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Objectives Bim is a BH3-only member of the Bcl-2 family, previous research showed Bim could induce the apoptosis of cardiomyocytes in rat model of myocardial infarction, the area of infarction and the expression of Bim were increased sharply when its subjected to cold stress, but the mechanism is unclear. To investigate the relationship between Pim-2 and Bim in cardiomyocytes when subjected to deeper temperature (25°), and discuss the biological functions of Pim-2. Methods Cultured rat cardiomyocytes H9c2 cells, cells were exposed to 25° for 4h, 12h, 24h to build the different degree model of cold stress. Transfected the overexpression and interference plasmid of Pim-2 to control and cold stress group. The ratio of apoptosis was determined by AnnexinV-FITC/PI, the activity of LDH were observed by automatic biochemistry analyser and the expression of Pim-2, Bim, caspase-3 were tested by Western blotting. Immunoprecipitation assay were used to identify the interaction of Pim-2 and Bim. Results Compared to the control group, apoptosis ratio, the LDH activity and the expression of Pim-2, Bim, caspase-3 were all increased in cold stress group (P Conclusions Pim-2 can resist the cardiomyocytes injury which caused by cold stress, the maight mechanism is to regulated the expression of Bim.

Objectives The aim of this meta-analysis is to perform an up-to-date assessment on short-term and long-term effectiveness of PCI for CTO recanalisation. Despite advances in procedural techniques and expertise, percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) in select patients remains a challenge. Recently, several observational studies which compared successful CTO with PCI versus failed CTO procedures have controversial outcomes. Methods We conducted with a search of PUBMED, ELSEVIER, and CLINICAL.COM and had concluded all of published studies, from January 2000 until July 2012, which compared PCI treatment of successful CTO to failed CTO procedures. Results A total of sixteen observational studies enrolling 10,256 patients (7,320 patients in successful CTO and 2,936 patients in failed CTO group) were included. Compared with failed CTO, successful CTO recanalisation group significantly reduced all-cause death (3.6% vs. 8.2%; P Conclusions Base on this meta-analysis, successful PCI recanalisation may be considered a efficacious option for the patients with CTO lesions and should be comfirmed by future randomised trials.

Objectives Experimental and clinical studies have suggested the presence of fragmented QRS (fQRS) are associated with various cardiovascular diseases. fQRS may predict major adverse cardiovascular events (MACE). A meta-analysis was conducted to investigate the relationship between fQRS and MACEs. Methods A systematic literature search of COCHRANE, MEDLINE, EMBASE, PUBMED, ELSEVIER, SPRINGERLINK and OVID from their respective inceptions to December 2012 was conducted using specific search terms such as “fragmented QRS” and “fQRS”. Data was extracted from applicable articles and odds risk (OR) or mean differences, including 95% confidence intervals (CI) were calculated using RevMan 5.1 software. Results A total of 14 cohort studies (N = 3609 patients) were identified. Compared with the non-fQRS group, MACEs was significantly higher in the fQRS group (OR 2.53, 95% CI [1.71, 3.73], P Conclusions Based on the current evidence, fQRS seems to be an effective marker in the prediction of MACEs in ischaemic and non-ischemic patients and the all-cause mortality in ischaemic patients.

Objectives To summarise the experience in transcatheter closure of residual fistula after surgery repair of tetralogy of Fallot (TOF). Methods Between January 2010 and November 2012, transcatheter closure was attempted on 9 (5 male, 4 female) patients, with residual membrane ventricular septal fistula following surgery repair of TOF. The mean age of patients was 15.68 ± 5.20 years (range from 4 to 36). Results 9 patients, diagnosed with TOF, underwent surgery repair. In two cases, the diameter of residual fistula was 6 mm and 5 mm measured by echocardiography after 1 month’s follow-up. 3 cases were found with systolic murmurs at 1 and 2-year follow-up respectively, with the size of fistula 7, 6, 9 mm and 8, 7, 8 mm. Another 1 case suffered from dyspnea 10 years after surgery, with a fistula of10 mm. Complete closure of the defect was obtained in 7 cases (77.78%), except that 2 patients required reoperation because of multiple outlet showed by left ventriculography. 5 cases were implanted with domestic symmetric VSD occluder (1 with 2 occluders), the other 1 case with thin-waist-big-side occluder and another 1 with patent ductus arteriosus (PDA) occluder. No patient had obvious complications related. Conclusions Transcatheter closure of residual fistula after surgery repair of TOF is effective and safe. Domestic VSD occluder and PDA occluder are applicable. It is important to prevent intraoperative injuries of muscle girder and chordae tendineae blocked by track wire and sheath.

Objectives To investigate the effectiveness and safety of the combination of passive leg movement and intravenous furosemide in patients with acute decompensated chronic heart failure (CHF). Methods 62 acute decompensated CHF in-patients with II-IV NYHA class were studied, and randomly divided into the passive exercise group (PM + Fs) and the control group (Fs). Each group included 31 patients. The control group received intravenous 20 mg furosemide after admission, while the passive exercise group received the combination of intravenous 20 mg furosemide plus passive leg movement at 40 cycles min -1 for 15 minutes. The serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels, blood pressure (BP) and heart rate (HR) were measured before and 2 hours after treatment. The 2-hour urinary volume was also recorded. Results 1. In comparison with the control group, the 2-hour urinary volume in the passive exercise group was significantly higher (656.77 ± 521.94 ml vs 389.03 ± 216.02 ml, P 2. The basic serum NT-pro BNP levels were similar between two groups (P > 0.05). In the control group, the NT-pro BNP level after treatment was significantly higher than that before treatment (5743.75 ± 5958.92 pg/ml vs 3917.99 ± 4707.97 pg/ml, P 3. The basic systolic blood pressure, diastolic blood pressure and heart rate were similar between two groups (P > 0.05), and there were no significant changes in all three values between before and after treatment in both groups (P > 0.05). Conclusions As intravenous furosemide plus passive leg movement enhances diuresis and decrease of the serum NT-pro BNP level without significant BP and HR changes in 2-hour period, this combination therapy may safely and effectively be used in CHF patients.

Objectives The aim of this meta-analysis is to perform an evaluation on short-term and longterm effectiveness of PCI for CTO recanalisation. Methods We conducted with a search of PUBMED, ELSEVIER, and CLINICAL. COM from January 2000 until July 2012. Either observational studies or randomised clinical trials which compared PCI treatment of CTO recanalisation to medical management were included. Two investigators independently extracted data in standard forms. The endpoints were analysed by using pooled estimates for death, myocardial infarction (MI), CABG, angina symptoms, repeat revascularisation, and the major adverse cardiac event (MACE). Results Sixteen observational studies comparing outcomes after failed vs. successful CTO recanalisation with PCI were found. These studies enrolling 10,256 patients observed at an average follow-up period of 5 years. Successful CTO recanalisation group significantly reduced the rates of all-cause death (OR-0.47, 95% CI 0.39-0.56, P Conclusions Base on this meta-analysis, PCI should be considered a efficacious option for the patients with CTO lesions and the future randomised trials should confirmed these results.

Objectives To summarise the experience in transcatheter closure of residual fistula after surgery repair of tetralogy of Fallot (TOF). Methods Between January 2010 and November 2012, transcatheter closure was attempted on 9 (5 male, 4 female) patients, with residual membrane ventricular septal fistula following surgery repair of TOF. The mean age of patients was 15.68 ± 5.20 years (rage from 4 to 36). Results 9 patients, diagnosed with TOF, underwent surgery repair. In two cases, the diameter of residual fistula was 6 mm and 5 mm measured by echocardiography after 1 month’s follow-up. 3 cases were found with systolic murmurs at 1 and 2-year follow-up respectively, with the size of fistula 7, 6, 9 mm and 8, 7,8 mm. Another 1 case suffered from dyspnea 10 years after surgery, with a fistula of 10 mm. Complete closure of the defect was obtained in 7 cases (77.78%),except that 2 patients required reoperation because of multiple outlet showed by left ventriculography. 5 cases were implanted with domestic symmetric VSD occluder (1 with 2 occluders),the other 1case with thin-waist-big-side occluder and another 1with patent ductus arteriosus (PDA) occluder. No patient had obvious complications related. Conclusions Transcatheter closure of residual fistula after surgery repair of TOF is effective and safe. Domestic VSD occluder and PDA occluder are applicable. It is important to prevent intraoperative injuries of muscle girder and chordae tendineae blocked by track wire and sheath.

Objective D-dimer is a primary degradation product of thrombus. Whether it will be increased in myocardial infarction is still controversial. To study the change of D-dimer in coronary artery disease, this study investigated the level of plasma D-dimer in different type AMI patients at different stage. Methods The study group consisted of 200 patients suffered with acute coronary syndrome (ACS) from Jan 2011 to Jun 2012. 100 of the patients were diagnosed as STEMI; the rest was NSTEMI. And 100 patients excluded organic disease were enrolled as the contrast group. Blood was drawn at the time of admission, 12h and 24 hours after that. The samples were measured for cTnI, BNP, hs-CRP and fibrin D-dimer. All ACS patients were underwent active PCI strategy. Results Mean age of these patients was 65.6 years. Female is about 41.2% and male about 58.8%. In patients with STEMI, the level of cTnI, BNP and hs-CRP was significantly higher than that in patients without organic disease at the time of admission, 12h and 24h after that. While the level of D-dimer was not significantly different among the three groups at any time. The data is 103.4 ± 13.3ug/l, 108.2 ± 9.4ug/l and 98.5 ± 12.6ug/l in STEMI patients at the time of admission, 12h and 24h after that, respectively. The level of D-dimer is 103.1 ± 11.3ug/l, 97.8 ± 8.6ug/l and 98.6 ± 11.6ug/l in NSTEMI patients at the time of admission, 12h and 24h after hat, respectively. The contrast patients data is 96.4 ± 9.3ug/l, 98.3 ± 8.6ug/l and 95.5 ± 10.2ug/l at the time of admission, 12h and 24h after that, respectively. Conclusions Early level of circulating cTnI, BNP and hs-CRP was significantly higher in ACS, while there was no dynamic change of D-dimer level in patients with ACS, whatever STEMI or NSTEMI.

Objective To summarise the experience in transcatheter closure of residual fistula after surgery repair of tetralogy of Fallot (TOF). Methods Between January 2010 and November 2012, transcatheter closure was attempted on 9(5 male, 4 female) patients, with residual membrane ventricular septal fistula following surgery repair of TOF. The mean age of patients was 15.68 ± 5.20 years (rage from 4 to 36). Results 9 patients, diagnosed with TOF, underwent surgery repair. In two cases, the diameter of residual fistula was 6mm and 5mm measured by echocardiography after 1month’s follow-up. 3 cases were found with systolic murmurs at 1 and 2-year follow-up respectively, with the size of fistula 7, 6.9mm and 8, 7.8mm. Another 1 case suffered from dyspnea 10 years after surgery, with a fistula of10mm. Complete closure of the defect was obtained in 7 cases (77.78%), except that 2 patients required reoperation because of multiple outlet showed by left ventriculography. 5 cases were implanted with domestic symmetric VSD occluder (1 with 2 occluders), the other 1case with thin-waist-big-side occluder and another 1 with patent ductus arteriosus (PDA) occluder. No patient had obvious complications related. Conclusions Ttranscatheter closure of residual fistula after surgery repair of TOF is effective and safe. Domestic VSD occluder and PDA occluder are applicable. It is important to prevent intraoperative injuries of muscle girder and chordae tendineae blocked by track wire and sheath.

Objective In China, the occurrence rule, mechanisms and prevention measures of diseases under extreme weather are few reported and which (del) only focused (focus) on pathophysiological manifestation rather than molecular mechanism level. So (del) (Thus,) further study in this work will be carried out from molecular cytological level. This study explored (del) the effect of hyperthermia on ventricular cardiomyocytes and the participative roles of classic MAPK - ERK5 pathways on hyperthermia induced cardiomyocytes damage. Methods Neonatal rat ventricular cardiac myocytes (NRVM) were isolated from the hearts of 1- to 3-day-old Sprague Dawley rats. NRVM were exposed to a hyperthermia (42°C, 60 min) environment. The degree of cell damage was observed at 0, 4, 8, 12, 16, and 24 h after recovery. The effects of hyperthermia on myocardial cells were probed by evaluating lactate dehydrogenase (LDH) release, cells beating rate and rhythm and viability (assessed by MTS assay). Apoptosis was detected using an annexin V-FITC/propidium iodide (PI) staining binding assay. Using western blot semi-quantitating Bim and extracellular signal-related kinase (ERK5) /phosphorylated extracellular signal-related kinase (p-ERK)(??). Using PD98059 as an inhibitor of MAPK pathways, semi-quantitating Bim by western blot(??). Results 1. The beating rate of myocardial cells was slightly decreased immediately after temperature recovery, (del)(and) gradually decreased with time prolonged, and the (del)(.) Cell viability was (del) decreased (p Conclusions Hyperthermia induces myocardial cells damage with apoptosis as main type. ERK5 participated the injure process of hyperthermia and Bim played its role via a MAPK-ERK5 pathway.

Objective To observe the changes of B-type natriuretic peptide (BNP) in chronic heart failure (CHF) patients with diabetes mellitus (DM). Methods In this study, 559 CHF patients were enrolled, of them 276 patients with coronary heart disease diagnosed by coronary angiography, 234 with hypertensive heart disease, and 49 with dilated cardiomyopathy. They were divided into non-DM group and DM group of 175 patients. NYHA cardiac function degree, and routine blood test, BNP, fasting blood glucose, serum creatinine were detected. Left ventricular ejection fraction and the average thickness of left ventricular wallwere detected by chocardiograpy. The heart failure scale was evaluated for each patient with the age, hypertension, LVEF, LVW and NYHA degree. And the relationship curve of scale-BNP was constructed. Results 1. The BNP was significantly higher in DM group than in non-DM group (1143.73±94.0 vs 884.34±57.0, p Conclusion As the CHF patients with DM have significantly higher BNP level, the DM history and fasting blood glucose should be taken into consideration when for evaluating the heart failure with BNP.

Double ventricular response in dual atrioventricular (AV) nodal pathways can result in nonreentrant supraventricular tachycardia. Since this condition was first described in 1979, around 20 cases have been reported. Here, we present the case of a patient with a confirmed diagnosis of double ventricular response in dual AV nodal pathways resembling an interpolated premature beat who underwent successful radiofrequency ablation of the slow pathway.