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To investigate the correlation of microalbuminuria (MA) and fibrinogen (Fib) to the severity of coronary artery lesions in patients with metabolic syndrome (MS).Eighty-five patients with MS undergoing coronary artery angiography were divided, according to the number of vessels involved, into multivessel disease group and non-multivessel disease group, and also according to the modified Gensini score, into severe lesion (Gensini score20) and non-severe lesion group. The correlations of MA and Fib to the number of involved vessels and the severity of the lesions were analyzed.The urinary albumin to creatinine ratio (ACR) and Fib were significantly different between the multivessel and non-multivessel disease groups (P0.05), and were found to be positively correlated to the number of coronary artery lesion (r=0.378, P=0.000; r=0.327, P=0.002). ACR, Fib, sex, smoking history and HDL-C differed significantly between severe lesion and non-severe lesion groups (P0.05), and ACR and Fib showed positive correlations to the Gensini score (r=0.337, P=0.002; r=0.286, P=0.008). Logistic regression analysis identified ACR as an independent predictor of multivessel disease (B=2.655, P=0.000) and Gensini score (B=1.803, P=0.009), independent of sex, age, body mass index, smoking history, diabetes mellitus, LDL-C and HDL-C.MA and Fib are positively correlated to the severity of coronary artery lesion, and MA is an independent predictor of multivessel disease and Gensini score in patients with MS.

To evaluate the changes of cerebral blood flow (CBF) with real-time contrast-enhanced ultrasound (CEU) in a canine model of acute cerebral ischemia.Cerebral perfusion was assessed in 6 dogs subjected to craniotomy with CEU at the time of 0, 30, 60, 90 and 120 min after occlusion of the left common carotid artery (LCCA). The microvascular volume (A) and blood flow velocity (beta) in the brain were measured from the time-versus-acoustic intensity plots, and the value of Axbeta were calculated. 99mTc-ECD brain single photon emission computed tomography (SPECT) was performed on the day before the experiment and at 120 min after LCCA occlusion. The radioactive counts on both sides of the cerebral cortex were calculated.A significant correlation was found between Axbeta from CEU and volume of the blood flow of the CCA from Doppler flowmetry. A, beta and Axbeta values varied significantly between the different time points (P0.001). The ipsilateral hemisphere showed a low-perfusion state while the contralateral hemisphere showed a high-perfusion state immediately after the occlusion.The changes of beta is the main regulation mechanism during acute cerebral ischemia in dogs.

To assess the efficacy and safety of intravascular ultrasound (IVUS)-guided interventional therapy for borderline lesions in patients with acute coronary syndrome (ASC).Thirty-one ASC patients with borderline lesions (coronary artery stenosis between 40%-70% confirmed by coronary arteriography [CAG]) and a minimal lumen area (MLA) of the infarction related artery(IRA)or =4.0 mm(2) shown by IVUS underwent percutaneous coronary intervention (PCI). Another 31 PCI cases without IVUS were also enrolled as the control group. The minimal luminal diameter, cross section luminal area, total cross section, plaque area and area stenosis rate were measured before and after stent deployment at a conventional or higher pressure in the IVUS group. All the patients were followed up for 10-12 months and clinically evaluated 1, 3, 6 month and 12 months after the procedure to collect the data of angina recurrence, myocardial infarction and revascularization.All the 31 cases were successfully stented with satisfied CAG results (with residual stenosis0, TIMI flow grade III) and without dissection or any related complications. Among the 32 stents, 28 showed insufficient adherence or underexpansion (stent malapposition) to require 18-20 atm dilation or another high pressure balloon to attain the adequate IVUS results. CAG and IVUS were repeated in 22 patients (70.97%) of the IVUS group during the 10 to 12 months of follow up. No stent restenosis occurred with the in-stent diameter late loss50%, nor was in-stent thrombus found by IVUS. Endomembrane proliferation was found but without any significant difference. Minimal stent lumen area were not significantly different from the immediate results after PCI (10.12-/+1.15 mm(2) vs 8.98-/+2.12 mm(2), P0.05). The 31 patients in the control group were successfully stented with satisactory CAG results, but 3 suffered angina at 3-6 months who showed stent restenosis and insufficient stent adherence.IVUS can more effectively guide the interventional therapy for ACS borderline lesions and assess the immediate efficacy of therapy than CAG. Post-dilation with higher pressure (16-20 atm) guided by IVUS can further improve the procedural results. IVUS-guided PCI for ACS borderline lesions ensures high immediate and long-term success rate.

To assess the value of renal vein renin , plasma endothelin (ET), nitric oxide (NO), calcitonin gene-related peptide (CGRP) in predicting the therapeutic effect of percutaneous renal artery stenting.Selective renal angiography was performed in 60 patients with coronary artery disease and hypertension. All the patients with obvious unilateral renal artery stenosis (lumen narrowingor =50%) underwent percutaneous transluminal renal angioplasty and stenting. Bilateral renal vein and inferior vena cava plasma renin activity (PRA) and plasma ET, NO, and CGRP levels were measured and the two-year follow-up data of the patients analyzed.In all the patients, PRA in the ischemic kidney was significantly higher than that in the contralateral kidney (3.89-/+3.14 vs 2.01-/+1.93 nmol/L/h, P0.05). After renal artery revascularization with stenting, PRA in the ischemic kidney was reduced obviously (P0.05), which was significantly lower in patients with renal vein renin ratio (RVRR)1.5 than in those with RVRR1.5 (1.92-/+2.15 vs 2.42-/+0.56 nmol/L/h, P0.05]. Plasma ET level was significantly higher, whereas plasma NO level significantly lower in patients with PVRR1.5 (P0.05). Greater improvement of blood pressure was observed in patients with RVRR1.5 after two years than in those with RVRR1.5 (P0.05).The activity of penal vein renin, plasma ET, NO, and CGRP may provide valuable information for predicting the therapeutic effect of percutaneous renal artery stenting.