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Vaccination against coronavirus disease 2019 in patients with pulmonary hypertension:A national prospective cohort study

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Chinese Medical Journal 2024年第6期137卷 669-675页

作者： Xiaohan Wu Jingyi Li Jieling Ma Qianqian Liu Lan Wang Yongjian Zhu Yue Cui Anyi Wang Cenjin Wen Luhong Qiu Yinjian Yang Dan Lu xiqi xu Xijie Zhu Chunyan Cheng Duolao Wang Zhicheng Jing Department of Cardiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Echocardiography National Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Pulmonary Circulation Shanghai Pulmonary HospitalTongji University School of MedicineShanghai 200433China Department of Cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Clinical Sciences Liverpool School of Tropical MedicineLiverpoolUnited Kingdom

Background:Coronavirus disease 2019(COVID-19)has potential risks for both clinically worsening pulmonary hypertension(PH)and increasing ***,the data regarding the protective role of vaccination in this population are still *** study aimed to assess the safety of approved vaccination for patients with ***:In this national prospective cohort study,patients diagnosed with PH(World Health Organization[WHO]groups 1 and 4)were enrolled from October 2021 to April *** primary outcome was the composite of PH-related major adverse *** used an inverse probability weighting(IPW)approach to control for possible confounding factors in the baseline characteristics of ***:In total,706 patients with PH participated in this study(mean age,40.3 years;mean duration after diagnosis of PH,8.2 years).All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in *** them,278 patients did not receive vaccination,whereas 428 patients completed the vaccination *** of the participants were infected with COVID-19 during our study ***,398 patients received inactivated severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)vaccine,whereas 30 received recombinant protein subunit *** adjusting for baseline covariates using the IPW approach,the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase(27/428[6.3%]vs.24/278[8.6%],odds ratio=0.72,P=0.302).Approximately half of the vaccinated patients reported at least one post-vaccination side effects,most of which were mild,including pain at the injection site(159/428,37.1%),fever(11/428,2.6%),and fatigue(26/428,6.1%).Conclusions:COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH,although there were some tolerable side effects.A large-scale randomized controlled trial is warr

关键词： Coronavirus disease COVID-19 Pulmonary hypertension Vaccination

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Association between coronary artery stenosis and myocardial injury in patients with acute pulmonary embolism: A case-control study

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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 12页

作者： Yang Yinjian Liu Chao Ma Jieling Zhu Xijie Ma Jingsi Lu Dan Yan Xinxin Gao xuan Wang Jia Wang Liting Zhang Sijin Li Xianmei Wu Bingxiang Sun Kai Mao Yimin xu xiqi Lian Tianyu Cheng Chunyan Jing Zhicheng Medical Science Research Center Institute of Clinical Medicine State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Cardiology Guangdong Cardiovascular Institute Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong China Department of Cardiology State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of School of Pharmacy Henan University Kaifeng Henan China Cardiac Department Aerospace Center Hospital Peking University Aerospace School of Clinical Medicine Beijing China Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Cardiovascular Medicine The Second Affiliated Hospital of Harbin Medical University Harbin Heilongjiang China Department of Medical Laboratory Weifang Medical University Weifang Shandong China Department of Respiratory Medicine The First Affiliated Hospital of Henan University of Science and Technology Luoyang Henan China Center of Basic Medical Research Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong China

Background: The potential impact of pre-existing coronary artery stenosis (CAS) on acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with ***: In this multicenter, prospective case-control study, 88 cases and 163 controls matched for age, sex, and study center were enrolled. Cases were patients with PE with elevated hs-cTnI. Controls were patients with PE with normal hs-cTnI. Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression was used to evaluate the association between CAS and hs-cTnI ***: The percentage of CAS was higher in the case group compared to the control group (44.3% [39/88]vs. 30.1% [49/163];P = 0.024). In multivariable conditional logistic regression model 1, CAS (adjusted odds ratio [OR], 2.680; 95% confidence interval [CI], 1.243–5.779), heart rate >75 beats/min (OR, 2.306; 95% CI, 1.056–5.036) and N-terminal pro-B type natriuretic peptide (NT-proBNP) >420 pg/mL (OR, 12.169; 95% CI, 4.792–30.900) were independently associated with elevated hs-cTnI. In model 2, right CAS (OR, 3.615; 95% CI, 1.467–8.909) and NT-proBNP >420 pg/mL (OR, 13.890; 95% CI, 5.288–36.484) were independently associated with elevated ***: CAS was independently associated with myocardial injury in patients with PE. Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.

关键词： Pulmonary embolism Coronary artery stenosis Myocardial injury Cardiac troponin I Myocardial ischemia Right ventricular dysfunction Case-control study Coronary computed tomography angiography

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《2023年JCS心肌炎诊断和治疗指南》解读

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协和医学杂志 2024年第2期15卷 320-327页

作者：张松邱露虹刘颖娴徐希奇哈尔滨医科大学附属第一医院心内科哈尔滨150001 中国医学科学院北京协和医院心内科北京100730

《2023年JCS心肌炎诊断和治疗指南》在心肌炎的定义和分类、流行病学、病理生理学、诊断标准、诊断流程、治疗及管理等多个方面进行了全新诠释,为临床医师提供了更贴合临床实际的心肌炎诊断和治疗建议。鉴于我国近期无心肌炎相关指导性... 详细信息

《2023年JCS心肌炎诊断和治疗指南》在心肌炎的定义和分类、流行病学、病理生理学、诊断标准、诊断流程、治疗及管理等多个方面进行了全新诠释,为临床医师提供了更贴合临床实际的心肌炎诊断和治疗建议。鉴于我国近期无心肌炎相关指导性文件发布,本文将结合国内外最新心肌炎研究进展,对该指南要点进行全面解读,以期为我国心肌炎临床诊疗提供参考。

关键词：心肌炎心内膜活检临床分型治疗

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多学科联合治疗成功抢救肺高压危象产妇1例

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中华心血管病杂志 2024年第4期52卷 420-424页

作者：邱露虹李源裴丽坚马国涛赵久良刘建根徐希奇中国医学科学院北京协和医学院北京协和医院心内科北京100730 中国医学科学院北京协和医学院北京协和医院妇产科北京100730 中国医学科学院北京协和医学院北京协和医院麻醉科北京100730 中国医学科学院北京协和医学院北京协和医院心外科北京100730 中国医学科学院北京协和医学院北京协和医院风湿免疫科北京100730 吉林大学第二医院心内科长春130041

肺高压危象是肺动脉高压的严重并发症之一,救治难度大,死亡风险高。以基础疾病控制、右心衰竭综合管理、充分肺高压靶向药物治疗、体外生命支持等为基础的多学科团队协作是肺高压危象救治成功的重要保证,可显著降低患者死亡风险。该文... 详细信息

肺高压危象是肺动脉高压的严重并发症之一,救治难度大,死亡风险高。以基础疾病控制、右心衰竭综合管理、充分肺高压靶向药物治疗、体外生命支持等为基础的多学科团队协作是肺高压危象救治成功的重要保证,可显著降低患者死亡风险。该文报道多学科团队联合成功救治肺高压危象产妇1例,以期为肺高压危象患者的救治提供经验和参考。

关键词：高血压,肺性肺高压危象多学科联合治疗产妇体外膜肺氧合曲前列尼尔

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超声心动图联合梅奥分期提高对轻链型心肌淀粉样变早期死亡高风险患者的识别

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科学通报 2024年第3期69卷 439-446页

作者：黎婧怡杨尹鉴邱露虹郭帆路丹胡婷婷沈恺妮徐希奇田庄张抒扬荆志成中国医学科学院/北京协和医学院北京协和医院心内科北京100730 中国医学科学院/北京协和医学院疑难重症及罕见病国家重点实验室医学科学研究中心北京100730 中国医学科学院/北京协和医学院北京协和医院血液科北京100730

轻链型心肌淀粉样变(AL-CA)是一类预后极差的浸润性心脏病,识别高危患者并尽早开展治疗,是改善预后的关键.梅奥分期是目前最常用的危险分层体系,但相同分期患者预后存在较大差异.本研究通过连续入选2020年5月~2022年12月间在北京协和医... 详细信息

轻链型心肌淀粉样变(AL-CA)是一类预后极差的浸润性心脏病,识别高危患者并尽早开展治疗,是改善预后的关键.梅奥分期是目前最常用的危险分层体系,但相同分期患者预后存在较大差异.本研究通过连续入选2020年5月~2022年12月间在北京协和医院确诊为AL-CA患者76名,旨在探讨超声心动图常规测量指标能否在现有危险分层基础上提高对AL-CA早期死亡高风险患者的识别.本研究中位随访时间为10月(5, 20), 20名患者6个月内死亡即早期死亡,左房前后径、左室射血分数(LVEF)、E/e′比值、(E/e′)/LVEF、梅奥2004分期Ⅲb期均对AL-CA患者6个月内死亡有预测价值(P<0.05).其中(E/e′)/LVEF预测价值最佳,(E/e′)/LVEF≥0.5联合梅奥2004分期Ⅲb期预测ALCA患者早期死亡优于梅奥2004分期.研究结果显示,超声心动图常规测量指标E/e′与LVEF的比值可在梅奥2004分期Ⅲb期基础上提高对早期死亡高风险患者的预测价值.

关键词：心肌疾病淀粉样变性超声心动图预后

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高水平临床研究推动肺动脉高压危险分层内涵发展

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科学通报 2024年第13期69卷 1715-1724页

作者：路丹张洁馨程春燕杨尹鉴刘滕飞张苏欣邱宝晨李贤美郭帆黎婧怡徐希奇孙凯荆志成北京大学航天临床医学院航天中心医院心脏医学部北京100049 中国医学科学院北京协和医学院北京协和医院心内科北京100730 南方医科大学附属广东省人民医院(广东省医学科学院) 广东省心血管病研究所广州510180 中国医学科学院北京协和医学院北京协和医院医学科学研究中心北京100730

肺动脉高压是一种疑难危重罕见病,一直以来被视为“心血管系统的癌症”,患者预后极差.对疾病进行危险分层可以帮助临床医生判断患者病情、指导治疗、评价疗效和预测预后,这需要大量的临床研究作为依据.高水平临床研究是解决临床实践问... 详细信息

肺动脉高压是一种疑难危重罕见病,一直以来被视为“心血管系统的癌症”,患者预后极差.对疾病进行危险分层可以帮助临床医生判断患者病情、指导治疗、评价疗效和预测预后,这需要大量的临床研究作为依据.高水平临床研究是解决临床实践问题的重要手段,我国肺动脉高压队列有着独特的特点,学习和借鉴国外肺动脉高压危险分层发展经验,对建立符合我国肺动脉高压人群的危险分层具有重要意义.本文以肺动脉高压危险分层发展为例,旨在深入剖析通过高水平临床研究解决临床问题的过程与方法.文章概述了肺动脉高压的发现与流行,明确了定义与深入开展临床研究的全过程;重点围绕靶向药治疗时代下肺动脉高压危险分层的建立与更新,总结临床研究推动肺动脉高压诊疗指南和治疗理念不断发展的方式方法;最后通过分析肺动脉高压危险分层在我国的应用现状和问题,希望国外研究肺动脉高压危险分层的思维方式对我国开展临床研究、解决临床实践中的问题有所启示.

关键词：临床研究肺动脉高压危险分层预后预测模型

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Non-Ischemic, Non-Hypoxic Myocardial Injury, and Long-Term Mortality in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

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Cardiology Discovery 2022年第2期2卷 77-82页

作者： Fajiu Li Xijie Zhu Ziyang Zhu Yinjian Yang Zhuang Tian Duolao Wang Shi Chen Xiaoyan Gao Yalin xu Bo Zhang Wei Yu Min Liu xiqi xu Chenghong Li Shuyang Zhang Department of Pulmonary and Critical Care Medicine Affiliated Hospital of Jianghan UniversityWuhanHubei 430015China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Medical Science Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Clinical Sciences Liverpool School of Tropical MedicineLiverpoolMerseyside L35QAUnited Kingdom Department of Geriatrics Affiliated Hospital of Jianghan UniversityWuhanHubei 430015China Department of Cardiology Affiliated Hospital of Jianghan UniversityWuhanHubei 430015China.

Objective:Cardiac damage is commonly reported in patients with coronavirus disease 2019(COVID-19)but its prevalence and impact on the long-term survival of patients remain *** study aimed to explore the prevalence of myocardial injury and assess its prognostic value in patients with ***:A single-center,retrospective cohort study was performed at the Affiliated Hospital of Jianghan *** from 766 patients with confirmed COVID-19 who were hospitalized from December 27,2019 to April 25,2020 were ***,clinical,laboratory,electrocardiogram,treatment data and all-cause mortality during follow-up were collected and ***:Of the 766 patients with moderate to critically ill COVID-19,86(11.2%)died after a mean follow-up of 72.8 *** injury occurred in 94(12.3%)*** mortality rate was 64.9%(61/94)and 3.7%(25/672)in patients with and without myocardial injury,*** regression showed that myocardial injury was an independent risk factor for mortality(hazard ratio:8.76,95%confidence interval:4.76–16.11,P<0.001).Of the 90 patients with myocardial injury with electrocardiogram results,sinus tachycardia was present in 29,bundle branch block in 26,low voltage in 10,and abnormal T-wave in ***:COVID-19 not only involves pneumonia but also cardiac *** injury is a common complication and an independent risk factor for mortality in COVID-19 patients.

关键词： Coronavirus COVID-19 Mortality Myocardial injury

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Standard Operation Procedure of Percutaneous Endomyocardial Biopsy in Peking Union Medical College Hospital

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Cardiology Discovery 2021年第3期1卷 148-153页

作者： xiqi xu Zhuang Tian Quan Fang Zhi-Cheng Jing Shuyang Zhang Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Percutaneous endomyocardial biopsy (EMB) is a technique that biopsy samples are obtained using bioptome through peripheral blood vessel. This technique has been used and refined more than 50 years in clinical application. Now EMB has become an important diagnostic tool in the diagnosis of myocarditis and cardiomyopathy. Department of cardiology, Peking Union Medical College Hospital (PUMCH) has performed more than 500 cases of EMB and accumulated abundant practical experience. The clinical practice guideline of percutaneous EMB in PUMCH was also established, including indications, contradictions, operation key points, sample handling and processing, post-procedure monitoring, and treatment strategy for potential complications, etc. Due to the limitation of EMB, cardiologists should collaborate with experts in echocardiography, cardiac magnetic resonance and cardiac pathology to avoid missed diagnosis and misdiagnosis. Cardiologists should pay more attention to the value of EMB and actively perform EMB to improve the diagnosis level for myocarditis and cardiomyopathy in China.

关键词： Myocarditis Cardiomyopathy Endomyocardial biopsy

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高压直挂大容量电池储能系统电池簇故障容错运行控制策略

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中国电机工程学报 2024年第16期44卷 6470-6481,I0015页

作者：吴西奇黄超刘畅李睿蔡旭电力传输与功率变换控制教育部重点实验室(上海交通大学) 上海市闵行区200240 海南金盘智能科技股份有限公司海南省海口市541004

高压直挂电池储能系统采用H桥电路级联方法升高电压后接入电网,将电池簇分散接入级联H桥变换器直流侧,具有高度模块化结构,对比低压方案具有单机容量大、效率高、响应速度快等明显优势。锂电池作为高能量密度储能介质,系统安全稳定运行... 详细信息

高压直挂电池储能系统采用H桥电路级联方法升高电压后接入电网,将电池簇分散接入级联H桥变换器直流侧,具有高度模块化结构,对比低压方案具有单机容量大、效率高、响应速度快等明显优势。锂电池作为高能量密度储能介质,系统安全稳定运行高度依赖电池芯的可靠性。传统电池簇容错控制通过设置交流旁路开关直接实现整个子模块切除,该策略不仅需要额外增加多个冗余模块,增加了储能成本,且调制比限制使故障电池簇退出数量有限,系统容量利用率不高。该文所提电池簇容错策略通过直流断路器切除故障电池簇后,将故障子模块由有功充放电模式切换至无功容错模式继续运行,充分发挥故障模块的电网电压支撑能力。所提控制策略能实现任意数量电池簇退出,剩余电池簇仍可继续存储或释放能量,提升了系统容量利用率。

关键词：高压直挂锂电池储能系统故障切除容错运行

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不容忽视的心肌炎——来自《2021年ESC急慢性心力衰竭诊断与治疗指南》的启示

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协和医学杂志 2022年第4期13卷 530-534页

作者：邱露虹刘颖娴徐希奇中国医学科学院北京协和医院心内科北京100730

2021年9月,Eur Heart J发布了《2021年ESC急慢性心力衰竭诊断与治疗指南》,该版指南对2016年版指南作出重要更新。其中,心肌炎作为心力衰竭的一种特定临床情况应给予重点关注。本文结合我国心肌炎临床诊疗实践,对新版指南中心肌炎部分... 详细信息

2021年9月,Eur Heart J发布了《2021年ESC急慢性心力衰竭诊断与治疗指南》,该版指南对2016年版指南作出重要更新。其中,心肌炎作为心力衰竭的一种特定临床情况应给予重点关注。本文结合我国心肌炎临床诊疗实践,对新版指南中心肌炎部分进行全面解读,以加深临床医师对此类疾病的认识和理解。

关键词：心力衰竭心肌炎诊断治疗

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