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Defective recovery of Qt dispersion following transcatheter aortic valve implantation： frequency, predictors and prognosis

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Journal of Geriatric Cardiology 2015年第5期12卷 482-488页

作者： Rutger-Jan Nuis Gokhan turgut Robert M van der Boon Nicolas M van Mieghem Sjoerd t Nauta Patrick W Serruys ron t van domburg Giulio Zuchelli Luc Jordaens Peter P de Jaegere Department of Cardiology Erasmus University Medical Center Rotterdam the Netherlands Department of Electrophysiology Erasmus Thoraxcenter Rotterdam the Netherlands Department of Biostatistics Erasmus Thoraxeenter Rotterdam the Netherlands Division of Cardiovascular Diseases Azienda Ospedaliero-Universitaria Pisana Pisa Italy

Background Corrected Qt dispersion （cQtD） has been correlated with non-uniform ventricular repolarisation and increased mortality. In patients with aortic stenosis, cQtD has been shown improved after surgical valve replacement, but the effects of transcatheter aortic valve implantation （tAVI） are unknown. therefore, we sought to explore the frequency, predictors and prognostic effects of defective cQtD recovery at 6 months after tAVI. Methods A total of 222 patients underwent tAVI with the Medtronic-CoreValve System between November 2005 and January 2012. Patients who were on class Ⅰ or Ⅲ antiarrhythmics or on chronic haemodialysis or who developed atrial fibrillation, a new bundle branch block or became pacemaker dependent after tAVI were excluded. As a result, pre-, post- and follow-up ECG （median： 6 months） analysis was available in 45 eligible patients. Defective cQtD recovery was defined as any progression beyond the baseline cQtD at 6 months. Results In the 45 patients, the mean cQtD was 47 ± 23 ms at baseline, 45 ±17 ms immediately after tAVI and 40 ± 16 ms at 6 months （15% reduction, P = 0.049）. Compared to baseline, cQtD at 6 months was improved in 60% of the patients whereas defective cQtD recovery was present in 40%. cQtD increase immediately after tAVI was an independent predictor of defective cQtD recovery at 6 months （per 10 ms increase; OR： 1.89, 95% CI： 1.15-3.12）. By univariable analysis, defective cQtD recovery was associated with late mortality （HR： 1.52, 95% CI： 1.05-2.17）. Conclusions Despite a gradual reduction ofcQtD after tAVI, 40% of the patients had defective recovery at 6 months which was associated with late mortality. More detailed ECG analysis after tAVI may help to avoid late death.

关键词： Aortic stenosis Conduction abnormalities Left bundle branch block Predictors Qt dispersion transcatheter aortic valve implantation

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Quality of Sleep at the Ward after Cardiothoracic Surgery

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Open Journal of Nursing 2015年第6期5卷 529-537页

作者： Jozefine Propper Richard van Valen ron tvan domburg Maaike Brunott Ad J.J.C.Bogers Department of Cardio-thoracic Surgery ThoraxcenterErasmus Medical CenterRotterdamThe Netherlands Department of Cardiology ThoraxcenterErasmus Medical CenterRotterdamThe Netherlands

Objective: Sleeping problems are among the issues most mentioned by patients after cardiothoracic surgery. these problems can have a negative effect on duration of the hospital stay and recovery. In the ward of our cardiothoracic surgery department, a study was initiated to assess the quality of sleep after cardiothoracic surgery. the primary objective was to investigate the effect of cardiothoracic surgery on the quality of sleep. the secondary objective was to investigate the quality of sleep. Correlations with perioperative factors and related issues such as the type of surgery and medication were sought. Methods: A consecutive prospective cohort study was initiated (N = 72). the study used validated questionnaires to assess sleep: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Verran Snyder-Halpern Sleep Scale (VSH) and the Factors Influencing Sleep Quality (FISQ). Results: the PSQI showed that the quality of sleep one month after surgery was inferior to the quality of sleep before surgery (p-value: 0.03). the efficiency of sleep (time spent in bed) was higher after surgery then before surgery (p-value: 0.01). the VSH showed increased impaired sleep on the third night after surgery. the most disruptive factors were not being comfortable in a hospital bed, pain and the noise of medical devices. Conclusions: the quality of sleep after cardiothoracic surgery is worse when compared with the preoperative situation. the chief influencing factors are discomfort in bed, pain and disturbance from medical devices. the use of pain medication does not improve the quality of sleep.

关键词： Cardiac Surgery thoracic Surgery Sleep Sleep Deprivation Factors Influencing Sleep Quality (FISQ)

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Carbonation of calcium-containing mineral and industrial by-products

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Frontiers of Chemical Science and Engineering 2010年第2期4卷 110-119页

作者： ron ZEVENHOVEN Anders WIKLUND Johan FAGERLUND Sanni ELONEVA Ben IN’t VEEN Hans GEERLINGS Gert van MOSSEL Harold BOERRIGtER Åbo Akademi University Thermal and Flow Engineering LaboratoryBiskopsgatan 8FI-20500Åbo/TurkuFinland Helsinki University of technology Department of Energy TechnologyPO Box 4400FI-02015 EspooFinland Shell Global Solutions International B.V. PO Box 3800NL-1030 BNAmsterdamthe Netherlands Delft University of technology Department of Chemical TechnologyJulianalaan 136NL-2628 BL Delftthe Netherlands

the use of carbon dioxide(CO_(2))and calciumcontaining by-products from industrial activities is receiving increasing interest as a route to valuable carbonate materials while reducing CO_(2) emissions and saving natural *** this work,wet-chemical experimental data was assessed,which involved the carbonation of three types of materials in aqueous solutions,namely,1)wollastonite,a calcium silicate mineral,2)steelmaking slag,a by-product of steel production,and 3)paper bottom ash(PBA)from waste paper *** were to achieve either a high carbonation degree and/or a pure carbonate product with potential commercial *** a pure precipitated calcium carbonate(PCC)material that may find use in paper industry products puts strong requirements on purity and *** parameters investigated were particle size,CO_(2)pressure,temperature,solid/liquid ratio,and the use of additives that affect the solubilities of CO_(2)and/or calcium *** and pressures were varied up to 180℃and 4 *** obtained with the wollastinite mineral allowed for a comparison between natural resources and the industrial by-product materials,the latter typically being more *** respect to temperature and pressure trends reported by others were largely confirmed,with temperatures above 150℃introducing thermodynamic limitations depending on CO_(2)*** influence of additives showed some promise,although costs may make recycling and reuse of additives a necessity for a largescale *** using steelmaking slag,magnetic separation may remove some iron-containing material from the process(although this is far from perfect),while the addition of bicarbonate supported the removal of phosphorous,aside from improving calcium *** experiments with paper bottom ash(PBA)gave new data,showing that its reactivity resembles that of steelmaking slag,while its composition results in relatively pure carbonate ***,with PBA no addi

关键词： mineralization industrial by-products calcium carbonate

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Cerebral magnetic resonance imaging in quiescent Crohn's disease patients with fatigue

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World Journal of Gastroenterology 2017年第6期23卷 1018-1029页

作者： Sanne van Erp Ece Ercan Perla Breedveld Lianne Brakenhoff Eidrees Ghariq Sophie Schmid Matthias van Osch Mark van Buchem Bart Emmer Jeroen van der Grond ron Wolterbeek Daniel Hommes Herma Fidder Nic van der Wee tom Huizinga Désirée van der Heijde Huub Middelkoop Itamar ronen Andrea van der Meulen-de Jong Department of Gastroenterology and Hepatology Leiden University Medical Center C.J.Gorter Center Leiden University Medical Center Department of Radiology Leiden University Medical Center Department of Medical Statistics Leiden University Medical Center Center for Inflammatory Bowel Diseases University of California Los Angeles Department of Gastroenterology and Hepatology University Medical Center Utrecht Department of Psychiatry Leiden University Medical Center Department of Rheumatology Leiden University Medical Center Department of Neuropsychology Leiden University Medical Center Department of Radiology Leiden University Medical CenterLeiden

to evaluate brain involvement in quiescent Crohn’s disease (CD) patients with fatigue using quantitative magnetic resonance imaging (MRI).MEtHODSMultiple MRI techniques were used to assess cerebral changes in 20 quiescent CD patients with fatigue (defined with at least 6 points out of an 11-point numeric rating scale compared with 17 healthy age and gender matched controls without fatigue. Furthermore, mental status was assessed by cognitive functioning, based on the neuropsychological inventory including the different domains global cognitive functioning, memory and executive functioning and in addition mood and quality of life scores. Cognitive functioning and mood status were correlated with MRI findings in the both study *** glutamate + glutamine (Glx = Glu + Gln) concentrations (P = 0.02) and ratios to total creatine (P = 0.02) were found in CD patients compared with controls. Significant increased Cerebral Blood Flow (P = 0.05) was found in CD patients (53.08 ± 6.14 mL/100 g/min) compared with controls (47.60 ± 8.62 mL/100 g/min). CD patients encountered significantly more depressive symptoms (P tive functioning scores related to memory (P = 0.007) and executive functioning (P = 0.02) were lower in CD patients and both scores showed correlation with depression and anxiety. No correlation was found subcortical volumes between CD patients and controls in the t1-weighted analysis. In addition, no correlation was found between mental status and MRI *** work shows evidence for perfusion, neurochemical and mental differences in the brain of CD patients with fatigue compared with healthy controls.

关键词： Magnetic resonance imaging Systemic inflammation Fatigue Crohn’s disease Cognition

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急性心肌梗死再灌注治疗20年后的持续疗效

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世界核心医学期刊文摘（心脏病学分册） 2005年第11期1卷 46-47页

作者： van domburg R. t. Sonnenschein K. Nieuwlaat R. 张平 Erasmus Medical Center Thoraxcentrum Ba 559 Dr Molewaterplein 40 3015 GD Rotterdam Netherlands Dr.

OBJECtIVES: the goal of this research was to clarify whether the benefit of reperfusion therapy for myocardial infarction was sustained long-term and to assess the gain in life expectancy by reperfusion therapy. BACKGROUND: Reperfusion therapy in acute myocardial infarction reduces infarct size and increases hospital survival. MEtHODS: We analyzed the 20-year outcome of 533 patients(mean age 56 years; 82%men) who were randomized to either reperfusion therapy or conventional therapy during the years 1981 to 1985. RESULtS: Mean follow-up was 21 years(range 19 to 23 years). At follow-up, 101 patients(36%) of the 269 patients allocated to reperfusion treatment and only 71 patients(26%) of the 264 conventionally treated patients were alive(p=0.02). the cumulative 10-, 15-, and 20-year survival rates were 69%, 48%, and 37%after reperfusion therapy and 59%, 38%, and 27%in the control group, respectively(p=0.005). Life expectancy of the reperfusion group was 15.2 years versus 12.4 years in the conventionally treated group(ption and subsequent coronary interventions were more frequent after reperfusion therapy, particularly during the first year. In multivariable analysis, reperfusion therapy was an important independent predictor of lower mortality at long-term follow-up(hazard ratio 0.7; 95%confidence interval 0.6 to 0.8). Other independent predictors of mortality were age, impaired left ventricular function, multivessel disease, infarct size, and inability to perform an exercise test at the time of discharge. CONCLUSIONS: this is the first study demonstrating sustained(20-year) improved survival after reperfusion therapy. the gain in life expectancy was almost three years, representing about one-third of the life-years lost by myocardial infarction.

关键词：再灌注治疗再梗死左心室功能累计生存率多支血管病变运动试验远期疗效多变量分析

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西罗莫司洗脱支架或传统支架植入后的晚期管腔丢失反应模式的比较

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世界核心医学期刊文摘（心脏病学分册） 2005年第4期1卷 47-48页

作者： Lemos P. A. Mercado N. van domburg R. t. P. W. Serruys 陶磊 Department of Cardiology Thoraxcenter Erasmus Medical Center Dr Molewaterplein 40 3015 GD Rotterdam Netherlands Dr.

Background-We investigated the pattern of late luminal loss after sirolimus- eluting or bare stem implantation. Methods and Results -the study population co mprised 238 patients treated with sirolimus-eluting stents and 526 patients tre ated with conventional stents. the distribution of late loss of sirolimus stents was largely skewed to the right and differed from the distribution for bare ste nts. When divided according to the presence of binary restenosis(diameter stenos is >50%), restenotic lesions in the bare stem group(26.0%) had a late loss of 1.40±0.64 mm and in the sirolimus group(7.9%) of 1.16±0.76 mm. Nonrestenotic lesions in the bare stent group had a late loss of 0.58±0.44 mm, whereas the la te loss of nonrestenotic lesions in the sirolimus group remained close to zero( -0.05±0.33 mm). Differences between poststenting and follow-up measurements i n the sirolimus group(late loss) resembled variations observed in repeated angio graphic measurements, as assessed from a random sample of 30 segments measured r epeatedly. After multivariate adjustment, stent type did not influence the degre e of late loss in restenotic lesions. However, nonrestenotic bare stents had a s ignificantly larger estimated luminal loss (0.58 mm; 95%CI, 0.52 to 0.65) than sirolimus-eluting stents, for which the predicted late loss was almost 0(-0.04 mm; 95%CI, -0.10 to 0.02). Conclusions -the pattern of late loss after sirol imus-eluting stent implantation follows a peculiar behavior, different from les ions treated with conventional stents. Whether this is explained by an unusual s tatistical distribution or a biological all-or-none response of restenosis aft er sirolimus-eluting stenting remains to be investigated.

关键词：支架植入反应模式再狭窄西罗莫司裸支架血管造影检查全或无类时生物反应随机样本

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Pleiotropic effects of lipid genes on plasma glucose,HbA1c,and HOMA-IR levels

Pleiotropic effects of lipid genes on plasma glucose,HbA1c,a...

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第十四次全国医学遗传学学术会议

作者： Naishi Li Marijke R.van der Sijde LifeLines Cohort Study Stephan J.L.Bakker Robin P.F.Dullaart Pim van der Harst ron t.Gansevoort Clara C.Elbers Cisca Wijmenga Harold Snieder Marten H.Hofker Jingyuan Fu 荷兰格罗宁根大学医学中心中国医学科学院北京协和医院

Objectives:Dyslipidemia is strongly associated with raised plasma glucose levels and insulin resistance(IR),and genome-wide association studies have identified 95loci that explain a substantial proportion of the variance in blood ***,the loci’s effects on glucose-related traits are largely *** current research aims to investigate relationship between the lipid loci and glucose-related *** and methods:We have studied these lipid loci and tested their association collectively and individually with fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),and IR in two independent cohorts:10,995 subjects from LifeLines Cohort Study and 2,438subjects from Prevention of Renal and Vascular Endstage Disease(PREVEND)***:In contrast to the positive relationship between dyslipidemia and glucose traits,the genetic predisposition to dyslipidemia showed a pleiotropic lowering effect on glucose ***,the genetic risk score related to higher triglyceride level was correlated with lower levels of FPG(P=9.6×10(-10)and P=0.03 in LifeLines and PREVEND,respectively),HbA1c(P=4.2×10(-7)in LifeLines),and HOMA of estimated IR(P=6.2×10(-4)in PREVEND),after adjusting for blood lipid *** the single nucleotide polymorphism level,15 lipid loci showed a pleiotropic association with glucose traits(Pt(CEtP,MLXIPL,PLtP,GCKR,APOB,APOE-C1-C2,CYP7A1,and tIMD4)had opposite allelic directions of effect on dyslipidemia and glucose ***:For the first time,we have systematically assessed the pleiotropic effect of lipid-associated SNPs on glucose-related ***,at a clinical level,dyslipidemia is associated with elevated plasma glucose levels and insulin resistance,we observed that the genetic predisposition to dyslipidemia is related to lower levels of fasting plasma glucose,HbA1c,and *** findings suggest a complex genetic regulation and metabolic interplay between lipids and glucose.

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置入2年后西罗莫司洗脱支架仍优于裸金属支架:来自RESEARCH注册研究的中期结果

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世界核心医学期刊文摘（心脏病学分册） 2006年第9期2卷 41-41页

作者： Ong A.t.L. van domburg R.t. Aoki J. P.W.Serruys 王亭忠 thoraxcenter Ba-583Dr.Molewaterplein 403015-GD RotterdamNetherlands.Dr

OBJECtIVES: the purpose of this study was to investigate the medium-term(two year) outcome of the unrestricted utilization of sirolimus-eluting stents(SES) in an all-comer population. BACKGROUND: Despite the implantation of SES in over a million patients to date, limited data exist on long-term outcomes. MEtHODS: Sirolimus-eluting stents were used as the default strategy as part of the Rapa mycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital(RESEARCH) regist ry. A total of 508 consecutive patients with de novo lesions exclusively treated with SES were compared with 450 patients who received bare stents in the immedi ately preceding period(pre-SES group). RESULtS: Patients in the SES group more frequently had multivessel disease, more type C lesions, received more stents, a nd had more bifurcation stenting. At two years, the cumulative rate of major adv erse cardiac events(death, myocardial infarction, or target vessel revasculariza tion) was 15.4%in the SES group and 22.0%in the pre-SES group(hazard ratio[HR ] 0.68, 95%confidence interval[CI]0.50 to 0.91; p=0.01). the two-year risk of target vessel revascularization in the SES group and in the pre-SES group was 8 .2%and 14.8%, respectively(HR 0.53, 95%CI 0.36 to 0.79; p=0.002). CONCLUSIONS : In an unrestricted population, the beneficial effects of sirolimus-eluting st ent implantation extend out to two years compared with bare-metal stents, drive n by a reduction in re-intervention rates. these findings should be confirmed b y the results of the large randomized trials.

关键词：雷帕霉素洗脱支架支架置入治疗金属支架注册研究西罗莫司中期多支血管病变不良心脏事件

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体重指数与已知或疑似冠心病患者结局的相关性

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世界核心医学期刊文摘(心脏病学分册) 2007年第9期 20-20页

作者： Galal W. van domburg R.t. Feringa H.H.H. D. Poldermans 黄欣 Department of Anesthesiology Erasmus MC Rotterdam Netherlands

体重指数(BMI)是体脂总含量的参数,在普通人群中BMI升高与死亡率的增加有关。但是,近期的研究显示BMI与特定患者群死亡率之间的相关性尚不确定。本研究检测了BMI与已知或疑似冠心病患者远期死亡

关键词：疑似冠心病 BM 患者体重指数结局情节相关性

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