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In-Hospital Cardiac Arrest after Emotional Stress in a Patient Hospitalized with Gastrointestinal Symptoms and Chronic Anxiety Disorder

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Cardiovascular Innovations and Applications 2021年第3期6卷 57-61页

作者： Tao Tu Jiang Li zhenfei fang Xinqun Hu Jianjun Tang Yanshu Zhao Liang Tang Shenghua Zhou Department of Cardiovascular Medicine The Second Xiangya Hospital of Central South UniversityNo.139 Middle Renmin RoadChangsha City410011 HunanChina

Background:We report an acute emotional stress-induced in-hospital cardiac arrest in a patient admitted with gas-trointestinal symptoms after experiencing chronic anxiety *** Presentation:The patient was admitted to the Second Xiangya Hospital,Central South University,with gastrointestinal symptoms and chronic anxiety disorder,and experienced cardiac arrest during hospitalization after acute emotional *** ventricular tachycardia and cardiogenic shock were evidenced in this patient after the acute emotional *** and extensive coronary spasm was confi rmed by emergency coronary angiography,and coronary spasm was relieved by intracoronary injection of *** patient recovered from myocardial infarction with nonobstructive coronary ***,the patient developed acute kidney dysfunction and severe pulmonary infection and eventually died of respiratory circulatory failure on the ninth day after the successful ***:Acute emotional stress on top of chronic anxiety disorder in patients hospitalized for noncardiovascu-lar reasons might lead to the development of life-threatening cardiovascular diseases,including coronary artery spasm and myocardial infarction with nonobstructive coronary *** management is of importance to im-prove the outcome of these patients.

关键词： Myocardial infarction with nonobstructive coronary arteries coronary artery spasm psycho-emotional disorders cardiac arrest

Clinical Signifi cance of Angiographically Detectable Neovascularity in Patients with Cardiac Myxoma

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Cardiovascular Innovations and Applications 2021年第4期6卷 99-108页

作者： Xiaofan Peng Yichao Xiao Yanan Guo Zhaowei Zhu Liyan Liao Xiaobo Liao Xinqun Hu zhenfei fang Xuping Li Shenghua Zhou Department of Cardiovascular Medicine The Second Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Pathology The Second Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Cardiovascular and Thoracic Surgery The Second Xiangya HospitalCentral South UniversityChangshaHunanChina

Background:Myxomas are the most common primary cardiac *** detectable neovascularity(ADN)of myxoma is increasingly being reported as a result of the use of coronary angiography(CAG)to detect coronary artery ***,the clinical signifi cance of these fi ndings is not fully ***:We enrolled 59 patients with cardiac myxoma who also underwent CAG between January 2013 and October *** were followed up for a mean of 28.9 months(range 1-69 months).The clinical features,echocardiography measurements,pathological examination fi ndings,CAG results,and outcomes during follow-up were compared between patients with ADN and patients without ***:ADN was found in 25 patients(42.4%).The arteries feeding the ADN included the right coronary artery(n=15),the left circumfl ex coronary artery(n=7),and both arteries(n=3).The patients with ADN had a higher proportion of eosinophils(3.2%vs.2.2%,P=0.03)and higher low-density lipoprotein cholesterol level(2.7 mmol/L vs.2.2 mmol/L,P=0.02).Myxoma pedicles were more likely to be located in the interatrial septum in patients with ADN(96%vs.73.5%,P=0.02).No signifi cant correlation was observed between the groups in clinical manifestations,atrial arrhythmia,myxoma size,cardiac chamber size,left ventricular ejection fraction,and the prevalence of complication with coronary artery disease[16%in the ADN group(n=4)vs.20.6%in the non-ADN group(n=7),P=0.66].However,patients with ADN tended to have a lower incidence of major adverse cardiac and cerebrovascular events on long-term follow-up(0%vs.14.7%,P=0.07).Conclusion:CAG-detected ADN in patients with cardiac myxoma is associated with a borderline lower rate of major adverse cardiac and cerebrovascular events.

关键词： Cardiac myxomas coronary angiography angiographically detectable neovascularity major adverse cardiac and cerebrovascular events

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Cardiovascular Innovations and Applications 2021年第3期6卷 25-32页

作者： Zhaowei Zhu Jianjun Tang Xiangping Chai zhenfei fang Qiming Liu Xinqun Hu Danyan Xu Jia He Liang Tang Shi Tai Yuzhi Wu Shenghua Zhou Department of Cardiovascular Medicine the Second Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Emergency the Second Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Radiology the Second Xiangya HospitalCentral South UniversityChangshaHunanChina

Aims:During the COVID-19 epidemic,chest computed tomography(CT)has been highly recommended for screen-ing of patients with suspected COVID-19 because of an unclear contact history,overlapping clinical features,and an overwhelmed health ***,there has not been a full comparison of CT for diagnosis of heart failure or COVID-19 ***:Patients with heart failure(n=23)or COVID-19 pneumonia(n=23)and one patient with both diseases were retrospectively *** information and chest CT images were obtained and ***:There was no difference in ground-glass opacity,consolidation,crazy paving pattern,the lobes affected,and septal thickening between heart failure and COVID-19 ***,a less rounded morphology(4%vs.70%,P=0.00092),more peribronchovascular thickening(70%vs.35%,P=0.018)and fi ssural thickening(43%vs.4%,P=0.002),and less peripheral distribution(30%vs.87%,P=0.00085)were found in the heart failure group than in the COVID-19 ***,there were also more patients with upper pulmonary vein enlargement(61%vs.4%,P=0.00087),subpleural effusion(50%vs.0%,P=0.00058),and cardiac enlargement(61%vs.4%,P=0.00075)in the heart failure group than in the COVID-19 ***,more fi brous lesions were found in the COVID-19 group,although there was no statistical difference(22%vs.4%,P=0.080).Conclusions:Although there is some overlap of CT features between heart failure and COVID-19,CT is still a useful tool for differentiating COVID-19 pneumonia.

关键词： Computed tomography COVID-19 pneumonia heart failure

经导管主动脉瓣置换术前后患者认知功能的评估和意义

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中华心血管病杂志 2021年第5期49卷 523-525页

作者：黄亿源方臻飞周胜华中南大学湘雅二医院心血管内科长沙410011

经导管主动脉瓣置换术(TAVR)为重度主动脉瓣狭窄患者的治疗提供了更多的选择,但脑损伤是TAVR术后的主要并发症之一。卒中增加患者死亡率,而亚临床脑梗死常引起患者的认知功能改变。但认知功能改变在TAVR术后患者中的发生率、危险因素、... 详细信息

经导管主动脉瓣置换术(TAVR)为重度主动脉瓣狭窄患者的治疗提供了更多的选择,但脑损伤是TAVR术后的主要并发症之一。卒中增加患者死亡率,而亚临床脑梗死常引起患者的认知功能改变。但认知功能改变在TAVR术后患者中的发生率、危险因素、对预后的影响等仍有待明确。该文就TAVR手术前后患者认知功能改变的研究进展做一综述。

关键词：主动脉瓣狭窄经导管主动脉瓣置换术认知功能

急诊经皮冠状动脉介入治疗急性ST段抬高型心肌梗死患者的住院期间预后分析

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中南大学学报（医学版） 2016年第11期41卷 1186-1192页

作者：陈晨阳黄亿源周胜华方臻飞中南大学湘雅二医院心血管内科长沙410011

目的:分析急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗急性心肌梗死(acute myocardial infarction,AMI)患者的病例资料,旨在探讨影响急诊PCI治疗AMI患者住院期间不良预后的相关因素。方法:回顾性分析2010年1月至... 详细信息

目的:分析急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗急性心肌梗死(acute myocardial infarction,AMI)患者的病例资料,旨在探讨影响急诊PCI治疗AMI患者住院期间不良预后的相关因素。方法:回顾性分析2010年1月至2014年12月中南大学湘雅二医院行急诊PCI治疗AMI的患者资料,根据是否发生心血管不良事件分为事件组及非事件组,比较两组间可能引起心血管不良事件发生的相关因素。结果:不良事件的发生率为22%(67/304);通过t检验或χ2检验发现:肌酐,脑钠肽(brain natriuretic peptide,BNP),红细胞比容,白细胞、年龄>75岁,Killip分级≥2级,术后心肌梗死溶栓治疗(thrombolysis in myocardial infarction,TI MI)血流≤2级,术前发生心律失常、多支病变,术后2 h ST段回落率<50%,长就诊至球囊扩张(door-to-balloon,D2B)时间差异具有统计学意义(P<0.05),进一步进行logistic回归分析,其结果显示:红细胞比容(red blood cell specific volume,HCT)、N端脑钠肽激素原前体(N-terminal pro-brain natriuretic peptide,NTpro BNP)、Ki l lip分级≥2级、术后TI MI血流≤2级、术后2 h ST段回落率<50%、长D2B时间是心血管不良事件发生的重要影响因素。结论:HCT,NT-pro BNP,Killip分级≥2级,术后TIMI血流≤2级,术后2 h ST段回落率<50%、长D2B时间是心血管不良事件发生的重要影响因素,对上述高危患者进行积极的监测与处理,能够有效改善AMI患者急诊PCI术后的预后,减少住院期间不良事件的发生。

关键词：急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗心血管不良事件影响因素

缺血后处理改善前壁急性心肌梗死患者再灌注心肌长轴的收缩功能

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中南大学学报（医学版） 2019年第12期44卷 1397-1405页

作者：杨祖荣周启昌方臻飞余丽周嘉炜赵白桦中南大学湘雅二医院超声科长沙410011 中南大学湘雅二医院心血管内科长沙410011

目的:探讨缺血后处理(ischemic postconditioning,IPTC)是否能改善左心室受损的局部或整体长轴的收缩功能。方法:试验分为PCI组、PCI+IPTC组及对照组。PCI组为前壁急性ST段抬高型心肌梗死患者(ST-segment elevation myocardial infarction,STEMI)患者32例,行首次急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术;PCI+IPTC组为前壁急性STEMI患者28例,行急诊PCI联合IPTC术;对照组为30例,行冠状动脉造影术。采集术前,术后0.5 h,1 d,3 d,1周,1个月和6个月二维动态超声心动图。对比研究PCI组、PCI+IPTC组与对照组各时间点局部与整体长轴应变参数。结果:PCI+IPTC组PCI术后1周内左心室梗死节段长轴应变高于PCI组(P0.05);PCI+IPTC组术后远期左心室局部及整体长轴应变与PCI组比较,差异均无统计学意义(均P>0.05)。结论:IPTC可改善前壁急性STEMI患者PCI术后早期左心室再灌注心肌的长轴收缩功能。

关键词：速度矢量成像应变缺血后处理经皮冠状动脉介入治疗急性心肌梗死

成人左向右分流先天性心脏病封堵术前NT-proBNP浓度与肺动脉高压的临床意义

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中西医结合心脑血管病杂志 2012年第6期10卷 670-672页

作者：李丽方臻飞朱丹湖南省邵阳市第一人民医院中南大学湘雅二医院

目的通过检测成人左向右分流先天性心脏病介入封堵术前血浆氮末端脑钠肽前体(NT-proBNP)浓度,研究NT-proBNP与肺动脉高压(PAH)关系,为临床评价先天性心脏病相关性PAH的程度提供参考。方法 2010年6月—2010年10月成功封堵的先天性心脏病... 详细信息

目的通过检测成人左向右分流先天性心脏病介入封堵术前血浆氮末端脑钠肽前体(NT-proBNP)浓度,研究NT-proBNP与肺动脉高压(PAH)关系,为临床评价先天性心脏病相关性PAH的程度提供参考。方法 2010年6月—2010年10月成功封堵的先天性心脏病患者83例为病例组,选20名健康正常人作为对照组。依据肺动脉平均压(mPAP)将病例组分为4组:正常PAH组(36例)、轻度PAH组(14例)、中度PAH组(12例)、重度PAH组(21例)。所有患者术前均行右心导管检查,测右房、右室压力、肺动脉收缩压(SPAP)、肺动脉平均压(mPAP)、全肺阻力(PVR)。测定患者术前血浆NT-proBNP浓度,分析与肺动脉压力相关性。结果各PAH组血浆NT-proBNP水平明显高于正常对照组,重度PAH组>中度PAH组>轻度PAH组>无PAH组>正常对照组,差异有统计学意义(P<0.01)。NT-proBNP水平与mPAP(r=0.893,P=0.000)、SPAP(r=0.921,P=0.000)、PVR(r=0.844,P=0.000)呈正相关。血浆NT-proBNP浓度67.5pg/mL诊断轻度PAH灵敏度92.9%,特异度94.4%,曲线下面积92.9%;147.0pg/mL诊断中度PAH灵敏度91.7%,特异度75.8%,曲线下面积79.5%;236.5pg/mL诊断重度PAH灵敏度95.2%,特异度73.0%,曲线下面积97.8%。结论成人左向右分流先天性心脏病患者血浆NT-proBNP水平随肺动脉压力升高而逐渐增加,可作为评价肺动脉高压的程度的一项指标。

关键词：氮末端脑钠肽前体先天性心脏病肺动脉高压介入封堵术

Initial Experience in GeminiOne^(TM)Transcatheter Mitral Valve Edge-to-edge Repair Device

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Cardiology Discovery 2024年第3期4卷 250-252页

作者： Da Zhu Shouzheng Wang Jinping Liu zhenfei fang Mao Chen Ben He Xiangbin Pan Department of Structure Heart Center Fuwai Yunnan HospitalChineseAcademy of Medical SciencesKunmingYunnan 650102China Departmentof Cardiovascular Surgery Zhongnan Hospital of Wuhan UniversityWuhanHubei 430071China Department of Cardiology the Second XiangyaHospital of Central South UniversityChangshaHunan 410011China Department of Cardiology West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of Cardiology ShanghaiChest HospitalShanghai 200030China Department of Structure HeartCenter Fuwai HospitalNational Center for Cardiovascular DiseasesChineseAcademy of Medical Sciences and Peking Union Medical CollegeBeijing100037China

Transcatheter edge-to-edge repair(TEER)of the mitral valve has emerged as a standard treatment for patients with severe degenerative mitral regurgitation at high or prohibitive surgical *** devices approved by the Food and Drug Administration including MitraClip(Abbott Vascular,California,USA)and PASCAL(Edwards Lifesciences,California,USA)cost over$33,000 in western countries.[1]This pricing presents a significant economic burden especially in developing countries,where TEER devices are typically not covered by health insurance.

关键词： PASCAL Mitra Abbott

经桡动脉冠状动脉介入治疗用于高龄急性冠脉综合征患者的疗效和安全性

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中国医药导报 2017年第5期14卷 67-70页

作者：廖志雄方臻飞湖南省中南大学湘雅二医院心血管内科湖南长沙410011

目的评价经桡动脉冠状动脉介入(PCI)治疗用于高龄急性冠脉综合征患者的疗效和安全性。方法回顾性分析2013年4月~2015年12月中南大学湘雅二医院心血管内科收治的高龄急性冠脉综合征患者228例的临床资料,根据介入途径的不同将所有患者分... 详细信息

目的评价经桡动脉冠状动脉介入(PCI)治疗用于高龄急性冠脉综合征患者的疗效和安全性。方法回顾性分析2013年4月~2015年12月中南大学湘雅二医院心血管内科收治的高龄急性冠脉综合征患者228例的临床资料,根据介入途径的不同将所有患者分为股动脉组(121例)和桡动脉组(107例)。记录两组患者X线曝光时间、穿刺时间、手术时间、术后卧床时间、术后住院时间、造影剂用量、穿刺成功率、PCI成功率,比较两组患者术后1个月主要心血管事件和穿刺部位并发症的发生率。结果两组X线曝光时间、手术时间、造影剂用量、穿刺成功率、PCI成功率比较,差异无统计学意义(P>0.05)。桡动脉组穿刺时间、术后卧床时间、术后住院时间均显著短于股动脉组,差异有统计学意义(P0.05)。桡动脉组穿刺部位并发症发生率显著低于股动脉组,差异有统计学意义(P<0.05)。结论经桡动脉和经股动脉行PCI用于高龄急性冠脉综合征患者的疗效相当,但是经桡动脉行PCI操作方便,卧床时间短,恢复快,且并发症少,具有良好的临床可行性和安全性。

关键词：经皮冠状动脉介入桡动脉股动脉高龄急性冠脉综合征