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Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope

Journal of Geriatric Cardiology 2024年第6期21卷 651-657页

作者： Bin TU Zi-Hao LAI Ai-Yue CHEN Zhi-Yuan WENG Si-Min CAI Zhu-Xin ZHANG li-Kun ZHOU li-hui zheng Yan YAO Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesNational Key LaboratoryChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Cardiac Center Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Cardiovascular Department The First Affiliated HospitalFujian Medical UniversityFujian Institute of HypertensionFujianChina Department of Cardiovascular The Second Affiliated Hospital of Zhejiang University School of MedicineZhejiangChina

BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(Pline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.

关键词： syncope subtypes diagnosis

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Ultrasound-guided stellate ganglion blockade: an appealing tactic for cardiac electrical storm

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Journal of Geriatric Cardiology 2023年第5期20卷 376-382页

作者： Zi-Hao LAI li-hui zheng Yan YAO Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Ventricular arrhythmia(VA)is a life-threatening cardiac emergency.When VA occurs three times or more within 24 h and interventions are required,it is defined as an electrical storm(ES)characterized by refractoriness and recurrence.[1]For patients with implantable cardioverter defibrillator(ICD),the notion is redefined as no fewer than three appropriate and separate(at least 5 min for each interval)ICD interventions given within 24 h.

关键词： cardiac storm electrical

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Situational continuity-based air combat autonomous maneuvering decision-making

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Defence Technology(防务技术) 2023年第11期29卷 66-79页

作者： Jian-dong Zhang Yi-fei Yu li-hui zheng Qi-ming Yang Guo-qing Shi Yong Wu School of Electronics and Information Northwestern Polytechnical UniversityXi'an710129China Military Representative Office of Haizhuang Wuhan Bureau in Luoyang Region 471000China

In order to improve the performance of UAV's autonomous maneuvering decision-making,this paper proposes a decision-making method based on situational continuity.The algorithm in this paper designs a situation evaluation function with strong guidance,then trains the Long Short-Term Memory(LSTM)under the framework of Deep Q Network(DQN)for air combat maneuvering decision-making.Considering the continuity between adjacent situations,the method takes multiple consecutive situations as one input of the neural network.To reflect the difference between adjacent situations,the method takes the difference of situation evaluation value as the reward of reinforcement learning.In different scenarios,the algorithm proposed in this paper is compared with the algorithm based on the Fully Neural Network(FNN)and the algorithm based on statistical principles respectively.The results show that,compared with the FNN algorithm,the algorithm proposed in this paper is more accurate and forwardlooking.Compared with the algorithm based on the statistical principles,the decision-making of the algorithm proposed in this paper is more efficient and its real-time performance is better.

关键词： UAV Maneuvering decision-making Situational continuity Long short-term memory(LSTM) Deep Q network(DQN) Fully neural network(FNN)

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Experimental study on the degree and damage-control mechanisms of fuzzy-ball-induced damage in single and multi-layer commingled tight reservoirs

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Petroleum Science 2023年第6期20卷 3598-3609页

作者： Chinedu J.Okere James J.Sheng li-Kun Fan Xiao-Wei Huang li-hui zheng Pan-Feng Wei Bob L.Herd Department of Petroleum Engineering Texas Tech UniversityTXUSA College of Petroleum Engineering China University of Petroleum(Beijing)Beijing102249China China Changqing Oilfield Company CNPCXi'an710018ShaanxiChina Beijing lihuiLab Energy Technology Co. Ltd.Beijing102200China

Fuzzy-ball working fluids(FBWFs)have been successfully applied in different development phases of tight reservoirs.Field reports revealed that FBWFs satisfactorily met all the operational and reservoir damage control requirements during their application.However,the damage-control mechanisms and degree of formation damage caused by fuzzy-ball fluids have not been investigated in lab-scale studies so far.In this study,the degree of fuzzy-ball-induced damage in single-and double-layer reservoirs was evaluated through core flooding experiments that were based on permeability and flow rate indexes.Additionally,its damage mechanisms were observed via scanning electron microscope and energy-dispersive spectroscopy tests.The results show that:(1)For single-layer reservoirs,the FBWF induced weak damage on coals and medium-to-weak damage on sandstones,and the difference of the damage in permeability or flow rate index on coals and sandstones is below 1%.Moreover,the minimum permeability recovery rate was above 66%.(2)For double-layer commingled reservoirs,the flow rate index revealed weak damage and the overall damage in double-layer was lower than the single-layer reservoirs.(3)There is no significant alteration in the microscopic structure of fuzzy-ball saturated cores with no evidence of fines migration.The dissolution of lead and sulfur occurred in coal samples,while tellurium in sandstone,aluminum,and magnesium in carbonate.However,the precipitation of aluminum,magnesium,and sodium occurred in sandstone but no precipitates found in coal and carbonate.The temporal plugging and dispersion characteristics of the FBWFs enable the generation of reservoir protection layers that will minimize formation damage due to solid and fluid invasion.

关键词： Drilling Fracture Fuzzy-ball fluids Formation damage analysis Muti-layer tight reservoirs Permeability damage index Flow rate damage index

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Associations of big endothelin-1 and C-reactive protein in atrial fibrillation

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Journal of Geriatric Cardiology 2016年第5期13卷 465-470页

作者： li-hui zheng Wei SUN Yan YAO Bing-Bo HOU Yu QIAO Shu ZHANG State Key Laboratory of Cardiovascular Disease Clinical EP Lab & Arrhythmia Center Fuwai Hospital Beijing China

BACKGROUND:Atrial fibrillation (AF) is associated with inflammation and endothelial dysfunction. However, the association between inflammation (as indexed by high-sensitivity C-reactive protein, hs-CRP) and endothelial function [as indexed by big endothelin-1 (ET-1)] in AF patients remains unclear.;METHODS:We enrolled 128 patients with lone AF, among which 83 had paroxysmal AF, and 45 had persistent AF. Eighty-two age- and gender-matched controls of paroxysmal supraventricular tachycardia without AF history were evaluated. Plasma hs-CRP, big ET-1 levels and other clinical characteristics were compared among the groups.;RESULTS:Patients with persistent AF had higher hs-CRP concentrations than those with paroxysmal AF (P 0.05), and both groups had higher big ET-1 levels than controls (P < 0.05). Multiple regression analyses revealed hs-CRP as an independent determinant of AF (P < 0.001). Further adjusted for big ET-1, both big ET-1 and hs-CRP were independent predictors for AF (P < 0.001), but the odds ratio for hs-CRP in predicting AF attenuated from 8.043 to 3.241. There was a positive relation between hs-CRP level and big ET-1 level in paroxysmal AF patients (r = 0.563, P < 0.05), however, the relationship in persistent AF patients was poor (r = 0.094, P < 0.05).;CONCLUSIONS:Both plasma hs-CRP and big ET-1 levels are elevated in lone AF patients, and are associated with AF. In paroxysmal lone AF patients, there were significant positive correlations between plasma hs-CRP level and big ET-1 level.

关键词：内皮素-1 C-反应蛋白房颤 ET-1 正相关关系血管内皮功能多元回归分析预测因子

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Relationship between red blood cell distribution width levels and atrial fibrillation in hypertensive patients

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Journal of Geriatric Cardiology 2020年第8期17卷 486-494页

作者： li-hui zheng Shang-Yu liU Feng HU Zhi-Cheng HU li-Shui SHEN ling-Min WU Yan YAO Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between AF and RDW in hypertensive patients.Methods We enrolled 432 hypertensive patients,including 350 AF patients and 82 patients as controls.Patients'demographic,clinical,laboratory and echocardiographic characteristics were recorded.The AF patients were further divided into the persistent and paroxysmal AF subgroups.Electrocardiograms were monitored to identify the cardiac rhythm during blood sampling,and based on the rhythm,the paroxysmal AF group was categorized into the presence(with AF rhythm during blood sampling)and absence(with sinus rhythm during blood sampling)groups.Results The AF group had elevated RDW levels than the controls(12.7%±0.8%vs.12.4%±0.7%,P=0.002),and the persistent AF subgroup had higher RDW levels than the paroxysmal AF subgroup(12.9%±0.8%vs.12.6%±0.8%,P=0.007).Furthermore,in the paroxysmal AF group,the presence group had higher RDW levels than the absence group(13.0%±0.6%vs.12.5%±0.9%,P=0.001).There was no significant difference in RDW levels between the persistent AF subgroup and presence group of the paroxysmal AF subgroup(P=0.533)and between the absence group of the paroxysmal AF subgroup and control group(P=0.262).In multivariate regression analysis,in hypertensive patients,the presence of AF rhythm is an independent predictor for increased RDW concentration(P=0.001).Conclusions The RDW may be associated with the presence of AF rhythm,which implies the importance of maintaining the sinus rhythm in hypertensive patients.

关键词： Atrial fibrillation Hypertension Inflammation Red blood cell distribution width

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Factors influencing adherence to non-vitamin K antagonist oral anticoagulants in the early period after atrial fibrillation catheter ablation in China

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Chinese Medical Journal 2020年第16期133卷 1989-1991页

作者： Zhi-Cheng Hu Shang-Yu liu ling-Min Wu li-Shui Shen li-Min liu Guo-liang li li-hui zheng Yan Yao Cardiac Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiology First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China

Anticoagulants are routinely prescribed in the first several weeks after atrial fibrillation(AF)catheter ablation.Nonvitamin K antagonist oral anticoagulants(NOACs)have been recommended over warfarin for their superiority.Unlike warfarin need regular clinical visit to perform blood test,NOACs are more patient friendly.But the lack of routine medical contact may lead to poor adherence.Strict adherence to anticoagulant treatment is essential for both efficacy and safety.Considering NOACs are increasingly commonly used in China,it is therefore necessary to evaluate the adherence of NOACs after AF catheter ablation.The purpose of this research was to investigate the treatment adherence and identify factors that could improve the quality of anticoagulation.

关键词： vitamin routine fibrillation

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Ablation strategies for arrhythmogenic right ventricular cardiomyopathy: a systematic review and meta-analysis

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Journal of Geriatric Cardiology 2020年第11期17卷 694-703页

作者： li-Shui SHEN li-Min liU li-hui zheng Feng HU Zhi-Cheng HU Shang-Yu liU Jin-Rui GUO Kush Kumar Bhagat Yan YAO Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Arrhythmia Center Yunnan Fuwai Cardiovascular HospitalKunmingChina Eternal hospital JaipurRajasthanIndia

Background Catheter ablation for ventricular tachycardia(VT) in patients with arrhythmogenic right ventricular cardiomyopathy(ARVC) has significantly evolved over the past decade. However, different ablation strategies showed inconsistency in acute and long-term outcomes. Methods We searched the databases of Medline, Embase and Cochrane library through October 17, 2019 for studies describing the clinical outcomes of VT ablation in ARVC. Data including VT recurrence, all-cause mortality, acute procedural efficacy and major procedural complications were extracted. A meta-analysis with trial sequential analysis was further performed in comparative studies of endo-epicardial versus endocardial-only ablation. Results A total of 24 studies with 717 participants were enrolled. The literatures of epicardial ablation were mainly published after 2010 with total ICD implantation of 73.7%, acute efficacy of 89.8%, major complication of 5.2%, follow-up of 28.9 months, VT freedom of 75.3%, all-cause mortality of 1.1% and heart transplantation of 0.6%. Meta-analysis of 10 comparative studies revealed that compared with endocardial-only approach, epicardial ablation significantly decreased VT recurrence(OR: 0.50;95% CI: 0.30–0.85;P = 0.010), but somehow increased major procedural complications(OR: 4.64;95% CI: 1.28–16.92;P = 0.02), with not evident improvement of acute efficacy(OR: 2.74;95% CI: 0.98–7.65;P = 0.051) or all-cause mortality(OR: 0.87;95% CI: 0.09–8.31;P = 0.90). Conclusion Catheter ablation for VT in ARVC is feasible and effective. Epicardial ablation is associated with better long-term VT freedom, but with more major complications and unremarkable survival or acute efficacy benefit.

关键词： Arrhythmogenic right ventricular cardiomyopathy Catheter ablation Ventricular tachycardia

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Association between big endothelin-1 and CHADS2/CHA2DS2-VASc scores in non-valvular atrial fibrillation

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Journal of Geriatric Cardiology 2019年第11期16卷 812-817页

作者： li-hui zheng Shang-Yu liU Feng HU Er-Peng liANG ling-Min WU Hong-Lei WANG Ammar M Killu Yan YAO Clinical EP Lab&Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina The First Affiliated Hospital College of Clinical Medicine of Henan University of Science and TechnologyLuoyangChina Department of Cardiovascular Medicine Mayo ClinicRochesterMNUSA

Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little data about the association between big ET-1 and thromboembolism risk in atrial fibrillation(AF).We aimed to investigate the relationship between big ET-1 and CHADS2/CHA2DS2-VASc scores used for evaluating thromboembolic risk in patients with non-valvular AF.Methods The study population consisted of 238 consecutive AF patients(67.6%with paroxysmal AF and 32.4%with persistent AF).The patients were divided into two groups(high-or low-intermediate risk group)based on CHADS2 and CHA2 DS2-VASc scores(score≥2 orlinical,laboratory,and echocardiographic parameters were evaluated,and the CHADS2/CHA2DS2-VASc scores were compared between groups.The association between big ET-1 levels and CHADS2/CHA2DS2-VASc score was assessed.Multivariate logistic regression analysis was performed to identify independent predictors of CHADS2/CHA2DS2-VASc scores.Results The high CHADS2/CHA2DS2-VASc score group had older age,higher big ET-1 levels,and enlarged left atrial diameter than the low CHADS2/CHA2DS2-VASc score group(P<0.05).Multiple logistic regression analysis revealed that big ET-1 level was an independent determinant of high CHADS2/CHA2DS2-VASc scores[odds ratio(OR)=2.545 and OR=3.816;both P<0.05].Conclusions Our study indicates that in non-valvular AF,big ET-1 was significantly correlated with CHADS2/CHA2DS2-VASc scores and an independent predictor of high CHADS2/CHA2DS2-VASc scores.Big ET-1 may serve as a useful marker for risk stratification in this setting.

关键词： Atrial fibrillation Cardiac risk factors Prevention Stroke

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Syntheses and properties of photostable near-infrared cyanines and their cyclodextrin conjugates

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Chinese Chemical Letters 2008年第6期19卷 739-741页

作者： li Qiu Wang lin Zhao Wei Wei Nie li hui zheng Ji Dong Wang Qiu Rong li Jing Zhai Zhi Wei liu Xiao Jun Peng Institute of Environment and Chemical Engineering Yanshan University Qinhaangdao 066004 PR China State Key Laboratory of Fine Chemicals Dalian University of Technology Dallan 116012 PR China

Three fluorescent indocyanines containing p-carboxybenzyl groups on N atoms in the heterocyclic tings were synthesized under supersonic. The maxima wavelength of the absorption and emission of the dyes were 550-800 nm in water. Compared with those in aqueous solutions, the fluorescence intensity of the dyes in the α/β-cyclodextrin, Al^3＋, Zn^2＋, Sn^2＋ or the α/β-cyclodextrin in the aqueous solutions of the cations became stronger. The crystal Shapes of the dyes and their cyclodextrin inclusions were mostly acicular or polygon. The NHS-carboxyl squarylium indocyanine was prepared and used to conjugate with taurine or benzylamine, the results indicated that the dyes could couple covalently to biomass containing free NH2 group. Structure and some thermal parameters of the molecule of the trimethine cyanine were obtained by DFT method of Gaussian O3.

关键词： Near-infrared indocyanine Fluorescence probe α-/β-Cyclodextrin inclusion Cation solutions Bioanalysis

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