1.Relationship between Left Ventricular Remodeling and Systolic Function Assessed by Left Ventricular Mid-wall Fractional Shortening
Dongmei MIAO ; Ping YE ; Peng GAO ; Jinrao ZHANG ; Wenkai XIAO
Chinese Journal of Rehabilitation Theory and Practice 2009;15(8):767-769
Objective To investigate the correlation between left ventricular remodeling and systolic function by mid-wall fractional shortening(mFS).Methods 51 cases of hypertension and 47 cases of healthy volunteers were enrolled and systolic parameters were measured as ejection fraction(EF), fractional shortening(FS) and mFS. Acorrding to left ventricular remodeling parameteres inclulding LVMI and RWT, hypertension group was divided into four subgroups. The correlation among these parameters were analyzed.Results Thicker left ventricular wall and lower mFS in patient with hypertension compaired with those in controll (P<0.05). There were negative correlation between mFS and RWTr=-0.42, P<0.05) and positive correlation between mFS and LVMI r=-0.67, P<0.01).Conclusion mFS is a valuable parameter compared with traditional parameteres such as EF and FS. There is a linear association between parameteres of ventricular remodeling and systolic function assessed by mFS in early stage of hypertension.
2.Arterial Stiffness and Diastolic Function in Primary Hypertension
Dongmei MIAO ; Ping YE ; Peng GAO ; Jinyao ZHANG ; Wenkai XIAO
Chinese Journal of Hypertension 2006;0(12):-
Objective To study the relationship between arterial compliance and diastolic dysfunction in essential hypertensive patients.Methods Fifty-one treated hypertensive patients and 47 normotensive controls were enrolled.Arterial stiffness was assessed by vascular e-TRACKING technology of ultrosonic.Tissue Doppler echocardiography combined with conventional Doppler echocardiography was used for assessment of left ventricular diastolic function and peak late diastolic velocity of mitral flow.The ratio of E/A,Em/Am and E/Em were measured.Results Compared with normotensive controls,hypertensive patients have increased arterial sclerosis index(?) [(10.5?3.8) vs control(8.1?3.4),P
3.Correlation of pelvic endometriosis cysts with pain and infertility
Hong ZHANG ; Yue YANG ; Wenhui DONG ; Wenkai GAO ; Fengmei WANG ; Lei CUI ; Xiaoyuan SUN
Clinical Medicine of China 2015;31(7):661-664
Objective To study the correlations of pelvic endometriosis cysts with pain and infertility according to the revised American Fertility Society (r-AFS) staging of endometriosis.Methods We retrospectively studied the clinical information of 258 cases patients with the ovarian endometriosis cysts who undergoing laparoscopic ovarian endometriosis cysts excision from January 2007 to December 2013.In accordance with the r-AFS,the correlation between pelvic adhesions and pain symptoms or infertility was evaluated.Results Among 258 cases with ovarian endometriosis cysts,there were 72.09% (186/258) of patients presented pelvic pain and 16.28% of patients presented infertility.The stages of r-AFS were that 16 cases in stage I,80 cases in stage Ⅱ,108 cases of in stage Ⅲ and 54 cases of stage Ⅳ.Also,186 cases with pain symptom,77.42% (144/186) of patients were in stage Ⅲ and Ⅳ,which was remarkably higher than that of no symptom group (25.00% (18/72),x2 =64.017,P < 0.05).Among 42 cases with infertility,there were 85.71% (36/42) of patients were in stage Ⅲ and Ⅳ,remarkably higher than of no infertility group (58.33% (126/216),x2 =11.283,P < 0.05).Conclusion The r-AFS stage of pelvic distribution in ovarian endometriosis cyst is closely correlated with pain symptoms and infertility.Patients in stage Ⅲ and Ⅳ with pain and infertility are more significant.
4.Effects of parathyroidectomy on heart rate circadian rhythm in patients with stage 5 chronic kidney disease combined with severe secondary hyperparathyroidism
Ying CUI ; Hui HUANG ; Wenkai REN ; Guang YANG ; Ming ZENG ; Xiaoming ZHA ; Shaowen TANG ; Yaoyu HUANG ; Zhanhui GAO ; Fangyan XU ; Wenbin ZHOU ; Hanyang QIAN ; Jing WANG ; Chun OUYANG ; Xueyan GAO ; Changying XING ; Yongyue WEI ; Ningning WANG
Chinese Journal of Nephrology 2021;37(5):414-423
Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.
5.Value of abnormal circadian rhythm of heart rate predicting the all-cause mortality in stage 5 chronic kidney disease patients
Wenkai REN ; Ying CUI ; Ming ZENG ; Hui HUANG ; Shaowen TANG ; Guang YANG ; Yaoyu HUANG ; Zhanhui GAO ; Fangyan XU ; Hanyang QIAN ; Jing WANG ; Chun OUYANG ; Xueyan GAO ; Yifei GE ; Yujie XIAO ; Changying XING ; Yongyue WEI ; Ningning WANG
Chinese Journal of Nephrology 2021;37(7):558-566
Objective:To investigate the predictive value of abnormal heart rate circadian rhythm for all-cause mortality in stage 5 chronic kidney disease (CKD 5) patients.Methods:The retrospective study was performed in CKD 5 patients enrolled from the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) and the Affiliated BenQ Hospital of Nanjing Medical University from February, 2011 to December, 2019. A total of 159 healthy volunteers were enrolled as the healthy control group during the same period. The circadian rhythm of heart rate was monitored by 24-hour Holter. Related indices (including 24-hour, daytime and nighttime mean heart rate, night/day heart rate ratio, 24-hour maximum heart rate, 24-hour minimum heart rate and difference between maximum and minimum of 24-hour heart rate) were calculated. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Cox regression model was used to analyze the risk factors of all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve and Log-rank test were used to compare the differences of cumulative mortality between high ratio group (night/day heart rate ratio>0.91) and low ratio group (night/day heart rate ratio≤0.91). The nonlinear relationship between night/day heart rate ratio and all-cause mortality was analyzed by restricted cubic spline plot. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the predictive value of night/day heart rate ratio for all-cause mortality in CKD 5 patients.Results:A total of 159 healthy volunteers and 221 CKD 5 patients were included in this study. There were 123 males (55.66%) and the age was (52.72±13.13) years old in CKD 5 patients. The total median follow-up time was 50.0 months. Compared with controls, 24-hour, nighttime mean heart rate, 24-hour minimum heart rate in CKD 5 patients were increased (all P<0.05), furthermore, the night/day heart rate ratio was higher [(0.91±0.09) vs (0.81±0.08), P<0.001], showing "non-dipping heart rate". However, the 24-hour maximum heart rate and the difference between maximum and minimum of 24-hour heart rate in CKD 5 patients were lower than controls (both P<0.05). Multivariate Cox regression analysis showed that the increased night/day heart rate ratio (per 0.1 increase, HR=1.557, 95% CI 1.073-2.258, P=0.020) was an independent influencing factor for all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve analysis showed that the cumulative mortality of the high ratio group was significantly increased than that of the low ratio group (Log-rank test χ 2=7.232, P=0.007). From the restricted cubic spline plot, there was a linear effect between night/day heart rate ratio and all-cause mortality ( P=0.141), and when night/day heart rate ratio was above 0.91, the risk of all-cause mortality was significantly increased in CKD 5 patients. According to time-dependent ROC curve, the accuracy of night/day heart rate ratio in predicting all-cause mortality was 70.90% even when the survival time was up to 70.0 months. Conclusions:The circadian rhythm of heart rate in CKD 5 patients displays "non-dipping" state. High night/day heart rate ratio is an independent influencing factor for all-cause mortality in CKD 5 patients.