Biomedical subjects

Peng Hao

Publications and source records attributed to Peng Hao.

8 recordsLinked to original sources

PubMed2006

Pulmonary vein tachycardia after pulmonary vein isolation in patients with atrial fibrillation.

BACKGROUND: Pulmonary vein (PV) isolation has been developed to treat patients with atrial fibrillation (AF), and the electrophysiological endpoint of PV isolation is the disappearance or dissociation of pulmonary vein potentials (PVPs). Pulmonary vein tachycardia (PVT) is the dissociated PV rhythm with a rapid rate. However, the characteristics and significance of PVT after pulmonary vein isolation in patients with AF remains unclear. METHODS: From June 2003 to June 2005, a total of 285 consecutive patients with drug refractory AF were included in this study, and they underwent segmental pulmonary vein ablation (SPVA) or circumferential pulmonary vein ablation (CPVA). PV isolation was the initial endpoint for both approaches with documenting disappearance or dissociation of PVPs. PVT was characterized as dissociated activities within PVs with a circle length (CL) of < 300 ms, and was classified into organized PVT or disorganized PVT according to the variance of CL. Systematic follow-up was conducted after initial procedures. Continuous variables were analyzed by Student's t test and categorical variables were analyzed by chi-square test. RESULTS: Three hundred and fifteen PVs were ablated in 85 patients underwent SPVA approach, 400 circular lesions surrounding ipsilateral PVs (including 790 PVs) were produced in the rest of 200 patients received CPVA approach. Electrical isolation was achieved in all of these PVs. Of these, PVPs were abolished in 89.8% (992/1105) of the ablated PVs, dissociated PV rhythms were documented in the rest 10.2 % (113/1105) of the treated PVs. Among the 113 dissociated PV rhythms, 28 met the criteria of PVT with mean CL of (155 +/- 43) ms (2 PVTs in 2 patients received SPVA, 26 PVTs in 18 patients underwent CPVA). PVT was more frequently documented in patients underwent CPVA approach [9.0% (18/200) vs 2.3% (2/85), P = 0.04]. During the 6-month follow-up, it was indicated that no significant difference existed in AF free rate between patients with PVT and those without PVT (P = 0.75). CONCLUSIONS: PVT dissociated from LA activations can be documented after PV isolation, especially in patients underwent CPVA approach. However, PVT does not affect the follow-up results.

Adolescent↗

PubMed2006

Is circumferential pulmonary vein isolation preferable to stepwise segmental pulmonary vein isolation for patients with paroxysmal atrial fibrillation?

BACKGROUND: Stepwise segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) have been developed to treat patients with atrial fibrillation (AF), but the preferable approach for paroxysmal AF (PAF) has not been established. METHODS AND RESULTS: One hundred and ten patients with symptomatic PAF were randomized into a stepwise SPVI group (n=55) or CPVI group (n=55). Systemic SPVI combined with left atrial linear ablation tailored by inducibility of AF was performed in the stepwise SPVI group. Circumferential linear ablation around the left and right-sided pulmonary veins (PVs) guided by 3-dimensional electroanatomic mapping was performed in the CPVI group. The endpoints of ablation are non-induciblity of AF in the stepwise SPVI group and continuity of circular lesions combined with PV isolation in the CPVI group. After the initial procedures, atrial tachyarrhythmis (ATa) recurred within the first 3 months in 23 of the 55 patients (41.8%) who underwent stepwise SPVI and in 20 of the 55 patients (36.4%) who had CPVI (p=0.69). Repeat procedures were performed in 7 patients from the stepwise SPVI group and 5 from the CPVI group (p=0.76). During the 3-9 months after the last procedure, 46 patients (83.6%) from the CPVI group and 43 (78.2%) from the stepwise SPVI group did not have symptomatic ATa while not taking anti-arrhythmic drugs (p=0.63). Severe subcutaneous hematoma or PV stenosis occurred in 3 patients. CONCLUSIONS: The efficacy of stepwise SPVI is comparable to that of CPVI for patients with PAF.

Adult↗

PubMed2005

Recurrent atrial tachycardia and atrial fibrillation after circumferential pulmonary vein ablation: what's the difference?

BACKGROUND: Recurrent atrial tachyarrhythmia (ATa) after circumferential pulmonary vein ablation (CPVA) includes atrial tachycardia (AT) and atrial fibrillation (AF). However, whether there are some differences in clinical course and mechanisms between the recurrent AT and the recurrent AF remained unclear. This study was conducted to investigate the incidence, mechanism, clinical course of the recurrent AT and AF in patients under CPVA. METHODS: One hundred and thirty consecutive patients (M/F = 95/35) with highly symptomatic and multiple antiarrhythmic drugs (AADs) refractory paroxysmal (n = 91) or persistent (n = 39) AF were included. The ablation protocol consisted solely of two continuous circular lesions around the ipsilateral pulmonary veins (PV) guided by CARTO system. The endpoint of CPVA is PV isolation. For patients with recurrent ATa within 2 months after the initial procedure, cardioversion with direct current was attempted if the ATa lasted for more than 24 hours. A repeat ablation procedure was performed only for patients with AADs refractory recurrent ATa and at least followed up for 2 months after the initial procedure. RESULTS: Within 2 months after the initial procedure, 52 patients (40.0%) had experienced episodes of symptomatic recurrent ATa. Among them, 23 patients (44.2%) with recurred AT alone (AT group), 14 patients (26.9%) with recurred AF alone (AF group), and 15 patients (28.8%) with recurred AT and AF (AT plus AF group). The delayed cure rate (65.2%) in AT group was significant higher than that in AF group (21.4%, P < 0.05) and AF plus AT group (26.7%, P < 0.05). A repeat ablation was performed in 21 patients, including 6 patients with recurrent AT alone, 8 patients with recurrent AF alone, and 7 patients with recurrent AF plus AT. The mean number of PV gaps was 1.2 +/- 0.4 in AT group, which was significantly lower than that in AF group (2.6 +/- 0.7, P < 0.05) and AF plus AT group (2.0 +/- 0.6, P < 0.05). Delayed cure rate and number of PV gaps between AF group and AF plus AT group were comparable (P > 0.05). CONCLUSIONS: Present study indicates that recurrent AT and AF after CPVA have the different clinical course and different electrophysiological findings during repeat procedure as follows: (1) After CPVA, spontaneous resolution of recurrent ATa was mainly found in patients with recurrent AT alone (about two thirds patients). (2) The type of recurrent ATa after CPVA is associated with the number of PV gaps.

Adult↗

PubMed2005

Impact of different ablation strategies on the delayed cure after trans-catheter ablation for treating patients with atrial fibrillation.

BACKGROUND: Delayed cure had been observed in recurrent cases after index ablation of atrial fibrillation (AF), however, its mechanism and incidence have not been elucidated in detail. This study aims to investigate the impact of different ablation strategies on the incidence of delayed cure and its possible mechanisms after trans-catheter ablation of AF. METHODS: One hundred and fifty-one consecutive cases with highly symptomatic, drug refractory AF were included in this study [M/F = 109/42, mean age (56.0 +/- 11.2) (18 - 79) years]. Segmental pulmonary vein ablation (SPVA) was performed in 83 patients with the guidance of circular mapping catheter (SPVA Group), circumferential PV linear ablation (CPVA) was carried out in the rest 68 cases under the guidance of 3 dimensional mapping system in conjunction with circular mapping catheter (CPVA Group). Delayed cure was defined as that early recurrence of atrial tachyarrhythmias (AF, atrial tachycardia, or atrial flutter) after ablation procedure was no longer observed during subsequent follow-up, and stable sinus rhythm was maintained > or = 2 months. RESULTS: Early recurrence of atrial tachyarrhythmias was detected in 41 cases from SPVA group and 23 cases from CPVA group, and delayed cure occurred in 21.9% (9/41) of the cases from SPVA group and 47.8% (11/23) of the cases from CPVA group, more delayed cure in later group was observed (P < 0.05). Meanwhile, patients in SPVA group took a longer time to achieve a delayed cure [(27.0 +/- 18.0) days vs (14.0 +/- 8.1) days, P < 0.05], and presented more recurrent episodes [(3.50 +/- 1.08) times a week vs (2.42 +/- 1.11) times a week, P < 0.05]. However, recurrent episodes after index ablation were markedly decreased in cases with delayed cure from both groups (P < 0.05). CONCLUSIONS: Despite of an early recurrence of atrial tachyarrhythmias after index ablation of AF, delayed cure occurs in a significant number of patients undergoing either SPVA or CPVA. However, different ablation strategies place different impact on the delayed cure, more delayed cure is obtained with CPVA approach, and the delayed cure occurs earlier with this approach; the average recurrent episodes before delayed cure are also less frequently detected in CPVA group compared with those in SPVA group.

Adolescent↗

PubMed2005

[Evaluation of early invasive or initially conservative strategies in patients with non-ST-segment elevation acute coronary syndrome at intermediate or high risk].

OBJECTIVE: To demonstrate the effect of early strategies and revascularization patterns on in-hospital major adverse cardiac events (MACE) in patients with non-ST-segment elevation acute coronary syndrome (ACS) at intermediate or high risk. METHODS: 910 Patients with non-ST-segment elevation ACS at intermediate or high risk were divided into either early invasive (n = 237) or initially conservative (n = 673) group according to whether or when coronary angiography (CAG) was performed after admission ( 48 h) in order to demonstrate the impact of early strategies and revascularization patterns on in-hospital MACE events (death, new-onset myocardial infarction or repeat revascularization). RESULTS: Compared with those of the initially conservative group, patients in the early invasive group had a shorter hospital stay and increased rate of MACE (6.3% vs 2.5%, OR 0.384, 95% CI 0.188 - 0.781, P = 0.006) or new-onset myocardial infarction (4.6% vs 0.9%, OR 0.185, 95% CI 0.068 - 0.505, P = 0.001), which was partly due to increased procedures of revascularization (86.9% vs 67.5%, P < 0.001). No differences were found among in-hospital mortality or rate of repeat revascularization between the two groups. During subgroup analysis, patients receiving PCI in the early invasive or initially conservative group had comparable rates of new-onset myocardial infarction, repeat revascularization or MACE events, whereas patients receiving CABG in the early invasive group had a higher rate of new-onset myocardial infarctions than those in the initially conservative group (7.5% vs 1.8%, P = 0.027). CONCLUSIONS: An early invasive strategy in patients with non-ST-segment elevation ACS had comparable in-hospital mortality and higher rate of in-hospital myocardial infarction compared with an initially conservative strategy, an early invasive strategy with PCI seems safe and feasible without increased risk of adverse clinical events. The impact of early CABG on in-hospital adverse events warrants further investigation.

Acute Coronary Syndrome↗

PubMed2005

[The application of basic fibroblast growth factor in tendon tissue engineering].

OBJECTIVE: To review the recent researches of basic fibroblast growth factor (bFGF) in tendon tissue engineering. METHODS: Recent original related literature was extensively reviewed and analyzed. RESULTS: bFGF played an important role in establishing standard tendon tissue engineering cell lines, inducing the compound and analysis of extracellular matrix, enhancing interactions between cells and extracellular matrix and accelerating tissue engineering materials' neovascularization. CONCLUSION: The progresses in increasing endogenetic bFGF expression, controlling the release of exogenous bFGF and improving the bio-utilization of bFGF has laid foundation for wider use of bFGF in tendon tissue engineering.

Animals↗

PubMed2005

[Comparison of different pulmonary vein isolation strategies for patients with paroxysmal atrial fibrillation].

OBJECTIVE: To compare two catheter ablation strategies for pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (PAF). METHODS: Fifty consecutive patients who underwent PV isolation by circumferential PV ablation (CPVA group) were compared with 50 consecutive patients who underwent PV isolation by segmental PV ablation (SPVA group). The enrolled subjects in this retrospective study were patients with frequent attacks (more than 3 times per month) and symptomatic PAF. Procedure-related parameters, safety and clinical outcome within 6 months after procedures for the 2 strategies were analyzed. RESULTS: The characteristics and mean procedure time were comparable between the 2 groups. The mean fluoroscopy time and mean ablation time were 57 min +/- 11 min and 42 min +/- 9 min in the SPVA group and 31 min +/- 8 min and 61 min +/- 13 min in the CPVA group (both P < 0.01), respectively. After the first procedure, symptomatic atrial tachyarrhythmias (ATa) recurred in 24 (48%) of 50 patients who underwent SPVA and 15 (30%) of 50 patients who underwent CPVA within 3 months (P = 0.10). During 6 months of follow-up, 82% of patients with CPVA and 60% of patients with SPVA were free of symptomatic ATa without any antiarrhythmic drugs for at least 3 months (P < 0.05). One patient per each group developed asymptomatic right superior PV stenosis. CONCLUSION: In patients with PAF, CPVA compares favorably with SPVA, but either of them yields a similar clinical safety.

Adolescent↗

PubMed2003

Human epithelial cancers secrete immunoglobulin g with unidentified specificity to promote growth and survival of tumor cells.

Immunoglobulins (Igs) are found thus far only to be produced by differentiated B lymphocytes. By immunohistochemistry analysis, in situ hybridization, and laser capture microdissection-assisted single-cell PCR, we demonstrate that human cancers of epithelial origin, including carcinomas of breast, colon, liver, lung, established epithelial cancer lines, as well as some normal lung tissues, also produce IgG in both cytoplasmic and secreted forms. Furthermore, blockade of tumor-derived IgG by either antisense DNA or antihuman IgG antibody increased programmed cell death and inhibited growth of cancer cells in vitro. More importantly, administration of antihuman IgG antibody also suppressed the growth of an IgG-secreting carcinoma line in immunodeficient nude mice. Our results support a role of tumor-derived IgG as growth factor for epithelial cancers. Prevalent expression of IgG in human carcinomas and its growth-promoting functions may have important implications in growth regulation and targeted therapy of human cancers.

Amino Acid Sequence↗