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      Curative Effect of Yangxin Dingji Capsule Combined With Mexiletine Hydrochloride on Postoperative Arrhythmia and Its Influences on the Vascular Endothelial Function in Coronary Bifurcation Lesions

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          Abstract

          Objective

          The aim of the study is to explore the curative effect of Yangxin Dingji capsule combined with mexiletine hydrochloride on postoperative ventricular arrhythmia (VA) and its influences on vascular endothelial function in coronary bifurcation lesions (CBL).

          Methods

          A total of 110 patients with CBL admitted to the hospital were enrolled as research subjects between January and December 2021. According to the random number table method, they were divided into a combination group and control group, with 55 cases in each group. The control group was treated with mexiletine hydrochloride, while the combination group was additionally treated with Yangxin Dingji capsules. All were continuously treated for 4 weeks. The clinical response rate between the two groups was compared. The frequencies of 24 h paroxysmal atrial fibrillation, premature atrial contraction, and premature ventricular contraction were compared by the Holter monitoring. The whole blood low-shear viscosity, whole blood high-shear viscosity, and fibrinogen (Fb) in both groups were measured by a full-automatic blood flow analyzer. The levels of plasma nitric oxide (NO), endothelin-1 (ET-1), and von Willebrand factor (vWF) were detected by the nitrate reductase method and enzyme-linked immunosorbent assay (ELISA). During treatment, the occurrence of adverse reactions (vomiting, loss of appetite, dry mouth, diarrhea, nausea) in both groups was statistically analyzed.

          Results

          After treatment, the total response rate of treatment in the combination group was significantly higher than that in the control group ( P < 0.05). After treatment, frequencies of paroxysmal atrial fibrillation, premature atrial contraction, and premature ventricular contraction in the combination group were significantly lower than those in the control group ( P < 0.05). Whole blood low-shear viscosity, whole blood high-shear viscosity, and the Fb level were significantly lower than those in the control group ( P < 0.05). After treatment, the NO level in the combination group was significantly higher than that in the control group ( P < 0.05), while levels of ET-1 and vWF were significantly lower than those in the control group ( P < 0.05). During treatment, there was no significant difference in the total incidence of adverse reactions between the two groups ( P > 0.05).

          Conclusion

          Yangxin Dingji capsule combined with mexiletine hydrochloride can significantly improve clinical effects in CBL patients, improve VA and vascular endothelial function, and reduce plasma viscosity without increasing the incidence of adverse reactions.

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          Most cited references10

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          Electrocardiographic landmarks of idiopathic ventricular arrhythmia origins

          Idiopathic ventricular arrhythmias occur in the absence of underlying structural heart disease and less commonly in the presence of coexistent, but mechanistically unrelated, myocardial scar. These arrhythmias originate from several anatomical sites in both ventricles, with a predilection in outflow tract structures. The 12-lead surface ECG is the initial mapping tool, which is widely used to identify their origin. Specific features can predict the site of idiopathic ventricular arrhythmias, thus differentiating right from left ventricular, as well as endocardial from epicardial origins. In this review, we aim to analyse electrocardiographic landmarks for determination of idiopathic ventricular arrhythmia sources, with specific emphasis on pertinent caveats and anatomical relationships.
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            Mexiletine Shortened QT Interval and Reduced Ventricular Arrhythmias in a Pedigree of Type 2 Long QT Syndrome Combined with Left Ventricular Non-Compaction.

            In this study, we present a case of a 22-year-old female with a family history of syncope, suffering from recurrent syncope since childhood. She had an obvious prolonged QTc interval of up to 651 ms, a bifid T wave pattern on electrocardiogram, and torsade de pointes, corresponding to a syncope episode. Additionally, her echocardiogram showed left ventricular non-compaction in the apex. After treatment with mexiletine, the QTc interval has been observed to shorten immediately, and the T wave morphology recovered. A similar effect was also observed in her mother and young sister. Administration of propranolol prolonged her QTc interval. Target sequencing of candidate genes revealed a missense mutation in the pore area of the hERG protein, coded by KCNH2. We diagnosed this as a case of type 2 long QT syndrome in which mexiletine could be effective in shortening the QTc interval.
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              Management of calcified coronary artery bifurcation lesions.

              Calcified coronary artery bifurcation lesions (CBL) remain a challenge for the interventional cardiologist. Evidence regarding treatment of CBL is minimal. Optimal plaque modification is the most important step prior to stent deployment. Provisional stenting is the preferred strategy for most bifurcation lesions. However, two-stent strategy should be considered for BL with compromised large SB (>2.5 mm) supplying a large territory, >70% SB stenosis and lesions more than 5 mm long. In this contemporary review article, we present a simplified approach to treating CBL and demonstrate the approach to specific case examples using our newly developed mobile application, BifurcAID.
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                Author and article information

                Contributors
                Journal
                Emerg Med Int
                Emerg Med Int
                emi
                Emergency Medicine International
                Hindawi
                2090-2840
                2090-2859
                2022
                30 August 2022
                : 2022
                : 4078895
                Affiliations
                1Department of Clinical Pharmacy, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang 315100, China
                2Department of Encephalopathy, Wuxi No. 2 Chinese Medicine Hospital, Wuxi, Jiangsu 214121, China
                3Department of Science and Education Section, Wuxi No. 2 Chinese Medicine Hospital, Wuxi, Jiangsu 214121, China
                4Department of Cardiovascular Medicine, Wuhan Caidian District People's Hospital, Wuhan, Hubei 430100, China
                Author notes

                Academic Editor: Weiguo Li

                Author information
                https://orcid.org/0000-0001-6382-2819
                Article
                10.1155/2022/4078895
                9448595
                36081956
                98ee2b86-6510-4996-9789-339e8835cab8
                Copyright © 2022 Nasha Sun et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 May 2022
                : 24 July 2022
                Categories
                Research Article

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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