (96.3%, 78/81), but in front of V(3) for tricuspid annulus septum wall group (47.73%, 42/88) (P<0.01). The S wave's amplitude smaller than-1.81 mV in lead V(2) can be used as a cutoff value to identify if PVC/VT is originating from free wall or septum of TA. R wave in inferior wall leads was found among 98.85% (86/87) patients with PVCs/VT originating from right ventricular outflow tract. Conclusion: A positive R wave in Ⅰ, aVL, V(5)-V(6) leads was found among most of patients with idiopathic ventricular arrhythmias originating from the tricuspid annulus regions, but VAs originating from different portions of tricuspid annulus area have distinct electrocardiographic characteristics.

Objective To investigate the radiofrequency catheter ablation(RFCA) of idiopathic ventricular arrhythmias(VAs) originating from the distal great cardiac veins(DGCV).Methods The study included 50 patients underwent successful RFCA of premature ventricular contraction(PVC)/ventricular tachycardia(VT) originating from different portions of the DGCV in Department of Cardiology,Second Affiliated Hospital of Wenzhou Medical University from October 2006 to March 2016.The intracardiac electrogram feature,intraventricular ablation mapping features and announcements of ablating PVC/VT originating from different portions of DGCV were assessed.Results The patients were divided into four groups according to the mapping and ablation results,DGCV1(11 patients,man 7,age 52.18±15.81),DGCV2(13 patients,man 7,age 51.01±15.22),proximalanterior interventricular vein(PAIV)(17 patients,man 9,age 52.51±14.35)and extend DGCV(EDGCV)(9 patients,man 3,age 52.91±14.11)groups.All four groups shared similar intracardiac electrogram feature in efficient ablation site.Bipolar mapping showed multi-peak fractional potentials 82.00%(41/50),26.00%(13/50)with reserve potentials.Pace-mapping can be achieved in 45 patients(90%).The QRS complex morphology of pacing were perfect match(12/12)with spontaneous PVC/VT in 22 patients,near-perfect match(11/12)in 18 patients,(10/12)in 5 patients.The veins of this area were thin and near the left coronary artery,so both coronary arteriongraphy(CAG) and coronary venography(CVG) should be performed before the ablation to ensure the security.Conclusion RFCA via the coronary venous system was a relatively effective and safe approach for PVC/VTs when fail to achieve the successful ablation in and under the aortic sinus and RVOT.

Idiopathic ventricular arrhythmias (VAs), including premature ventricular contractions (PVCs) and idiopathic ventricular tachycardia (IVT), are common and usually without apparent underlying structural heart disease; treatment with radiofrequency catheter ablation (RFCA) of those of endocardial origin has rapidly increased [ 1 Ouyang F. Fotuhi P. Ho S.Y. et al. Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: electrocardiographic characterization for guiding catheter ablation. J Am Coll Cardiol. 2002; 39: 500-508 Abstract Full Text Full Text PDF PubMed Scopus (462) Google Scholar , 2 Yoshida N. Inden Y. Uchikawa T. et al. Novel transitional zone index allows more accurate differentiation between idiopathic right ventricular outflow tract and aortic sinus cusp ventricular arrhythmias. Heart Rhythm. 2011; 8: 349-356 Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar ], with alternative use of left coronary veins for the estimated 9% of IVT cases of epicardial origin [ 3 Daniels D. Lu Y. Morton J. et al. Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram. Circulation. 2006; 113: 1659-1666 Crossref PubMed Scopus (300) Google Scholar , 4 Li Y.C. Lin J.F. Li J. Catheter ablation of idiopathic ventricular arrhythmias originating from left ventricular epicardium adjacent to the transitional area from the great cardiac vein to the anterior interventricular vein. Int J Cardiol. 2013; 167: 2673-2681 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar , 5 Obel O.A. D'Avila A. Neuzil P. et al. Ablation of left ventricular epicardial outflow tract tachycardia from the distal great cardiac vein. J Am Coll Cardiol. 2006; 48: 1813-1817 Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar ]. Based on a 12-patient study [ [4] Li Y.C. Lin J.F. Li J. Catheter ablation of idiopathic ventricular arrhythmias originating from left ventricular epicardium adjacent to the transitional area from the great cardiac vein to the anterior interventricular vein. Int J Cardiol. 2013; 167: 2673-2681 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar ], we reported in this journal that: 1. differing 12-lead body-surface electrocardiogram (ECG) characteristics of symptomatic PVCs/IVT originating from 3 regions of left coronary veins (distal great vein [DGCV], proximal anterior interventricular vein [PAIV], and extension tributary of EDGV [EDGCV]) help regionalize arrhythmia origin; and 2. RFCA for PVCs/IVT of coronary venous system origin appeared effective. We report here on an expanded study that: 1. recognized distinct ECG characteristics which aid in mapping PVCs/IVT origin to 4, in contrast to the previously reported 3, left ventricular (LV) epicardial regions adjacent to the transitional area from GCV to AIV; 2. defined IDT ≥70 ms and MDI ≥0.54 to differentiate PVCs/IVT of DGCV from those of LV endocardium, aortic sinus of Valsalva (ASOV) or right ventricular outflow tract (RVOT) origin; and 3. confirmed favorable outcomes after successful RFCA for PVCs/IVT within the coronary venous system.

Objective To investigate the effect of carotid atherosclerosis on renal atherosclerosis in rabbits and its possible mechanism. Methods 16 male Japanese white rabbits were randomly divided into operation group with carotid artery injured by air- drying and sham operation group (control group) and fed high cholesterol chow. Blood creatinine and angiotensin II were measured before and 8 weeks after operation. The rabbits were executed and prepared for pathologi-cal examination. The intima- media thickness(I/M ratio) of carotid and renal arteries was measured and compared between two groups. Results Blood angiotensin II was significantly higher in operation group[(43.23±0.12)pg/ml] than in con-trol group [(37.02±0.42)pg / ml](P<0.05).There was no difference of creatinine between two groups. The I / M ratio of carotid artery as wel as renal artery was significantly higher in operation group (1.28±0.08, 0.45±0.11) than in control group (0.04±0.02, 0.12±0.04)(P<0.01or0.05). Conclusion The development of carotid atherosclerosis aggravates re-nal atherosclerosis. Activation of renin- angiotensin system may be one of the mechanisms for such a change.

Objective To investigate whether carotid atherosclerosis aggravates aorta atherosclerosis in rabbit model.Methods A total of 16 male Japanese white rabbits were randomly divided into sham operation(control) and air-drying operation(experiment) groups.The baroreceptor reflex sensitivity(BRS) of heart rate was measured for rabbits after 8 weeks cholesterol feeding.All animals were executed for pathological examinations and measuring the intima-media thickness(I/M ratio).Results Carotid and aorta I/M ratios were significantly higher in the rabbits of operation group(1.28±0.082 and 0.65±0.218,respectively) than in the rabbits of control group(0.04±0.015 and 0.41±0.175,respectively)(P<0.05).The BRS of heart rate was significantly lower in the rabbits of operation group(1.02±0.098) than in the rabbits of control group(1.23±0.121)(P<0.05).Conclusion Carotid atherosclerosis may aggravate the aorta atherosclerosis through the decline of BRS.

Objective To study the role played by apelin in the development of left ventricular hypertrophy in rat models of renal hypertension.Methods Ten male Sprague-Dawley rat models of renal hypertension were established with one-side renal artery clipped(2 kidneys-1 clip model).The models were sacrified 8 weeks later for examination of plasma and left ventricle homogenate expressions of apelin(with RIA).The mean carotid avterial pressure(mCAP) and left ventricular enddiastolic pressure(LVEDP) as well as left ventricular mass(LVM)/body weight(BW) ratio were also determined in these models.Ten normal rats served as controls and were treated in the same way.Results ① The mCAP,LVEDP and LVM/BM ratio were significantly higher in the models than those in the controls,being 36.58%(P<0.05) 33.38%(P<0.01) and 20.24%(P<0.01) higher respectively.② The plasma(263.88±24.3pg/ml) and left ventricular homogenate(18.32±13.89pg/mg.pro) expressions of apelin were also significantly higher than those(222.58±41.94pg/ml and 5.96±1.98pg/mg.pro respectively) in controls(all P<0.05).Conclusion Apelin probably played an important role in the development of left ventricular hypertrophy in rat models of renal hypertension.