1.The value of quantitative flow ratio in the hemodynamic evaluation of myocardial bridge
Meng WANG ; Xingman FAN ; Quanlong WANG ; Yukun CAO ; Chenyue MA ; Qiongyi HE ; Haitao ZHANG
Chinese Journal of Cardiology 2024;52(2):165-171
Objective:To explore the application value of quantitative flow ratio (QFR) in the hemodynamic evaluation of myocardial bridge and to preliminarily evaluate the correlation and related influencing factors between deformation quantitative flow ratio (D-QFR) and QFR.Methods:This is a cross-sectional study. Patients with CAG-confirmed simple myocardial bridge of the middle anterior descending coronary artery from June 2012 to June 2022 at the Air Force Medical Center were retrospectively included in this study. Systolic stenosis of mural coronary arteries (MCA) and myocardial bridge length were measured using quantitative coronary angiography. The patients were divided into mild stenosis group (<50% systolic stenosis) and moderate-to-severe stenosis group (≥50% systolic stenosis) according to the Nobel grading criteria. At different time periods (systolic and diastolic), the QFR values were measured at 3 locations (1 to 2 cm before the MCA entrance, the middle segment of the MCA, and 1 to 2 cm after the MCA exit), denoted as QFRa, QFRb, and QFRc, respectively, and the D-QFR values, incorporating vessel deformation information, were recorded. The MCA distal QFR≤0.8 in either stage was defined as an abnormal QFR value. QFR values were compared between the two groups at different locations and within each group. Factors associated with abnormal QFR values were analysed using multifactorial logistic regression. Spearman rank correlation analysis was used to examine the correlation between D-QFR values and systolic and diastolic QFR values.Multiple linear regression was used to analyse the factors associated with D-QFR.Results:A total of 83 patients were enrolled, including 58 males, aged (57.1±13.1) years. There were 48 cases in the mild stenosis group and 35 cases in the moderate-to-severe stenosis group, and the differences in systolic and diastolic QFRb and QFRc values between the two groups were statistically significant (all P<0.05). Within-group comparisons showed the values of QFRb and QFRc in the systolic phase were lower than those in the diastolic phase; QFRb and QFRc were both lower than QFRa during the same period (all P<0.05). Multifactorial logistic regression analysis showed that MCA systolic stenosis ( OR=1.225, 95% CI 1.093-1.372, P<0.001) was an influential factor for abnormal QFR. D-QFR values were positively correlated with both systolic and diastolic QFR values (correlation coefficients were 0.849 and 0.675, respectively, both P<0.01). Multiple linear regression analysis showed that D-QFR values were negatively correlated with age ( β=-0.208, P=0.029), systolic stenosis ( β=-0.500, P<0.001), and myocardial bridge length ( β=-0.211, P=0.036). Conclusions:The QFR values in middle and distal of myocardial bridge decrease. The systolic stenosis rate of myocardial bridge is an important factor affecting QFR value. D-QFR is positively correlated with both systolic and diastolic QFR values. Age, myocardial bridge systolic stenosis rate and length are factors influencing the D-QFR values.
2.Current status of blood pressure control in elderly hypertensive patients under the antihypertensive standard recommended by Chinese experts
Qiongyi HE ; Xingman FAN ; Chenyue MA ; Meng WANG ; Jing ZHANG ; Haitao ZHANG
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(1):34-37
Objective To analyze the antihypertensive compliance rate,drug use and complication distribution among very old hypertensive inpatients under the antihypertensive standard of 150/90 mm Hg in our country(1 mm Hg=0.133 kPa).Methods A total of 409 hospitalized patients aged ≥80 years and diagnosed with hypertension in all departments of Air Force Medical Center of PLA were enrolled,and according to their clinical outcomes,they were divided into intensive antihypertensive group(106 cases,SBP<130 mm Hg),standard antihypertensive group(155 ca-ses,SBP 130-149 mm Hg)and non-standard blood pressure group(148 cases,SBP ≥150 mm Hg).The status of blood pressure control was analyze in each group.Results When 150/90 mm Hg was used as the blood pressure standard,25.9%were in the intensive blood pressure group,37.9%were in the standard blood pressure group,36.2%were in the non-standard blood pressure group.The proportion of patients aged>90 years was significantly lower in the non-standard blood pressure group than the intensive antihypertensive group and the standard anti-hypertensive group(4.1%vs 7.5%and 12.3%,P<0.05).The ratio of single-drug therapy was significantly higher in the standard antihypertensive group than the intensive antihypertensive group(46.5%vs 32.1%,P<0.05),and that of dual combination therapy was obviously higher in the intensive antihypertensive group than the standard antihypertensive group(35.8%vs 22.6%,P<0.05).The proportions of heart damage and cerebrovascular damage were significantly higher(43.4%vs 21.9%,26.4%vs 14.8%),and the proportion of complicated retinopathy was notably lower(11.3%vs 23.9%)in the intensive antihypertensive group than the standard antihypertens-ive group(P<0.05).Conclusion For very old hypertensive patients in our country,it is more sci-entific and practical to use 150/90 mm Hg as the starting standard for blood pressure reduction.Intensified blood pressure reduction increases cardiovascular and cerebrovascular damages in them instead.
3.Analysis and exposure evaluation of cadmium residues in different tissues of portunus and mantis shrimp
Hongxin NIU ; Shenliang LYU ; Chenyue FAN ; Yuejian JIANG ; Xiaoling XIONG ; Renping TONG
Shanghai Journal of Preventive Medicine 2023;35(8):735-739
ObjectiveTo understand the concentration of heavy metal cadmium and cadmium in portunus and mantis shrimp, and to timely identify food safety problems and potential hazards. MethodsPortunus and mantis shrimp samples from different provinces were collected and categorized based on different regions and locations, and some samples were made from tissue parts. Graphite furnace atomic absorption spectrometry was used to detect cadmium items, the cadmium exposure of portunus and mantis shrimp was evaluated simultaneously ResultsThe detection rate of cadmium in 124 batches of portunus sold in Shanghai was 100% (124/124), the detection rate of cadmium in 63 batches of mantis shrimp sold in the market was also 100% (63/63). The cadmium content varied in different tissue parts, and the cadmium enrichment in hepatopancreas was the highest in the edible parts of portunus and mantis shrimp. The average detection value, 50th percentile value, 95th percentile value of cadmium in the hepatopancreas of portunus accounted for 52.64%, 49.28% and 98.65% of the PTMI, respectively. The average detection value, 50th percentile value and 95th percentile value of cadmium in the hepatopancreas of mantis shrimp accounted for 30.76%, 32.04% and 46.16% of the PTMI, respectively. ConclusionThe average residual levels of heavy metal cadmium in portunus and mantis shrimp are within the safe range.