RESUMEN
AIMS: Although catheter ablation for idiopathic ventricular arrhythmia (VA) has been generally well-established, VA originating from the great cardiac vein (GCV) may be clinically challenging due to its epicardial origin, proximity to coronary arteries and limited accessibility. The purpose of this study was to explore its electrophysiological characteristics and identify effective mapping/ablation strategies for idiopathic premature ventricular complexes (PVCs) originating from the GCV. MATERIALS AND METHODS: Between January 2013 to January 2018, 12 patients (who were diagnosed with PVCs originating from the GCV) among the 305 patients with idiopathic left ventricular outflow tract tachycardia were included. The origin of the ectopy was localized by mapping, the characteristics of the electrocardiogram (ECG) were analyzed, and all the patients with PVCs originating from GCV were treated by radiofrequency catheter ablation (RFCA). The safety and efficacy of RFCA were evaluated. KEY FINDINGS: The origin of the ectopy was successfully localized in GCV for all 12 patients by mapping, and access to GCV via the coronary sinus was feasible. Successful RFCA was achieved in 11 of 12 patients (91.67% acute procedural success) without perioperative complications. During a median follow-up of 12.6⯱â¯6.5â¯months, only one patient had recurrent VA (recurrence rate: 9.1%). SIGNIFICANCE: ECG characteristics may be helpful for identifying patients with PVCs originating from the GCV. RFCA within the coronary venous system appears to be safe and effective for these patients, and should be considered when routine RFCA from the endocardium or aortic sinus of the Valsalva is not effective.
Asunto(s)
Ablación por Catéter/métodos , Vasos Coronarios/fisiopatología , Complejos Prematuros Ventriculares/fisiopatología , Complejos Prematuros Ventriculares/terapia , Adulto , Anciano , Ablación por Catéter/efectos adversos , Seno Coronario , Electrocardiografía , Fenómenos Electrofisiológicos , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Brachial-ankle pulse wave velocity (baPWV), a direct measure of aortic stiffness, has increasingly become an important assessment for cardiovascular risk. The present study established the reference and normal values of baPWV in a Central Asia population in Xinjiang, China. METHODS: We recruited participants from a central Asia population in Xinjiang, China. We performed multiple regression analysis to investigate the determinants of baPWV. The median and 10th-90th percentiles were calculated to establish the reference and normal values based on these categories. RESULTS: In total, 5,757 Han participants aged 15-88 years were included in the present study. Spearman correlation analysis showed that age (r = 0.587, p < 0.001) and mean blood pressure (MBP, r = 0.599, p <0.001) were the major factors influencing the values of baPWV in the reference population. Furthermore, in the multiple linear regression analysis, the standardized regression coefficients of age (0.445) and MBP (0.460) were much higher than those of body mass index, triglyceride, and glycemia (-0.054, 0.035, and 0.033, respectively). In the covariance analysis, after adjustment for age and MBP, only diabetes was the significant independent determinant of baPWV (p = 0.009). Thus, participants with diabetes were excluded from the reference value population. The reference values ranged from 14.3 to 25.2 m/s, and the normal values ranged from 13.9 to 21.2 m/s. CONCLUSIONS: This is the first study that has established the reference and normal values for baPWV according to age and blood pressure in a Central Asia population.
Asunto(s)
Presión Sanguínea , Análisis de la Onda del Pulso , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Tobillo/irrigación sanguínea , Arteria Braquial/fisiología , Enfermedades Cardiovasculares/diagnóstico , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Flujo Sanguíneo Regional , Análisis de Regresión , Adulto JovenRESUMEN
Objective: To analyze influence of acute coronary syndrome (ACS) complicated abnormal glucose metabolism on fibrinolytic system. Methods: A total of 135 ACS inpatients were selected. According to glucose metabolism status, they were divided into pure ACS group (n=48), type 2 diabetes mellitus (T2DM) + ACS group (n=46) and impaired glucose tolerance (IGT) + ACS group (n=41); another 35 subjects hospitalized and undergoing physical examination during the same period were enrolled as normal control group. Plamsa DD levels were measured and compared among all groups. Results: Compared with normal control group and pure ACS group, there were significant rise in triglyceride level [(1.12±0.39) mmol/L, (1.52±0.92) mmol/L vs. (2.57±1.17) mmol/L, (2.32±0.96) mmol/L] in T2DM+ACS group and IGT+ACS group, P<0.01 all; compared with normal control group, there were significant rise in plasma DD level in pure ACS group, T2DM+ACS group and IGT+ACS group [(360.50±74.95) ng/ml vs. (795.24±134.10) ng/ml vs. (663.31±116.06) ng/ml, (702.40±126.64) ng/ml] P<0.01 all, and those of T2DM+ACS group and IGT+ACS group were significantly lower than that of pure ACS group, P<0.05 both. Conclusion: Fibrinolytic system function of patients with ACS complicated impaired glucose tolerance is significantly lower than that of pure ACS patients.