1.Concomitant intervention for significant preoperative mitral regurgitation during left ventricular assist device implantation: current state and perspectives
Zhihua WANG ; Zhaoyun CHENG ; Junlong HU ; Yaojue SONG ; Junjie SUN ; Zeyuan ZHAO ; Haoqi LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(11):692-696
The prevalence of heart failure(HF) is increasing worldwide, and mitral regurgitation(MR) is a common manifestation in patients with end-stage HF. Currently, the indications for concomitant surgical intervention of significant preoperative MR during left ventricular assist device(LVAD) implantation are still controversial. Based on discussing the etiology, classification, and pathophysiology of functional MR in patients with end-stage HF, this paper reviews the relevant factors affecting the prognosis of such patients and the progress of research related to whether to perform mitral valve surgery to intervene in significant MR during LVAD implantation, to provide a further reference for clinical practice.
2.Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years
Runqing GU ; Congyi ZHENG ; Linfeng ZHANG ; Zuo CHEN ; Xin WANG ; Xue CAO ; Yixin TIAN ; Lu CHEN ; Haoqi ZHOU ; Chen CHEN ; Zhen HU ; Yuxin SONG ; Lan SHAO ; Ye TIAN ; Zengwu WANG
Chinese Journal of Internal Medicine 2023;62(3):290-296
Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.
3.Impact of Airway Stepwise Management Strategy on Hospital Acquired Pneumonia in the Ultra Elderly Critically Ill Patients
Meishan LU ; Xinbo WANG ; Hongmin ZHANG ; Zhenzhen HU ; Yanchao LI ; Jiayong LI ; Haoqi HU ; Xiaoting WANG
Medical Journal of Peking Union Medical College Hospital 2024;15(3):567-572
To explore the impact of an airway stepwise management strategy in the treatment of hospital acquired pneumonia (HAP) in the ultra elderly critically ill patients. Clinical data on the ultra eldely(≥80 years old) HAP patients at the department of Critied Care Medicine, Peking Union Medical College Hospital from January 2021 to April 2023 was retrospective collected, and the enrolled patients were divided into an observation group (January 2022-April 2023) and control group (January 2021-December 2021) according to the airway stepwise management strategy. In the control group, conventional airway manage- ment was used, and in the observation group, an airway stepwise management strategy from simple to complex and from noninvasive to invasive was used. The oxygenation indices before and after airway interventiont, tracheal intubation/tracheostomy rate, and invasive ventilator usage rate was compared in both groups. A total of 61 HAP patients who met the inclusion and exclusion criteria were selected, including 31 in the observation group and 30 in the control group. Compared with before airway intervention, the arterial partial pressure of carbon dioxide gradually decreased, arterial partial pressure of oxygen and oxygenation index gradually increased at 12 h, 48 h and 72 h of airway intervention(all The application of an airway stepwise management strategy in the ultra elderly HAP patients can significantly improve oxygenation status and reduce iatrogenic trauma.
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