The current study demonstrated that the prevalence of metabolic syndrome was dramatically high in hypertensive women, even in the rural areas of China. Further, our study indicated that remarkable ethnic differences exist in the prevalence of metabolic syndrome. Obese and moderate levels of physical activity were a modifiable risk factor.

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The ankle-brachial index (ABI) is a simple, inexpensive diagnostic test for peripheral artery disease (PAD). However, it has shown variable accuracy for identification of significant stenosis. The authors performed a structured review of the sensitivity and specificity of ABI ≤ 0.90 for the diagnosis of PAD. MEDLINE, EMBASE, Cochrane databases, Science Citation Index database, and Biological Abstracts database were searched for studies of the sensitivity and specificity of using ABI ≤ 0.90 for the diagnosis of PAD. Eight studies comprising 2043 patients (or limbs) met the inclusion criteria. The result indicated that, although strict inclusion criteria on studies were formulated, different reference standards were found in these studies, and methods of ABI determination and characteristics of populations varied greatly. A high level of specificity (83.3-99.0%) and accuracy (72.1-89.2%) was reported for an ABI ≤ 0.90 in detecting ≥ 50% stenosis, but there were different levels of sensitivity (15-79%). Sensitivity was low, especially in elderly individuals and patients with diabetes. In conclusion, the test of ABI ≤ 0.90 can be a simple and useful tool to identify PAD with serious stenosis, and may be substituted for other non-invasive tests in clinical practice.

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Abstract-Because of its complexity, the atrioventricular node (AVN), remains 1 of the least understood regions of the heart. The aim of the study was to construct a detailed anatomic model of the AVN and relate it to AVN function. The electric activity of a rabbit AVN preparation was imaged using voltage-dependent dye. The preparation was then fixed and sectioned. Sixty-five sections at 60-to 340-m intervals were stained for histology and immunolabeled for neurofilament (marker of nodal tissue) and connexin43 (gap junction protein). This revealed multiple structures within and around the AVN, including transitional tissue, inferior nodal extension, penetrating bundle, His bundle, atrial and ventricular muscle, central fibrous body, tendon of Todaro, and valves. A 3D anatomically detailed mathematical model (Ϸ13 million element array) of the AVN and surrounding atrium and ventricle, incorporating all cell types, was constructed. Comparison of the model with electric activity recorded in experiments suggests that the inferior nodal extension forms the slow pathway, whereas the transitional tissue forms the fast pathway into the AVN. In addition, it suggests the pacemaker activity of the atrioventricular junction originates in the inferior nodal extension. Computer simulation of the propagation of the action potential through the anatomic model shows how, because of the complex structure of the AVN, reentry (slow-fast and fast-slow) can occur. In summary, a mathematical model of the anatomy of the AVN has been generated that allows AVN conduction to be explored. Figure 1A). The function of the AVN is to conduct action potentials at an appropriate conduction velocity from the atria to the ventricles. Functionally, the AVN is complex. For example, the AVN shows dual pathway conduction: the slow pathway into the AVN runs from the isthmus (between coronary sinus and tricuspid valve) to the apex of the triangle of Koch, whereas the fast pathway is more cranial ( Figure 1B). The AVN is a subsidiary pacemaker, and the leading pacemaker site has been reported to be within the slow pathway. 1 AVN reentrant tachycardia is the most common paroxysmal supraventricular tachycardia (except atrial fibrillation) in adults 2 ; prevention involves ablation of the isthmus. 2 The AVN, perhaps more than any other tissue in the heart, owes its complexity of function to its complexity of structure (ie, anatomy). To understand the structure-function relationships of the AVN, the aim of the present study was to generate an anatomic model of the AVN and relate it to function. For research and teaching, there is an effort to build a "virtual heart." 3 This requires anatomic models in the form of mathematical arrays or finite element models for each part of the heart. Such models exist for the atria, ventricles, and sinoatrial node (SAN). 3,4 Here is the first such anatomic model (mathematical array) of the AVN. The study was carried out on the rabbit, because the rabbit AVN preparation is amenable to experimentation and is widely used, an...