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ABSTRACT: To determine the impact of smoking behaviors on long-term outcomes of coronary artery bypass grafting (CABG).
We conducted this survey in 2541 consecutive patients who underwent CABG in Fu Wai hospital from January 1, 2004 to December 30, 2005. The preoperative and postoperative smoking habits were obtained. The patients were divided into never smokers and ever smokers. The ever smokers were further divided into the current smokers who smoked before and after CABG and former smokers who stopped smoking before CABG, quitters who stopped smoking after CABG. Death, major adverse cardiovascular or cerebrovascular events and angina pectoris were observed. The relative risk of adverse events in different patients were analyzed by univariate and multivariate Cox analysis.
The patients were followed up for 4.27 to 6.41 years (average 5.09 years). After CABG, the percentage of persistent smoking patients was 22.1%. After adjusting baseline characteristics, relative risk for tumor related death (RR: 2.38, 95%CI: 1.06 - 5.36), major adverse cardiovascular or cerebrovascular events (RR: 1.26, 95%CI: 1.01 - 1.57) and angina pectoris (RR: 1.29, 95%CI: 1.04 - 1.59) were significantly higher in ever smokers than in never smokers. Similarly, relative risk of death from all causes (RR: 2.60, 95%CI: 1.53 - 4.46), cardiac death (RR: 2.51, 95%CI: 1.32 - 4.78), tumor cause death (RR: 5.12, 95%CI: 2.08 - 12.59), major adverse cardiovascular or cerebrovascular events (RR: 1.83, 95%CI: 1.42 - 2.34) and angina pectoris (RR: 1.69, 95%CI: 1.33 - 2.16) were also significantly higher in current smokers than in never smokers. Outcome was similar between patients who stopped smoking and never smokers (all P > 0.05).
Smoking prevalence is still high in patients after CABG in China. Persistent smoking is associated with higher rates of mortality and morbidity after CABG while smoking cessation is associated with reduction of morbidity and mortality in patients after CABG.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 09/2011; 39(9):825-9.
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ABSTRACT: Neural remodeling after myocardial infarction (MI) may cause fatal ventricular arrhythmia. Schwann cells (SCs), which are important for neurogenesis, are dramatically reduced after MI. We investigated the feasibility of modifying nervous system regeneration after MI and the efficacy by which it may prevent ventricular arrhythmia following SC transplantation.
Immediately after creation of MI, syngenic Lewis rats were randomized into cell transplantation (n=80) and control groups (n=72). SCs were isolated from sciatic nerves, and 5×10(6) cells were intramyocardially injected into the infarct region. Expression levels of myocardial nerve growth factor, vascular endothelial growth factor, growth-associated protein 43, connexin 43, and laminin in the SC group were significantly higher than control at 7 and 14 days after cell transplantation. Immunohistochemical staining illustrated increases in sympathetic and parasympathetic nerves in both groups. However, SC transplantation significantly increased the parasympathetic/sympathetic ratio at 14 days after cell injection. Dynamic electrocardiography and programmed electric stimulation were also performed. The SCs significantly decreased the low-/high-frequency ratio and arrhythmia score of programmed electric stimulation-induced ventricular arrhythmia at 2 weeks after cell injection. However, SCs did not restore heart function.
Transplanted SCs in the infarcted myocardium secrete multiple biological molecules, which alter the ratio of parasympathetic/sympathetic nerve density to normalize irritable myocardium. SC transplantation might be a novel cell-based antiarrhythmic therapy following MI.
Circulation 09/2010; 122(11 Suppl):S193-200. · 14.74 Impact Factor
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ABSTRACT: Bone marrow derived mesenchymal stem cells (BMSCs) have shown to be an appealing source for cell therapy and tissue engineering. Previous studies have confirmed that the application of low-level laser irradiation (LLLI) could affect the cellular process. However, little is known about the effects of LLLI on BMSCs. The aim of this study was designed to investigate the influence of LLLI at different energy densities on BMSCs proliferation, secretion and myogenic differentiation.
BMSCs were harvested from rat fresh bone marrow and exposed to a 635 nm diode laser (60 mW; 0, 0.5, 1.0, 2.0, or 5.0 J/cm(2)). The lactate dehydrogenase (LDH) release was used to assess the cytotoxicity of LLLI at different energy densities. Cell proliferation was evaluated by using 3-(4, 5-dimethylithiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) and 5-bromo-2'-deoxyuridine (BrdU) assay. Production of vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay (ELISA). Myogenic differentiation, induced by 5-azacytidine (5-aza), was assessed by using immunocytochemical staining for the expression of sarcomeric alpha-actin and desmin.
Cytotoxicity assay showed no significant difference between the non-irradiated group and irradiated groups. LLLI significantly stimulated BMSCs proliferation and 0.5 J/cm(2) was found to be an optimal energy density. VEGF and NGF were identified and LLLI at 5.0 J/cm(2) significantly stimulated the secretion. After 5-aza induction, myogenic differentiation was observed in all groups and LLLI at 5.0 J/cm(2) dramatically facilitated the differentiation.
LLLI stimulates proliferation, increases growth factors secretion and facilitates myogenic differentiation of BMSCs. Therefore, LLLI may provide a novel approach for the preconditioning of BMSCs in vitro prior to transplantation.
Lasers in Surgery and Medicine 01/2009; 40(10):726-33. · 2.75 Impact Factor
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Jian-feng Hou MD,
PhD Hao Zhang MD,
Xin Yuan MD,
Jun Li BS,
Ying-jie Wei PhD,
Sheng-shou Hu MD, Jian‐feng Hou,
Hao Zhang,
Xin Yuan,
Jun Li,
Ying‐jie Wei,
Sheng‐shou Hu
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ABSTRACT: Background and Objectives
Bone marrow derived mesenchymal stem cells (BMSCs) have shown to be an appealing source for cell therapy and tissue engineering. Previous studies have confirmed that the application of low-level laser irradiation (LLLI) could affect the cellular process. However, little is known about the effects of LLLI on BMSCs. The aim of this study was designed to investigate the influence of LLLI at different energy densities on BMSCs proliferation, secretion and myogenic differentiation.Study Design/Materials and MethodsBMSCs were harvested from rat fresh bone marrow and exposed to a 635 nm diode laser (60 mW; 0, 0.5, 1.0, 2.0, or 5.0 J/cm2). The lactate dehydrogenase (LDH) release was used to assess the cytotoxicity of LLLI at different energy densities. Cell proliferation was evaluated by using 3-(4, 5-dimethylithiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) and 5-bromo-2′-deoxyuridine (BrdU) assay. Production of vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay (ELISA). Myogenic differentiation, induced by 5-azacytidine (5-aza), was assessed by using immunocytochemical staining for the expression of sarcomeric α-actin and desmin.ResultsCytotoxicity assay showed no significant difference between the non-irradiated group and irradiated groups. LLLI significantly stimulated BMSCs proliferation and 0.5 J/cm2 was found to be an optimal energy density. VEGF and NGF were identified and LLLI at 5.0 J/cm2 significantly stimulated the secretion. After 5-aza induction, myogenic differentiation was observed in all groups and LLLI at 5.0 J/cm2 dramatically facilitated the differentiation.ConclusionsLLLI stimulates proliferation, increases growth factors secretion and facilitates myogenic differentiation of BMSCs. Therefore, LLLI may provide a novel approach for the preconditioning of BMSCs in vitro prior to transplantation. Lasers Surg. Med. 40:726–733, 2008. © 2008 Wiley-Liss, Inc.
Lasers in Surgery and Medicine 11/2008; 40(10):726 - 733. · 2.75 Impact Factor
