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Journal of Geriatric Cardiology 2006年第1期3卷 29-34页

作者： Sze Piaw CHIN Tiong Kiam ONG Chee Khoon LIEW M.Tobias Seyfarth Fong Yean Yip ALAN Houng Bang LIEW Kui Hian SIM Dept of Cardiology Sarawak General Hospital siemens cardiac solutions erlangen Germany

Background and objectives The recent joint ACCF/AHA clinical competence statement on cardiac imaging with multi-detector computed tomography recommended a minimum of 6 months training and 300 contrast examinations, of which the candidate must be directly involved in at least 100 studies. Whether this is adequate to become proficient in interpretation of coronary computed tomogsignificant coronary stenosis in a center with 1 year's experience using a 64-row scanner. Methods A total of 778 patients underwent contrast-enhanced CTA between January and December 2005. Out of these patients, 301 patients also underwent contrast-enhanced conventional coronary angiography (CCA). These patients were divided into 4 groups according to the time the examination was underwent. Group Q1: first quarter of the year (n=20), Group Q2: second quarter (n=128), Group Q3: third quarter (n=134), and Group Results The sensitivity, specificity, positive, and negative predictive values were Q1 - 64%, 89%, 49% and 94%, respectively; Q2 -79%, 96%, 74% and 97%, respectively; Q3 - 78%, 96%, 74%, 97%, respectively, and Q4 - 100% for all. Conclusions In a center with formal training and high caseload, our accuracy in CTA analysis reached a plateau after 6 months experience. Test-bolus protocols produce better image quality and can improve accuracy. New centers embarking on CTA will need to overcome an initial 6-month learning curve depending upon the caseload during which time they should consider correlation with CCA.

关键词： computed tomography training angiography coronary artery disease

Feasibility and accuracy of coronary imaging in elderly patients using the 64-row multi-detector computed tomography: a correlation study with conventional coronary angiography

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Journal of Geriatric Cardiology 2006年第1期3卷 9-14页

作者： Chee Khoon LIEW Sze Piaw CHIN Tiong Kiam ONG Seyfarth Tobias Yean Yip FONG Choon Kiat ANG Houng Bang LIEW Rapaee ANNUAR Kui Hian SIM Deptartment of Cardiology Sarawak General Hospital SarawakMalaysia siemens cardiac solutions erlangen Germany Universitv Malaysia Sarawak Malaysia

Background Elderly patients generally have higher occurrence of coronary calcification, increased heart rate and difficulty with prolonged breath-holding. The aim of our study was to investigate the feasibility and accuracy of using 64-row multi-detector computed tomography (MDCT) in the assessment of coronary artery stenoses in elderly patients. Methods One hundred and fifty two patients with suspected or known coronary artery disease were divided into 4 groups according to their age (Group A: 40-49 years,n=34; Group B: 50-59 years, n=57; Group C: 60-69 years, n=48; Group D: 70 years and above; n=13). Coronary CT angiography (CTA) using a 64-row MDCT was performed and the findings were compared with that of conventional coronary angiography (CCA).Using axial images, multi-planar reconstructions (MPR) and maximum intensity projections (MIP), coronary segments of lumen diameter = 1.5mm were analyzed for the presence of significant stenosis (= 50% ). Results Percentages of poor image quality from coronary CTA preventing reliable correlations with CCA were 21%, 14%, 19% and 62% in Groups A to D respectively. Patients in Group D had significantly higher calcium scores compared with the other groups (P＜0.001). In patients where CTA images were of acceptable quality, percentages of accurate correlations with CCA were 89.8%, 93.4%, 86.6% and 78.0% for Groups A to D *** were no significant difference in serum creatinine, heart rate and contrast volume between the 4 groups. Conclusions The 64-row MDCT coronary angiography was less accurate and feasible for patients aged 70 years or above due to heavy coronary calcification and inability to perform a satisfactory breath-hold. However, a high diagnostic accuracy with the MDCT is possible in patients aged less than 70 years.

关键词： computed tomography angiography coronary artery disease elderly

Assessment of left ventricular ejection fraction: comparison of two dimensional echocardiography, cardiac magnetic resonance imaging and 64-row multi-detector computed tomography

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Journal of Geriatric Cardiology 2006年第1期3卷 2-8页

作者： Chee Khoon LIEW Rapaee ANNUAR Tiong Kiam ONG Sze Piaw CHIN Tobias Seyfarth Yean Yip FONG Choon Kiat ANG Houng Bang LIEW Kui Hian SIM Department of Cardiology Sarawak General Hospital Sarawak Malaysia University Malaysia Sarawak siemens cardiac solutions erlangen Germany Department of Cardiology Sarawak General Hospital SarawakMalaysia

Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson *** The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P ＜0.01) or Simpson method (r = 0.92, P＜0.01). It also correlated well with LVEF measured using 2D echo (r = 0.80, P ＜ 0.01). Conclusion LVEF measurements by 64-row MDCT correlated well with LVEF measured by CMR and 2D echo. The correlation between 64-row MDCT and CMR was better than the correlation between 2D echo with CMR. Standard data set from a 64-row MDCT coronary study can be reliably used to calculate the LVEF.

关键词： ejection fraction echocardiography magnetic resonance imaging computed tomography

High-resolution computed tomography in patients with atypical 'cardiac' chest pain: a study investigating patients at 10-year cardiovascular risks defined by the Framingham and PROCAM scores

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Journal of Geriatric Cardiology 2006年第1期3卷 17-21页

作者： Choon Kiat ANG Alan Yean Yip FONG Sze Piaw CHIN Tiong Kiam ONG Seyfarth M Tobias Chee Khoon LIEW Rapaee ANNUAR Houng Bang LIEW Kui Hian SIM Deptartment of Cardiology Sarawak General Hospital Sarawak Malaysia siemens Medical solutions Germany Deptartment of Cardiology Sarawak General Hospital SarawakMalaysia University Malaysia Sarawak Malaysia

Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score ＞400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores.

关键词： multi-detector computed tomography atypical 'cardiac' chest pain coronary artery disease risk stratification

Effect of Cardioplegia for Myocardial Protection in Pediatric cardiac Surgery:A Network Meta-Analysis

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Congenital Heart Disease 2021年第6期16卷 609-645页

作者： Ke Zhou Dongyu Li Xintong Zhang Wensheng Wang Shusen Li Guang Song Department of cardiac Surgery Shengjing Hospital of China Medical UniversityShenyangChina Department of Ultrasound Shengjing Hospital of China Medical UniversityShenyangChina

Cardioplegia has been widely used to reduce myocardial injury during pediatric cardiac surgery;however,which cardioplegia solution has the best protective effect has not been ***,we compared the myocardial protective effects of different cardioplegia solutions used in pediatric cardiac *** databases were searched to identify the relevant randomized controlled trials.A network meta-analysis with a Bayesian framework was *** outcomes included the following biochemical and clinical outcomes:serum concentrations of the creatine kinase-myocardial band at 6 h postoperatively;cardiac troponin I(cTnI)at 4,12,and 24 h postoperatively;spontaneous beating after declamping;postoperative arrhythmias;inotropic support percentage and duration;mechanical ventilation hours;intensive care unit stay in days;hospital stay in days;and *** group treated with cold crystalloid cardioplegia(cCCP)was chosen as the control *** 22 studies involved 1529 *** types of cardioplegia solutions were described in these studies,including cold blood cardioplegia,cCCP,del Nido,histidine-tryptophan-ketoglutarate(HTK),terminal warm blood cardioplegia,and warm blood cardioplegia(wBCP).The serum concentrations of the 24-h cTnI with wBCP(MD=−2.52,95%CI:−4.74 to−0.27)was significantly lower than *** serum concentrations of the 24-h cTnI with HTK(MD=4.91,95%CI:2.84–7.24)was significantly higher than *** was no significant difference in other biochemical and clinical outcomes when compared to *** conclusion,wBCP may have a superior myocardial protective effect with lower 24-h cTnI levels postoperatively and similar clinical outcomes after pediatric cardiac surgery.

关键词： Cardioplegia pediatric cardiac surgery cardiac troponin I meta-analysis

Advantage of Cariporide(HOE642)over Citrate as A Low Ca++ Strategy in Cardioplegia

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Advantage of Cariporide(HOE642)over Citrate as A Low Ca++ St...

心脏MR压缩感知超快速电影序列评价左右心室收缩功能的应用价值

The Fifth China International Congress on Thoracic and Cardiovasculal Surgery

作者： RosenfeldtFL FukuhiroY WowkM OuR PepeS cardiac Surgical Research Unit Baker InstituteMelbourne Australia

Backgroud:Post-ischaemic intracellular Caoverload impairs myocardial recovery after cardio-plegia(CP).Caoverload may be countered by direct reduction of extracellular Ca,citrate chela-tion of Cain CP or indirectly by Na/H exchanger inhibition(Na/H I).The recentGuardian trial of Na/H with Cariporide(Car)found that it afforded protection against ischaemia/reperfusion injury in cardiac surgery but this was not compared to other Cacontrol ***-jective:To compare Mg-based cardioplegic solutions designed to minimize Caoverload and im-

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中华放射学杂志 2023年第3期57卷 300-305页

作者：尹刚董文浩陈秀玉杨新令安靖庞加宁张岩陆敏杰赵世华中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院磁共振影像科北京100037 西门子(深圳)磁共振有限公司深圳518057 siemens Medical solutions USA IncChicagoIL 60611USA

目的对比传统分段采集电影序列(Seg), 探讨心脏MR(CMR)压缩感知(CS)超快速电影序列评价左右心室收缩功能的临床应用价值。方法前瞻性纳入2021年12月至2022年1月在阜外医院进行CMR检查的心脏疾病患者27例。随机顺序进行Seg、屏气下CS(bh... 详细信息

目的对比传统分段采集电影序列(Seg), 探讨心脏MR(CMR)压缩感知(CS)超快速电影序列评价左右心室收缩功能的临床应用价值。方法前瞻性纳入2021年12月至2022年1月在阜外医院进行CMR检查的心脏疾病患者27例。随机顺序进行Seg、屏气下CS(bhCS)和自由呼吸下CS(fbCS)覆盖左右心室的多层短轴电影扫描。采用Friedman检验评价3种方法的总体图像质量、血池心肌信号比(BMC)和边缘锐度。分别测量3种方法的左心室舒张末期容积(EDV)、收缩末期容积(ESV)、每博输出量(SV)、射血分数(EF)、心肌质量(mass)及右心室EDV、ESV、SV、EF, 并用Bland-Altman分析bhCS与Seg、fbCS与Seg间测量结果的一致性, 并做相关性检验。结果 24例患者3种方法所有总体图像质量≥2分, 有诊断意义, 纳入后续分析。Seg、bhCS和fbCS的成像时间不同且依次降低, 分别为375.0(332.0, 405.6)、50.0(47.8, 53.7)和20.0(17.8, 23.7)s, 差异有统计学意义(χ^(2)=48.00, P0.96, P<0.001)。结论 CS超快速电影序列比传统序列节省了扫描时间且提供了相似的图像质量, 且无论是否屏气, CS序列心功能结果与传统电影序列具有良好的一致性和高度的相关性。

关键词：磁共振成像压缩感知心室容积收缩功能

From hardware store to hospital:a COVID-19-inspired,cost-effective,open-source,in vivo-validated ventilator for use in resource-scarce regions

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Bio-Design and Manufacturing 2022年第1期5卷 133-140页

作者： Matthew H.Park Yuanjia Zhu Hanjay Wang Nicholas ATran Jinsuh Jung Michael JPaulsen Annabel M.Imbrie‑Moore Samuel Baker Robert Wilkerson Mateo Marin‑Cuartas Danielle M.Mullis Y.Joseph Woo Department of Cardiothoracic Surgery Stanford UniversityFalk Cardiovascular Research Building CV-235300 Pasteur DriveStanfordCA 94305-5407USA Department of Mechanical Engineering Stanford UniversityStanfordCAUSA Department of Bioengineering Stanford UniversityStanfordCAUSA Department of Comparative Medicine Stanford UniversityStanfordCAUSA University Department of cardiac Surgery Leipzig Heart CenterLeipzigGermany

Resource-scarce regions with serious COVID-19 outbreaks do not have enough ventilators to support critically ill patients,and these shortages are especially devastating in developing *** help alleviate this strain,we have designed and tested the accessible low-barrier in vivo-validated economical ventilator(ALIVE Vent),a COVID-19-inspired,cost-effective,open-source,in vivo-validated solution made from commercially available *** ALIVE Vent operates using compressed oxygen and air to drive inspiration,while two solenoid valves ensure one-way flow and precise cycle *** device was functionally tested and profiled using a variable resistance and compliance artificial lung and validated in anesthetized large *** functional test results revealed its effective operation under a wide variety of ventilation conditions defined by the American Association of Respiratory Care guidelines for ventilator *** large animal test showed that our ventilator performed similarly if not better than a standard ventilator in maintaining optimal ventilation *** FiO2,respiratory rate,inspiratory to expiratory time ratio,positive-end expiratory pressure,and peak inspiratory pressure were successfully maintained within normal,clinically validated ranges,and the animals were recovered without any *** regions with limited access to ventilators,the ALIVE Vent can help alleviate shortages,and we have ensured that all used materials are publicly *** this pandemic has elucidated enormous global inequalities in healthcare,innovative,cost-effective solutions aimed at reducing socio-economic barriers,such as the ALIVE Vent,can help enable access to prompt healthcare and life saving technology on a global scale and beyond COVID-19.

关键词： COVID-19 Ventilator Open-source

Initial Experience with the Ventrassist cardiac Assist Device: A Rotary Pump without Bearings

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Initial Experience with the Ventrassist Cardiac Assist Devic...

定量临床核心脏病学(第2部分):应用进展及新技术

The Fifth China International Congress on Thoracic and Cardiovasculal Surgery

作者： DSEsmore JASmith JAnderson PAyre GTansley NJames JBegg JWoodard PWatterson Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney. Cardiothoracic Surgery Dept.and cardiac Surgical Research Unit Alfred HospitalBaker Institute and Monash UniversityMelbourne and Micromedical IndustriesSydney.

＜正＞ Objective:With the high prevalence of cardiac failure in the community and the shortage of trans-plant donor hearts,new solutions are needed to treat end stage cardiac *** ideal mechanicalcardiac assist device would be long-lasting,and non-traumatic to *** of current de-vices include valves that are subject to wear and thrombosis,or bearings that may wear and damageblood elements.A novel cardiac assist device,the VentrAssist rotary pump,has been developed by theUniversity of Technology,Sydney and Micromedical Industries ***:The pump,made oftitanium alloy cont ins a four lobed rotor,hydraulically suspended in the blood path without conven-tional *** rotor is driven at 1500 to 3000 rpm by electromagnets built into the pump housing

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中华核医学与分子影像杂志 2022年第9期42卷 568-576页

作者： Piotr J.Slomka Jonathan B.Moody Robert J.H.Miller Jennifer M.Renaud Edward P.Ficaro Ernest V.Garcia 王丽(译) 杨敏福(审校) Department of Imaging(Division of Nuclear Medicine) Medicineand Biomedical SciencesCedars-Sinai Medical CenterLos AngelesCA INVIA Medical Imaging solutions Ann ArborMI Department of cardiac Sciences University of CalgaryCalgaryABCanada Division of Cardiology Department of Internal MedicineUniversity of MichiganAnn ArborMI Department of Radiology and Imaging Sciences Emory UniversityAtlantaGA 首都医科大学附属北京朝阳医院核医学科北京100020

定量分析已广泛用于核心脏病学图像的处理和解读、改进疾病诊断和危险分层。该文为继续教育文章(含2部分)的第2部分,将对新兴的定量分析工具的临床潜在应用进行综述,介绍机械运动同步性、心室功能、灌注和融合显像定量分析技术,对PET和S... 详细信息

定量分析已广泛用于核心脏病学图像的处理和解读、改进疾病诊断和危险分层。该文为继续教育文章(含2部分)的第2部分,将对新兴的定量分析工具的临床潜在应用进行综述,介绍机械运动同步性、心室功能、灌注和融合显像定量分析技术,对PET和SPECT评估心肌血流量的新方法进行讨论。心肌活性、微钙化定量检测及心脏结节病和心脏淀粉样变的定量评估亦在文中描述。人工智能在改善图像分析、提高疾病诊断效能和风险预测方面的潜在作用将在文末进行论述。上述新技术的临床潜在应用及优化实施方法将在文中重点阐述。

关键词：核心脏病学心肌血流量定量人工智能相位分析