Sun Mingyu

GW28-e1149 Three-dimensional reconstruction analysis of the esophagus, left atrium, and pulmonary veins: Implications for cryoablation of atrial fibrillation

To assess the posterior left atrial–esophageal relationship throughout the cryoablation of atrial fibrillation, avoiding esophageal injury and even more severe complication of post procedure atrial esophageal fistula. From July 2016 to September 2016, 36 consecutive atrial fibrillation patients

GW24-e1262 Features and treatments of hypertension in elderly patients with Stanford B aortic dissection

Objectives To summarise the features and treatments of hypertension in elderly patients with Stanford B aortic dissection. Methods Retrospectively analysed the features and treatments of hypertension between the elderly patients (≥ 60 years, n = 91) and the non-elderly patients (< 60 years, n = 187) who were suffered from Stanford B aortic dissection and hospitalised between April 2002 and July 2011. Results The proportion of male in elderly group was higher than that in non-elderly group (P < 0.05). Smoking was similarly common in both groups. The proportions of patients accompanied with diabetes mellitus, hyperlipidemia, hypertension and renal inadequacy had no statistics differences between two groups. Coronary artery disease, atherosclerotic ulcer and cardiac insufficiency were more often seen in elderly group (P < 0.05). Histories of hypertension were more often given while the first-time diagnosis of hypertension were made less frequently in elderly group (P < 0.05). Isolated systolic hypertensions were seen with greater frequency in the elderly group (P < 0.05). The courses of hypertension were longer in the elderly group than those in the non-elderly group (P < 0.05). The proportions of family history of hypertension and hypertension of grade 1, grade 2 and grade 3 had no statistics differences between two groups. The highest systolic pressures, diastolic pressures and pulse pressures of the patients on admission and the average systolic pressures, diastolic pressures and pulse pressures after treatments had no statistics differences between two groups. The combined treatments were applied frequently in both groups. The usages of intravenous drugs had no differences between two groups. Combinations of 2 antihypertensive drugs were more often used in the elderly group than those in the non-elderly group (P < 0.05). Combinations of 3 antihypertensive drugs were used most frequently in both groups. Calcium-channel blocker, β-receptor blocker, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, diureticum, angiotensin receptor blocker + diureticum and α1 + β receptor blocker were adopted in turn as hypotensive drugs in elderly group. α1 + β receptor blocker was less used in the elderly group (P < 0.05). Conclusions The awareness rate of hypertension was higher and the highest blood pressures on admission were lower in elderly patients with Stanford B aortic dissection. The types of anti-hypertension drugs were less and α1 + β receptor blocker was less used in the elderly group.

ASSA13-08-8 Features and Treatments of Hypertension in Elderly Patients with Stanford B Aortic Dissection

Objective To summarise the features and treatments of hypertension in elderly patients with Stanford B aortic dissection. Methods Retrospectively analysed the features and treatments of hypertension between the elderly patients (≥ 60 years, n = 91) and the non-elderly patients (n = 187) who were suffered from Stanford B aortic dissection and hospitalised between April 2002 and July 2011. Results The proportion of male in elderly group was higher than that in non-elderly group (P < 0.05). Smoking was similarly common in both groups. The proportions of patients accompanied with diabetes mellitus, hyperlipidemia, hypertension and renal inadequacy had no statistics differences between two groups. Coronary artery disease, atherosclerotic ulcer and cardiac insufficiency were more often seen in elderly group (P < 0.05). Histories of hypertension were more often given while the first-time diagnosis of hypertension were made less frequently in elderly group (P < 0.05). Isolated systolic hypertensions were seen with greater frequency in the elderly group (P < 0.05). The courses of hypertension were longer in the elderly group than those in the non-elderly group (P < 0.05). The proportions of family history of hypertension and hypertension of grade 1, grade 2 and grade 3 had no statistics differences between two groups. The highest systolic pressures, diastolic pressures and pulse pressures of the patients on admission and the average systolic pressures, diastolic pressures and pulse pressures after treatments had no statistics differences between two groups. The combined treatments were applied frequently in both groups. The usages of intravenous drugs had no differences between two groups. Combinations of 2 antihypertensive drugs were more often used in the elderly group than those in the non-elderly group (P < 0.05). Combinations of 3 antihypertensive drugs were used most frequently in both groups. Calcium-channel blocker, β-receptor blocker, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, diureticum, angiotensin receptor blocker+diureticum and α1 + β receptor blocker were adopted in turn as hypotensive drugs in elderly group. α1 + β receptor blocker was less used in the elderly group (P < 0.05). Conclusions The awareness rate of hypertension was higher and the highest blood pressures on admission were lower in elderly patients with Stanford B aortic dissection. The types of anti-hypertension drugs were less and α1 + β receptor blocker was less used in the elderly group.

ASSA13-10-13 Cellular Repressor E1A-Stimulated Genes Controls Phenotypic Switching of Adventitial Fibroblasts by Blocking p38MAPK Activation

Background Phenotypic modulation of adventitial fibroblasts (AFs) plays an important role in the pathogenesis of proliferative vascular diseases. The current study aimed to identify the role of cellular repressor E1A-stimulated genes (CREG), a critical mediator in the maintenance of vascular homeostasis, in AF phenotypic modulation and adventitial remodelling. Methods Two models of AF phenotypic modulation were used: the in vivo injury-induced adventitial remodelling and the in vitro Ang II-induced AF phenotypic modulation. CREG’s function in AFs was investigated after over-expression of CREG with infection with adenovirus expressing full-length human CREG cDNA. Results Using in situ double-immunofluorescence staining, we ascertained that CREG expression was significantly downregulated in the adventitia after vascular injury, and its expression pattern was conversely correlated with the expression of smooth muscle α-actin (α-SMA), a marker for differentiation of AFs into myofibroblasts. In vitro data confirmed the association of CREG in angiotensin II (Ang II)-induced AF differentiation. Additionally, over-expression of CREG attenuated Ang II-induced α-SMA expression in AFs. CREG over-expressing AFs showed decreased levels of proliferation on days 2 to 5 following stimulation by Ang II compared with controls, with changes in the cell cycle profile as shown by BrdU incorporation assay and fluorescence activated cell sorting analysis. Moreover, wound healing assay and transwell migration model demonstrated that upregulation of CREG expression inhibited Ang II-induced AF migration. We found that CREG mediated its counterbalancing effects in Ang II-induced phenotypic modulation, proliferation and migration by inhibition of the p38MAPK signalling pathway, validated by pharmacological blockade of p38MAPK with SB 203580 and by over-expression of p38MAPK with transfectants expressing constitutively active p38αMAPK. Conclusions Our findings suggest that CREG is a novel AF phenotypic modulator in a p38MAPK-dependent manner. Modulating CREG on the local vascular wall may become a new therapeutic target against proliferative vascular diseases.

ASSA13-10-14 Cellular Repressor of E1A-Stimulated Genes Accelerates Endothelial Angiogenesis Via Integrin-Linked Kinase-PINCH-CDC42 Activation

Background Cellular repressor of E1A-stimulated genes (CREG) is an important endothelial-protective gene, which is reported to modulate the mobility of endothelial cells. Objective The study aimed to investigate the effects of CREG on endothelial angiogenesis. Methods Aortic expression of CREG protein was detected by western blot and immnuostaining in CREG heterozygous (CREG+/-) mice and wild-type littermates. Perfusion recovery of hind limb was valued by laser Doppler in mice and wild-type littermates 14 days after the hind limb arterial ligation. The matrigel experiments in vivo and in vitro were performed after the human umbilical vein endothelial cells (HUVEC) were infected by adenovirus overexpressing CREG or adenovirus expressing GFP as control, and the filopodium formation was observed to evaluate the CREG function on neovascularization. Different integrin-linked kinase (ILK) subunit site mutant plasmids and small interfering RNA identified p-Cdc42 were transfected into HUVEC to explore the mechanism through which CREG-mediated endothelial angiogenesis. Results Aortic expression of CREG protein was detected to reduce remarkably in CREG+/- mice compared to that in wild-type littermates. Meanwhile, laser Doppler perfusion imaging showed that perfusion recovery was significantly impaired in CREG+/- mice than that in wild-type littermates after 14 days hind limb arterial ligation (78.23 ± 7.2% vs 12.15 ± 2.058% in calf; 58.23 ± 6.5% vs 32.15 ± 3. 514% in thigh; P < 0.001). Subsequently, overexpression of CREG in HUVEC increased endothelial cell network formation in vitro, enhanced neovascularization and improved limb perfusion in vivo, accompanied by filopodium formation and changes in cell shape. Mechanismly, integrin-linked kinase (ILK), a key adhesion plaque protein, participated in CREG-mediated endothelial angiogenesis. Furthermore, studies using small interfering RNA identified p-Cdc42 to be a key downstream molecule of ILK involved in CREG-mediated endothelial cell filopodium formation. Transfection with binding-site-mutant plasmids of ILK and co-immunoprecipitation revealed that CREG activated the ILK-PINCH complex, which is involved in the regulation of p-Cdc42 activation. Conclusions CREG overexpression stimulates the endothelial filopodium formation and regulates angiogenesis via the ILK/PINCH/p-Cdc42 signalling pathway, which provides the basis for future studies in the field of angiogenesis.