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Chinese Medical Journal 2007年第21期120卷 1940-1942页

作者： TANG Ri-bo LIU Xiao-hui DONG Jian-zeng LIU Xing-peng kang jun-ping MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Postcardiac injury syndrome （PCIS） is characterized by inflammation of the pericardium, pleura and pulmonary parenchyma following a cardiac injury. It has been described in many patients after a variety of cardiac insults including infarction, surgery, trauma, implantation of a pacemaker, percutaneous coronary angioplasty and radiofrequency ablation of cardiac *** report a rare case of PCIS that occurred after circumferential pulmonary vein radiofrequency ablation for atrial fibrillation （AF）.

关键词： postcardiac injury syndrome atrial fibrillation circumferential pulmonary vein ablation

Image integration system to guide catheter ablation of atrial tachycardia with a multi-key-isthmus reentrant in a patient with a repaired atrial septal defect： a case report

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Chinese Medical Journal 2008年第9期121卷 859-861页

作者： YU Rong-hui DONG Jian-zeng LIU Xing-peng LONG De-yong kang jun-ping MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Recurrent atrial tachycardia （AT） is often observed late .after heart surgery and it contributes significantly to the morbidity and mortality of this group of patients. In patients with structurally normal hearts the most prevalent type of AT is a macroreentrant atrial tachycardia （MAT）, more specifically known as common atrial flutter （AFL）. In contrast, in patients with repaired structural heart disease other ATs may occur due to the existence of variable and multiple arrhythmogenic substrates, related to the underlying heart disease and/or the surgical incisions.

关键词： integration catheter ablation atrial tachycardia atrial septal defect macroreentry

Comparison of drug eluting stent implantation with coronary artery bypass surgery in the treatment of patients with chronic total occlusion and multiple vessel disease

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Chinese Medical Journal 2011年第8期124卷 1169-1174页

作者： LIU Wei MA Chang-sheng kang jun-ping DU Xin CHEN Fang ZHOU Yu-jie Lu Shu-zheng HUANG Fang-jiong GU Cheng-xiong ZHU Xiao-Ling Department of Carcliology Beiiing Anzllen Hospital Capital Medical University Beijing 100029 China Department of Cardiac Surgery Beijing Anzllen Hospital Capital MedicalUniversity Beijing 100029 China

Background In patients with chronic total occlusion （CTO） and multivessel coronary artery disease, the comparison of surgical and the percutaneous revascularization strategies has rarely been conducted. The aim of this study was to compare long term clinical outcomes of drug eluting stent （DES） implantation with coronary artery bypass surgery （CABG）in the patients with CTO and multivessel *** From a prospective registry of 6000 patients in our institution, we included patients with CTO and multivessel coronary artery disease who underwent either CABG （n=679） or DES （n=267） treatment. Their propensity risk score was used for adjusting baseline *** At a median follow-up of three years, propensity score adjusted Cox regression analysis showed that the rate of major adverse cardiac cerebrovascular events （MACCE） was lower in CABG group （12.7% vs. 24.3%, hazard ratio （HR） 1.969, 95% Cl 1.219-3.179, P=0.006） mainly due to lower rate of target vessel revascularization in CABG group than in DES group （3.1% vs. 17.2%, HR 16.14, 95% CI 5.739-45.391, P ＜0.001）. The incidence of cardiac death or myocardial infarction （composite end point） was not significantly different between these two groups. On multivariate analysis, the significant predictors of MACCE were only the type of revascularization. Age, left ventricular ejection fraction （LVEF）, and complete revascularization were identified as significant predictors of composite end *** Our study shows that in patients with CTO and multivessel coronary disease, DES can offer comparable long term outcomes in cardiac death and myocardial infraction free survival in comparison with CABG. However, there is an increased rate of MACCE which results from more repeat revascularizations. Obtaining a complete revascularization is crucial for decreasing adverse cardiac events.

关键词： chronic total occlusion drug eluting stent cardiopulmonary bypass complete revascularization

~rognostic value of baseline C-reactive protein levels in patients mdergoing coronary revascularization

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Chinese Medical Journal 2010年第13期123卷 1628-1632页

作者： LI Xu LIU Xiao-hui NIE Shao-ping DU Xin Lu Qiang kang jun-ping DONG Jian-zeng GU Cheng-xiong HUANG Fang-jiong ZHOU Yu-jie CHEN Fang Lu Shu-zheng WU Xue-si MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029China Department of Heart Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029China

Background C-reactive protein （CRP） is a lowly expressed marker for inflammatory response. This study aimed to evaluate the prognostic value of baseline CRP levels in patients undergoing coronary revascularization in the context of modern medical treatment. Methods This was a retrospective study in a single center. Four hundred and fourteen patients were enrolled, who underwent coronary revascularization and received adequate medication for secondary prevention of coronary heart disease. The study compared the follow-up clinical outcomes between high level CRP group （CRP 〉5 mg/L） and low level one. The median follow-up time was 551 days. Results Compared with low CRP group, the relative risk （RR） of the major adverse cardiovascular and cerebral events （MACCE） in high CRP group was 5.131 （95% CI： 1.864-14.123, P=0.002）. There were no significant differences in death myocardial infarction and stroke during the follow-up between two groups, but a higher risk of re-revascularization was found in high CRP group （RR 6.008, 95% CI： 1.667-21.665, P=0.006）. Cox regression analysis showed that only CRP level could contribute to MACCE during the follow-up. MACCE-free rate was much lower in high CRP group （Kaplan-Meier log-rank P 〈0.001）. Conclusion In the context of modern medical treatment, the baseline level of CRP is an independent predictor for long-term prognosis in patients with coronary revascularization.

关键词： C reactive protein coronary heart disease revascularization prognosis

Unconscious sedation/analgesia with propofol versus conscious sedation with fentanyl/midazolam for catheter ablation of atrial fibrillation:a prospective,randomized study

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Chinese Medical Journal 2007年第22期120卷 2036-2038页

作者： TANG Ri-bo DONG Jian-zeng ZHAO Wen-du LIU Xing-peng kang jun-ping LONG De-yong YU Rong-hui HU Fu-li LIU Xiao-hui MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Department of Anesthesiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Catheter ablation of atrial fibrillation （AF） has been ,increased dramatically recently. However, it is an unpleasant procedure with intolerable pain without sedation. Propofol and fentanyl/midazolam have been widely used in painful clinical examination and cardiovascular procedures with established safety and efficacy. Propofol, alfentanyl and midazolam were administrated for catheter ablation in some electrophysiological labs for a less painful procedure. However, there is few published work on the sedation regimen for catheter ablation of AF.

关键词： atrial fibrillation ablation sedation

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无慢性肾病冠心病患者肾功能对预后的影响

中华内科杂志 2008年第9期47卷 735-738页

作者：张强马长生聂绍平吕强康俊平刘小慧首都医科大学附属北京安贞医院心内科 100029

目的了解未诊断慢性肾脏疾病（CKD），且接受血运重建冠心病患者的肾功能状态，探讨肾功能与患者预后之间的关系，明确选择合理的血运重建方式能否使患者获益。方法入选无肾脏病史、并接受血运重建治疗的冠心病患者，肾功能根据肌酐清... 详细信息

目的了解未诊断慢性肾脏疾病（CKD），且接受血运重建冠心病患者的肾功能状态，探讨肾功能与患者预后之间的关系，明确选择合理的血运重建方式能否使患者获益。方法入选无肾脏病史、并接受血运重建治疗的冠心病患者，肾功能根据肌酐清除率（CrCl）分级，评价不同肾功能患者的临床特征、冠状动脉病变和血运重建情况以及临床预后。结果入选患者2896例，肾功能不全患者的住院期和随访期病死率以及随访期卒中的发生率高于肾功能正常患者。多因素回归分析显示，血运重建术后死亡的独立危险因素分别为：血运重建方式、年龄和CrCl。在肾功能正常和轻度肾功能不令的冠心病患者中，经皮冠状动脉介入术组的病死率显著低于冠状动脉旁路移植术组。结论在未诊断CKD的冠心病患者中，轻、中度的肾功能不全并不少见，并与血运重建术后的不良事件相关。冠状动脉血运重建方式影响肾功能正常或轻度不全患者的预后。

关键词：冠状动脉疾病肾功能衰竭,慢性血管成形术

Effect of metabolic syndrome on prognosis and clinical characteristics of revascularization in patients with coronary artery disease

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Chinese Medical Journal 2006年第22期119卷 1871-1876页

作者： HU Rong MA Chang-sheng NIE Shao-ping LU Qiang kang jun-ping DU Xin ZHANG Yin GAO Ying-chun HE Li-qun JIA Chang-qi LIU Xin-min DONG Jian-zeng LIU Xiao-hui CHEN Fang ZHOU Yu-jie LU Shu-zheng WU Xue-si Department of Cardiology Beijing Anzhen Hospital Capital University of Medical Sciences Beijing 100029 China

Background People with metabolic syndrome are at higher risk for developing coronary artery disease （CAD）. The effect of the metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. This study was conducted to assess the prevalence, characteristics, in hospital and long term prognosis of CAD with metabolic syndrome and to determine the factors influencing the prognosis of the disease. Methods The DESIRE registry contains data of 3696 patients with CAD between 2001 and 2004. Mean long term followup was （8294±373） days. Diagnosis of metabolic syndrome was based on modified International Diabetes Federation （IDF） Worldwide Definition of the Metabolic Syndrome, using body mass index （BMI） instead of waist circumference. Results Of 2596 patients with complete records of height, weight, and so on, 1280 （49.3%） were identified with metabolic syndrome. The patients with metabolic syndrome had higher level of body mass index, systolic blood pressure, diastolic blood pressure, fasting glucose and disordered blood lipid （all P〈0.0001）, with higher creatinine [（10.5±4.3） mg/L vs （9.9±2.9） mg/L, P〈0.0001] and the number of white blood cells [（7.49±2.86）×10^9/L VS （7.19 ± 2.62） ×10^9/L, P=0.008） compared with those without metabolic syndrome. The patients with metabolic syndrome showed severer coronary angiographic alterations （left main artery and/or ≥2-vessel）（73.6% vs 69.6%, P=0.031）. There were no significant differences of major adverse cardiac and cerebral events （MACCE） or mortality in hospital between the two groups. During followup, the ratio of MACCE in CAD with metabolic syndrome patients increased significantly （11.8% vs 10.0%, P=0.044）. Fasting blood glucose （≥ 1000 mg/L） and triglyceride （TG ≥1500 mg/L） were responsible for most of the increased risk associated with the metabolic syndrome （adjusted OR 1.465, 95% CI 1.037-1.874, P=0.032; OR 1.378, 95% CI 1.01±1.768, P=0.044）. Conclusions The prevalence of metabolic syndrome was very

关键词： coronary artery disease revascularization metabofic syndrome

Outcome of catheter ablation of atrial fibrillation in patients with prior ischemic stroke

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Chinese Medical Journal 2013年第6期126卷 1033-1038页

作者： LI Song-nan kang jun-ping DU Xin HE Xiao-nan LONG De-yong YU Rong-hui TANG Ri-bo SANG Cai-hua JIANG Chen-xi NING Man DONG Jian-zeng MA Chang-sheng Department of Cardiology Beijing An Zhen Hospital Capital Medical University Beijing 100029 China

Background Catheter ablation for atrial fibrillation （AF） has been demonstrated to be effective in a subsets of patients with AF. However, very few data are available in regard to patients with prior history of stroke undergoing catheter ablation. This study aimed to investigate the outcome of catheter ablation in AF patients with prior ischemic stroke. Methods Between January 2008 and December 2011, of 1897 consecutive patients who presented at Beijing An Zhen Hospital for treatment of drug-refractory AF, 172 （9.1%） patients in the study population had a history of ischemic stroke. All patients underwent catheter ablation and were followed up to assess maintenance of sinus rhythm and recurrence of symptomatic stroke. Results Among these 1897 patients, 1768 （93.2%） who had complete follow-up information for a minimum of six months were included in the final analysis. Patients in the stroke group （group I） and the no-stroke group （group II） were similar in regards to gender, body mass index （BMI）, history of diabetes, type of AF, and left atrial size. The patients in group I were older than those in group II, and had a higher incidence of hypertension, chronic heart failure, lower left ventricular ejection fraction （LVEF）, and higher CHADS2 scores. Six months after ablation, 107 （68.6%） patients in group I and 1403 （87.1%）in group II had discontinued warfarin treatment （P 〈0.001）. During a median follow-up of （633＋415） days, 65 patients in the group I and 638 in group II experienced AF recurrence, and five patients in group I and 28 in group II developed symptomatic stroke. The rates of AF recurrence and recurrent stroke were similar between group I and group II （41.7% vs. 39.6%, P=0.611; 3.2% vs. 1.7%, P=0.219; respectively）. Conclusion Catheter ablation of AF in patients with prior stroke is feasible and efficient.

关键词： atrial fibrillation catheter ablation stroke recurrence

Coronary stenting versus bypass surgery in heart failure patients with preserved ejection fraction

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Chinese Medical Journal 2012年第6期125卷 1000-1004页

作者： XUE Zeng-ming LI Wei-ju MA Chang-sheng NIE Shao-ping DONG Jian-zeng LIU Xiao-hui kang jun-ping LU Qiang DU Xin WANG Xiao CHiN Fang ZHOU Yu-jie LU Shu-zheng HUANG Fang-jiong GU Cheng-xiong WU Xue-si Department of Cardiology Beijing Anzhen Hospital Capital Medical university Beijing 100029 China Department of Cardiology Peking University Hospital Beijing 100873 China Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical university Beijing 100029 China

Background The optimal revascularization strategy in patients with heart failure with preserved ejection fraction （HFPEF） remains unclear. The aim of the present study was to compare the effects of percutaneous coronary intervention （PCI） and coronary artery bypass grafting （CABG） in patients with HFPEF. Methods From July 2003 through September 2005, a total of 920 patients with coronary artery disease （CAD） and HFPEF （ejection fraction 〉50%） underwent PCI （n=350） or CABG （n=570）. We compared the groups with respect to the primary outcome of mortality, and the secondary outcomes of main adverse cardiac and cerebral vascular events （MACCE）, including death, myocardial infarction, stroke and repeat revascularization, at a median follow-up of 543 days. Results In-hospital mortality was significantly lower in the PCI group than in the CABG group （0.3% vs. 2.5%, adjusted P=0.016）. During follow-up, there was no significant difference in the two groups with regard to mortality rates （2.3% vs. 3.5%, adjusted P=0.423）. Patients receiving PCI had higher MACCE rates as compared with patients receiving CABG （13.4% vs. 4.0%, adjusted P 〈0.001）, mainly due to higher rate of repeat revascularization （adjusted P 〈0.001）. Independent predictors of mortality were age, New York Heart Association （NYHA） class and chronic total occlusion. Conclusion Among patients with CAD and HFPEF, PCI was shown to be as good as CABG with respect to the mortality rate, although there was a higher rate of repeat revascularization in patients undergoing PCI.

关键词： revascularization coronary artery disease heart failure

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急性冠状动脉综合征患者血运重建的预后

中华内科杂志 2011年第7期50卷 585-588页

作者：康俊萍马长生吕强聂绍平刘小慧董建增首都医科大学附属北京安贞医院心内科 100029

目的了解接受血运重建治疗的急性冠状动脉综合征患者的近期和长期预后。方法入选2003年7月1日至2005年9月30日在我院接受血运重建治疗的6005例患者，1年后对患者进行电话或门诊随访。比较ST段抬高心肌梗死（STEMI）、非ST段抬高急性心... 详细信息

目的了解接受血运重建治疗的急性冠状动脉综合征患者的近期和长期预后。方法入选2003年7月1日至2005年9月30日在我院接受血运重建治疗的6005例患者，1年后对患者进行电话或门诊随访。比较ST段抬高心肌梗死（STEMI）、非ST段抬高急性心肌梗死（NSTEMI）和不稳定性心绞痛患者的临床和预后[不良心脑血管事件（MACCE）包括全因死亡、非致死性心肌梗死、非致死性卒中和再次血运重建]情况。结果共4865例患者，其中STEMI患者955例，NSTEMI患者263例，不稳定性心绞痛患者3647例，3组患者的院内和18个月生存率（分别为96％、98％和98％）差异无统计学意义，不稳定性心绞痛患者18个月MACCE发生率较低（STEMI，NSTEMI和不稳定性心绞痛3组无事件生存率分别为86％、86％和89％）。结论接受血运重建的STEMI、NSTEMI和不稳定性心绞痛患者临床情况有所差异，但是近期和长期病死率相似，不稳定性心绞痛患者的长期MACCE发生率低。

关键词：心肌梗死心绞痛血管成形术,经腔,经皮冠状动脉