TRA Group Research Articles

Radial versus femoral approach for percutaneous coronary interventional procedures in the aged

：Objective To evaluate the safety and effect oftransradialartery approach for coronary intervention in the aged.Methods There were 314 cases whichwere more than 60 years old with coronary artery disease in hospital from Mar 2007 to May2009, who accepted coronary intervention.They were randomly divided into Transradialgroup(TRA, n=157) and Transfemoral group(TRF, n=157).The success rate and time ofpuncture, x-ray exposure time, procedure duration, complication in puncture site andpulmonary embolism were observed in the two groups.Results 149 out of 157 cases success inTRA group and 155 cases in TRF group.The success rate was not different.The success rateof puncture,xray exposure time and procedure duration had no difference between the twogroups.But the complication in puncture site and pulmonary embolism were more in TRF groupthan in TRA group. Conclusions Pereutaneous transradial artery approach is secure andeffective for coronary intervention treatment in the aged and has few vascularcomplications. Key words: Aged; Radial artery; Femoral artery; Angioplasty;

Regulatory effect of ulinastatin on NF-κB and MMP-2/TIMP-2 in rats with acute renal trauma

Objective:To investigate the expression of nuclear factor-κB(NF-κB),matrix metalloproteinase-2(MMP-2),tissue inhibitor of metalloproteinase-2(TIMP-2) in the kidneys of rats with acute renal trauma,and to discuss the influence of ulinastatin on their expression and its protective mechanism on the kidney.Methods: The animal model was established by striking the rachi-costaz zone with falling object from the height of 45 cm.Sixty-six rats were randomly divided into three groups:normal control group (C,n=6),trauma group (TRA,n=30),and ulinastatin+trauma (UTI,n=30); the last 2 groups were further divided into 1 h,6 h,12 h,18 h and 24 h subgroups,with 6 animals at each time point.Tissue microarray and immunohistochemistry were used to examine the expression of NF-κB and MMP2/TIMP-2 in different groups.Results: MMP-2 and NF-κB began to express 1 h after trauma in TRA group and their expression was significantly stronger than that in the control group(P0.05,P0.01); their expression reached the peaks at 12 h and 6 h after trauma and then gradually decreased.The expression of MMP-2 and NF-κB in UTI group reached their peaks 18 h and 12 h after trauma,respectively,and was significantly higher than that in the control group(P0.01),but was lower than that in the TRA group at corresponding time points(P0.01,P0.05).The expression of TIMP-2 was significantly stronger than that in the control group and TRA group at 6 h,12 h and 18 h after trauma(P0.01,P0.05).Conclusion: The expression of NF-κB,MMP-2 is increased in acutetraumatic tissue of the kidney; the increase of TIMP-2 is not evident.Ulinastatin can protect the kidney by inhibiting the expression of MMP-2 and NF-κB and maintaining the balance of MMP-2/TIMP-2.

Histopathologic changes of the radial artery wall secondary to transradial catheterization

The immediate effects of transradial access on the radial artery wall are unknown. In this study we sought to assess the histological changes induced by catheterization on the radial artery. Thirty-four patients undergoing coronary artery bypass grafting (CABG) had radial arteries harvested to serve as bypass conduits. The proximal and distal ends of the radial artery conduits were sectioned and embedded in paraffin. Both ends of all specimens were evaluated by a blinded pathologist for intimal hyperplasia, medial inflammation, medial calcification, periarterial tissue or fat necrosis, adventitial inflammation, adventitial necrosis, and adventitial neovascularization. Fisher's exact test was used for statistical analysis. Fifteen previously catheterized radial arteries (TRA group) were compared with 19 noncatheterized arteries (NCA group). The distal ends of the TRA group showed significantly more intimal hyperplasia (73.3% vs 21.1%; p = 0.03), periarterial tissue or fat necrosis (26% vs 0%; p = 0.02), and more adventitial inflammation (33.3% vs 0%; p = 0.01) than the distal ends of the NCA group. The distal ends of the TRA group also showed significantly more intimal hyperplasia (73.3% vs 26.6%; p = 0.03) and adventitial inflammation (33.3% vs 0%; p = 0.01) than the proximal ends of the same arteries. There were no histological differences in the proximal ends of the two groups. Transradial catheterization induces significant histological changes suggestive of radial artery injury limited to the puncture site in the form of intimal hyperplasia, medial inflammation, and tissue necrosis. Both the proximal and distal ends of the radial artery show a spectrum of atherosclerotic changes independent of its use for transradial catheterization.

Effect of verapamil, trandolapril and their combination on vascular function and structure in essential hypertensive patients

AimThe aim of the present study is to evaluate the effect of treatment with verapamil, trandolapril and their combination on peripheral microcirculation vasoreactivity. MethodsTwenty hypertensive patients were randomized to receive oral trandolapril (4mg oid; TRA) or verapamil (240mg oid; VER) for 6 months and then the combination of the two drugs for additional 6 months. At baseline, 6 months and 12 months, peripheral microcirculation vasoreactivity was evaluated by forearm blood flow technique (venous plethysmography), as vasodilation to an endothelium-dependent (acetylcholine) and an endothelium-independent stimulus (sodium nitroprusside, SNP); minimal forearm vascular resistances (MFVR) were also evaluated. ResultsBlood pressure decreased similarly and progressively in both groups throughout the study period. In VER, 6-month verapamil treatment significantly increased vasodilation to acetylcholine, but not to SNP. The superimposition of trandolapril increased the response to SNP, and less to acetylcholine. In TRA group, 6-month treatment with trandolapril improved the response to SNP, but not to acetylcholine. In this group, the superimposition of verapamil caused a significant improvement in the response to acetylcholine, but not to SNP. At the end of the study, MFVR were significantly reduced in both groups, but to a greater extent in TRA. ConclusionThe present study demonstrates that chronic treatment with verapamil ameliorates endothelial function in the forearm microcirculation of essential hypertensive patients, while trandolapril protects microcirculation from structural alterations. The combination of the two drugs is potentially a powerful tool to counteract hypertension-related microvascular dysfunction and damage.

Endurance training guided individually by daily heart rate variability measurements

Purpose of this study was to test utility of heart rate variability (HRV) in daily endurance exercise prescriptions. Twenty-six healthy, moderately fit males were randomized into predefined training group (TRA, n = 8), HRV-guided training group (HRV, n = 9), and control group (n = 9). Four-week training period consisted of running sessions lasting 40 min each at either low- or high-intensity level. TRA group trained on 6 days a week, with two sessions at low and four at high intensity. Individual training program for HRV group was based on individual changes in high-frequency R-R interval oscillations measured every morning. Increase or no change in HRV resulted in high-intensity training on that day. If there was significant decrease in HRV (below reference value [10-day mean-SD] or decreasing trend for 2 days), low-intensity training or rest was prescribed. Peak oxygen consumption (VO(2peak)) and maximal running velocity (Load(max)) were measured in maximal treadmill test before and after the training. In TRA group, Load(max) increased from 15.1 +/- 1.3 to 15.7 +/- 1.2 km h(-1) (P = 0.004), whereas VO(2peak) did not change significantly (54 +/- 4 pre and 55 +/- 3 ml kg(-1) min(-1) post, P = 0.224). In HRV group, significant increases were observed in both Load(max) (from 15.5 +/- 1.0 to 16.4 +/- 1.0 km h(-1), P < 0.001) and VO(2peak) (from 56 +/- 4 to 60 +/- 5 ml kg(-1) min(-1), P = 0.002). The change in Load(max) was significantly greater in HRV group compared to TRA group (0.5 +/- 0.4 vs. 0.9 +/- 0.2 km h(-1), P = 0.048, adjusted for baseline values). No significant differences were observed in the changes of VO(2peak) between the groups. We concluded that cardiorespiratory fitness can be improved effectively by using HRV for daily training prescription.

Enhancement of the teratogenicity of all-trans-retinoic acid by maternal restraint stress in mice as a function of treatment timing.

In CD-1 mice, maternal restraint stress was combined with all-trans-retinoic acid (tRA) given during the restraint period (9:00 a.m. to 9:00 p.m.) to determine in what manner and to what degree teratogenesis might be affected by treatment timing within the stress period and to determine the optimum timing for stress-enhanced production of fetal defects. Eleven groups were treated on gestation day 9 (copulation plug = day 1): group 1, vehicle (corn oil) control (C); group 2, food/water deprived (FWD); group 3, restraint only (R); group 4, tRA plus food/water deprivation (tRA+FWD); groups 5 and 6, tRA at 0 or 4 hr after 9:00 a.m., i.e., tRA(0) and tRA(4), respectively; and groups 7-11, restraint plus tRA at 0, 2, 4, 8, or 12 hr after 9:00 a.m., (i.e., R+tRA(0), R+tRA(2), R+tRA(4), R+tRA(8), and R+tRA(12), respectively). The tRA dose was 20 mg/kg, PO; mice were restrained in the supine position. FWD mice were deprived for the same 12 hr as the restrained mice. All stated differences were significant (P < or = 0.05), based on litter incidences. The incidences of short tails (65%), fused ribs (62%), and fused vertebrae (37%) were elevated in the R+tRA(4) group in comparison with all others, and there appeared to be more exencephalies in R+tRA(2) litters than in any others. The incidence of supernumerary ribs was elevated in the R group in comparison with C and FWD; it was further elevated by tRA at all treatment times.(ABSTRACT TRUNCATED AT 250 WORDS)

Thromboxane A2 Receptor Antagonist SQ29548 Does Not Improve Canine Postischemic Cerebral Hypoperfusion

The thromboxane receptor antagonist SQ29548 was administered to mongrel dogs after an 11-min period of global cerebral ischemia to test the hypothesis that it would improve delayed postischemic cerebral hypoperfusion (PIH) during concurrent elevations in cerebral venous thromboxane B2 (TxB2), the stable metabolite of thromboxane A2 (TxA2). Immediately following an 11-min period of aortic root cross-clamping, six dogs received 0.2 mg/kg of SQ29548 intravenously followed by continuous infusion of 0.2 mg/kg/h (TRA group) and six received a saline placebo (control). Over the next 120 min, cerebral venous outflow was measured from the confluence of the sagittal and lateral sinuses, while arterial and cerebral venous samples were obtained for measurement of TxB2. Delayed postischemic cerebral hypoperfusion, confirmed in the control group (p < 0.05) (16 +/- 2.7 vs. 32 +/- 2.4 ml/min baseline), was nearly identical in the TRA group (14 +/- 0.9 vs. 30 +/- 2.5 ml/min baseline). Cerebral venous TxB2 levels rose dramatically in both groups after ischemia (3670 +/- 440 vs. 1100 +/- 350 pg/ml baseline, control and 2720 +/- 170 vs. 580 +/- 100 pg/ml baseline, TRA group) (p < 0.05). There were no significant group mean differences in any of the other hemodynamic data except mean arterial pressure (MAP) at T120 and Hgb at baseline. We conclude that postischemic intravenous administration of the thromboxane receptor-specific antagonist SQ29548 fails to improve delayed postischemic cerebral hypoperfusion and does not alter cerebral venous TxB2 release in this canine model of global cerebral ischemia.