1.Prognostic value of serum adiponectin and fibroblast growth factor-23 in patients undergoing heart valve replacement
Chao ZHANG ; Dong HAN ; Dikun FAN ; Jianchao GAO ; Kan YANG
Journal of Clinical Medicine in Practice 2024;28(3):58-62
Objective To investigate the prognostic value of serum adiponectin and fibroblast growth factor-23(FGF23)levels in patients undergoing cardiac valve replacement.Methods A to-tal of 98 patients undergoing heart valve replacement were selected as the study group.The patients in the study group were divided into good prognosis group(n=67)and poor prognosis group(n=31).A total of 90 healthy subjects were selected as control group.Spearman method was used to analyze the correlation of serum adiponectin and FGF23 levels with plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,respectively.Multivariate Logistic regression analysis was used to analyze the prognostic fac-tors of patients with heart valve replacement.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum adiponectin and FGF23 levels in patients with heart valve replacement.Results Serum FGF23,NT-proBNP level and APACHE Ⅱ score in the study group were significantly higher,and serum adiponectin level was significantly lower than that in the control group(P<0.05).The levels of serum FGF23,NT-proBNP and APACHE Ⅱ score in the poor prognosis group were significantly higher,and the serum adiponectin level was significantly lower than that in the good prognosis group(P<0.05).Serum FGF23 level was positively correlated with NT-proBNP level and APACHE Ⅱ score(P<0.05).Serum adiponectin level was negatively corre-lated with NT-proBNP level and APACHE Ⅱ score(P<0.05).The levels of serum adiponectin,FGF23,NT-proBNP and APACHE Ⅱ score were the influencing factors for the prognosis of patients with heart valve replacement(P<0.05).The area under the curve(AUC)of serum adiponectin and FGF23 for predicting the prognosis of patients undergoing cardiac valve replacement was 0.862 and 0.807,respectively,and the AUC of the combined prediction was 0.911.The AUC of com-bined prediction of adiponectin and FGF23 was higher than that of individual prediction(P<0.05).Conclusion The combination of serum adiponectin and FGF23 has a good effect in predic-ting the prognosis of patients with heart valve replacement.Serum adiponectin and FGF23 are expec-ted to be effective indicators for evaluating the prognosis of patients undergoing heart valve replace-ment.
2.Application effect of transthoracic echocardiography monitoring in percutaneous closure of patent foramen ovale
Chao ZHANG ; Dong HAN ; Dikun FAN ; Jianchao GAO ; Kan YANG
Journal of Clinical Medicine in Practice 2024;28(9):25-28
Objective To observe the effect of transthoracic echocardiography(TTE)monitoring in percutaneous closure of patent foramen ovale(PFO).Methods The data of 98 patients with PFO were retrospectively analyzed.All patients underwent interventional plugging.They were divided into X-ray group(n=50)and TTE group(n=48)according to different intraoperative guidance methods.The occlusions,complications,surgical indexes,right-to-left shunt(RLS)grading and the improve-ment of headache in patients with migraine were compared between the two groups.Results A total of 98 cases of PFO were successfully occluded,among which 2 cases in the TTE group received transesophageal ultrasound guidance due to poor intraoperative sound window.The operation time of the TTE group was significantly longer than that of the X-ray group(P<0.05).After operation,RLS rating and Headache Impact Test-6(HIT-6)score of migraine patients in the two groups were signifi-cantly lower than those before operation(P<0.05).Conclusion Simple TTE guided percutaneous PFO occlusion has a good improvement effect on RLS and migraine in PFO patients,and can avoid ra-diation damage caused by X-ray to doctors and patients.
3.Prognostic value of serum adiponectin and fibroblast growth factor-23 in patients undergoing heart valve replacement
Chao ZHANG ; Dong HAN ; Dikun FAN ; Jianchao GAO ; Kan YANG
Journal of Clinical Medicine in Practice 2024;28(3):58-62
Objective To investigate the prognostic value of serum adiponectin and fibroblast growth factor-23(FGF23)levels in patients undergoing cardiac valve replacement.Methods A to-tal of 98 patients undergoing heart valve replacement were selected as the study group.The patients in the study group were divided into good prognosis group(n=67)and poor prognosis group(n=31).A total of 90 healthy subjects were selected as control group.Spearman method was used to analyze the correlation of serum adiponectin and FGF23 levels with plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,respectively.Multivariate Logistic regression analysis was used to analyze the prognostic fac-tors of patients with heart valve replacement.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum adiponectin and FGF23 levels in patients with heart valve replacement.Results Serum FGF23,NT-proBNP level and APACHE Ⅱ score in the study group were significantly higher,and serum adiponectin level was significantly lower than that in the control group(P<0.05).The levels of serum FGF23,NT-proBNP and APACHE Ⅱ score in the poor prognosis group were significantly higher,and the serum adiponectin level was significantly lower than that in the good prognosis group(P<0.05).Serum FGF23 level was positively correlated with NT-proBNP level and APACHE Ⅱ score(P<0.05).Serum adiponectin level was negatively corre-lated with NT-proBNP level and APACHE Ⅱ score(P<0.05).The levels of serum adiponectin,FGF23,NT-proBNP and APACHE Ⅱ score were the influencing factors for the prognosis of patients with heart valve replacement(P<0.05).The area under the curve(AUC)of serum adiponectin and FGF23 for predicting the prognosis of patients undergoing cardiac valve replacement was 0.862 and 0.807,respectively,and the AUC of the combined prediction was 0.911.The AUC of com-bined prediction of adiponectin and FGF23 was higher than that of individual prediction(P<0.05).Conclusion The combination of serum adiponectin and FGF23 has a good effect in predic-ting the prognosis of patients with heart valve replacement.Serum adiponectin and FGF23 are expec-ted to be effective indicators for evaluating the prognosis of patients undergoing heart valve replace-ment.
4.Application effect of transthoracic echocardiography monitoring in percutaneous closure of patent foramen ovale
Chao ZHANG ; Dong HAN ; Dikun FAN ; Jianchao GAO ; Kan YANG
Journal of Clinical Medicine in Practice 2024;28(9):25-28
Objective To observe the effect of transthoracic echocardiography(TTE)monitoring in percutaneous closure of patent foramen ovale(PFO).Methods The data of 98 patients with PFO were retrospectively analyzed.All patients underwent interventional plugging.They were divided into X-ray group(n=50)and TTE group(n=48)according to different intraoperative guidance methods.The occlusions,complications,surgical indexes,right-to-left shunt(RLS)grading and the improve-ment of headache in patients with migraine were compared between the two groups.Results A total of 98 cases of PFO were successfully occluded,among which 2 cases in the TTE group received transesophageal ultrasound guidance due to poor intraoperative sound window.The operation time of the TTE group was significantly longer than that of the X-ray group(P<0.05).After operation,RLS rating and Headache Impact Test-6(HIT-6)score of migraine patients in the two groups were signifi-cantly lower than those before operation(P<0.05).Conclusion Simple TTE guided percutaneous PFO occlusion has a good improvement effect on RLS and migraine in PFO patients,and can avoid ra-diation damage caused by X-ray to doctors and patients.