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Precision Clinical Medicine 2021年第3期4卷 192-203页

作者： Yiming Li Kaiyu Jia Yuheng Jia Yong Yang Yijun Yao Mao Chen Yong Peng Department of cardiology West China HospitalSichuan UniversityChengdu 610041China

Risk assessment in coronary artery disease plays an essential role in the early identification of high-risk ***,conventional invasive imaging procedures all require long intraprocedural times and high *** rapid development of coronary computed tomographic angiography(CCTA)and related image processing technology has facilitated the formulation of noninvasive approaches to perform comprehensive *** has shown that CCTA has outstanding performance in identifying the degree of stenosis,plaque features,and functional ***,advancements in radiomics and machine learning allowmore comprehensive interpretations of CCTA *** paper reviews conventional as well as novel diagnostic and risk assessment tools based on CCTA.

关键词： coronary computed tomographic angiography(CCTA) coronary artery disease risk assessment prediction value

Arrhythmic risk stratification in ischemic,non-ischemic and hypertrophic cardiomyopathy:A two-step multifactorial,electrophysiology study inclusive approach

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World Journal of cardiology 2022年第3期14卷 139-151页

作者： Petros Arsenos Konstantinos A Gatzoulis Dimitrios Tsiachris Polychronis Dilaveris Skevos Sideris Ilias Sotiropoulos Stefanos Archontakis Christos-Konstantinos Antoniou Athanasios Kordalis Ioannis Skiadas Konstantinos Toutouzas Charalambos Vlachopoulos Dimitrios Tousoulis Konstantinos Tsioufis First Department of cardiology National and Kapodistrian University of AthensHippokration HospitalAthens 11527AttikaGreece Athens Heart Center Athens Medical CenterAthens 15125AttikaGreece Department of cardiology Hippokration HospitalAthens 11527AttikaGreece Fifth Department of cardiology Hygeia HospitalMarousi 15123AttikaGreece

Annual arrhythmic sudden cardiac death ranges from 0.6%to 4%in ischemic cardiomyopathy(ICM),1%to 2%in non-ischemic cardiomyopathy(NICM),and 1%in hypertrophic cardiomyopathy(HCM).Towards a more effective arrhythmic risk stratification(ARS)we hereby present a two-step ARS with the usage of seven non-invasive risk factors:Late potentials presence(≥2/3 positive criteria),premature ventricular contractions(≥30/h),non-sustained ventricular tachycardia(≥1episode/24 h),abnormal heart rate turbulence(onset≥0%and slope≤2.5 ms)and reduced deceleration capacity(≤4.5 ms),abnormal T wave alternans(≥65μV),decreased heart rate variability(SDNN440 ms in males and>450 ms in females)which reflect the arrhythmogenic mechanisms for the selection of the intermediate arrhythmic risk patients in the first *** the second step,these intermediate-risk patients undergo a programmed ventricular stimulation(PVS)for the detection of inducible,truly high-risk ICM and NICM patients,who will benefit from an implantable cardioverter *** HCM patients,we also suggest the incorporation of the PVS either for the low HCM Risk-score patients or for the patients with one traditional risk factor in order to improve the inadequate sensitivity of the former and the low specificity of the latter.

关键词： Arrhythmic sudden cardiac death Risk stratification Non-invasive risk factors Electrophysiology study Two-step approach Arrhythmias in cardiomyopathy

Risk analysis of gastrointestinal bleeding in hospital patients with acute myocardial infarction undergoing primary PCI

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Journal of Geriatric cardiology 2023年第5期20卷 386-390页

作者： Yan-Yan JIN Ming YE Hai GAO Center for Coronary Artery Disease Division of CardiologyBeijing Anzhen HospitalCapital Medical UniversityBeijingChina

Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the cornerstone of acute myocardial infarction(AMI)management,both invasive and conservative.[1,2]This dual strategy improved ischemic outcomes but was offset by an increased bleeding *** prognostic importance of bleeding events has been well established over the past decades,as several studies have shown a strong association between bleeding and mortality.[3]The CRUSADE score is superior to other scores in predicting in-hospital major bleeding *** this regard,in its non-ST elevation acute coronary syndromes(NSTE-ACS)guidelines,the European Society of cardiology(ESC)stated that the CRUSADE score could be considered for bleeding risk quantification of coronary angiography in NSTE-ACS patients(class IIb,level B evidence).[4]However,the most common site of spontaneous.

关键词： bleeding acute patients

Performance of dual-source CT with high pitch spiral mode for coronary stent patency compared with invasive coronary angiography

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Journal of Geriatric cardiology 2016年第10期13卷 817-823页

作者： Xia YANG Qiang YU Wei DONG Zhen-Hong FU Jun-Jue YANG Jun GUO Yun-Dai CHEN Department of cardiology Chinese PLA General Hospital. Beijing China Department of Hepatobiliary Surgery Chinese PLA General Hospital Beijing China

Objective To investigate the performance of dual-source computed tomography （DSCT） using high-pitch spiral fliPS） mode for coronary stents patency. Methods We conducted a prospective study on 120 patients with 260 previous stents implanted due to recurred suspicious symptoms of angina scheduled for invasive coronary angiography （ICA）, while DSCT were conducted using HPS mode. Results There was no significant impact of age, body mass index or heat rate （HR） on image quality （P 〉 0.05）, while HR variability had a slight impact on that （P 〈 0.05）. Sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） of DSCT in detection of in-stent restenosis （ISR） based per-patient were 92.3%, 96.7%, 88.9%, and 97.8%, respectively. And those based per-stent were 87%, 96.8%, 83.3%, and 97.7% with un-assessment stents, 97.4%, 99.5%, 97.4%, and 99.5% without un-assessment stents. There was significant differ- ence on sensitivity, specificity, PPV and NPV between diameter 〉 3.0 mm group （93.3%, 97.9%, 87.5%, and 98.9%） and diameter 〈 3.0 mm group （80%, 93.3%, 80.0%, and 93.3%）（P 〈 0.05）, and that between stent number 〉 3 group （82.3%, 77.8%, 66.7%, and 60%） with 〈 3 group （97.3%, 80%, 96.5%, and 75%）. The effective dose of DSCT （1.4 ± 0.5 mSv） is significantly less than that by invasive coronary angiography [4.0 ± 0.8 mSv （P 〈 0.01）]. Conclusion DSCT using HPS mode provides good diagnostic performance on stent patency with lower effective dose in patients with HR 〈 65 beats/rain.

关键词： Coronary angiography High-pitch spiral mode Percutaneous coronary intervention Stent

Impact of invasive treatment strategy on health-related quality of life six months after non-ST-elevation acute coronary syndrome

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Journal of Geriatric cardiology 2014年第3期11卷 206-211页

作者： Li-Xia YANG Yu-Jie ZHOU Zhi-Jian WANG Yue-Ping LI Meng CHAI Department of cardiology Beijing Anzhen Hospital Capital Medical University N0. 2 Anzhen Avenue Chaoyang District Beijing 100029 China

BackgroundFew studies have compared change in the health-related quality of life （HRQL） following treatment of non-ST-elevation acute coronary syndrome （NSTE-ACS） with either percutaneous coronary intervention （PCI） or coronary artery bypass grafting （CABG）. This study is tocompare changes in HRQL six months after hospital discharge between NSTE-ACS pa-tients who underwent either PCI or *** HRQL was assessed using the Seattle angina questionnaire at admission and six months after discharge in 1012 consecutive patients with NSTE-ACS. To assess associations of PCI and CABG with HRQL changes, logistic regression models were constructed treating changes in the score of each dimension of the Seattle angina question-naire as dependent *** Although both the PCI and CABG groups experienced angina relief and other improvements at 6-month follow-up （P〈0.001）, the CABG relative to PCI group showed more significant improvements in angina frequency （P= 0.044） and quality of life （P= 0.028）. In multivariable logistic analysis, CABG also was an independent predictor for both im-provement of angina frequency （OR： 1.62, 95%CI： 1.09-4.63,P= 0.042） and quality of life （OR： 2.04, 95%CI： 1.26-6.92,P= 0.038） relative to *** In patients with NSTE-ACS, both PCI and CABG provide great improvement in disease-specific health status at six months, with that of CABG being more prominent in terms of angina frequency and quality of life.

关键词： Non-ST elevation acute coronary syndrome Quality of life Therapeutic strategy

Osteopontin targeted theranostic nanoprobes for laser-induced synergistic regression of vulnerable atherosclerotic plaques

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Acta Pharmaceutica Sinica B 2022年第4期12卷 2014-2028页

作者： Mengqi Xu Cong Mao Haoting Chen Lu Liu Yabin Wang Abid Hussain Sulei Li Xu Zhang Ruslan G.Tuguntaev Xing-Jie Liang Weisheng Guo Feng Cao Department of cardiology National Clinical Research Center for Geriatric Diseases&Second Medical Center of Chinese PLA General HospitalBeijing 100853China Department of Minimally invasive Interventional Radiology Key Laboratory of Molecular Target&Clinical PharmacologySchool of Pharmaceutical Sciences&the Second Affiliated HospitalGuangzhou Medical UniversityGuangzhou 510260China Laboratory of Controllable Nanopharmaceuticals Chinese Academy of Sciences(CAS)Center for Excellence in Nanoscience and CAS Key Laboratory for Biomedical Effects of Nanomaterials and NanosafetyNational Center for Nanoscience and TechnologyBeijing 100190China Department of Urology Chinese PLA General HospitalBeijing 100853China

Vulnerable atherosclerotic plaque(VASPs)is the major pathological cause of acute cardiovascular *** detection and precise intervention of VASP hold great clinical significance,yet remain a major *** therapy(PDT)realizes potent ablation efficacy under precise manipulation of laser *** this study,we constructed theranostic nanoprobes(NPs),which could precisely regress VASPs through a cascade of synergistic events triggered by local irradiation of lasers under the guidance of fluorescence/MR *** NPs were formulated from human serum albumin(HSA)conjugated with a high affinity-peptide targeting osteopontin(OPN)and encapsulated with photosensitizer IR780 and hypoxia-activatable tirapazamine(TPZ).After intravenous injection into atherosclerotic mice,the OPN-targeted NPs demonstrated high specific accumulation in VASPs due to the overexpression of OPN in activated foamy macrophages in the carotid *** the visible guidance of fluorescence and MR dual-model imaging,the precise near-infrared(NIR)laser irradiation generated massive reactive oxygen species(ROS),which resulted in efficient plaque ablation and amplified hypoxia within *** response to the elevated hypoxia,the initially inactive TPZ was successively boosted to present potent biological suppression of foamy *** therapeutic administration of the NPs for 2 weeks,the plaque area and the degree of carotid artery stenosis were markedly ***,the formulated NPs displayed excellent *** conclusion,the developed HSA-based NPs demonstrated appreciable specific identification ability of VASPs and realized precise synergistic regression of atherosclerosis.

关键词： Vulnerable atherosclerotic plaques Theranostic nanoprobe Human serum albumin Osteopontin Photodynamic therapy Hypoxia Reactive oxygen species Tirapazamine

Congenital coronary artery anomalies:what about the young?

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Journal of Geriatric cardiology 2004年第1期1卷 15-16页

作者： Phillip Moore Division of Pediatric cardiology University of California San FranciscoUSA

Drs. Rigatem, Rigatelli, and Trivellato present a complete retrospective review of the prevalence of congenital coronary abnormalities in a cohort of consecutive adult patients catheterized at their institution and compare them to younger patients ＜ 65 years of *** review in detail the clinical implications of these findings and then offer an algorithm for management. This article is particularly timely and significant as we move into an era of non-invasive coronary imaging with CT,MRI, and improved echo that will allow ns to make these diagnoses more often and with greater accuracy in younger patients. This will have a significant impact on the nanagement of symptomatic patients diagnosed at catheterization but also on asymptomatic patients diagnosed on screening evaluations.

关键词： retrospective young prevalence cohort fistula 曲加 abnormal tonic 玄石 sinus

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胃食管反流会引起冠心病患者心肌缺血?

世界核心医学期刊文摘(心脏病学分册) 2006年第2期 59-60页

作者： Dobrzycki S. Baniukiewicz A. Korecki J. 张宪伟 Department of invasive cardiology Medical University in Bialystok Ul. Sklodowskiej 24a 15-276 Bialystok Poland

Background: Gastro-esophageal reflux disease(GERD) may cause chest pain. The aim was to determine the correlation between ischemia and gastro-esophageal reflux in patients with CAD and to assess the influence of short-term “ anti-reflux” therapy on the ischemia in patients with GERD and CAD. Methods: Fifty patients with angiographically proven CAD underwent simultaneous 24-h continuous ECG and esophageal pH monitoring. We assessed the number of ST-segment depression episodes(ST dep.) and total duration of ischemic episodes, expressed as total ischemic burden(TIB). In pH-metry, we assessed: time percentage of pH lower than 4, total time of pH lower than 4 and the number of pathological refluxes(PR). Patients fulfilling the GERD criteria received a 7-day therapy with omeprazol 20 mg bid. On the 7th day of therapy, simultaneous Holter and esophageal pH monitoring was repeated. Results: Total number of 224 PRs in 42 patients(84% ) was recorded during esophageal pH- metry. GERD criteria were fulfilled in 23 patients(46% ). Out of 218 episodes of ST dep., 45(20.6% ) correlated with PR. GERD patients had larger TIB and higher number of ST dep.(p< 0.015 and p< 0.035, respectively). The anti-reflux therapy reduced all analyzed parameters of esophageal pH monitoring(p< 0.0022) as well as the number of ST dep.(p< 0.012) and TIB(p< 0.05). Conclusions: Gastro-esophageal reflux disease is common in patients with CAD and may provoke myocardial ischemia. Short-term proton pump inhibitors therapy that restores normal esophageal pH significantly reduces myocardial ischemia, possibly due to elimination of acid-derived esophago-cardiac reflex compromising coronary perfusio - the phenomenon known as “ linked angina” .

关键词：心肌缺血患者食管反流 GERD

Calcified plaque: the Achilles' Heel of present computed tomography coronary angiography for the elderly?

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Journal of Geriatric cardiology 2006年第1期3卷 15-16页

作者： Gianluca Rigatelli Interventional cardiology Unit Rovigo General Hospital Rovigo Italy

　　Nine percent to 27% of cardiac catheterizations today showed either angiographic normal coronary arteries or minimal atherosclerosis. 1,2 Given the expense of cardiac catheterization and the desire to use this valuable resource for therapeutic rather than diagnostic purpose, there is a strong impetus to develop non-invasive means of accurately detecting significant coronary artery stenosis.……

关键词： the Achilles Calcified plaque Heel of present computed tomography coronary angiography for the elderly

Validation of the use of foreign gas rebreathing method for non-invasive determination of cardiac output in heart disease patients

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2005年第12期6卷 1157-1162页

作者： DONG Liang（董樑） WANG Jian-an（王建安） JIANG Chen-yang（蒋晨阳） Department of cardiology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou 310016 China

Objective: To compare a new device (Innocor) for non-invasive measurement of cardiac output (CO) by foreign gas rebreathing method with conventional techniques used in the measurements of cardiac function. Methods: Cardiac outputs measured by Innocor (CORB) were compared with CO obtained by echocardiography (COEC), Swan-Ganz thermodilution (COTD), and left ventricle radiography (COLVR) in 34 patients subjected to cardiac catheterization. Values obtained from the four methods were analyzed by linear regression and paired values were compared by the method of Bland and Altman in SPSS. Results: There was strong positive correlation (r=0.94) between Innocor cardiac output values and the corresponding values obtained by ther-modilution and between COEC and COLVR values. Thermodilution appears to overestimate cardiac output when compared to the values obtained with Innocor by (0.66±0.22) L/min (Pinvasive measurement of cardiac output with good prospects for clinical application in heart disease patients.

关键词： Indirect Fick (foreign gas rebreathing) Swan-Ganz Cardiac output Left ventricle radiography Echocardiography