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老年心脏病学杂志（英文版）

老年心脏病学杂志（英文版）

Journal of Geriatric Cardiology
期刊简介《老年心脏病学杂志（英文版）》(Journal of Geriatric Cardiology, JGC)是由中国人民解放军总医院主管、解放军总医院老年心血管病研究所主办、科学出版社第二主办的国际性医学学术期刊。该杂志创刊于2004年，国际标准刊号ISSN1671-5411，国内统一刊号CN11-5329/R。《老年心脏病学杂志（英文版）》致力于国际老年心脏病学交流，特别是将国内老年心脏病学及相关领域的学术进展介绍给国外同行。主要栏目有临床研究、基础研究、综述、病例报告、专题论文集、读者来信等。目前该刊已经被SCIE、PubMed Central (PMC)、Scopus、EMBase、Chemical Abstract（CA）、DOAJ、Chinese Science Citation Database (CSCD)、WanFang Data、CAS-OAJ、Open J-Gate 及Google Scholar等国内、国际重要文献检索系统收录, 是中国大陆心血管领域第一本被SCI收录的期刊。特色与优势快速评审：所有来稿均可在一个月内得到审稿意见，接受稿件可在三个月内发表；评审专家阵容强大：我们有来自世界各地的360名心血管领域专家为我们审稿,能保证每篇稿件的审稿质量，即使您的文章经评审后不能在本杂志上发表，详尽的评审意见也会对您的研究起到非常好的促进作用；文章可见度高：本刊目前被许多国际著名医学数据库收录，比如SCIE、PubMed、Scopus、 EMBase等，保证了每篇发表文章的可见度。
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  • 发文量：1152
  • 被引量：292
  • H指数：2
  • 开始收录时间：2004(1)
  • CNKI综合因子：0.461
  • 维普期刊影响因子： 0.381
  • 万方期刊影响因子：0.77
  • 创刊时间：2004
  • 国内刊号/CN：11-5329/R
    国际刊号/ISSN：1671-5411
  • 发行周期：季刊
    邮发代号：
  • 主管单位：解放军总医院
    主办单位：老年心血管病研究所
老年心脏病学杂志（英文版）-联系信息
  • 主编：Yun-Dai CHEN
  • 电话：010-64007042
  • 邮箱：jgc@jgc301.com
  • 地址：16 Dong-Huang-Cheng-Gen North Street,Beijing
  • 邮编：100717
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老年心脏病学杂志（英文版） >2021年第10期

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  • 摘要：@@ In this issue of the Journal of Geriatric Cardiology;Jing et al. showed off their near perfect results of percutaneous coronary interventions (PCI) through transfemoral approach (TFA) and transradial approach (TRA) in the elderly Chinese patients. All patients were older.than 60years of age, with an average of 67.
  • 摘要：@@ In vivo visualization of the coronary arteries is the most elegant way to confirm or refute any iatrogenic or pathological lesions and their association with any short- and long-term positive or negative results.
  • 摘要：Objective Heart failure is an epidemic in the elderly, but there is a striking lack of data in this clinically important patient population. We investigated the demographics, cardiac performance, and medication management of a segment of the hospital population in at least their eighth decade of life. Methods We retrospectively reviewed 75 records of heart failure patients who were 80 years of age or older. Records were reviewed for demographic information, presence or absence of diastolic dysfunction, evaluation of ejection fraction, and medication usage including angiotensin-concerting enzyme (ACE) inhibitors, angiotensin receptor antagonists (ARBs),beta-adrenergic blockers, digoxin, and aldosterone antagonists. Assessment for contra-indications to ACE inhibitor or ARBs use was also performed to assess co-morbidities that limit treatment of heart failure. Results The population of very elderly with heart failure is heterogeneous. We found a higher proportion of females as well as higher rates of diastolic dysfunction in patients aged ≥ 90 years compared to patients between the ages of 80-89 years. Usage of ACE inhibitors, ARBs and beta-adrenergic blockers was strikingly low throughout the very elderly population. While co-morbid conditions limited use of agents in many cases, there was a lack of explicit contra-indication in most patients not on an ACE inhibitor or an ARB. Conclusions Heart failure is not a single disease processes, but a continuum of disease processes that vary with age. The elderly with heart failure are an undertreated population, in part due to the multitude of co-morbidities that affect them. Further prospective studies are needed to better understand the physiology and ideal treatment regiment in this growing population.
  • 摘要：@@ Case presentation rnA 75-year-old male patient received esophageal carcinoma surgery in Oct 2005. The next day of the operation, he had dyspnea, chest discomfort and sweating when he was on some activities.
  • 摘要：Hypertension is a common clinical problem in the elderly worldwide and physicians of all types are likely to encounter patients with hypertensive urgencies and emergencies in these patients. Although various terms have been applied to these conditions,they are all characterized by acute elevations in blood pressure and evidence of end-organ injury. Prompt, but carefully considered therapy is necessary to limit morbidity and mortality. A wide range of pharmacologic alternatives are available to the practitioner to control blood pressure and treat complications in these patients. The management of the elderly patient with hypertensive crises needs to include close monitoring and a gentle decline in blood pressure to avoid catastrophic complications, exacerbation of ischemic myopathy, and vascular insufficiency.
  • 摘要：@@ In general, percutaneous coronary intervention (PCI)is contra-indicated in patients with bleeding and those that are easy to bleed because during PCI the patients need full anticoagulation to counter any thrombotic formation caused by introduction and manipulation of devices in the vascular system.
  • 摘要：Objective To assess the feasibility and safety of transradial approach in Chinese elderly patients undergoing coronary intervention.Methods In this prospective study, 764 elderly patients with coronary artery disease received percutaneous coronary intervention via either a transradial approach (TRA group) or a transfemoral approach (TFA group). The procedural success rate, success rate of artery access, puncture time, fluoroscopy time, dose of contrast, local complications and post-procedural pulmonary embolism were recorded and compared between 2 groups. Results There was no significant difference of the procedural success rate between the TRA group and the TRF group (96.3% vs. 98.2%, P＞0.05); there were also no differences of success rate of cannulation, mean fluoroscopy time and mean dose of contrast between the 2 groups. The mean puncture time was longer in the TRA group than in the TFA group (3.8±2.1 min vs. 2.0±3.4 min, P＜0.05). However, there were fewer access site-related complications in the TRA group than in the TFA group. Postprocedural pulmonary embolism occurred in 2 patients in the TFA group but none in the TRA group. Conclusion Transradial coronary intervention was feasible and safe in most Chinese elderly patients when performed by experienced operators.
  • 摘要：Background and objectives Recent studies have shown that abdominal obesity is an important component for the diagnosis of metabolic syndrome (MS) and MS is a high risk factor for cardiovascular disease and diabetes mellitus. The aim of this study was to develop a new formula for screening and diagnosis of MS using the waist circumference (WC) and skin fold thickness at the point A8(SFA8) on the Erdheim diagram. Methods A total of 358 essential hypertensive patients (189 male and 169 female) with a mean age of 59.0±9.7 years were included; 151 healthy people (79 male, 72 female) with a mean age of 57.3± 12.1 years (similar to hypertensive patients) who were non-hypertensive and non-diabetic served as a control group. All subjects had no evidence of hepatic, renal, or endocrine disease as determined by history, physical examination and screening blood tests. Height, weight, WC, SFA8, blood pressure (BP), fasting plasma glucose, HDL-cholesterol and triglyceride levels were measured in all subjects. Abdominal obesity measured by WC using the Asia-Pacific criteria (IDFA) was applied for meeting the MS definition. The normal value of SFA8 was measured in the nonMS group. Relationships between SFA8 and systolic BP, diastolic BP, fasting plasma glucose, HDL-cholesterol and triglyceride levels were calculated in the control group. A new formula was developed according to high SFA8 and high WC. Results The normal value of SFA8 in non-MS group was 23.6±7.2 mm in male and 26.5±4.6 mm in female, respectively. The value of SFA8 in MS group was 36.7± 7.4 mm in male and 38.9 ± 8.1 mm in female, respectively. The value of WC in MS group and non-MS group were 92.5±3.0 cm and 79.4±6.1 cm in male and 86.3±6.4 cm and 74.7±5.4 cm in female, respectively. There was a correlation between SFA8 and systolic BP, diastolic BP, fasting plasma glucose, HDL-cholesterol and triglyceride in control group (the correlation coefficients were 0.29, 0.23, 0.25, -0.31and 0.46, respectively, P ＜ 0.01). A new formula for MS was suggested as high WC (≥ 90 cm in male, ≥ 80 cm in female) + high SFA8(≥ 30 mm). The sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of the new formula assessed with the IDFA definition were 94%, 93%, 7%, 6%, 92% and 95%, respectively. The percentage of all patients who met the criteria for MS by conventional definition was 46.2%. The percentage of all patients who met the criteria by the new definition was 47.0%. There was no difference between the prevalence percentage of the MS according to new criteria and the IDFA criteria in all patients, in male and in female, respectively (P ＞ 0.05). Conclusion This new formula for MS might be useful for easy screening. The advantage over current criteria is the lack of need for laboratory testing.
  • 摘要：Approximately 50% of all heart failure patients in the US are above 75 years of age, which is almost similar to most European countries and the Middle and the Far East. Even though aging is an independent molecular process with a multitude of genetic predetermination and biochemical mediations, aging itself does not automatically result in cardiac insufficiency. On the other hand, with increasing age, cardioprotective mechanisms in response to stress are lost, and progressive cardiomyocyte degeneration with replacement fibrosis is often seen in older hearts, even though the exact triggers are not completely understood. Older patients with heart failure have distinct features that require special attention in diagnosis as well as therapy. The elderly more frequently suffer from multiple co-morbidities and might have atypical clinical presentations. Several precautions are essential in the treatment of heart failure in the elderly due to co-existing morbidities and the pharmacokinetic and pharmacodynamic changes related to increased age. Also, treatment expectations, compliance, mental status and cognitive function might play a major role regarding optimized treatment and monitoring options in the elderly suffering from heart failure. This review summarizes current issues of heart failure management in the elderly.
  • 摘要：@@ The treatment of choice in symptomatic cases of patients with severe bradycardia remains the implantation of a pacemaker.
  • 摘要：Objective To determine whether sleep-disordered breathing (SDB) may lead to nocturnal myocardial ischemia and whether the severity of this ischemia may be relieved by nasal continuous positive airway pressure (CPAP). Methods Overnight polysomnogram examination and simultaneous 3-channel Holter monitoring were performed on 76 patients with moderate to severe SDB and no history of coronary heart disease. All the cases were treated with CPAP for one night. ST depression was defined as a ST segment decrease of more than 1 mm from baseline and lasting 1 min or more. The total duration (minutes) of ST depression was indexed to the total sleep time (minutes per hour of sleep). Results Twenty-eight patients (37%) showed ST segment depression during their sleep. Before CPAP treatment, the respiratory disturbance index (RDI) and arousal index were significantly higher during periods of ST depression than when ST segments were isoelectric, whereas no significant difference was found in blood oxygen saturation (SaO2). After the CPAP treatment of patients with ST depression, the duration of ST depression was significantly reduced from 36.8±18.9 to 11.4±13.2 min/h (P＜0.05). ST depression-related indexes, including RDI, arousal index and the percentage of sleep time spent at SaO2 below 90% (TS90/ TST), were all significantly decreased, with RDI from 63.4±23.8 to 8.1±6.6 /h, arousal index from 51.2±18.9 to 9.6±5.4 /h, and TS90/ TST from 50.6±21.4 to 12.9±14.7% (P＜0.05). Conclusion ST-segment depression is rather common in patients with moderate to severe SDB, and CPAP treatment can significantly reduce the duration of ST depression. ST depression in these patients may reflect the myocardial ischemia that really exists and the non-ischemic changes associated with recurrent SDB.
  • 摘要：@@ IntroductionrnAffecting over half a million people per year, stroke is the third leading cause of death in the United States. Approximately 30% of strokes are caused by carotid occlusive disease.
  • 摘要：We report a modified technique to perform iliac artery stenting through the brachial artery access. A 6F Brite tip sheath (Cordis, Jonhson & Jonhson Medical, Miami Lakes, FL, USA) is inserted into either brachial artery and a standard 4F Judkins Right diagnostic catheter was inserted over a 260 cm 0.038" Terumo Stiff wire (Terumo Corp, Tokyo, Japan) through the sheath. The catheter is navigated down to the aortic bifurcation, and after selecting the common iliac artery ostium, the wire is navigated through the lesion and advanced to the ipsilateral superficial femoral arteries. The catheter should be then moved forward over the wires beyond the lesion and the Terumo guidewire is replaced by two 0.038" 260 cm Supracor wires (Boston Scientific Corporation, San Jose, CA, USA). In order to facilitate advancement of the stent without risk of dislodgement as well as to check the position with low contrast dose injection, a 6 F (or 7F if large stent is selected) 90cm Shuttle Flexor introducer long sheath (Cook Group, Bloomington, IN, USA) should be advanced over the Supracor wire until it reaches the common iliac artery ostium. A road-map technique can be used to check the ostium position in order to properly deploy the selected stent. This technique promises to be safe and effective offering more support than guiding catheter technique; moreover it reduces the stress on the arterial vessel at the subclavian site and enables a stiff balloon or stent catheter to be advanced even through a very elongated and calcified aorta without the risk of stent dislodgement.
  • 摘要：@@ Carotid artery stenting (CAS) is an alternative treatment for patients with severe carotid artery stenosis, especially those with prohibitively high surgical risks.
  • 摘要：The daily practice of cardiopulmonary resuscitation (CPR) in elderly patients has brought up the attention of outcome research and resource allocation. Determinants to predict survival have been well identified. There has been empirical evidence that CPR is of doubtful utility in the geriatric population, more studies have showed controversial data. Sometimes situations in which CPR needs to be given in the elderly, causes stress to healthcare providers, due to lack of communication of the patient's wishes and the belief that it will not be successful. It is of importance to state that we have the duty to identify on time the patients that will most likely benefit from CPR, and find out the preferences of the same. Whenever it is possible to institute these guidelines, we will avoid patient suffering.
  • 摘要：Objective To determine the plasma urolensin Ⅱ(UⅡ) levels in various types of coronary heart disease and to clarify how the plasma UⅡ levels correlate with the clinical presentation, extent and severity of coronary artery atherosclerosis (CAD). Methods: One hundred and three aged patients undergoing elective diagnostic coronary angiography for proven or clinical suspected coronary heart disease were enrolled in this study. The extent and severity of coronary artery disease were evaluated by vessel score and Gensini score, respectively. Plasma UⅡ levels were measured by radioimmunoassay. Results: The plasma UⅡ levels in the patients with modest to severe coronary stenosis (3.03±0.34 pg/ml, 1.83±0.67 pg/ml) were significantly lower than that in subjects with normal coronary artery (4.80±1.11 pg/ml, P＜0.001). The plasma UⅡ levels in patients with coronary heart disease were also significantly lower than that in patients with insignificant coronary stenosis (P ＜ 0.001). Compared to patients with stable angina pectoris, plasma UⅡ levels in patients with acute coronary syndrome were significantly decreased (1.89±0.51 pg/ml vs 2.42±0.77 pg/ml, P＜ 0.001). Plasma UⅡ levels were found to be negatively correlated with the severity of coronary artery stenosis (r = -0.488, P＜0.001), as well as the vessel score (r = -0.408, P＜0.05) in the patients with CAD. Conclusion: Significant inverse correlations exist between the plasma UⅡ levels, and the extent and severity of coronary artery stenosis. These findings suggest that plasma UⅡ contribute to the development and progression of coronary artery stenosis, and may be a novel marker to predict clinical types, as well as the extent and severity of coronary artery disease in the patients.
  • 摘要：@@ Coronary subclavian steal syndrome arises when a stenosis of the subclavian artery results in reduced antegrade or retrograde flow in an internal mammary artery with resultant coronary ischemia.
  • 摘要：In the last few years the treatment of superficial femoral artery (SFA) occlusive disease has undergone greater changes in management including more aggressive endoluminal therapy, especially in the elderly patients who are at high risk for extra-vascular comorbidities from the surgical approach. While acute and chronic arterial limb ischemia is the conditions which the interventional cardiologists frequently encounter, the elderly population represents special problematic clinical and anatomical setting due to heavy calcification and poor distal run-off. Arterial thrombolysis, rheolytic thrombectomy, mechanical thrombectomy, laser angioplasty, cryoplasty, and new flexible long stents are some of the promising techniques to improve the technical and clinical outcomes in these elderly patients.
  • 摘要：To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient's refusal for surgery, direct carotid access was his only option.
  • 摘要：Sepsis is among the most common reason for admission to intensive care units throughout the world. In the US and most Western nations sepsis is largely a disease of the elderly. Management of elderly patients with severe sepsis is challenging. Early recognition of this syndrome, together with the early administration of appropriate antibiotics and cautious fluid resuscitation is the cornerstone of therapy. Echocardiography together with non-invasive or invasive hemodynamic monitoring is recommended in patients who have responded poorly to fluids or have significant underlying cardiac disease. This paper reviews the hemodynamic changes that characterize sepsis, particularly as they apply to elderly patients and provides recommendations for the management of these patients.
  • 摘要：Objective To evaluate the early and mid-term results of endovascular repair for acute and chronic type B aortic dissection, and to compare the clinical outcomes between the 2 groups. Methods From May 2002 to December 2006, 50 patients with type B aortic dissection were treated by endovascular stent-graft. There were 23 patients in the acute aortic dissection (AAD) group and 27 patients in the chronic aortic dissection (CAD) group. All patients were followed up from 1 to 54 months (average, 17±16 months).The immediate and follow-up clinical outcomes were documented and compared between the 2 groups. Results Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 50 patients. Compared to the CAD group, the AAD group had a higher percentage of pleural effusion (17.4% vs. 0%,P=0.04) and visceral /leg ischemia (26.1% vs 3.7%, P=0.04). Procedure related complications, including endoleak and post-implantation syndrome, occurred more frequently in the AAD group than in the CAD group (21.7% vs 3.7% and 30.4% vs 11.1%, respectively; P=0.08 and P=0.04). Kaplan-Meier analysis showed no difference in the survival rate at 4 years between the 2 groups (86.4% vs 92.3%, P=0.42 by log-rank test). However, the event-free survival rate was higher in patients with chronic dissection than in patients with acute aortic dissection (96.2% vs 73.9%; P=0.02 by log-rank test). Conclusions Endovascular repair with stent-graft was safe and effective for the treatment of both acute and chronic type B aortic dissection. However, both immediate and long term major complications occurred more frequently in patients with acute dissection than in those with chronic dissection.
  • 摘要：@@ Within the recent months, endovascular repair of aortic aneurysms has become a rather interesting alternative to patients considering open surgery. In the past, the procedure was typically and more solely reserved to a selected group of elderly patients with several co-morbidities.
  • 摘要：Background and Objective Elderly patients who have been submitted to coronary bypass grafting with the left internal mammary artery (LIMA) may develop a coronary-subclavian steal syndrome because of a left subclavian artery (LSA) stenosis. Usually stenting of LSA is performed by the standard femoral route with guiding catheter technique, but this technique can be particularly difficult in elderly patients who often have iliac-femoral kinking and aortic tortuosity. We compared a new "ad hoc" brachial artery approach technique with the standard guiding catheter technique through the femoral access. Methods Between January 2005 and September 2006, four patients underwent LSA stenting using the left brachial artery access obtained with a 6F or 7F 45-cm-long valved anti-kinking sheath as the Super Arrow Flex sheath (Arrow International, PA, USA). The sheath was positioned just before the LIMA graft ostium and a 0.035 inch 260-cm-long Storq guidewire (Cordis Inc., Johnson & Johnson, Warren, NJ) was advanced across the lesion to the descending aorta. A balloon-expandable Genesis (Cordis Inc., Johnson & Johnson, Warren, NJ) endovascular stent was easily deployed, and the correct position was checked by direct contrast injection through the long sheath. This small group of patients has been compared to a group of 5 age-matched patients with coronary steal syndrome in whom the procedure has been performed with standard technique including femoral approach and guide catheter. Results The procedure was successful in all patients; vertebral and LIMA ostia remained patent in all cases. In the control group, cannulation of the subclavian artery was difficult in two cases, while one patient developed a groin hematoma. Mean pretreatment gradient was 32 mm Hg with a range of 25 to 40 mm Hg (34 mmHg, range 26-43, in the control group, P=0.87) and fell to 2 mm Hg with a range of 0 to 4 mm Hg (3.1 mmHg, range 0 to 5, P=0.89) posttreatment. Mean contrast dose was 60±16 ml (138±26 ml in the control group, P＞0.01), whereas mean fluoroscopy and procedural time were 5.7±1.6 minutes (10.8±1.0 minutes in the control group, P＞0.01) and 15.7±6.3 minutes (28±7.1 minutes in the control group, P＞0.01). At a mean follow-up of 10±3.2 months all patients are alive and free from angina and residual induced ischemia. Conclusions Our brief study suggested that brachial artery access be considered the optimal route to treat coronary-subclavian steal syndrome in elderly patients because of clear advantages; these included no manipulation of catheter to cannulate the artery, perfect coaxial position of the catheter at the site of LSA stenosis, clear visualization of the LIMA and vertebral ostia, and easy access to these vessels in case of plaque shifting or embolic protection device deployment.
  • 摘要：Smoking should be stopped and hypertension, diabetes mellitus, dyslipidemia, and hypothyroidism be treated in elderly patients with peripheral arterial disease (PAD). Statins reduce the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudication in persons with PAD and hypercholesterolemia. Antiplatelet drugs such as aspirin or clopidogrel, especially clopidogrel, angiotensin-converting enzyme inhibitors, and statins should be given to all persons with PAD. Beta blockers should be given if coronary artery disease is present. Exercise rehabilitation programs and cilostazol lengthen exercise time until intermittent claudication develops. Chelation therapy should be avoided.
  • 摘要：Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.
  • 摘要：Background and Objective Previous study showed tenecteplase and alteplaxe were equovalent for 30-day mortality in the treatment of acute myocardial infarction. The purpose of this open-label, randomized, multi-center, angiographic trial was to assess the efficacy and safety of tenecteplase compared with alteplase in Chinese patients with acute myocardial infarction. Methods We recruited patients with acute ST-elevation myocardial infarction presenting within 6 hours of symptom onset from October, 2002 to March,2004, in 5 hospitals in Beijing. After giving informed consent, patients were randomly assigned a single-bolus injection of tenecteplase (30-50 mg according to body weight) or front loaded alteplase (100 mg), and underwent coronary angiography at 90 min after starting the study drug. All patients received aspirin and heparin (target activated partial thromboplastin time 50-70 s). The primary efficacy end point was the rate of TIMI grade 3 flow at 90 minutes. Other efficacy end points included TIMI grade 2/3 flow at 90 minutes. Safety end points included all stroke, intracranial hemorrhage (ICH), moderate/severe hemorrhage (except for ICH), all-cause mortality at 30-days, and major non-fatal cardiac events at 30 days. Results Overall 110 patients were eligible for statistical analysis, with 58 patients assigned to receive tenecteplase and 52 patients to alteplase. Tenecteplase produced a rate of TIMI grade 3 flow at 90 minutes after the start of thrombolysis(68.4%) similar to that of alteplase (66.7%, P=1.0); the rates of TIMI grade 2 or 3 were similar for patients treated with tenecteplase versus alteplase (89.5% versus 80.4%, respectively, P=0.278). At 30 days, rates for all strokes were similar for the two groups (5.17% for tenecteplase and 1.92% for alteplase, P=0.62); rates of ICH were 3.45% and 1.92% (tenecteplase and rt-PA,P=1.00) respectively. The rate of moderate/severe hemorrhage was 8.62% with tenecteplase and 5.77% with alteplase (P=0.72); total mortality was almost identical in the two groups (13.8% versus 9.6%, respectively, P=0.565) while the rates of non-fatal cardiac complications were 10.35% and 11.54% (tenecteplase and alteplase, P=1.0). Conclusions The efficacy of a single-bolus, weightadjusted tenecteplase fibrinolytic regimen is equivalent to front-loaded alteplase in terms of the rates of TIMI grade 3 flow, and TIMI 2 or 3 flow, but the 30-day mortality and ICH in both groups was so high that the use of tenecteplase is not permitted in China. These negative safety results might be due to the high rate of percutaneous coronary intervention (PCI) and high dose of bolus heparin and suboptimal concomitant medical therapy during hospitalization, so further studies are needed to confirm the safety for tenecteplase in Chinese patients.
  • 摘要：Tumors of the cardiac conduction system (CCS) have rarely been reported. The CCS from 198 cardiac-related deaths (GroupⅠ),and 838 deaths from non-cardiovascular diseases or trauma (Group Ⅱ ), were studied. Sampling was done of the sinoatrial node (SAN)and atrio-ventricular node (AVN) along their long axis of each node as a single block and the His bundle (HB) perpendicular to its long axis in 2-4 blocks. Five-micron serial sections were made; tissue slices were taken intermittently, every 20th from the SAN, every 10th from the AVN, and every 30th from the HB and bundle branches (BB), by continuous slices three times. Tumors in the CCS were found in 12 cases (1.155 %), where 10 (0.965%) were primary tumors, and 2 (0.193%) were metastatic tumors. The primary tumors included 4 fibromata compressing the HB (0.386 %), 4 hemangiomata (0.386%), 1 AVN tumor (0.097 %), and 1 rhabdomyoma (0.097 %). In 8 of the 10 cases, the tumors were located in the AVN or HB. The metastatic tumors originated from lymphocytic leukemia and malignant lymphoma (histiocytic type) in lung, and were all found in the SAN. Of the 12 cases, 2 were from the group Ⅰ. Tumors in the CCS are the smallest tumors in different parts of the body, which can cause sudden death.
  • 摘要：@@ Following ST-segment elevation myocardial infarction(STEMI), early and complete epicardial reperfusion is associated with improved survival.
  • 摘要：@@ The benefits of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) beyond blood pressure reduction have been proven through many large studies (HOPE, LIFE) in high risk CVD patients;1 post hoc studies have shown reductions in new onset type 2 diabetes mellitus (DM).
  • 摘要：@@ In this issue of the Journal of Geriatric Cardiology,Huang et al. have reported the detection of coronary artery disease with electron-beam computed tomography (EBCT),utilizing non-contrast and contrast imaging techniques (EBCTA) in several subgroups including type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), coronary heart disease, and normal subjects.

    老年心脏病学杂志（英文版）的期刊信息

    • 曾用名：
    • 创刊时间：2004
    • 地区：CHINA MAINLAND
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