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Changes of I_(K,ATP) current density and allosteric modulation during chronic atrial fibrillation

Chinese Medical Journal 2005年第14期118卷 1161-1166页

作者： WUGang HUANGCong-xin TANGYan-hong JIANGHong WANJun CHENHui XIEQiang HUANGZheng-rong departmentofcardiology RenminHospitalofWuhanUniversityWuhan430060China departmentofcardiology RenminHospitalofWuhanUniversityWuhan430060China

Background Atrial fibrillation (AF) is the most common supraventriculararrhythmia in clinical practice. Chronic atrial fibrillation (CAF) is associated with ionicremodeling. However, little is known about the activity of ATP-sensitive potassium current I_(K,ATP) during CAF. So we studied the changes of I_(K, ATP) density and allosteric modulation ofATP-sensitivity by intracellular pH during CAF. Methods Myocardium samples were obtained from theright auricular appendage of patients with rheumatic heart disease complicated with valvular diseasein sinus rhythm (SR) or CAF. There were 14 patients in SR group and 9 patients in CAF group. Singleatrial cells were isolated using an enzyme dispersion technique. IKiATP was recorded using thewhole-cell and inside-out configuration of voltage-clamp techniques. In whole-cell model, myocytesof SR and CAF groups were perfused with simulated ischemic solution to elicit I_(K, ATP). Ininside-out configuration, the internal patch membranes were exposed to different ATP concentrationsin pH 7. 4 and 6. 8. Results Under simulated ischemia, I_(K, ATP) current density of CAF group wassignificantly higher than in SR group [(83.5 ± 10.8) vs. (58.7 ±8.4) pA/pF, P < 0. 01 ] . I_(K,ATP) of the two groups showed ATP concentration-dependent inhibition. The ATP concentration for 50%current inhibition (IC_(50) ) for the SR group was significantly different in pH 7. 4 and pH 6. 8(24 vs. 74 μmol/L, P < 0. 01). The IC_(50) did not change significantly in CAF group when the pHdecreased from 7. 4 to 6. 8. Conclusions During CAF, I_(K, ATP) current density was increased andits allosteric modulation of ATP-sensitivity by intracellular pH was diminished.

关键词： atrial fibrillation potassium current current density allostericmodulation

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Covert lung abscess as a cause of atrial arrhythmia: case report

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Chinese Medical Journal 2005年第14期118卷 1227-1229页

作者： LIMei LIAODe-ning ZHANGJia-you YINRen-fu WUZong-gui departmentofcardiology ChangzhengHospitalShanghai200003China departmentofcardiology ChangzhengHospitalShanghai200003China

Atrial arrhythmia is common in clinic. Recently, it was revealed that ectopicimpulses originating in sleeve muscles around the orifices of pulmonary veins (PVs) were deemed tobe one of the most important reasons that trigger or drive atrial arrhythmia, which was calledmyocardial sleeve related arrhythmia. Electrical isolation by radiofrequency ablation is becominghighlight and proved to be an effective method for the arrhythmia. We report a 55-year-old man withparoxysmal atrial tachy-arrhythmias admitted for PV electrical isolation. An abscess was discoveredin right inferior lung before the operation. The arrhythmia was disappeared after resection of theabscess. It implies that for such sufferer and recidivist after ablation, the factors outside thepulmonary veins should be excluded or treated as far as possible, especially before radiofrequencyablation therapy.

关键词： atrial arrhythmia pulmonary vein lung abscess

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Effects of irbesartan on atrial cell electrophysiology

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Chinese Medical Journal 2005年第3期118卷 231-233页

作者： HUANGCong-xin CAOFeng JIANGHong WANGTeng LIXia departmentofcardiology RenminHospitalofWuhanUniversityWuhan430060China departmentofcardiology RenminHospitalofWuhanUniversityWuhan430060China

Atrial fibrillation (AF) is the most common sustained arrhythmia encounteredin clinical practice.1 Its incidence increases with age and the presence of structural heartdisease. It is a major cause of stroke, especially in the elderly. It has been shown thatangiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardialinfarction.2 Several studies have shown that activation of the rennin-angiotensin system isassociated with the mechanisms of AF. Irbesartan is a long-acting angiotensin II type 1 receptorantagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstratedthat patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrialfibrillation than did patients treated with amiodarone alone.4 These findings suggest that theinhibition of angiotensin II may prevent AF, but its underlying electrophysiological mechanisms areobscure. The purpose of this study is to investigate the effects of irbesartan on atrial cellelectrophysiology.

关键词： irbesartan arrhythmia electrophysiology ion channels

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Ectopic activity induced by elevated atrial pressure in rabbit pulmonary vein in vitro

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Chinese Medical Journal 2005年第14期118卷 1210-1213页

作者： LIUJie HUANGCong-xin BAOMing-wei WANGTeng departmentofcardiology RenminHospitoalofWuhanUniversityWuhan430060China departmentofcardiology RenminHospitoalofWuhanUniversityWuhan430060China

Atrial fibrillation ( AF ) is a common tachyarrhythmia and may cause seriouscomplications, such as stroke. When atrial pressure was elevated, the effect refraction period (ERP)was shortened and the conductivity in atria was slowed and the heterogeneity of different parts ofatria was increased These changes facilitate the occurrence and maintenance of AF. Recent researchesdemonstrated that pulmonary veins (PVs) are important sources of ectopic beats in the initiation ofparoxysmal AF. In patients with drug-resistant chronic AF and structural heart disease, afterelectrical cardioversion, the PVs are also the dominant trigger in reinitiating AF. Yamane et alreported that, AF patients were often with dilated PVs if the AF was initiated by focal activity inPVs. Atrial myocardial fibers wrap around the PVs entering the left atrium to form PV myocardialsleeves (PVMSs), and this structure is the origin of focal activity. Little is known about theeffects of elevated atrial pressure on PV electrophysiology. In the present study, we found that,spontaneous activity in PVMSs could be induced by elevated atrial pressure and it could affect theatrial rhythm.

关键词： atrial fibrillation electrophysiology action potential

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Effectof Ginsenoside Re on Cardiomyocyte Apoptosis and Expression of Bcl-2/Bax Gene after Ischemia and Reperfusion in Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第4期22卷 305-309页

作者：刘正湘李志刚刘晓春 departmentofcardiology DepartmentofNeurobiology

To observe the effectof ginsenoside Re on cardiomyocyte apoptosis and Bcl- 2 / Bax gene expression after ischemia (30 m in) and reperfusion (6 h) in rats and to elucidate the possible m echanism s of ginsenoside Re on inhibition of cardiom yocyte apoptosis,the ischem ia/ reperfusion heart m odel was established by ligating the left anterior descending branch of coronary artery in Wistar rats.The apoptotic cardiom yocytes were confirmed by transm ission electron m icroscopy and counted by in situ nick end labeling(TU NEL) method and lightm icroscopy.The m RNA and protein expression of Bcl- 2 and Bax genes were studied by in situ hybridization and im munohis- tochemical staining.Mean optical density (OD) value of the positive fields of m RNA and protein expression was quantitatively exam ined by im age analysis system.The results were as follows: (1) The apoptotic cardiomyocytes were found in ischemic fields in the ischem ia/ reperfusion group and weren't observed in the sham- operation group by transmission electron microscopy;(2 ) The num bers of the apoptotic cells were134.4 5± 4 5 .6 1/ field in the ischemia/ reperfusion group,and 90 .6 6± 19.2 2 / field in the ginsenoside Re- treated group.The differences was significant between two groups(P0 .0 5 ) ,but gene expression of Bax was decreased significantly in the ginsenoside Re- treated group as compared with the ischem ia/ reperfusion group(P<0 .0 1) .The ratio of Bcl- 2 / Bax was increased significantly in the ginseno- side Re- treated group when com pared with the ischem ia/ reperfusion group and sham- operation group.These findings suggest that m yocardial ischem ia- reperfusion can induce cardiom yocy

关键词： ginsenoside Re ischemia/ reperfusion cardiomyocyte apoptosis Bcl- 2 / Bax

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Anticoagulation control in atrial fibrillation patients present to outpatient clinic of cardiology versus anticoagulant clinics

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Chinese Medical Journal 2005年第14期118卷 1206-1209页

作者： DUXin MAChang-sheng LIUXiao-hui DONGJian-zeng WANGJun-nan CHENGXiao-jing departmentofcardiology AnzhenHospitalCapitalUniversityofMedicalSciencesBeijing100029China departmentofcardiology AnzhenHospitalCapitalUniversityofMedicalSciencesBeijing100029China

Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiacarrhythmia in clinical practice, which if untreated results in a doubling of cardiovascularmorbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 timeshigher than patients in sinus rhythm. During recent years, several randomised clinical trialsconducted by investigators around the world involving 13 843 participants with NVAF havedemonstrated convincingly the value of warfarin therapies for stroke prevention in high riskpatients. However, the dose response of warfarin is complex and its activity is easily altered byconcurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice androutine monitoring of the international normalized ratio (INR) is important, because lowanticoagulant intensity predisposes the patients to thromboembolic complications and high intensityto haemorrhage. Studies suggested that anticoagulant clinics could improve the quality ofanticoagulation control, and anticoagulant clinics are common in western countries. However, inChina, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, whilethe quality of anticoagulation control is never investigated. We therefore assessed anticoagulationcontrol in the outpatient clinic of cardiology, and the quality of anticoagulation control since theestablishment of anticoagulant clinics.

关键词： atrial fibrillation anticoagulation control anticoagulant clinics

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Polymorphism of the second exon of human leukocyte antigen-DQA1, -DQB1 gene and genetic susceptibility to idiopathic dilated cardiomyopathy in people of the Han nationality in northern China

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Chinese Medical Journal 2005年第3期118卷 238-241页

作者： LIUWei LIWei-min SUNNing-ling departmentofcardiology FirstAffiliatedHospitalofHarbinMedicalUniversityHarbin150001China departmentofcardiology People＇sHospitalofPekingUniversityBeijing100034China

Idiopathic dilated cardiomyopathy ( IDC) is characterized by dilation andimpaired contraction of the left ventricle or both, and it is a relevant cause of heart failure anda common indication for heart transplantation. The major pathogenetic hypothesis in IDC involvesautoimmune mediated damage to myocytes. The development of autoimmune inflammatory damage occursonly in patients with a predisposing genetic background. Changes in the immune system concerningcell-mediated and humoral immunity have been detected. The immune system is strictly related tohuman leukocyte antigen (HLA), which is located on the surface of antigen presenting cells. Itsprimary function is to restrict T-cell receptors in the process of recognizing auto- or exteriorantigen, and thus participates in or mediates immunological recognition, immunological response andimmune regulation at various levels. HLA is a genetic marker of susceptibility to autoimmunemyocardial damage. In the present study, the HLA-DQA1 and -DQB1 alleles in IDC patients weredetected with the techniques of polymerase chain reaction-sequence specific primers ( PCR-SSP) toexplore the immunogenetic mechanisms involved in the pathogenesis of IDC.

关键词： idiopathic dilated cardiomyopathy human leukocyte antigen genepolymorphism genetic susceptibility

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Assessment of left ventricular segmental function after autologous bone marrow stem cells transplantation in patients with acute myocardial infarction by tissue tracking and strain imaging

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Chinese Medical Journal 2005年第14期118卷 1175-1181页

作者： RUANWen PANCui-zhen HUANGGuo-qian LIYan-lin GEJun-bo SHUXian-hong departmentofcardiology ZhongshanHospitalofFudanUniversityShanghai200032China

Background Emerging evidence suggests that stem cells can be used to improvecardiac function in patients after acute myocardial infarction. In this randomized trial, we aimedto use Doppler tissue tracking and strain imaging to assess left ventricular segmental functionafter intracoronary transfer of autologous bone-marrow stem cells ( BMCs) for 6 months' follow up.Methods Twenty patients with acute myocardial infarction and anterior descending coronary arteryocclusion proven by angiography were double-blindedly randomized into intracoronary injection ofbone-marrow cell (treated, n = 9 ) or diluted serum ( control, n = 11) groups. GE vivid 7 andQ-analyze software were used to perform echocardiogram in both groups 1 week, 3 months and 6 monthsafter treatment. Three apical views of tissue Doppler imaging were acquired to measure peak systolicdisplacement ( D_s) and peak systolic strain (ε_(peak)) from 12 segments of LV walls. Leftventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume ( ESV) wereobtained by Simposon's biplane method. Results (1) 3 months later, D_a and ε_(peak) over theinfract-related region clearly increased in the BMCs group [D_8: (4.49 ±2.71) mm vs (7.56 ±2.95)mm, P 0.05; ε_(peak): ( - 13.84 ± 6.05) %vs ( - 15.04 ± 6.75) % , P > 0.05 ]. At the same time, D_s over the normal region also increased,but the D_8 enhancement was markedly higher in the BMCs group than that in the control group [ (3.21±3.17) mm vs (0.76 ± 1.94) mm, P 0.05). (2) LVEF in treated and control groups were almost the same at baseline (1st week after PCI) [ (53.37 ± 8.92) % vs (53.51 ± 5.84) % , P > 0.05 ]. But 6 months later, LVEFin the BMCs group were clearly higher than that in the control group [(59.33 ± 12.91)% vs (50.30 ±8.30)%, P < 0.05 ]. (3) There were no evident d

关键词： echocardiography tissue doppler imaging acute myocardial infarction bonemarrow stem cells cell transplantation

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Pulmonary vein occlusion and remodeling after electrical isolation treatment for atrial fibrillation: a case report

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Chinese Medical Journal 2005年第14期118卷 1225-1226页

作者： DONGYing-xue GAOLian-jun ZHANGShu-long LIUJin-jiu LIShi-jun BIANXiao-ming LINZhi-hu YANGYan-zong departmentofcardiology FirstAffiliatedHospitalofDalianMedicalUniversityDalian116021China departmentofcardiology FirstAffiliatedHospitalofDalianMedicalUniversityDalian116021China

Pulmonary vein (PV) stenosis or occlusion is a recently describedcomplication of radiofrequency ablation for atrial fibrillation (AF), though favorable results of PVostial ablation have fueled great enthusiasm. The presenting symptoms include dyspnea, cough,hemoptysis, pleural infusion and pulmonary consolidation. We report a case with left PVs occlusionafter ablations, treated with the surgical operation for the PV reconstruction. All the symptomsincluding the left pleural effusion were relieved after the operation. To our knowledge, the case wepresent here is the first surgical operation for PVs occlusion in China's Mainland, which will extendthe understanding of the pulmonary complications and provide an effective strategy for removing thePV occlusion.

关键词： pulmonary vein occlusion radiofrequency ablation atrial fibrillation

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Effects of granulocyte-macrophage colony stimulating factor on the repair of vessel intima damaged by balloon

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Chinese Medical Journal 2005年第3期118卷 220-225页

作者： ZHANGXing-hua MAXiao-jing ZHAOTong departmentofcardiology ShandongProvincialHospitalJinan250021China DepartmentofIntensiveCareUnit ShandongProvincialHospitalJinan250021China departmentofcardiology SecondAffiliatedHospitalofShandongUniversityJinan250000China

The dysfunction of vascular endothelial cells plays a key role in startingand facilitating restenosis. The acceleration of intima repair and the recovery of endothelialfunction would reduce the restenosis rate. This study was undertaken to assess the effect ofgranulocyte-macrophage colony stimulating factor ( GM-CSF) on the repair of damaged iliac arteries.Twenty-four male New Zealand white rabbits undergoing primary iliac artery deendothelialization wererandomly divided into two groups ( GM-CSF group and control group) . The GM-CSF group received asubcutaneous injection of GM-CSF (10 μg ? kg^(-1) ? d^(-1) ) , and the control groupwas given a subcutaneous injection of equivalent saline. The iliac arteries of all animals weredamaged by balloon after 7 days. The levels of nitric oxide ( NO) were detected before, 1 week, 2weeks and 4 weeks after angioplasty. The repair and hyperplasia of the intima were observedmicroscopically and the indices of stenosis were evaluated by computerized planimetry after 4 weeksof angioplasty. The NO levels of the GM-CSF group were higher than those of the control group 2weeks and 4 weeks after angioplasty [91.92 +-11.57) μmol/L vs. (81. 67 +- 12. 18) μmol/L; (97. 67+- 10. 13 ) ( μmol/L vs. (83. 16 +-12. 64) μmol/L]. Four weeks after balloon damage,histological examination showed that neointima formation, vascular smooth muscle cells and fibroustissue of the GM-CSF group were less than those of the control group. The endothelium of the GM-CSFgroup was more integrated, and stenosis of lumen was slighter than that of the control group.Morphometry showed the lumen area of the GM-CSF group was larger than that of the control group[(1.27 +-0. 31) mm^2 vs. (0. 92 +- 0. 24) mm^2 ] , the neointimal area and percent of intimahyperplasia were significantly smaller than those of the control group [ (0. 85 +-0. 34) mm vs. (1.18 +-0. 38) mm^2; (40 +- 7)% vs. (55 +- 6)%]. GM-CSF could facilitate the repair of the intima,reduce neointima formation, better the function of the endothelium, and decrease

关键词： granulocyte-macrophage colony stimulating factor angioplasty hyperplasia

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