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To explore the clinical predictive factors of coronary artery stenosis located distally to myocardial bridging (MB).A total of 603 patients with MB-mural coronary artery (MB-MCA) diagnosed by angiography initially were enrolled during May 2004 to May 2009. Their angiographic and clinical data were collected according to an uniform protocol. And standard questionnaires were used to acquire demographic information and clinical examinations. Univariate and multivariate analysis were performed to explore the related clinical predictive factors.A total of 644 MB-MCAs were detected. Diastolic vessel diameters in MCAs were significantly smaller than those in reference segments ( (2.29 ± 0.39) vs (2.48 ± 0.40) mm, P0.001) . Lesions located distally to MB detected in 36 patients were significantly fewer than those proximally to MB in 382 patients (5.9% vs 62.4%, P0.001) . Univariate analysis suggested that the narrowing degree of vessel located proximally to MB, the narrowing degree and the number of diseased coronary vessels of non-MB-MCAs and course of hypertension were positively correlated with the narrowing degree of vessel located distally to MB (all P0.05) . Multivariate Logistic regression analysis suggested that the number of cigarettes per day, the narrowing degree of diseased coronary vessels of non-MB-MCAs, the narrowing degree of vessel located proximally to MB and diastolic narrow rate of MCA were positively correlated with the occurrence of coronary artery stenosis located distally to MB (all P0.05) . Their standardized coefficients (β) were 0.763, 0.727, 0.420 and 0.403 respectively. And the corresponding Exp (β) were 2.146 (1.089-4.229) , 2.070 (1.371-3.125) , 1.521 (1.050-2.204) and 1.496 (1.094-2.045) .The number of cigarettes per day, the narrowing degree of diseased coronary vessels of non-MB-MCAs, the narrowing degree of vessel located proximally to MB and diastolic narrowing rate of MCA are likely to be important clinical predictive factors of coronary artery stenosis located distally to MB.

To explore the imaging and clinical characteristics and related risk factors of patients with coronary artery stenosis located proximally to myocardial bridging.This study enrolled 603 patients with angiography evidenced myocardial bridging-mural coronary artery between May 2004 to May 2009. Angiographic and clinic data were collected according to uniform protocol and standard questionnaires were used to obtain patients' demographic and clinical information. Univariate and multivariate analysis were performed to explore related risk factors.Chest pain was present in 247 cases (41.0%). Dynamic ST-T changes were found in 229 cases (38%). A total of 644 myocardial bridging-mural coronary arteries were detected including 382 (62.4%) segments located proximally to myocardial bridging. Diastolic vessel diameters in the myocardial bridging segment were significantly smaller than reference segments (all P0.01). Stepwise multiple regression analysis suggested that vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non- myocardial bridging-mural coronary arteries, age, LDL-C/HDL-C, male gender, diabetes, and systolic narrow rate of myocardial bridging-mural coronary arteries were positively related with the narrowing degree of the first coronary artery stenosis located proximally to myocardial bridging (P0.05 or P0.01). Vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non- myocardial bridging-mural coronary arteries, age, LDL-C/HDL-C, male, diabetes and dyslipidemia were positively related with the narrowing degree of the most severe coronary artery stenosis located proximally to myocardial bridging (P0.05 or P0.01).Myocardial ischemia is common in patients with myocardial bridging and the artery segments located proximally to myocardial bridging are prone to stenosis. Systolic narrow rate of myocardial bridging-mural coronary arteries is one of major determinants of coronary artery stenosis located proximally to myocardial bridging. Whereas the other coronary heart disease risk factors are likely to play more important roles.

To probe the efficacy and feasibility of the transradial approach for diagnostic coronary angiography with 5F universal catheter.Transradial coronary angiography was performed in 3094 consecutive patients, 2396 men and 698 women, aged 30 - 81 years, mean age (56.1 +/- 9.8) years, from July 2000 to April 2004. Patients were divided into 5F improved Terumo catheter group (improved Terumo group, n = 985), 5F universal Terumo catheter group (Terumo group, n = 1024) and 5F universal Medtronic catheter group (Medtronic group, n = 1085). The procedure success rate, duration of operation and fluoroscopy between groups were compared.The procedure success rate was 98.4% in improved Terumo group, 98.0% in Terumo group, and 96.0 % in Medtronic group, respectively. The success rate was higher in improved Terumo group than in Medtronic group (P0.05). The average duration of operation and fluoroscopy in improved Terumo group was (17.9 +/- 5.8) min and (4.8 +/- 1.8) min, in Terumo group was (18.2 +/- 5.5) min and (5.0 +/- 1.7) min, but (21.1 +/- 7.2) min and (5.2 +/- 1.9) min in Medtronic group. There were significant differences among group (P0.05).(1) Transradial coronary angiography with small diameter universal catheter is safe and easy to perform with a higher success rate and allow earlier patient ambulation, and should be strongly encouraged and recommended. (2) Option of angiographic catheter plays a key role in the safety, efficacy and quality of transradial coronary angiography. Seemingly, the improved Terumo group was excellent and shoud be popularized.

This report provides analysis of the complication rates, the risk factors, prevention and treatments of the complications of selective coronary interventions.The types, the incidence, and the annual distribution characteristics of the complications in 2 868 cases of coronary interventions performed from October 1987 to December 2000 were reviewed, and the risk factors, prevention and treatments of the complications were analyzed.During the study period, 2 868 procedures of percutaneous coronary interventions (PCI) were performed. The total complication rate of PCI was 8.30% (6.33% - 20.00%). The procedure-related mortality rates were 0.07%. The complications included non-fatal Q wave myocardial infarctions (0.17%), coronary artery dissecting (2.58%), acute coronary artery occlusion (1.99%), coronary artery thrombosis (0.38%), coronary artery spasm (1.32%), coronary artery perforation (0.31%), severe arrhythmia (0.63%), severe contrast allergic reaction (0.07%), peripheral vascular complication (0.90%), and heart failure (0.10%). Emergent coronary artery bypass surgery (CABG) was required in 0.10% of the patients with PCI. The independent risk factors of the complications of PCI included unstable angina, coronary multivessel disease, and heart failure.The complication rates of PCI decreased with the accumulation of experiences. The complication rates in this group of patients are lower than the reported ones. This result is probably due to strictly selecting the indication, actively preventing and treating the complications.

To study the incidence rates, risk factors, prevention and treatments of complications of selective coronary arteriography.A retrospective survey was conducted on the data of the incidence and annual distribution characteristics of complications among 9 196 cases that underwent selective coronary arteriography performed October 1987 to December 2000, and analyze the risk factors and prevention and treatment of these complications.The total complication rate was 1.33%. The procedure-related mortality rates were 0.02%. The incidence rate of non-fatal Q wave myocardial infarction, coronary artery spasm, severe arrhythmia, severe contrast allergic reaction, peripheral vascular complication, and heart failure in coronary arteriography was 0.01%, 0.13%, 0.29%, 0.04%, 0.35%, and 0.08%, respectively. No emergent coronary artery bypass surgery was required in patients with coronary arteriography. The independent risk factors of the complications of coronary arteriography included unstable angina, coronary multivessel disease, left main coronary artery disease and heart failure.The complication rate of coronary arteriography decrease with the accumulation of experience. The complication rate in this group is lower than in other reports probably due to strictly selecting of indication and active prevention and treatment of complications.