简介：Hypertrophiccardiomyopathy(HCM)isacommongeneticcardiovasculardiseaseandappearsinallethnicgroups.HCMisdiagnosedonthebasisofleftventricularhypertrophy.EchocardiographyisakeytechniqueinthediagnosisofHCM,theprognosisofpatientswithHCM,themanagementstrategyforHCM,andthefollow-upofpatientswithHCM.ThisreviewbrieflydescribesanddiscussesthepracticaluseofestablishedechocardiographytechniquesandthecurrentandemergingechocardiographicmethodsthatcanhelpphysiciansinthecorrectdiagnosticandpathophysiologicalassessmentofpatientswithHCM.

简介：Thescopeofinterventionalcardiologyhasrapidlyexpandedoverthelastseveraldecades.Inafieldwhereproceduraltreatmentoptionsforavarietyofcomplexcardiovascularconditionshavegrownexponentially,theimportanceofproceduralsafetycontinuestocometotheforefront.Thisismostevidentinthemovementtowardradialaccessastheinitialapproachforoperatorsinthecardiaccatheterizationlaboratory.Astheevidencegrowsforthesuperiorityofradialaccessoverfemoralaccesswithregardtoreducingbleedingeventsandimprovingclinicaloutcomes,wediscussthemodernapproachtoobtainingaccess,andhighlightbestpractices.

简介：Coronaryangiographyaftercardiacarrestisimportanttoascertainpotentialtreatablecausesofcardiacarrest,salvagemyocardium,andpotentiallyincreaselong-termsurvival.Thecauseofadultout-of-hospitalcardiacarrestistypicallymyocardialischemia.Morethan50%ofsuchresuscitatedindividualswillhaveanacutelyoccludedepicardialcoronaryonemergencycoronaryangiography.ThisincludesthreeinfourwithST-segmentelevationandoneinthreewithoutSTsegmentelevation.Inthelattertheonlyreliablemethodofdetectioniscoronaryangiography.Numerouscohortstudies,nowincludingmorethan8000patients,haveshownanassociationbetweensurvivalandearlycoronaryangiographyand/orpercutaneouscoronaryintervention.Publicreportingofpercutaneouscoronaryintervention30-daymortalityrateshasbeenanimpedimentforextendingthistherapytoallresuscitatedindividualswhoexperiencedout-of-hospitalcardiacarrest,sincecurrentdatabasestodofullyrisk-adjustratesforthissubgroup.Sincereeffortsareunderwaytocorrectthissituation.

简介：Atrialnatriureticpeptide(ANP)isapeptidehormonethathaspotentnatriuretic,diuretic,vasodilator,sympatholytic,andrenin-andaldos-terone-suppressingactivitiesandisinvolvedintheregulationofvolumeandelectrolytebalanceandbloodpressure.Further,ANPhasalsobeenshowntoinhibitcellulargrowth,proliferationandinduceapoptosisinavarietyofcelllines,includingvascularsmoothmusclecellsandcardiacmyocytes.RecentstudieshavedemonstratedthatANPisnotonlyinvolvedinbloodpressureandvolumehomeostasisbutalsointhedirectregulationofcardiacgrowth.Weandotherinvestigatorshavedemonstratedtheexistenceofnatriureticpeptidereceptorsintheheartandcardiaccells,suggestingthatANPhasdirectactionsoncardiactissue.SeveralrecentinvivostudieshavesuggestedthatstatementofANPisinverselyrelatedtocardiacgrowth/hypertrophy.TransgenicmiceoverexpressingANPhavelowerheartweightandbloodpressurethanwildtypemice.Conversely,we

简介：Cholesterolcrystalshavelongbeenrecognizedaspartofatheroscleroticplaques.Theyhavebeenvisualizedbylightmicroscopyasemptyspacesorimprintswherecrystalswereoncepresentandthendissolvedbytissueprocessing.Thus,untilnow,theirroleinatherosclerosisandplaquerupturehadbeenconsideredtobeinert.However,bytheprocessingoftissuewithoutethanolitwaspossibletovisualizetheirextensivenessandpotentialroleintissueinjury.Also,itwasdemonstratedthatcholesterolexpandsinvolumewhencrystallizingfromtheliquidtothesolidstate,whichisthepresumedcauseofplaquerupturebysharp-tippedcrystalsgrowingoutoftheplaque'snecroticcore.Specifically,inpatientswhodiedofmyocardialinfarction,allculpritcoronarylesionshadextensivecholesterolcrystalsperforatingthefibrouscapandintima,whilethosepatientswhodiedofothercausesandhadplaquesdidnothavecrystalsperforatingthecapandintima.Additionally,cholesterolcrystalstravelingdownstreamfromtheplaquerupturesitecanscrapetheendotheliumandpromotevasospasm.Moreover,cholesterolcrystalslodgingintothemusclecantriggeraninflammationwithnecrosisindependentofcirculatorycompromiseorischemia.Thesefindingssuggestthatcholesterolcrystalscouldplayacriticalroleinplaquerupture,aswellasvascularandmyocardialinjury.

简介：Ifsystolicanteriormotion(SAM)ofaredundantanteriorleafletofthemitralvalveiscombinedwithsystolicthickeningofanasymmetricseptum,(ASH),anarrowoutflowchanneloftheleftventricleisformed.Thisnarrowedoutflowchannelisthenresponsibleforthemidsystolicpressuredifferencebetweenthebodyoftheleftventricleandtheoutflowareaoftheleftventricle.Thisresultsinhypertrophic“obstructive”cardiomyopathy(HOCM).

简介：Cardiacmagneticresonance(CMR)imagingplaysanimportantroleinthediagnosisandmanagementofcardiovasculardiseases.Thestate-of-the-artCMRimaginghasmanyadvantagesincardiacimaging,includingexcellentspatialandtemporalresolution,unrestrictedimagingfield,noexposuretoionizingradiation,excellenttissuecontrast,anduniquemyocardialtissuecharacterization.ClinicalCMRimagingisusedduringthecardiovasculardiagnosticworkupintheUnitedStatesandsomeEuropeancountries.UseofCMRimagingisemerginginhospitalsinChinaandhasapromisingfuture.Thisreviewbrieflydescribesthereal-worldclinicalapplicationofCMRimaginginChinaanddiscussobstaclesforitsfuturedevelopment.

简介：Acutecoronarysyndrome(ACS)isthemaincauseofdeathworldwideandtheleadingcauseofdiseaseburdeninhigh-incomecountries.ACSreferstoaconstellationofclinicalsymptomsthatarecompatiblewithacutemyocardialischemia.Itdescribesaspectrumofclinicalmanifestationsthatresultfromacommonpathophysiologicalprocess.ThemostcommoncauseofACSareruptureofanatheroscleroticlesioncontainingalargenecroticcoreandathinfibrouscapfollowedbyacuteluminalthrombosis.Itwasthoughtthatahigh-resolutionimagingmodalitywouldbeidealtodetecthigh-riskplaquesbeforetheirdisruptionandtheformationofanocclusivethrombus.Opticalcoherencetomographyhasproventobeaninvaluabletoolinearlydetectionofhigh-riskplaquesandparticularlyintheunderstandingofACS.ThisreviewfocusesonthecurrentevidencefortheroleofopticalcoherencetomographyinthediagnosisandtreatmentofpatientswithACS.

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简介：BackgroundAfterpercutaneouscoronaryintervention(PCI),somepatientsmaysufferfromrestenosisandstentthrombosis.Manystudiessuggestthatendothelialprogenitorcell(EPC)hasanimportantroleinpreventingrestenosisandstentthrombosis.AnovelstentwhichcanattractEPChasbeendesignedtoprovideabetteroutcomefortheseproblems.MethodThedataofthepresentreviewwasobtainedbysearchingPUBMEDandotherdatabases(1994-2011)usingthekeytermsof'endothelialprogenitorcell','reendothelialization','restenosis','stentthrombosis',and'percutaneouscoronaryintervention'.ResultRapidreendothelializationisessentialinpreventingrestenosisandstentthrombosis.EPCcandifferentiateintoendothelialcellandacceleratethereendothelialization.Afternumerouspreclinicalandclinicalresearches,thecorrelationbetweencirculatingEPCstorestenosisstillremainspoorlyunderstood.However,manystudieshaveshowntheimportantroleofEPCindiminishingtheriskofthrombosisfollowingstentimplantation.Somepharmacologicalagentshavebeenreportedcanincreasethenumberand/orfunctionsofEPC.Recently,CD34+antibodycoatedstenthasbeendevelopedtoattractEPCtothehealingendothelium,andhasshowedfavorableresults.ConclusionEPChasimportantroleinrapidreendothelializationaftervascularinjury.EPCcanpreventstentthrombosisafterPCI,howevertheeffectsofEPCinpreventingrestenosisneedfurtherinvestigations.ThecapturingCD34+stentissafeandsignificantlydecreasesstentthrombosis.

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简介：Acuteaorticsyndromeincludesclassicaorticdissection,aorticintramuralhematoma,andpenetratingatheroscleroticulcer–agroupofconditionsthataredefinedbytheirdynamicevolutionandsimilarclinicalmanifestation.Accuratediagnosisandprompttreatmentareessentialasalltheaforementionedconditionsareasignificantthreattoapatient’slife.However,acuteaorticsyndromeandespeciallyaorticintramuralhematomamaybechallengingdiagnosticproblems.Intravascularultrasoundimagingisadiagnosticmethodthatcanbeusefulformorethoroughevaluationoftheaorticlesionandcanparticularlyaidindiscerningthedifferentformsofacuteaorticsyndrome.Wepresentacaseofapatientwithaorticintramuralhematomathatwasmissedbyconventionalimagingstudiesbutwassuccessfullyvisualizedwithintravascularultrasoundimaging.

简介：Background:Thesafetyandefficacyofcoronaryarterybypassgrafting(CABG)andsecond-generationdrug-elutingstents(DESs)inpatientswithcoronaryarterydisease(CAD)remaincontroversial.ThereforeweaimedtocomparetheoutcomesofCADpatientstreatedwithCABGandsecond-generationDESs.Methods:WesystematicallysearchedthePubMed,CochraneLibrary,Ovid,andElsevierdatabases.Studiescomparingsecond-generationDESswithCABGinCADpatientswereincluded.RevMan5.3wasusedtoextractandpoolthedatafromtheapplicablestudies.Results:Sixtrials(N=6604participants)wereincludedinthismeta-analysis.AmongalloftheCADpatients,second-generationDESswereassociatedwithnodifferencesintherisksofall-causedeath[riskratio(RR)1.18,95%confidenceinterval(CI)0.98–1.43,P=0.09],cardiovasculardeath(RR1.14,95%CI0.81–1.59,P=0.45),myocardialinfarction(RR1.22,95%CI0.98–1.54,P=0.08),andstroke(RR0.83,95%CI0.59–1.17,P=0.29),butincreasedtherisksofrevascularization(RR1.95,95%CI1.66–2.30,P<0.001)andmajoradversecardiacandcerebrovascularevents(RR1.72,95%CI:1.31–2.26,P<0.001)whencomparedwithCABG.Conclusions:InthetreatmentofCADpatients,second-generationDESswasnotassociatedwithincreasedrisksofall-causedeath,cardiovasculardeath,myocardialinfarction,andstroke,butincreasedtherisksofrevascularizationandmajoradversecardiacandcerebrovasculareventswhencomparedwithCABG.

简介：IntroductionandPatientDescription,Assessmentofpatientswithanginapectorisisachallengefortheclinicalcardiologist.Myocardialischemiaandanginapectoriscanbecausedbyvariousmechanisms,suchascoronaryatherosclerosis,vasospasm,orcoronarymicrovasculardysfunction[1].Moreover,thesemechanismsmayoverlapinagivenpatient,makingitdifficulttodeterminethecauseofangina.Wereportherethecaseofa57-year-oldfemalepatientwithahistoryofanginapectoristhatstarted3monthspreviously.Hersymptomsoccurredpredominantlyatrestbutalsowitheffort.Thepatientwasanactivesmokerwhosmokedabout15cigarettesperday(~20packyears).Moreover,shehadhypertensiontreatedwithenalapril.HerLDLlevelwas75mg/dlwithoutanycholesterol-loweringtherapy.Shewassentfordiagnosticcoronaryangiographyforsuspectedstenosingcoronaryarterydisease.