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Accurate diagnosis of severe coronary stenosis based on resting magnetocardiography: a prospective, single-center, cross-sectional analysis

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Journal of Geriatric Cardiology 2024年第4期21卷 407-420页

作者： Jian-Guo CUI Feng TIAN Yu-Hao MIAO Qin-Hua JIN Ya-Jun SHI Li LI Meng-Jun SHEN Xiao-Ming XIE Shu-Lin ZHANG Yun-Dai CHEN School of Medicine Nankai UniversityTianjinChina Senior Department of Cardiology the Sixth Medical CenterChinese PLA General HospitalBeijingChina Joint Laboratory of Bioimaging Technology and Applications SAS-SIM-IT&MEDIShanghaiChina Shanghai Institute of Microsystem and Information Technology Chinese Academy of SciencesShanghaiChina

OBJECTIVE To evalu ate the role of resting magnetocardiography in identifying seve re coronary artery stenosis in patients with suspected coronary artery *** A total of 513 patients with angina symptoms were included and divided into two groups based on the extent of coronary artery disease determined by angiography:the non-severe coronary stenusis group(stenosis) and the severe coronary stenosis group(≥70% stenosis).The diagnostic model was constructed using magnetic field map(MFM) parameters,either individually or in combination with clinical *** performance of the models was evaluated using receiver operating characteristic curves,accuracy,sensitivity,specificity,positive predictive value(PPV) and ne gative predictive value(NPV).Calibration plots and decision curve analysis were performed to investigate the clinical utility and performance of the models,*** In the severe coronary stenosis group,QR_MCTDd,S_MDp,and TT_(MA)C_(50) were significantly higher than those in the non-severe coronary stenosis group(10,46±10.66 vs,5.11±6.07,P stenosis group were lower(0.23±0.16 vs.0.28±0.16,P<0.001;55.06±48.68 vs.59.24±53.01,P<0.001;51.67±39.32 vs. 60.45±51.33,P <0.001).Seven MFM parameters were integrated into the model,resulting in an area under the curve of 0.810(95% CI:0.765-0.855).The sensitivity,specificity,PPV,NPV,and accurecy were 71.7%,80.4%,93.3%,42.8 %,and 73.5%;*** combined model exhibited an area under the curve of 0.845(95% CI:0.798-0.892).The sensitivity,specificity,PPV,NPV,and accuracy were 84.3%,73.8%,92.6%,54.6%,and 82.1%;*** curves demonstrate d excellent agreement between the nomogram prediction and actual *** decision curve analysis showed that the c ombine d model provided greater net benefit compared to the magnetocardingraphy model.C

关键词： coronary stenosis specificity

Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines Elvira-Ruiz Cesar Caro-Martinez Pedro JoseFlores-Blanco Juan JoseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola JoseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

Causal effect of psoriasis on aortic valve stenosis:a two-sample Mendelian randomization study

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Journal of Geriatric Cardiology 2024年第9期21卷 865-873页

作者： Ke-Xin JIANG Yan WANG Yu-Tong LIU Yanjiani XU Fang-Yang HUANG Mao CHEN Department of Cardiology West China HospitalSichuan UniversityChengduChina Laboratory of Cardiac Structure and Function Institute of Cardiovascular DiseasesWest China HospitalSichuan UniversityChengduChina West China School of Medicine Sichuan UniversityChengduSichuanChina

Background Epidemiological studies have suggested a potential connection between psoriasis and an increased risk of aortic valve stenosis(AS),though the impact of psoriasis on AS progression remains *** study aims to investigate the causal relationship between psoriasis and AS using Mendelian randomization(MR)analysis,as well as to uncover potential mechanisms underlying this *** A two-sample MR analysis was conducted using publicly available summary statistics from genome-wide association studies(GWAS)of psoriasis and ***-eQTL and significant genes were identified for each causal single-nucleotide polymorphisms(SNPs),followed by pathway enrichment and protein-protein interaction(PPI)analysis for functional *** genes were pinpointed by *** transcriptional profile of AS population was acquired,and interconnected genes networks were clustered using Molecular Complex Detection(MCODE).Results Our results demonstrate a significant causal relationship between psoriasis and AS,with a genetic predisposition to psoriasis associated with a higher AS risk(odds ratio:1.46).Pathway and PPI analyses unveiled 15 hub genes,including HLA-C,HLA-B,ISG15,IFIT3,and MX2,along with immune-related pathways linking psoriasis and ***,the transcriptional profiling of the AS database highlighted the significant involvement of adaptive immune cells in AS ***,among the 15 hub genes,ISG15,MX2,OAS3,OASL,IFI6,and EPSTI1 exhibited higher expression in the AS *** Our study provides compelling evidence supporting a causal relationship between psoriasis and ***,the identified hub genes and immune-related pathways may play an important role in the development of both diseases.

关键词： psoriasis stenosis involvement

Angiography-derived radial wall strain predicts coronary lesion progression in non-culprit intermediate stenosis

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Journal of Geriatric Cardiology 2022年第12期19卷 937-948页

作者： Zhi-Qing WANG Bo XU Chun-Ming LI Chang-Dong GUAN Yue CHANG Li-Hua XIE Su ZHANG Jia-Yue HUANG Patrick W Serruys William Wijns Liang-Long CHEN Sheng-Xian TU Department of Cardiology Fujian Heart Medical CenterFujian Institute of Coronary Heart DiseaseFujian Medical University Union HospitalFujianChina Biomedical Instrument Institute School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina Department of Cardiology National Clinical Research Center for Cardiovascular DiseasesFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina The Lambe Institute for Translational Medicine and Curam University of GalwayGalwayIreland

BACKGROUND Intermediate coronary lesions(ICLs)are highly prevalent but ported mixed *** strain has been associated with plaque vulnerability,yet its role in predicting lesion progression is largely *** purpose of this study was to determine the predictive value of angiography-derived radial wall strain(RWS)for progression of untreated non-culprit *** Post-hoc analysis was conducted in a study cohort including 603 consecutive patients with 808 ICLs identified at index procedure with angiographic follow-up of up to two *** analysis was performed on selected angiographic frames with minimal foreshortening and vessel *** progression was defined as≥20%increase in percent diameter *** Lesion progression occurred in 49 ICLs(6.1%)with a median follow-up period of 16.8 *** RWS(RWSmax),frequently located at the proximal and throat plaque regions,distinguished progressive ICLs from silent *** largest area under the curve value of 0.75(95%CI:0.67–0.82,P12.6%.According to this threshold,178 ICLs were classified as having a high strain *** to a high strain amplitude with RWS_(max)>12.6%was independently associated with an increased risk of lesion progression(adjusted HR=6.82,95%CI:3.67–12.66,P<0.001).CONCLUSIONS Assessment of RWS from coronary angiography is feasible and provides independent prognostic value in patients with untreated ICLs.

关键词： coronary stenosis strain

Etiology spectrum and clinical characteristics of renal artery stenosis in a Chinese cohort

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Journal of Geriatric Cardiology 2021年第2期18卷 104-113,I0001页

作者： Xu MENG Yi ZHOU Xiong-Jing JIANG Jun CAI Hui-Min ZHANG Hai-Ying WU Wen-Jun MA Ying LOU Ya-Xin LIU Xian-Liang ZHOU Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Emergency and Critical Care Center Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

OBJECTIVE To analyze the causes of renal artery stenosis(RAS)and compare the clinical characteristics in accordance with the primary disease among patients aged from 30 to *** Patients were grouped by etiologies of *** were retrospectively examined and compared regarding demographic data,clinical manifestations,laboratory findings,and imaging *** A total of 152 patients(74 females,78 males;mean age:40.70±6.01 years)were enrolled,including 84 patients(55.3%)with atherosclerosis(AS),46 patients(30.3%)with Takayasu arteritis(TA),18 patients(11.8%)with fibromuscular dysplasia(FMD),and four patients(2.6%)with other *** in AS group had greater body mass index,higher prevalence of comorbidities and higher rate of smoking and drinking *** patients showed more constitutional symptoms and vascular findings,and higher erythrocyte sedimentation *** in both AS group and TA group mainly located on ostia and proximal segments,but RAS in FMD group mainly involved middle to distal segment of renal *** AS group had significantly lesser stenosis than the other *** renal function evaluated by the estimated glomerular filtration rate did not significantly differ among the groups,the incidence of kidney shrinkage was significantly higher in the TA and FMD groups(39.1%and 50%,respectively)than in the AS group(8.3%).The FMD group had milder cardiac damage than other *** AS was the most common cause of RAS in patients aged from 30 to 50,followed by TA and *** etiology of RAS should be carefully distinguished based on clinical manifestations,laboratory findings,and imaging to ensure that proper treatment is provided.

关键词： clinical stenosis finding

Effects of magnetic field,porosity,and wall properties for anisotropically elastic multi-stenosis arteries on blood flow characteristics

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Applied Mathematics and Mechanics(English Edition) 2011年第8期32卷 1047-1064页

作者： Kh.S.MEKHEIMER M.H.HAROUN M.A.ELKOT Department of Mathematics Faculty of Science Al-Azhar University Department of Mathematics Faculty of Education Ain Shams University Department of Mathematics Faculty of Science Suez Canal University

A mathematical model for blood flow through an elastic artery with multistenosis under the effect of a magnetic field in a porous medium is presented. The considered arterial segment is simulated by an anisotropically elastic cylindrical tube filled with a viscous incompressible electrically conducting fluid representing blood. An artery with mild local narrowing in its lumen forming a stenosis is analyzed. The effects of arterial wall parameters represent viscoelastic stresses along the longitudinal and circumferential directions T t and T θ , respectively. The degree of anisotropy of the vessel wall γ, total mass of the vessel, and surrounding tissues M and contributions of the viscous and elastic constraints to the total tethering C and K respectively on resistance impedance, wall shear stress distribution, and radial and axial velocities are illustrated. Also, the effects of the stenosis shape m, the constant of permeability κ, the Hartmann number Ha and the maximum height of the stenosis size δ on the fluid flow characteristics are investigated. The results show that the flow is appreciably influenced by surrounding connective tissues of the arterial wall motion, and the degree of anisotropy of the vessel wall plays an important role in determining the material of the artery. Further, the wall shear stress distribution increases with increasing T t and γ while decreases with increasing T θ , M, C, and K. Transmission of the wall shear stress distribution and resistance impedance at the wall surface through a tethered tube are substantially lower than those through a free tube, while the shearing stress distribution at the stenosis throat has inverse characteristic through totally tethered and free tubes. The trapping bolus increases in size toward the line center of the tube as the permeability constant κ increases and decreases with the Hartmann number Ha increased. Finally, the trapping bolus appears, gradually in the case of non-symmetric stenosis, and disap

关键词： stenosis degree of anisotropy free tube tethered tube trapping bolus

Hemodynamics of Enhanced External Counterpulsation with Different Coronary stenosis

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Computer Modeling in Engineering & Sciences 2018年第8期116卷 149-162页

作者： Sihan Chen Bao Li Haisheng Yang Jianhang Du Xiaoling Li Youjun Liu College of Life Science and Bio-engineering Beijing University of TechnologyNo.100 Ping-leyuanChaoyang DistrictBeijing100124China. The Eighth Affiliated Hospital Sun Yat-sen UniversityNo.3025 ShenNan RoadShenZhenGuangDong518033China.

Enhanced external counterpulsation(EECP)is able to treat myocardial ischemia,which is usually caused by coronary artery ***,the underlying mechanisms regarding why this technique is effective in treating myocardial ischemia remains unclear and there is no patient-specific counterpulsation mode for different rates of coronary artery stenosis in *** study sought to investigate the hemodynamic effect of varied coronary artery stenosis rates when using EECP and the necessity of adopting targeted counterpulsation mode to consider different rates of coronary artery *** 3-dimensional(3D)coronary models with different stenosis rates,including 55%(Model 1),65%(Model 2),and 75%(Model 3),were generated,then coupled with a 0-dimensional(0D)lumped parametric model of the blood circulatory *** was applied to the 0D/3D coupled models to study the hemodynamic response of the coronary *** the same counterpulsation mode,the ratio of diastolic blood pressure to systolic blood pressure of 3 models during counterpulsation was 1.4,and the cardiac output and coronary artery flow rate increased *** low wall shear stress(WSS)and high oscillatory shear index(OSI)areas were mainly located at the posterior end of the stenosis and coronary artery ***,with an increase in the rate of coronary artery stenosis,the increased percentage of flow rate through the coronary artery stenosis and area-averaged WSS *** geometric multiscale model in this study can be used to effectively simulate the hemodynamic characteristics of cardiovascular system following the application of *** precise hemodynamic effect of the coronary artery stenosis can be *** was found from the hemodynamic factors that the coronary artery with lower stenosis rate more likely led to better vascular endothelial ***,it is necessary to adopt patient-specific counterpulsation mode accounting for different condition of coro

关键词： Enhanced external counterpulsation coronary artery stenosis geometric multiscale method wall shear stress hemodynamics

Impact of high-fat diet and vitamin D_3 supplementation on aortic stenosis establishment in waved-2 epidermal growth factor receptor mutant mice

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Journal of Integrative Medicine 2019年第2期17卷 107-114页

作者： Bérénice Colleville Nicolas Perzo Guillaume Avinée Ana?s Dumesnil Frederic Ziegler Paul Billoir Hélène Eltchaninoff Vincent Richard Eric Durand Department of Biology Institut National de la Santé et de la Recherche Médicale U1096 (Endothélium Valvulopathies et Insuffisance Cardiaque) Normandie University Fédération Hospitalo-Universitaire REMODeling in Valvulopathy and Heart Failure Department of Cardiology Rouen University Hospital Department of Biology Institut National de la Santé et de la Recherche Médicale U1073 (Nutrition Inflammation et Dysfonction de l’axe Intestin-Cerveau) Normandie University Institute for Clinical Biology-General Biochemistry Unit Rouen University Hospital Department of Vascular Hemostasis Rouen University Hospital

Objective: The use of animal models of aortic stenosis(AS) remains essential to further elucidate its pathophysiology and to evaluate new therapeutic strategies. The waved-2 mouse AS model has been proposed;data have indicated that while aortic regurgitation(AR) is effectively induced, development of AS is *** aimed to evaluate the effect of high-fat diet(HFD) and vitamin D_3 supplementation in this ***: HFD and subcutaneous vitamin D_3 injections were initiated at the age of 6 weeks until the age of 6(n = 16, 6-month treatment group) and 9(n = 11, 9-month treatment group) months. Twelve waved-2 mice without supplementation were used as control. Echocardiography was performed at 3, 6 and 9 months. Blood serum analysis(calcium, 1,25(OH)_2D_3 and cholesterol), histology and immunohistochemistry(CD-31, CD-68 and osteopontin) were evaluated at the end of the experiment(6 or 9 months).Results: Total cholesterol and 1,25(OH)_2D_3 were significantly increased relative to the control group. HFD and vitamin D_3 supplementation did result in improvements to the model, since AS was only detected in 6(15.3%) mice(2 in the 3 groups) and AR was developed in the remaining animals. Echocardiographic parameters, fibrosis, thickness, inflammation and valvular calcification, were not significantly different between the 6-month treatment and control groups. Similar results were also observed in the 9-month treatment ***: These results suggest that HFD and vitamin D_3 supplementation have no effect in the waved-2 mouse model. This model essentially mimics AR and rarely AS. Further studies are needed to find a reliable animal model of AS.

关键词： Experimental model Epidermal growth factor receptor Vitamin D3 High-fat diet Aortic stenosis Aortic regurgitation

Association of atherosclerotic plaque features with collateral circulation status in elderly patients with chronic carotid stenosis

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Journal of Geriatric Cardiology 2020年第4期17卷 202-209页

作者： Hui-Min XU Ran HUO Rui-Jing XIN Dan-Dan YANG Ying LIU Ning LANG Xi-Hai ZHAO Tao WANG Hui-Shu YUAN Department of Radiology Peking University Third HospitalBeijingChina Department of Radiology Zhongda HospitalMedical School of Southeast UniversityNanjingChina Beijing Institute of Brain Disorders Laboratory of Brain DisordersMinistry of Science and TechnologyCollaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina Center for Biomedical Imaging Research Department of Biomedical EngineeringTsinghua University School of MedicineBeijingChina Department of Neurosurgery Peking University Third HospitalBeijingChina

Objective To determine the association of carotid plaque features with collateral circulation status in elderly patients with moderate to severe carotid *** Elderly patients(>60 years)with moderate to severe carotid stenosis were recruited and categorized into good and poor collateral circulation groups,and underwent magnetic resonance imaging and computed tomography *** carotid plaque features including lipid-rich necrotic core,intraplaque hemorrhage,calcification,and fibrous cap rupture(FCR)were evaluated,and maximum wall thickness,normalized wall index(NWI),and luminal stenosis were *** association between these variables and collateral circulation status was *** Of the 97 patients(78 males,mean age:69.0±6.1 years),19(19.6%)had poor *** poor collateral group had a significantly higher NWI(93.7%±5.0%vs.89.0%±7.9%,P=0.011),a greater extent of stenosis(80.0%±11.4%vs.75.3%±9.4%,P=0.036)and FCR(84.2%vs.55.1%,P=0.020)compared with good collateral *** NWI(OR=3.83,95%CI:1.36–10.82,P=0.011)and more FCR(OR=6.77,95%CI:1.35–33.85,P=0.020)were associated with poor collateral circulation after adjustment for the confounding *** combination of NWI,FCR,systolic blood pressure,and triglycerides had the highest area-under-the-curve(AUC=0.85)for detection of poor *** Carotid plaque features,specifically NWI and FCR,are independently associated with poor collateral circulation,and the combination of carotid plaque features and traditional risk factors has a stronger predictive value for poor collateral circulation than plaque features alone.

关键词： Atherosclerosis Carotid stenosis Collateral circulation Computed tomography angiography Magnetic resonance imaging