Metformin has been used in diabetes for more than 60 years and has excellent safety in the therapy of human type 2 diabetes (T2D). There is growing evidence that the beneficial health effects of metformin are beyond its ability to improve glucose metabolism. Metformin not only reduces the incidence of cardiovascular diseases (CVD) in T2D patients, but also reduces the burden of atherosclerosis (AS) in pre-diabetes patients. Vascular smooth muscle cells (VSMCs) function is an important factor in determining the characteristics of the entire arterial vessel. Its excessive proliferation contributes to the etiology of several types of CVD, including AS, restenosis, and pulmonary hypertension. Current studies show that metformin has a beneficial effect on VSMCs function. Therefore, this review provides a timely overview of the role and molecular mechanisms by which metformin acts through VSMCs to protect CVD.
Background: Cardiovascular disease is the leading cause of death in both developed and developing countries. Di'ao Xinxuekang (DAXXK) is a pure Chinese medicine herbal preparation refined from dioscin extracted from the roots of Dioscorea panthaica Prain et Burk and Diosorea nipponica Makino. Objective: To evaluate the application of DAXXK in Cardiovascular disease. Methods: : We searched and summarized all the studies on DAXXK and Cardiovascular disease in pumend, Google, and CNKI. Results: Modern pharmacological studies have shown that DAXXK has pharmacological effects such as dilating blood vessels, lowering blood pressure and cardiac load, improving hemodynamics, lowering blood lipids and anti-platelet aggregation, and is widely used for the therapy of various kinds of cardiovascular diseases, including hypertension, atherosclerosis, coronary heart disease (CHD), angina pectoris (AP) and myocardial infarction. We provide an overview of the clinical efficacy, molecular mechanisms, safety and therapeutic potential of DAXXK in the treatment of cardiovascular disease, aiming to provide clues and evidence for clinical decision-making. Conclusion: DAXXK exerts cardiovascular protection by regulating a variety of cardiovascular disease-related signaling pathways.
Objective Catheter ablation of anteroseptal atrioventricular (AV) accessory pathway (AP) is still challenging because of their proximity to the normal AV conduction system that may be damaged with ablation. Traditionally, catheter ablation of anteroseptal APs via the inferior vena cava approach. In a few cases, anteroseptal AP ablation may fail because of conservative energy delivery at these sites or anatomical factor. In the recent years, a few cases of successful anteroseptal AP ablation in the noncoronary cusp (NCC) or sub tricuspid annulus have been reported. However, when need to map and ablate from the NCC or sub tricuspid annulus in patients with anteroseptal APs and what will be the mapping results at the NCC in patients with anteroseptal APs successful ablated in the, right anteroseptal region (RAS) have not been well evaluated. The purpose of this study was to discuss the characteristics of surface ECG, anatomic consideration, electrophysiology, and the strategy of ablation of anteroseptal APs in order to increase the success rate and safety of radiofrequency catheter ablation. Methods There were 55 consecutive patients (age 53 ± 11 years, 36 male) out of 2200 patients presenting with anteroseptal APs who underwent RF ablation at our centre between July 2006 and March 2013. On the basis of successful ablation location, these patients were divided into right anteroseptal region group (RAS group, through inferior vena cava approach), noncoronary cusp group (NCC group, through retrograde aorta approach) and sub tricuspid annulus group (Sub-TA group, throngh superior vena cava approach). The clinical characteristics, surface electrocardiogram (ECG), intracardiac electrogram findings, and response to ablation in these patients between three groups were analysed. The strategies for mapping and ablation of anteroseptal APs were discussed. Results Successful ablation were achieved in all the 55 patients with anteroseptal APs. The sites with successful ablation were located in the RAS, adjacent to the His bundle region, in 48 patients including in 9 patients whose initial ablation were unsuccessful in the NCC. In the 4 cases with successful ablation in the NCC, the initial attempt ablation in the NCC without trying in the RAS was performed in 1 cases in whom the decision to target the NCC was based on previous experience of V-A fusion pattern adjacent to the His bundle region suggestive of an NCC AP site. In 1 of the 4 patients, irrigated energy (30–40 W and infusion rate of 17–30 ml/min) was used to eliminated the AP in the NCC after failed ablation with non-irrigated energy. There were 3 cases underwent successful ablation at Sub-TA region by a superior approach from the right internal jugular vein. There were no important complications during perioperative period. All the patients underwent a period of 8 months to 7 years of follow-up by telephone or outpatient department. Four patents ablated in RAS region recurred. No recurrence in patients underwent successful ablation in NCC or Sub-TA region. Conc...
Objective To explore the methods, strategy and short-term outcome of cyroballoon ablation for paroxysmal atrial fibrillation. Methods To analyse the data of cryoballoon ablation for the first 5 patients with PAF in our hospital. Results The mean procedure time of the 5 patients were 153 ± 43.5 min (170 min, 100 min, 120 min, 210 min and 165 min). The mean fluoroscopy time was 51.2 ± 15.0 min (54 min, 33 min, 41 min, 72 min and 56 min). The mean time of cryoballoon ablation in each pulmonary vein was 209.0s ± 74.7s (29s – 300s). The temperature of the cryoballoon was -43.5 ± 8.6°C (-27°C – -61°C). The cryoballoon ablation times in each vein was 3 ± 1.3 (2–6 times per pulmonary vein). The complications of the procedure (such as phrenic nerve palsy, pericardia tamponade) was not happened. In one patient, the left pulmonary vein potential was not completely isolated. The radiofrequency ablation catheter was used to achieve pulmonary vein isolation entirely. After 1 or 2 months' follow-up, atrial fibrillation was not happened in all 5 patients. Conclusions Cryoballoon ablation of atrial fibrillation is relatively simple, no 3D mapping, and shorter learning curve. But the X-ray fluoroscopy time is longer in earlier period and need making progress.
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