OBJECTIVETo assess the diagnostic value of 8 equations using different variables for determining the estimated glomerular filtration rate (eGFR) in patients with cardiovascular diseases.

METHODSGFR was estimated in 208 patients with cardiovascular diseases by (99m)Tc-DTPA dynamic renal imaging, and the eGFR was derived from 8 equations using different variables.

RESULTSIn patients with chronic kidney disease (CKD) stages 1-3, the eGFR calculated suing serum creatinine (SCr)-based equation was better correlated to GFR estimated by (99m)Tc-DTPA renal imaging than that derived from cystatin C (Cys C)-based equations, whereas in patients with CKD stages 4 and 5, the estimates by the latter equation showed a better correlation to GFR. Compared with (99m)Tc-DTPA renal imaging, MDRD-based equation and simple MDRD equation resulted in a higher eGFR in patients with CKD stages 4 and 5, the Rule equation had a lower eGFR in CKD stages 1 and 2, the Macisaac equation yielded a higher eGFR in CKD stages 2-5, and the Tan equation showed a higher eGFR in CKD stages 2 and 3. In patients with mild renal dysfunction, the Scr-based equation had a higher AUC(ROC) than Cys C-based equation, which was reversed in patients with severe renal dysfunction; the AUC(ROC) of the two equations were comparable in patients with moderate renal dysfunction. Compared with (99m)Tc-DTPA renal imaging, the modified MDRD equation and Arnal-Dade equation showed no significant difference in the eGFR in patients with CKD stages 1-5.

CONCLUSIONModified MDRD equation (or simple MDRD equation) and Arnal-Dade equation are superior to other calculation methods for estimating the GFR in Chinese patients with cardiovascular disease.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiovascular Diseases ; physiopathology ; Child ; Chronic Disease ; Creatinine ; blood ; Cystatin C ; blood ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Kidney Diseases ; physiopathology ; Male ; Middle Aged ; Young Adult

Although the majority of coronary artery anomalies are found incidentally and not clinically significant, the interarterial course between the major vessels of the aberrant artery may be responsible for syncope, angina, arrhythmias or sudden death. There are only a few case reports describing the origination of all the coronary arteries from a single ostium. This anomaly occurs in only 0.024%-0.044% of the population. Left coronary artery originating from the right coronary is a rare coronary abnormality. Here we report a case of acute myocardial infarction in a patient with anomalous left coronary artery originating from the right coronary artery, as was confirmed by computerized tomography angiogram, which showed that only one single coronary artery stem originating from the right sinus of Valsalva trifurcated into a right coronary artery, left circumflex artery and a hypoplastic left anterior descending artery. Subsequent percutaneous coronary intervention (PCI) procedures were performed successfully. PCI procedures should be carried out with great caution in such cases, and this condition should be managed as a left main lesion.
Coronary Angiography ; methods ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; diagnostic imaging ; therapy ; Percutaneous Coronary Intervention

OBJECTIVETo assess the changes of serum C-reactive protein (CRP) level, left atrial size and atrial premature contraction (PAC) in patients with obstructive sleep apnea syndrome (OSAS).

METHODSThis study involved 277 patients with OSAS diagnosed after an overnight polysomnography, who underwent a 24-h Holter electrocardiography and ambulatory blood pressure monitoring for detection of PAC. According to the apnea-hypopnea index (AHI), 137 patients with PAC identified from these patients were classified into 3 groups, namely the mild (5≥AHI<15), moderate (15≥AHI<30) and severe (AHI≥30) groups. Serum CRP level was assessed by a high-sensitivity radio-immunoassay. The left atrial diameter and echocardiographic parameters were recorded by transthoracic Doppler echocardiography (TTE).

RESULTSWe found a high prevalence of PAC in these OSAS patients (137/277, 49.4%). Serum CRP was significantly higher in severe OSAS group (5.01∓4.68 mg/L) than in the moderate (3.03∓1.94 mg/L) and mild OSAS (2.98∓1.82 mg/L) groups (P=0.040 and 0.033, respectively). The left atrial diameter was significantly increased in severe OSAS group (40.1∓7.9 mm) as compared to that in moderate (37.9∓5.5 mm) and mild (33.7 ∓ 3.8 mm) groups (P=0.025 and 0.002, respectively). The severity of OSAS was positively correlated to both CRP (r=0.304, P=0.034) and left atrial diameter (r=0.411, P=0.003). After adjusting for gender, age and body mass index (BMI), a strong correlation was found between the left atrial diameter and CRP (r=0.594, P=0.0005).

CONCLUSIONThere is a high prevalence of PAC in OSAS patients. The progression of OSAS is associated with increased serum CRP level and left atrial size in patients with premature atrial complexes. Our study suggests that inflammation associated with OSAS might contribute to atrial structural and electrical remodeling in OSAS patients with PAC.

Adult ; Aged ; Atrial Premature Complexes ; complications ; pathology ; C-Reactive Protein ; metabolism ; Electrocardiography ; Female ; Heart Atria ; pathology ; Humans ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Sleep Apnea Syndromes ; blood ; complications