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An unexpected electrocardiogram sign of subacute left ventricular free wall rupture: Its early awareness may be lifesaving

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World Journal of Emergency Medicine 2020年第2期11卷 117-119页

作者： Hong-yi Wu Ju-ying Qian Qi-bing Wang jun-bo ge Shanghai Shanghai Institute of Cardiovascular Diseases Department of CardiologyZhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND:Post-infarct left ventricular free wall rupture(LVFWR)is not always an immediately catastrophic *** rupture can be subacute,allowing time for diagnosis and ***,early recognition of the entity may be ***:We present an electrocardiogram(ECG)change pattern in two cases,which was erroneously attributed to *** women in their 80s were admitted to our institute after experiencing the sudden onset of chest *** were managed as anterior ST-segment elevation myocardial infarction without reperfusion ***,they experienced a recurrence of severe chest pain with cardiogenic shock during *** ECG recorded at that time showed a ST-segment re-elevation in infract-related ***:The two cases were regrettably received a misjudgement of reinfarction at first,and one of the patients even was administrated with tirofi *** the diagnosis of subacute LVFWR was made through antemortem ***:New ST-segment elevation(STE)in infarct-associated leads,coupled with recurrence of chest pain and new-onset hypotension,may constitute the premonitory signs of a subacute LVFWR.

关键词： Myocardial infarction Myocardial rupture Electrocardiogram Diagnosis

Nonhypertensive male with multiple paragangliomas of the heart and neck:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5707-5714页

作者： Qi Wang Zhe-Yong Huang jun-bo ge Xian-Hong Shu Department of Cardiology Zhongshan HospitalFudan UniversityShanghai Institute of Cardiovascular DiseasesShanghai 200032China

BACKGROUND Paraganglioma is a rare disease that can be lethal if ***,quick recognition is very *** paragangliomas are found in patients who have *** classic symptoms are the triad of headaches,palpitations,and profuse *** describe a very rare case of multiple paragangliomas of the heart and bilateral carotid artery without hypertension and outline the management strategies for this *** SUMMARY A 46-year-old man presented with the chief complaint of recently recurrent chest pain with a history of hemangioma of the bilateral carotid artery that had been surgically *** was found to have an intracardiac mass in the right atrioventricular groove and underwent successful *** final pathology demonstrated that the intracardiac mass was a cardiac paraganglioma,and the patient had an increased level of normetanephrine in the *** pathology and immunohistochemistry results showed that the bilateral carotid masses were also *** the 3 mo follow-up period,the patient did not experience recurrence of chest *** To our knowledge,this is the first case of multiple paragangliomas of the heart and neck without *** rare disease can be lethal if left ***,quick recognition is very *** key to the diagnosis of cardiac paraganglioma is the presence of typical symptoms,including headaches,palpitations,profuse sweating,hypertension,and chest *** can demonstrate the intracardiac *** is important to determine the levels of normetanephrine in the *** detection of genetic mutations is also *** resection is necessary to treat the disease and obtain pathological evidence.

关键词： Chest pain Intracardiac mass Cardiac paraganglioma Normetanephrine Pathological evidence Case report

Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in China

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Journal of geriatric Cardiology 2020年第5期17卷 246-255,I0002-I0004页

作者： Xiao-Ning HAN Shu-Bin QIAO jun-bo ge Ya-Ling HAN Ji-Yan CHEN Zu-Yi YUAN bo YU Jie JIANG Yong HUO Department of Cardiology Peking University First HospitalBeijingChina National Center for Cardiovascular Diseases Fuwai HospitalBeijingChina Department of Cardiology Zhongshan Hospital Affiliated to Fudan UniversityGuangzhouChina Department of Cardiology the General Hospital of Shenyang MilitaryShenyangChina Department of Cardiology Guangdong General HospitalGuangzhouChina Department of Cardiology the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina Department of Cardiology the Second Affiliated Hospital of Harbin Medical UniversityHarbinChina

Objective To describe the long-term antithrombotic management patterns(AMPs)and clinical outcomes of Chinese patients with acute coronary syndrome(ACS).Methods This was an observational,multicenter,longitudinal cohort extension study of Chinese patients who had completed the EPICOR Asia 2-year follow-up study post-hospitalization for an ACS *** in AMP and clinical outcomes for up to 5 years post-ACS event were *** Overall,2334 patients with ACS were enrolled at 49 *** mean age was 61.6 years and 76.3%were *** study end,2093 patients completed the 3-year *** baseline(2 years post-ACS event),72.4%of patents received one antiplatelet(AP)medication,with aspirin being the preferred one.A small proportion of patients(21.5%)was treated with two or more APs(2+AP),and even fewer patients(6.1%)did not receive any AP medication at *** study completion,the proportion of patients without AP therapy increased to 13.6%,while the percentage of patients on one AP and 2+AP decreased to 69.3%and 17.1%,***,a higher incidence of clinical events(composite of all-cause mortality,myocardial infarction,stroke)was observed for the 2+AP(13.2%)subgroup than for the no AP(10.5%)and one AP(8.6%)***,the 2+AP subgroup exhibited the greatest number of bleeding events,outpatient visits,and hospitalization *** myocardial infarction or stroke,bleeding events prompted an adjustment in *** Most patients in China received at least one AP medication up to 5 years after an ACS event.

关键词： Acute coronary syndrome Antithrombotic agents Antithrombotic management patterns Observational study Real-world

Chinese expert consensus on the clinical application of drugcoated balloon(2^(nd) Edition)

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Journal of geriatric Cardiology 2024年第2期21卷 135-152页

作者： The Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon(2^(nd)Edition) jun-bo ge Yun-Dai CHEN 不详 Zhongshan Hospital Fudan University Chinese PLA general Hospital

Percutaneous coronary interventions have progressed through the era of plain balloon dilation, bare-metal stent insertion to drug-eluting stent treatment, which has significantly reduced the acute occlusion and restenosis rates of target vessels and improved patient prognosis, making drug-eluting stents the mainstream interventional treatment for coronary artery disease. In recent years, drug-coated balloons(DCBs) have become a new treatment strategy for coronary artery disease, and the drugs used in the coating and the coating technology have progressed in the past years. Without permanent implant, a DCB delivers antiproliferative drugs rapidly and uniformly into the vessel wall via the excipient during a single balloon dilation. Many evidence suggests that DCB angioplasty is an effective measure for dealing with in-stent restenosis and de novo lesions in small coronary *** more clinical studies are published, new evidence is emerging for the use of DCB angioplasty in a wide range of coronary diseases, and the indications are expanding internationally. Based on the latest research from China and elsewhere, the Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon has updated the previous DCB consensus after evidence-based discussions and meetings in terms of adequate preparation of in-stent restenosis lesions, expansion of the indications for coronary de novo lesions, and precise guidance of DCB treatment by intravascular imaging and functional evaluation.

关键词： balloon drugs dealing

Wire trapping technique combined with retrograde approach for recanalization of chronic total occlusion

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Chinese Medical Journal 2008年第17期121卷 1753-1756页

作者： ge jun-bo ZHANG Feng ge Lei QIAN Ju-ying WANG Hao Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China

Coronary chronic total occlusion （CTO）, defined as a ,total occlusion of duration 〉3 months, remains a technical challenge for the interventional cardiologists. The major limitation in percutaneous coronary intervention （PCI） of CTO is the inability to penetrate and cross the occlusion with a guidewire. It was reported that the immediate angiographic success rate varied from 50% to 70% using the standard antegrade techniques.1 To improve this suboptimal success rate, the authors firstly introduced retrograde approach through the collateral channels as a novel technique and successfully recanalized a left main CTO using this technique when demonstrating the live cases in Transcatheter Cardiovascular Therapeutics （TCT） 2005. Recently, modified techniques based on the retrograde approach have demonstrated that this approach could provide a high success rate with PCI.3-5 In the present report, we described a new method, wire trapping technique combined with retrograde approach, which was applied successfully in three patients with CTO.

关键词： chronic total occlusion retrograde approach wire trapping coronary angioplasty

A new sequential two-stent strategy for treating true distal left main trifurcation lesion

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Journal of geriatric Cardiology 2021年第6期18卷 487-491页

作者： Yu-Xiang DAI Chen-Guang LI Jia HUANG Ren-De XU Shu-Fu CHANG Hao LU Dao-Yuan REN Lei ge Ju-Ying QIAN Feng ZHANG jun-bo ge Department of Cardiology Zhongshan HospitalFudan UniversityShanghai Institute of Cardiovascular DiseasesShanghaiChina

The incidence of significant left main(LM)coronary artery stenosis identified by coronary angiography was 5%−17.5%in various clinical presentations;about 80%of stenosis involved the LM bifurcation(LMB).[1]Although per-cutaneous coronary intervention(PCI)is an appro-priate alternative to coronary artery bypass graft in LM disease with low-to-intermediate anatomical complexity,[2]PCI for LMB lesions remains the most technically challenging for interventional cardiolo-gists with higher rates of acute periprocedural com-plications and higher risk of long-term major ad-verse cardiac events in the era of drug-eluting stent(DES).

关键词： stenosis acute bypass

Impact of the gut microbiome on atherosclerosis

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mLife 2024年第2期3卷 167-175页

作者： Yuqin Mao Chao Kong Tongtong Zang Lingsen You Li-Shun Wang Li Shen jun-bo ge Department of Cardiology Shanghai Institute of Cardiovascular DiseasesZhongshan HospitalFudan UniversityShanghaiChina National Clinical Research Center for Interventional Medicine ShanghaiChina Center for Traditional Chinese Medicine and Gut Microbiota Minhang HospitalFudan UniversityShanghaiChina

Atherosclerosis is a chronic inflammatory metabolic disease with a complex ***,the exact details of its pathogenesis are still unclear,which limits effective clinical treatment of ***,multiple studies have demonstrated that the gut microbiota plays a pivotal role in the onset and progression of *** review discusses possible treatments for atherosclerosis using the gut microbiome as an intervention target and summarizes the role of the gut microbiome and its metabolites in the development of *** strategies for the treatment of atherosclerosis are *** review provides clues for further research on the mechanisms of the relationship between the gut microbiota and atherosclerosis.

关键词： atherosclerosis coronary heart disease gut microbiome metabolites treatment

Nine-month Angiographic and Two-year Clinical Follow-up of Novel Biodegradable-polymer Arsenic Trioxide-eluting Stent Versus Durable-polymer Sirolimus-eluting Stent For Coronary Artery Disease

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Chinese Medical Journal 2015年第6期128卷 768-773页

作者： Li Shen Wei Yang Jia-Sheng Yin Xue-bo Liu Yi-ZheWu Ai-jun Sun Ju-Ying Qian jun-bo ge Department of Cardiology Shanghai Institute of Cardiovascular Diseases Zhongshan Hospital Fudan University Shanghai 200032 China Department of Cardiology First Affiliated Hospital of Harbin Medical University Harbin Heilongjiang 150001 China Department of Cardiology East Hospital Tongji University School of Medicine Shanghai 200120 China

Background:Despite great reduction of in-stent restenosis,first-generation drug-eluting stents (DESs) have increased the risk of late stent thrombosis due to delayed *** trioxide,a natural substance that could inhibit cell proliferation and induce cell apoptosis,seems to be a promising surrogate of sirolimus to improve DES *** randomized controlled trial was to evaluate the efficacy and safety of a novel arsenic trioxide-eluting stent (AES),compared with traditional sirolimus-eluting stent (SES).Methods:Patients with symptoms of angina pectoris were enrolled and randomized to AES or SES *** primary endpoint was target vessel failure (TVF),and the second endpoint includes rates of all-cause death,cardiac death or myocardial infarction,target lesion revascularization (TLR) by telephone visit and late luminal loss (LLL) at 9-month by angiographic ***:From July 2007 to 2009,212 patients were enrolled and randomized 1 ∶1 to receive either AES or *** 2 years of follow-up,TVF rate was similar between AES and SES group (6.67％ vs.5.83％,P =0.980).Frequency of all-cause death was significantly lower in AES group (0 vs.4.85％,P =0.028).There was no significant difference between AES and SES in frequency of TLR and in-stent restenosis,but greater in-stent LLL was observed for AES group (0.29 ± 0.52 mm vs.0.1 0 ± 0.25 mm,P =0.008).Conclusions:After 2 years of follow-up,AES demonstrated comparable efficacy and safety to SES for the treatment of de novo coronary artery lesions.

关键词： Arsenic Trioxide Coronary Artery Disease Drug-eluting Stent

Small balloon strategy associated with low pacemaker implantation rate after self-expanding transcatheter valve implantation

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World Journal of Emergency Medicine 2021年第1期12卷 48-53页

作者： Yuan Zhang Wen-zhi Pan Li-hua Guan Xiao-chun Zhang Sha-sha Chen Li-fan Yang Lei Zhang Ming-fei Li Dan-dan Chen Da-xin Zhou jun-bo ge Department of Cardiology Shanghai Institute of Cardiovascular DiseaseZhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND: This study aims to investigate whether small balloon aortic valvuloplasty(BAV) reduces the need for permanent pacemaker implantation (PPMI) after transcatheter aortic valveimplantation (TAVI).METHODS: This was a retrospective analysis using data from our local TAVI database. SmallBAV was defined as a small balloon size (=18 mm) pre-dilatation. Normal BAV was defined as aballoon size >18 mm. The primary endpoint was the incidence of new ***: Of 99 consecutive TAVI patients, five patients were excluded due to pre-existingpermanent pacemaker. Patients in the small BAV group (n=57) had a signifi cantly lower PPMI ratecompared with the normal BAV group (n=37) (3.5% vs. 18.9%, P=0.026). Moderate or severe aorticvalve regurgitation post-procedure was similar between the small BAV and normal BAV groups (5.3%vs. 8.1%, P=0.480);likewise, the mean aortic gradient post-procedure did not differ significantly(11.5±5.2 mmHg vs. 12.2±7.3 mmHg, 1 mmHg=0.133 kPa, P=0.580) between the groups. Devicesuccess rates were also similar (94.7% vs. 91.8%, P=0.680). In multivariable analysis, small BAV(P=0.027), the ratio of prosthesis diameter to annulus diameter (P=0.048), and mean aortic gradientby echo in the basement (P=0.021) were independent predictors of ***: The small BAV strategy is associated with a low rate of permanentpacemaker implantation after transcatheter self-expanding valve implantation in this single-centerobservational study.

关键词： Transcatheter aortic valve implantation Balloon aortic valvuloplasty Balloon size Permanent pacemaker implantation