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Diagnostic accuracy of a deep learning approach to calculate FFR from coronary CT angiography

Journal of Geriatric Cardiology 2019年第1期16卷 42-48页

作者： Zhi-Qiang WANG Yu-Jie ZHOU Ying-Xin ZHAO Dong-Mei SHI Yu-Yang LIU Wei LIU Xiao-Li LIU Yue-Ping LI department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Disease Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease Clinical Center for Coronary Heart Disease Capital Medical University

Background The computational fluid dynamics(CFD)approach has been frequently applied to compute the fractional flow reserve(FFR)using computed tomography angiography(CTA).This technique is *** developed the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value out of CTA images in five *** study is to evaluate the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value from CTA images as an efficient *** A single-center,prospective study was conducted and 63 patients were enrolled for the evaluation of the diagnostic performance of *** quantification method for the three-dimensional coronary arterial geometry and the deep learning based prediction of FFR were developed to assess the ischemic risk of the stenotic coronary *** performance of the DEEPVESSEL-FFR was assessed by using wire-based FFR as reference *** primary evaluation factor was defined by using the area under receiver-operation characteristics curve(AUC)*** For per-patient level,taking the cut-off value<0.8 referring to the FFR measurement,DEEPVESSEL-FFR presented higher diagnostic performance in determining ischemia-related lesions with area under the curve of 0.928 compare to CTA stenotic severity ***-FFR correlated with FFR(R=0.686,P<0.001),with a mean di&ference of-0.006士0.0091(P=0.619).The secondary evaluation factors,indicating per vessel accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were 87.3%,97.14%,75%,82.93%,and 95.45%,*** DEEPVESSEL-FFR is a novel method that allows efficient assessment of the functional significance of coronary stenosis.

关键词： Computed tomography angiography Coronary artery Deep learning Fractional flow reserve

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Effectiveness and Safety of Transcatheter Closure of Various Ventricular Septal Defects Using Second-Generation Amplatzer Duct Occluders

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Congenital heart disease 2023年第2期18卷 183-195页

作者： Jianming Wang Qiguang Wang Xiaotang Sheng Jingsong Geng Jiawang Xiao Xianyang Zhu department of Congenital heart disease General Hospital of Northern Theater CommandShenyangChina

Objective:This study was designed to determine the long-term safety and efficacy of using the Amplatzer Duct Occluder ii(ADO ii)for the closure of various ventricular septal defects(VSDs).Methods:From January 2011 to December 2019,selected VSD patients were treated through transcatheter intervention using ADO ii *** closure results and complications from 188 patients,involving 167 perimembranous ventricular septal defects(pmVSDs),9 intracristal VSDs,11 post surgery residual shunts and 1 post closure residual shunt with the mean outlet diameter3.1±0.8 mm under angiography,were enrolled in this ***:The success rate was 98.9%for all *** the median 77-month follow-up period,no cases of complete atrioventricular block(cAVB),infective endocarditis or death *** major adverse event(0.5%)was recorded:cerebrovascular accident occurred 1 day after the procedure in one patient who was transferred to the neurology *** residual shunt rate was 44.6%,which was the most common minor adverse *** cardiac conduction block rate was 4.3%.Specifically,one pmVSD patient developed intermittent LBBB during the 28-month *** were 3 patients(1.6%)with new-onset mild tricuspid insufficiency,and the insufficiency degree was stable during *** was no new-onset aortic insufficiency that ***:Transcatheter closure of pmVSDs,some intracristal VSDs,some postsurgery or postclosure residual shunts using ADO ii occluders were both safe and effective and yielded excellent long-term results in selected patients.

关键词： Ventricular septal defects Amplatzer Duct Occluder ii long-term follow-up transcatheter closure

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Simultaneous Transcatheter Closure of the Left Atrial Appendage and Congenital Interatrial Communication Closure

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Congenital heart disease 2022年第1期17卷 61-70页

作者： Jianming Wang Xianyang Zhu Xiaotang Sheng Jingsong Geng Jiawang Xiao Qiguang Wang department of Congenital heart disease General Hospital of Northern Theater CommandShenyangChina

Background:Left atrial appendage closure(LAAC)with simultaneous interventional occlusion therapy for congenital interatrial communication has become a new focus of patients with nonvalvular atrial *** is known about the results of mid-and long-term ***:The aim of this study was to evaluate the midand long-term safety and effectiveness of simultaneous transcatheter closure of the left atrial appendage(LAA)and congenital interatrial communication closure in atrial fibrillation(AF)***:From Jan 2016 to June 2017,27 patients with AF were treated with simultaneous transcatheter closure of the LAA and atrial septal defect(ASD,n=22),patent foramen ovale(PFO,n=5).Results:The perioperative closure success rate was 96.3%,except for cardiac tamponade occurred in one ASD *** the median 37.6-month follow-up period,no cases of cerebrovascular or peripheral vascular embolism,bleeding,infective endocarditis or thrombosis along the occluders were *** the 21 patients with NYHA Class iiI,nineteen had significant improvements to NYHA Classes I or ii,and 81.5%of patients were free from major or minor adverse events during midand long-term ***:Simultaneous closure of the LAA and congenital interatrial communication closure is a viable option for patients with nonvalvular atrial fibrillation who are at risk of stroke or systemic embolism,and it is effective and yields excellent mid-and long-term results.

关键词： Left atrial appendage atrial fibrillation interatrial communication cardiac catheterization

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Clinical relevance of atrial septal aneurysm and patent foramen ovale with migraine

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World Journal of Clinical Cases 2018年第15期6卷 916-921页

作者： Lu He Ge-Sheng Cheng Ya-Juan Du Yu-Shun Zhang department of Structural heart disease Xi'an Jiaotong University Medical College First Affiliated Hospital

AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled *** We studied a total of 450 migraineurs who had rightto-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3^(rd) edition and evaluated using the Headache Impact Test-6(HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A(PFO with ASA, n = 80) and B(PFO without ASA, n = 370). Baseline characteristics and procedural and follow-up data were reviewed. RESULTS Compared to group B, group A had an increased frequency of ischemic lesions(11.3% vs 6.2%, P = 0.038) and migraine with aura(32.5% vs 21.1%, P = 0.040). The PFO size was significantly larger in group A(P = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the oneyear follow-up after the PFO closure [61(9) vs 63(9), P = 0.227; 36(13) vs 36(10), P = 0.706].CONCLUSION Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.

关键词： Patent foramen ovale Migraine Atrial septal aneurysm Contrast transthoracic echocardiography Right-to-left shunt Transesophageal echocardiography

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Minimally invasive thoracoscopic left atrial appendage occlusion compared with transcatheter left atrial appendage closure for stroke prevention in recurrent nonvalvular atrial fibrillation patients after radiofrequency ablation:a prospective cohort study

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Journal of Geriatric Cardiology 2021年第11期18卷 877-885页

作者： Jian-Long WANG Kuo ZHOU Zheng QIN Wan-Jun CHENG Ling-Zhi ZHANG Yu-Jie ZHOU department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Interventional department Luanzhou People’s HospitalTangshanChina department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerot1ic DiseaseClinical Center for Coronary Heart DiseaseBeijingChina

BACKGROUND Tanscatheter left atrial appendage(LAA)closure and minimally invasive thoracoscopic LAA occlusion are local interventions of LAA for stroke prevention in patients with nonvalvular atrial fibrillation(NVAF).However,the safety and efficacy of these methods have not been *** prospective cohort study aimed to assess the safety and efficacy of those two treatment approaches for stroke prevention in NVAF *** Two hundred and nine recurrent NVAF patients who received radiofrequency ablation were *** pa-tients were treated with transcatheter LAA closure or thoracoscopic LAA *** patients were followed up from the first postoperative day and evaluated for efficacy endpoints(stroke/transient ischemic attack(TIA),systemic embolism(SE),and death)and a safety endpoint(bleeding events).Perioperative complications were *** After a median follow-up of 1.8 years(383 patient-years),the overall rate of the composite efficacy endpoints was similar between the two groups(3.8 vs.2.7 events per 100 patient-years;HR=0.71;95%CI:0.225−2.237;P=0.559).However,regarding primary safety endpoint,there were 1.5 bleeding events per 100 patient-years in the thoracoscopic LAA occlusion group,com-pared with 6.4 in transcatheter LAA closure group(HR=0.246;95%CI:0.074−0.819;P=0.022).The incidence of operative com-plications was 3/138(2.17%)in thoracoscopic LAA occlusion group and 1/71(1.41%)in transcatheter LAA closure *** Thoracoscopic LAA occlusion and transcatheter LAA closure have similar efficacy in preventing stroke in NVAF ***,the thoracoscopic group had fewer bleeding events than the transcatheter group,but the former group required a longer hospital stay.

关键词： prevention patients transcatheter

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Appropriate heart Rate in a Patient with Repaired Tetralogy of Fallot

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Congenital heart disease 2022年第6期17卷 647-652页

作者： Aya Miyazaki Hideki Uemura Yasuyo Takeuchi Junya Tomida Yasuo Ono Yoshifumi Fujimoto Norie Mitsushita Akio Ikai department of Transitional Medicine Division of Congenital Heart DiseaseShizuoka General HospitalShizuokaJapan Congenital heart disease Center Nara Medical UniversityKashiharaJapan department of Cardiology Shizuoka General HospitalShizuokaJapan department of Clinical Engineering Shizuoka General HospitalShizuokaJapan

Appropriate heart rate in a failing pulmonary ventricle remains unknown, particularly in congenital heart diseasewith unique hemodynamics. A 71-year-old male with repaired tetralogy of Fallot and a pacemaker for a sinusnode dysfunction suffered from heart failure symptoms with preserved left ventricular function. Simply changingthe pacemaker’s lower rate from 60 to 75 bpm, New York heart Association classification improved from iiI to ii,and hemodynamic parameters drastically improved. We regarded this case as informative. Appropriate heart ratecould be higher in congenital patients with failing right and non-failing left ventricles than in adults with malfunctioningLV.

关键词： heart rate repaired tetralogy of Fallot failing right ventricle pacemaker lower rate the right-left ventricular interaction

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Efficacy,Safety and Characteristics of the Amplatzer Vascular Plug ii and IV Utilization for Various Percutaneous Occlusions in Children under 10 Years

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Congenital heart disease 2022年第4期17卷 421-436页

作者： Hugues Lucron Alban-Elouen Baruteau Caroline Ovaert Ali Houeijeh Mélanie Brard Patrice Guerin François Bourlon Claire Dauphin Saskia Tuttle Maha Tagorti Rishika Banydeen François Godart Antilles-Guyane M3C Paediatric Cardiology Center University Hospital of MartiniqueFort-de-FranceFrance L’institut du Thorax INSERMCNRSUNIV NantesCHU NantesNantesFrance department of Paediatric Cardiology and Pediatric Cardiac Surgery University Hospital of NantesNantesFrance department of Paediatric and Congenital heart disease University Hospital of MarseilleMarseilleFrance department of Paediatric and Congenital heart disease University Hospital of Lille-Nord de FranceLilleFrance department of Paediatric and Congenital heart disease Cardiothoracic Center of MonacoMonaco department of Paediatric and Congenital heart disease University Hospital of Clermont-FerrandClermont-FerrandFrance Clinical Research department CHU Martinique(University Hospital of Martinique)Fort-de-FranceFrance

Objectives:We aim to describe the efficacy,safety,and characteristics of the Amplatzer Vascular Plug(AVP)ii and IV“off-label”use for multiple cardiovascular occlusions in children under 10 ***:Observational retrospective multicenter(2007–2020,6 centers)review of paediatric procedures using AVP ii or ***:A total of 125 children(49.6%aged≤1 year,147 lesions)underwent 136 successive procedures(success rate:98.5%)using 169 devices(109 AVP IV,60 AVP ii).The mean device diameter was 7.7±3.2 mm(4–20 mm).The median AVP size to vessel diameter ratio was 1.3(0–2).The median age and weight at implantation were 1.0 year(0.01–9.98)and 8.4 kg(1–69).Procedures were heterogeneous(55 patent ductus arteriosus(PDA),28 collaterals,18 sequestrations,22 arteriovenous/veinovenous/coronary fistulas,6 vertical veins,6 conduits,5 ventricular septal defects,7 miscellaneous).Day 1 and 6-month occlusion rates were respectively 94.8%and 98.5%.Major adverse events(MAE)occurred in 5.2%of cases(no procedure-related deaths),and more frequently in weight≤5 kg(p=0.01),younger patients(p=0.03)during PDA closure(p=0.02)of tubular types(p=0.02)using larger devices(p=0.03)and AVP ii(p=0.003).Independent predictor of MAE risk was a higher AVP diameter to patient weight ratio(Odds-ratio:2.33,95%confidence interval 1.31–4.13,p=0.004,optimal cut off:1.45).Conclusions:Both AVPs are safe and effective for percutaneous occlusions in children under *** devices represent an alternative“off label”use for well selected paediatric patients.

关键词： Amplatzer vascular plug(AVP)ii and IV cardiovascular occlusions off-label use children under 10 years efficacy safety

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Effect of advanced age on plasma homocysteine levels and its association with ischemic stroke in non-valvular atrial fibrillation

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Journal of Geriatric Cardiology 2017年第12期14卷 743-749页

作者： Yan YAO Li-Jian GAO Yong ZHOU Jing-Hua ZHAO Qiang LV Jian-Zeng DONG Mei-Sheng SHANG department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing China Center for coronary heart disease Department of Cardiology Cardiovascular Institute & Fuwai Hospital CAMS & PUMC National Center for Heart Dis- ease Beijing China Beijing Institute of heart Lung and Blood Vessel Diseases Beijing Anzhen Hospital Capital Medical University Beijing China

Background Elevated homocysteine （Hcy） has been reported to be associated with cardiovascular events in atrial fibrillation （AF） pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of ad- vanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecu- tive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65-74 years and aged over 75 years （15.7 ±4.6 μmol/L, 17.1 ±4.9 μmol/L, both P 〈 0.01 compared with the first four age groups）. Hcy was much higher in AF patients than in controls at the same age group （all P 〈 0.05）. The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65-74 years [odds ratios （OR）： 1.742, 95% confidence interval （CI）： 1.223-2.482, P = 0.002] and age ≥ 75 years （OR： 2.637, 95% CI： 1.605-4.335, P 〈 0.001） were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients.

关键词： Advanced age Atrial fibrillation Homocysteine ischemic stroke

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The role of degenerative pathways in the development of irreversible consequences after brain ischemia

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Neural Regeneration Research 2019年第6期14卷 982-983页

作者： Ryszard Pluta Marzena U?amek-Kozio? Laboratory of ischemic and Neurodegenerative Brain Research Mossakowski Medical Research CentrePolish Academy of Sciences First department of Neurology Institute of Psychiatry and Neurology

ischemic stroke and irreversible consequences:ischemic stroke in humans is the second most common cause of death in the world(Mozaffarian et al.,2016).The outcomes after a stroke are often dependent on complications,including motor disorders,depression and dementia(Pluta et al.,2018a),which causes a high risk of re-hospitalization and/or palliative *** is also the main reason for long-term disability in people after stroke,with up to half of those who survived the stroke will not regain their independence until the end of their lives(Mozaffarian et al.,2016).According to epidemiological forecasts,human ischemic stroke will soon become the dominant cause of death worldwide(Bejot et al.,2016)as well as dementia with the phenotype of Alzheimer’s disease(AD;Kim and Lee 2018).It is suggested that human ischemic stroke and experimental brain ischemia in animals are associated with the possible development of AD neuropathology(Pluta et al.,2018a).

关键词： degenerative pathways irreversible consequences brain ischemia

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Genotoxicity of gold nanoparticles functionalized with indolicidin towards Saccharomyces cerevisiae

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Journal of Environmental Sciences 2018年第4期30卷 138-145页

作者： Elisabetta de Alteriis Annarita Falanga Stefania Galdiero Marco Ouida Valeria Maselli Emilia Galdiero department of Biology University of Naples "Federico II" 80100 Naples Italy department of Pharmacy University of Naples "Federico II" 80134 Naples Italy

The toxic effects of gold nanoparticles surface-functionalized with the antimicrobial peptide indolicidin（Au NPs-indolicidin） towards the yeast Saccharomyces cerevisiae, one of the major eukaryotic model organisms, have been evaluated. Growth and survival,genotoxicity, as measured by comet assay, and expression of the YCA1, an apoptosis indicating gene, following 72 hr exposure of yeast to Au NPs-indolicidin, and to Au NPs and indolicidin alone have been examined. The gold nanoparticles exerted toxicity with DNA damage, accompanied by reactive oxygen species production（ROS）, but they do not inhibit yeast growth and viability. Genotoxicity was less pronounced for surface-functionalized nanoparticles, showing that S. cerevisiae is quite resistant to the complex Au NPs-indolicidin.A progressive reduction of the genotoxic effect was observed along 72 hr exposure,presumably due to the activation of DNA repair mechanisms. These findings suggest the occurrence of a physiological protective response of S. cerevisiae towards nanoparticles,thereby providing useful information to the assessment of the environmental impact of metal nanoparticles.

关键词： Ecotoxicity Antimicrobial peptide Comet assay Yeast Nanoparticles Oxidative stress

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