PubMed Health⌕ Search

Biomedical subjects

Yanzhou Zhang

Publications and source records attributed to Yanzhou Zhang.

7 recordsLinked to original sources

Thrombolytic therapy with urokinase for pulmonary embolism in patients with stable hemodynamics.

BACKGROUND: Thrombolytic agents such as urokinase have been used in the treatment of patients with massive pulmonary embolism and hypotension, but their effect in patients with submassive pulmonary embolism and normal blood pressure has been controversial. MATERIAL/METHODS: Urokinase (20,000 IU /kg) was intravenously administered to 36 patients who had pulmonary embolism and a normal blood pressure. This was followed by subcutaneous injection of a low-molecular-weight heparin for a week. RESULTS: Improvement in clinical symptoms and reduction in pulmonary pressure was observed in 28 (77.8%) patients within the first week of the thrombolytic therapy. The improvement rate in patients with embolic symptoms of less than 14 days, and in those who had symptoms between 14 and 30 days before the thrombolytic therapy was 86% and 50%, respectively (p<0.01). Non-life threatening bleeding complications were observed in 10 (22.2%) patients. CONCLUSIONS: Thrombolytic therapy with urokinase followed by low-molecular-weight heparin is an effective therapeutic strategy for patients with pulmonary embolism and stable haemodynamics. However, the long-term benefits of this strategy remain to be seen and further studies are warranted.

Adult↗

Increased coronary flow may prolong transmural ventricular repolarisation.

An increase in spatial dispersion of ventricular refractory periods reflects inhomogeneity of ventricular refractoriness and is associated with an increased risk of life-threatening ventricular arrhythmias. Spatial dispersion in ventricular refractoriness is determined by the differences in refractory periods of myocytes in epicardium, mid-myocardium and endocardium. Prolongation of ventricular repolarisation with drugs or physical means may reduce the spatial dispersion and the risk of arrhythmia. An increase in coronary flow has been shown to prolong the duration of ventricular repolarisation measured from epicardium in the intact animal heart. We hypothesised that an increase in coronary flow may also prolong ventricular repolarisation cross the three layers of ventricular myocardium through the release of nitric oxide. The simultaneously prolongation of transmural repolarisation may reduce the spatial dispersion of ventricular repolarisation and hence, the risk of life-threatening ventricular arrhythmias.

Action Potentials↗

B-type natriuretic peptide is an independent predictor for cardiovascular death in patients with no clinical signs of ventricular dysfunction after acute myocardial infarction.

B-type natriuretic peptide (BNP) is released from cardiac ventricles in response to increased wall tension in patients with heart failure. It has been used as a biochemical marker for the diagnosis of congestive heart failure. BNP is also increased in patients with acute myocardial infarction, and is associated with an increased risk of cardiovascular mortality in those with impaired left ventricular function after myocardial infarction. We hypothesized that an increase in BNP soon after acute myocardial infarction is an independent predictor for long-term prognosis in patients with no clinical signs of left ventricular function.

Cardiovascular Diseases↗

Atrial vulnerability is a major mechanism of paroxysmal atrial fibrillation in patients with Wolff-Parkinson-White syndrome.

Atrioventricular re-entrant tachycardia is the most common form of tachycardia in patients with Wolff-Parkinson-White (WPW) syndrome where one or more accessory pathways are present between atria and ventricles. Paroxysmal atrial fibrillation (PAF) is also a relatively common form of tachycardia in these patients. The mechanisms of PAF in patients with WPW syndrome are not completely understood. Previous studies have mainly focused on the role of accessory pathways in the development of PAF. However, up to 24% of patients still experience PAF after successful ablation of accessory pathways by surgical incision or radiofrequency catheter ablation techniques. We hypothesized that there are two primary mechanisms involved in the pathogenesis of PAF in patients with WPW syndrome. One is related to the accessory pathways that predispose the atria to fibrillation; the other is increased atrial vulnerability that is independent of the accessory pathways. Clarification of these mechanisms is critical in developing more effective means for the prevention or treatment of PAF in patients with WPW syndrome.

Atrial Fibrillation↗

Prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes.

BACKGROUND: B-type natriuretic peptide (BNP) is released from the cardiac ventricles in response to increased wall tension in patients with heart failure. The significance of blood BNP in predicting cardiac death in patients with acute coronary syndromes (ACS) in Chinese patients is yet to be established. METHODS: Blood BNP concentration was measured in 106 ACS patients 1-3 days after onset of ischemic symptoms. Patients were followed-up for 6 months on mortality and other cardiovascular events. RESULTS: During the follow-up, cardiac death occurred in 13 patients (non-survival group). Another 12 patients were hospitalized due to recurrence of ACS or heart failure. The mean blood BNP concentration in the non-survival group was significantly higher than that of the survival group (median 1132 vs. 116 ng/L, p <0.001). Multivariate logistic regression analysis incorporating age, gender, history of hypertension, diabetes, left ventricular ejection fraction, troponin I and therapeutic regimens indicated that BNP was an independent predictor of cardiac death in these patients (odds ratio = 21.19, 95% confidence interval 4.53-99.06, p <0.001). CONCLUSIONS: BNP is a useful parameter in predicting cardiac death in Chinese patients with ACS.

Acute Disease↗

Taurine may prevent diabetic rats from developing cardiomyopathy also by downregulating angiotensin II type2 receptor expression.

OBJECTIVE: In diabetes, intracellular accumulation of sorbitol resulting from the high extracellular levels of glucose leads to depletion of intracellular compounds including taurine. This is associated with the development of late diabetic complications such as cardiomyopathy. The development of myocyte hypertrophy has been largely attributed to angiotensin II, whose growth properties are antagonized by taurine. However, the interaction between taurine, angiotensin II type2 receptor (AT2) and cardiomyopathy related to angiotensin II is still unknown. This study investigates the roles of taurine and AT2 in rats with streptozotocin (STZ)-induced diabetic cardiomyopathy. METHODS: Of 60 female 4-week-old Wistar rats, 8 were treated with common diet and the other 52 with high sugar/fat diet (during the whole experiment) to induce insulin resistance. At the 4th week, of the 52 rats, 7 treated with sodium citrate buffer (pH = 4.5) were grouped into control group1 (con1) and the other 45 were treated by intraperitoneal injection (I.P) with STZ to develop type 2 diabetes. At the 28th week, the maximal velocity decrease of pressure per second in left ventricle within the period of isovolumic relaxation (-dp/dt(max)) was detected by a cannula through right carotid artery. After the cannula operation, of the 45 rats, all the living 24 with -dp/dt(max)< or = 5250 mmHg/s, who had developed diabetic cardiomyopathy, were grouped as follows: 7 treated with double distilled H2O (I.P) were grouped into control group2 (con2). 8 treated with AT2 agonist (CGP42112A) (I.P) were grouped into experimental group1 (exp1). Another 9 treated with taurine (I.P) were grouped into experimental group2 (exp2). All injections lasted 4 weeks (Q.D) and the heart weight (HW) was recorded. To examine cardiomyocyte apoptosis index (CAI), mRNA and protein of AT2 and Bcl-2 in cardiomyocytes, methods of terminal-deoxynucltidyl transferase mediated nick end labeling (TUNEL), reversal transcription polymerase chain reaction (RT-PCR) and immunoblot (Western Blot) were used, respectively. RESULTS: Values of -dp/dt(max) in exp1, exp2 or con2 were much less than those in con1, respectively (p < 0.01). CAI (= stained cell number/total cell number x 100%) and AT2 values both in mRNA and protein levels in con1 were less than those in the other three groups, respectively (p < 0.01). The three parameters above were more in exp1 but less in exp2 than those in con2, respectively (p < 0.01). The three parameters and HW in exp1 were much higher than those in exp2, respectively (p < 0.01). Changes of Bcl-2 were opposed to those of AT2. CONCLUSIONS: A high expression of AT2 may accelerate the apoptosis of cardiomyocytes in diabetic rats and play a role in precipitating diabetic cardiomyopathy; taurine may protect diabetic rats from developing cardiomyopathy also by downregulating AT2 receptors.

Animals↗

Long-term efficacy of slow-pathway catheter ablation in patients with documented but noninducible supraventricular tachycardia.

BACKGROUND: The long-term efficacy of radiofrequency catheter ablation of slow pathway in patients with dual atrioventricular node pathway and a documented but noninducible paroxysmal supraventricular tachycardia (PSVT) is not entirely clear. METHODS: Forty nine patients (Group A) with documented but noninducible PSVT and dual atrioventricular node pathway were prospectively studied. Programmed electrical stimulation induced a single atrioventricular node echo beat in 13 patients, and double echo beats in 9 at baseline or during isoproterenol infusion. Clinical and electrophysiological characteristics of Group A patients were compared with that of age- and gender-matched patients with dual atrioventricular node pathway but inducible PSVT (Group B). RESULTS: There was no significant difference in the electrophysiological properties of the fast and slow pathways between the two groups. Catheter ablation eliminated the slow pathway in all patients. There was no recurrence of PSVT in either Group A or Group B during the follow-up of 38 +/- 5 months. CONCLUSIONS: In patients with dual atrioventricular node pathway and a documented but noninducible PSVT, catheter ablation of slow pathway is highly effective in preventing tachycardia in long term.

Adult↗