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Intracoronary pressure gradient measurement in acute myocardial infarction patients with the no-reflow phenomenon during primary percutaneous coronary intervention

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Chinese Medical Journal 2020年第7期133卷 766-772页

作者： Ming-Dong Gao En-Yuan Zhang Yuan-Ying Liu Xiao-Wei Li Jian-Yong Xiao Gen-Yi Sun Yin Liu Department of coronary Care unit Tianjin Chest HospitalTianjin 300222China

Background:Various experimental and clinical studies have reported on coronary microcirculatory dysfunction("no-reflow"phenomenon).Nevertheless,pathogenesis and effective treatment are yet to be fully *** study aimed to measure the intracoronary pressure gradient in the no-reflow artery during emergent percutaneous coronary intervention and explore the potential mechanism of ***:From September 1st,2018 to June 30th,2019,intracoronary pressure in acute myocardial infarction patient was continuously measured by aspiration catheter from distal to proximal segment in the Department of coronary Care unit,Tianjin Chest Hospital,respectively in no-reflow arteries(no-reflow group)and arteries with thrombolysis in myocardial infarction-3 flow(control group).At least 12 cardiac cycles were consecutively recorded when the catheter was pulled *** forward systolic pressure gradient was calculated as proximal systolic pressure minus distal systolic *** between groups was made using the Student t test,Mann-Whitney U-test or Chi-square test,as ***:Intracoronary pressure in 33 no-reflow group and 26 in control group were *** intracoronary forward systolic pressure gradient was-1.3(-4.8,0.7)and 3.8(0.8,8.8)mmHg in no-reflow group and control group(Z=-3.989,Pcoronary forward pressure gradient showed significant difference between that before and after nicorandil medication(Z=-3.668,Pcoronary revascularization is significantly associated with local hemodynamic abnormalities in the coronary *** nicorandil administration at the distal segment of a coronary artery with an aspiration catheter could improve the microcir

关键词： Acute myocardial infarction coronary hemodynamics Intracoronary pressure gradient No-reflow Primary percutaneous coronary intervention

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Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

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Frontiers of Nursing 2024年第1期11卷 67-76页

作者： Jamileh Farokhzadian Somayeh Jouparinejad Mahdieh Montazeri Elham Bakhshipour Amirreza Sabzi Fatemeh Falahati-Marvast Nursing Research Center Kerman University of Medical SciencesKermanIran coronary Care unit Shafa HospitalKerman University of Medical SciencesKermanIran Department of Health Information Sciences Faculty of Management and Medical Information SciencesKerman University of Medical SciencesKermanIran Medical Informatics Research Center Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran Biomechanics and Movement Sciences Interdisciplinary Program University of DelawareNewarkDEUSA Student Research Committee Shiraz University of Medical SciencesShirazIran Department of Health Technology Assessment School of Public HealthShahid Sadoughi University of Medical SciencesYazdIran

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care *** cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP *** intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,*** received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate *** competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and *** planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

关键词： evidence-based practice nursing informatics nursing informatics competency information literacy critical care nursing

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

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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 valuecoronary stenosis.

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

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Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

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World Journal of Clinical Cases 2024年第7期12卷 1235-1242页

作者： Ling Wang Deng-Yan Long Intensive Care unit People's Hospital of Qiandongnan Miao and Dong Autonomous PrefectureKaili 556000Guizhou ProvinceChina

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse ***,there is a lack of effective preventive *** To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and *** Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU *** data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were *** relationships between these variables and ICU-AW were *** iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic *** Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW ***,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical *** most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechani

关键词： Intensive care unit-acquired weakness Risk factors Machine learning Prevention Strategies

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Association of serum complement C1q with cardiovascular outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention

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Journal of Geriatric Cardiology 2022年第12期19卷 949-959,1007-1010页

作者： Qiu-Xuan LI Xiao-Teng MA Qiao-Yu SHAO Zhi-Qiang YANG Jing LIANG Li-Xia YANG Dong-Mei SHI Yu-Jie ZHOU Zhi-Jian WANG Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic DiseaseClinical Center for Coronary Heart DiseaseCapital Medical UniversityBeijingChina

OBJECTIVE To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI),and evaluate the value of C1q modified by high-sensitivity C-reactive protein(hs-CRP)levels as an independent *** As a single-center prospective observational study,we analyzed 1701 patients who had received primary or elective PCI for ACS at Beijing Anzhen Hospital,Capital Medical University,Beijing,China between June 1,2016 and November 30,*** associations of C1q modified by hs-CRP with major adverse cardiovascular events(MACE)were determined in survival *** Patients with the lowest C1q tertile had the highest cumulative risk of MACE(log-rank P=0.007).In fully adjusted Cox regression models,stratifying the total population according to hs-CRP dichotomy,C1q was significantly associated with MACE in patients with hs-CRP levels less than 2 mg/L but not in those with 2 mg/L or more(P_(interaction)=0.02).In patients with hs-CRP levels less than 2 mg/L,with the lowest C1q tertile as reference,the risk of MACE was reduced by 40.0%in the middle C1q tertile[hazard ratio(HR)=0.600,95%CI:0.423–0.852,P=0.004]and by 43.9%in the highest C1q tertile(HR=0.561,95%CI:0.375–0.840,P=0.005).CONCLUSIONS Serum complement C1q is significantly associated with cardiovascular outcomes in patients with ACS undergoing PCI,only when hs-CRP levels are less than 2 mg/*** finding implicates the usefulness of C1q for the risk stratification in ACS patients with reduced systemic inflammation.

关键词： C1q patients coronary

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Clinical phenotype and genetic analysis of patients with left ventricular noncompaction caused by the biallelic mutation of MYBPC3 and MYH7

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China Medical Abstracts(Internal Medicine) 2024年第1期41卷 38-38页

作者：张亚辉 Dept Acute coronary Syndrome Ward Coronary Artery Dis CenterBeijing Anzhen HospCapital Med UnivBeijing 100029

Objective To explore the relationship between pathogenic gene,mutation and phenotype of left ventricular noncompaction (LVNC) patients and their family *** The subjects were the proband with LVNC and her family *** medical history including electrocardiogram,echocardiography and cardiac magnetic resonance examination of the proband and family members was collected.

关键词： patients ventricular cardiac

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A case report of chylous ascites after cardiac surgery

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Emergency and Critical Care Medicine 2024年第1期4卷 42-45页

作者： Shuaishuai Yuan Pailing Xie Xiantao Liu Peijun Li The University of Hong Kong-Shenzhen Hospital Cardiovascular Medicine Center Cardiac Intensive Care unit ShenzhenGuangdongChina.

Background:Chylous ascites(CA),an emulsion rich in triglycerides,is a rare type of ascites,especially after cardiac ***,there are few reports of the occurrence of CA after mitral valve replacement,aortic valve replacement,tricuspid valvuloplasty,and coronary artery bypass *** presentation:We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence,aortic incompetence,tricuspid incompetence,and coronary atherosclerotic heart *** days after surgery,3000 mL of milky-yellow ascites appeared in the abdominal cavity,diagnosed as CA by laboratory *** ascites gradually disappeared after being drained,and the patients *** curative was objective,but the exact cause is not ***:Although CA is rare,it may occur during the surgical intervention in cardiac surgery.

关键词： Cardiac intensive care unit Cardiac valve replacement Case report Chylous ascites coronary artery bypass graft Department of cardiac surgery

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Impact of emergency percutaneous coronary intervention on outcomes of ST-segment elevation myocardial infarction patients complicated by out-of-hospital cardiac arrest

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Chinese Medical Journal 2012年第8期125卷 1405-1409页

作者： LIU Hong-wei PAN Wei WANG Lan-feng SUN Yan-ming LI Zhu-qin WANG Zhong-hua coronary Care unit Division of CardiologyFirst Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiang 150001China

Background Cardiac arrest is one of the most serious complications of acute myocardial infarction （AMI）, especially in the out-of-hospital patients. There is no general consensus as to whether percutaneous coronary intervention （PCI） is effective in treating ST-segment elevation myocardial infarction （STEMI） patients complicated by out-of-hospital cardiac arrest （OHCA）. In our study, we evaluated the efficacy of PCI in treating STEMI patients complicated by OHCA through observing their clinical conditions in hospital; including total mortality, adverse cardiac events, stroke, acute renal failure, and gastrointestinal bleeding events. Methods A total of 1827 STEMI patients were enrolled in this study, where 81 were STEMI with OHCA. Between the patients with and without OHCA, and the OHCA patients with and without PCI, we compared the clinical characteristics during hospitalization, including total mortality and incidences of adverse cardiac events, and stroke. Results Compared to the patients without OHCA, the OHCA patients had significantly lower systolic blood pressure （P 〈0.05） and a faster heart rate （P〈0.05）, and a higher percentage of Killip class IV or Glasgow coma scale （GCS）〈7 on admission （P 〈0.001）. And the in-hospital mortality was higher in the OHCA patients （55.6% vs. 2.4%, P 〈0.001）. Comparing the OHCA patients without PCI to the patients with PCI, there was no obvious difference of heart rate, blood pressure or the percentage of Killip class IV and GCS -〈7 on admission, but the incidences of cardiogenic shock, stroke were significantly lower in the with-PCI group during hospitalization （P 〈0.001, P 〈0.05）. And the in-hospital mortality of the OHCA patients receiving PCI was significantly lower （36.7% vs. 84.3%, P 〈0.001）. Conclusions During hospitalization, the incidence of adverse events and mortality are higher in the STEMI with OHCA patients, comparing with the STEMI without OHCA. Emergency PCI reduces the incidence of adverse events and decreases

关键词： percutaneous coronary intervention out-of-hospital cardiac arrest ST-elevation myocardial infarction prognosis

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Optical coherence tomography-guided excimer laser coronary angioplasty in overlapping stents with severe under-expansion and underlying calcification

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Journal of Geriatric Cardiology 2021年第2期18卷 146-149页

作者： Guang-Yao ZHAI Xun-Xun FENG Jian-Long WANG Yu-Yang LIU Qian-Yun GUO Yu-Jie ZHOU Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic DiseaseClinical Center for Coronary Heart DiseaseCapital Medical UniversityBeijingChina

Excimer laser coronary angioplasty(ELCA)modifies atherosclerotic plaques through its photochemical,photothermal and photodynamic characteristics,while making up for the limitations of intimal disassembly and restenosis of balloon angioplasty without causing significant *** American Food and Drug Administration approved of the first clinical application of ELCA in *** then,ELCA has been used as an adjunct therapy in the treatment of various subsets of coronary artery *** considered to be a relatively safe and effective technique for coronary lesions when routine angioplasty is technically insufficient.

关键词： coronary angioplasty routine

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Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report

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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang Intensive Care unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China Department of Cardiac Surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely ***,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important *** the incidence of LVT during VA-ECMO is not high,the consequences of embolization are *** SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 *** excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for *** day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic *** ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral *** LVT with high mobility during VA-ECMO may cause embolism in important ***,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

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