1.Study on anti-inflammatory, eliminating phlegm and bacteriostatic action of Yuxuan granule
Jian XIE ; Xin MOU ; Aiwu WANG
International Journal of Traditional Chinese Medicine 2013;(3):221-224
Objective To reveal the mechanism of Yuxuan granule(YXG) in treating pharyngitis from anti-inflammatory,expectorant,and antibacterial actions.Methods Xylene-induced ear edema and cotton pellet induced granuloma mice models were adopted to observe the anti-inflammatory effects of YXG Phenol red secretion in mice test was adopted to observe the expectorant activity of YXG Five bacteria by tube dilution method was adopted to observe antimicrobial action of YXG Besides,the changes of routine indexes in blood and tumor necrosis factor (TNF),interleukin-1 (IL-1) in serum were measured in acute pharyngitis models.Results YXG has shown a dose-dependent of its anti-inflammatory action.In the test of xylene induced mice ear swelling and cotton ball induced granuloma,the swelling degree of the control group,positive control groupand YXG high (6.14g/kg),medium (3.07g/kg) and low (1.53g/kg) concentration group were (9.00± 1.50) mg,(3.50±0.10)mg,(4.25±1.08)mg,(5.54±0.97)mg,(8.05±0.08)mg and (1.22±1.50)mg,(0.50±0.10)ag,(0.45± 0.08) mg,(0.75± 0.97) mg,(0.70 ± 0.08) mg respectively.YXG also had obviously expectorant effect to the golden staphylocoecus ameus,hemolytic streptococcus,streptococcus pneumoniae,salmonella typhi and corynebacterium diphtheriae,with the minimum inhibition concentration of 55,100,68 and 35 mg/ml respectively; YXG also reduced leukocyte count [percentage of leukocyte was (9.88± 1.22) × 109/L,(7.50± 1.58) ×109/L,(6.02± 1.05) × 109/L,(8.38± 1.13) × 109/L,(8.75 ± 1.08) × 109/L in the five groups respectively],neutrophils [the value was (35.62±5.00)×109/L,(28.49±3.40)×109/L,(28.89±5.22)× 109/L,(29.34±4.83)×109/L,(33.43 ± 4.27) × 109/L in the five groups respectively],lymphocytes [the value was (70.72± 5.04) %,(67.89 ±4.37)%,(60.14±3.88)%,(65.38±4.45)%,(65.65±4.28)% in the five groups respectively],TNF in blood serum [the value was (90.25±2.29)ng/ml,(80.23 ± 0.60) ng/ml,(76.83±0.33)ng/ml,(78.00 ± 0.34) ng/ml,(80.52±1.14)ng/ml in the five groups respectively] and IL-1 [the value was (222.06±50.22)pg/ml,(149.55±50.02)pg/ml,(130.37 ± 30.61)pg/ml,(158.68 ± 40.00)pg/ml,(178.76 ± 39.26)pg/ml in the five groups respectively] in the acute pharyngitis rat.Conclusion Through the anti-inflammatory,expectorant,antimicrobial activity and reducing levels of TNF,IL-1 YXG achieves the goal of treating pharyngitis.
2.Efficacy observation of cervical spondylosis treated with acupuncture at three lines of cervical Jiaji (EX-B 2).
Jian-mou XIE ; Zhi-qiang CHEN ; Wei GUO ; Qing-hui CHEN ; Xiao-xiao LIN ; Xiu-qin QUE ; Lu-chang YU ; Ze-jian SU
Chinese Acupuncture & Moxibustion 2014;34(9):863-866
OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis between acupuncture at three lines of cervical Jiaji (EX-B 2) and oral administration of jingfukang granules.
METHODSThree hundred cases of cervical spondylosis were divided into an acupuncture group and a medication group, 150 cases in each one. In the acupuncture group, according to the different types of cervical spondylosis, acupuncture was applied at three lines of cervical Jiaji (EX-B 2), once a day. In the medication group, jingfukang granules were prescribed for oral administration, one bag each time, three times a day. The treatment of ten days made one session in the two groups and two sessions were required totally. Before and after two sessions of treatment, the clinical assessment scale for cervical spondylosis (CASCS) was adopted to evaluate the score of subjective symptoms, clinical physical signs and adaptability as well as the total score in the patients of the two groups and the efficacy was compared.
RESULTSThe patients' symptoms and physical signs were alleviated, the adaptability was improved and the score of each item and the total score were increased in the two groups after treatment (all P<0.01). The improvements in the acupuncture group were better than those in the medication group (all P<0.01). The curative and markedly effective rate was 90.7% (136/150) in the acupuncture group, better than 66.0% (99/150) in the medication group (P<0.01).
CONCLUSIONAcupuncture at three lines of cervical Jiaji (EX-B 2) achieves the significant clinical efficacy on cervical spondylosis. This therapy is superior to relieving symptoms and physical signs and recovering adaptability as compared with jingfukang granules.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult
3.Detection of T lymphocyte subsets in patient with glioma
Yong-Gao MOU ; Xing-Hai DENG ; Su-Li YAN ; Da-Nian WEI ; Ke SAI ; Hai-Tao XIE ; Xiang-Heng ZHANG ; Zhen-Ning WANG ; Gang LI ; Tie-Jian LIU ; Zhong-Ping CHEN
Chinese Journal of Neuromedicine 2009;8(12):1244-1247
Objective To explore the relationship between T lymphocyte subsets and both glioma malignancy and its prognosis, and determine a clinical immunologic index for evaluating preoperative glioma malignancy and its prognosis. Methods The data of 117 inpatients with primary intracranial tumors, including glioma (n=85) and meningioma (n=32), were retrospectively analyzed. Fluorescence-activated cell sorting (FACS) analysis was performed to detect the preoperative contents of T lymphocyte subsets on 32 patients with meningioma and patients with glioma, including 45 high-grade glioma (WHO, grade Ⅲ-Ⅳ) and 40 low-grade glioma (WHO, grade Ⅰ -Ⅱ); and then the differences of their immunologic indexes were analyzed. Based on the detection result of T lymphocyte subsets, patients with glioma were divided into two groups: CD4~+CD8~+<1 and CD4~+CD8~+>1. Follow-up for 3-5 years was performed and the survival difference of these two groups was analyzed. Results Patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+ and an increased value of CD8~+ with significant difference as compared with patients with low-grade glioma (P<0.05); patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+, and an increased value of CD8~+ with statistical significance compared with patients with meningioma (P <0.05); patients with low-grade glioma showed a decreased ratio of CD4~+CD8~+ with statistical significance compared with the patients with meningioma (P<0.05). Patients with glioma showed a decreased ratio of CD4~+CD8~+ and CD4~+, and an increased CD8~+ with statistical significance compared with patients with meningioma (P<0.05). After follow-up for 3-5 years, 48 patients with glioma was found in the CD4~+CD8~+>1 group with 21 death (43.8%) and 31 months as a median survival time; 37 patients with glioma was found in the CD4~+CD8~+<1 group with 23 death (62.2%) and 16 months as a median survival time. The Kaplan-Meier survival curves were analyzed with statistical significance (P<0.05). Conclusion The prognosis is poor in patients with low ratio of CD4~+CD8~+. The preoperative level of T lymphocyte subsets in peripheral blood, correlated to the glioma malignancy, can be considered as an index to evaluate the glioma malignancy and the prognosis in patients with glioma.
4.Predictive value of gated myocardial perfusion imaging for all-cause mortality risk in patients with familial hypercholesterolemia
Jian JIAO ; Luya WANG ; Wei DONG ; Tiantian MOU ; Ying ZHANG ; Zhi CHANG ; Xiaofen XIE ; Junqi LI ; Hongzhi MI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(5):297-302
Objective:To evaluate the predictive value of stress+ rest gated myocardial perfusion imaging (G-MPI) in assessing all-cause mortality risk in patients with familial hypercholesterolemia (FH).Methods:From June 2010 to March 2022, 72 patients (39 males, 33 females; age (21.1±12.3) years) who diagnosed with FH clinically and genetically and underwent stress+ rest G-MPI in Beijing Anzhen Hospital, Capital Medical University were retrospectively followed up. Image analysis was performed using the 17-segment 5-point method to obtain left ventricular myocardial perfusion and functional parameters. Patients were followed for all-cause mortality events, and predictors associated with the risk of all-cause mortality were analyzed using Cox regression. The efficiencies of predictors were evaluated by ROC curve analysis, and the Kaplan-Meier method and log-rank test were used to compare the differences in the incidence of all-cause mortality in different groups of patients with FH. Independent-sample t test or Mann-Whitney U test was used to analyze the data. Results:The follow-up time of 72 patients was 7(4, 10) years, and all-cause death occurred in 16(22.2%) patients during the follow-up period. There were statistically significant differences in total cholesterol (TC), low density lipoprotein cholesterol (LDLC), summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), stress end-systolic volume (SESV), stress ejection fraction (SEF), rest end-diastolic volume (REDV), rest end-systolic volume (RESV) and rest ejection fraction (REF) between the death group and the survival group ( t values: from -2.65 to 4.47, z values: from -3.43 to -1.98, all P<0.05). Cox regression analysis showed that SDS (hazard ratio ( HR)=1.337, 95% CI: 1.114-1.604, P=0.002), SESV ( HR=1.019, 95% CI: 1.008-1.030, P<0.001) and LDLC ( HR=1.355, 95% CI: 1.049-1.749, P=0.020) were independent predictors associated with the risk of all-cause mortality in patients with FH. The optimal cut-off value of SESV for predicting mortality in patients with FH determined by ROC curve analysis was 35.5 ml, with the AUC of 0.701 (95% CI: 0.517-0.885). The incidence of all-cause mortality in the group with SESV≥35.5 ml was significantly higher than that in the group with SESV<35.5 ml (28.6% vs 6.9%; χ2=5.15, P=0.023). Conclusion:Stress+ rest G-MPI is an important imaging method for all-cause mortality risk assessment in patients with FH, and SDS, SESV and LDLC are important factors in predicting mortality in patients with FH.
5.Study on corresponding areas the liver and lung channels in brain with fMRI.
Fang-Ming XU ; Peng XIE ; Fa-Jin LÜ ; Jun MOU ; Yong-Mei LI ; Jian-Nong ZHAO ; Wei-Juan CHEN ; Qi-Yong GONG ; Li-Bo ZHAO ; Qing-Jun LIU ; Lin SHEN ; Hong ZHAI ; De-Yu YANG
Chinese Acupuncture & Moxibustion 2007;27(10):749-752
OBJECTIVETo explore distribution of the Liver and Lung Channels in the brain so as to provide imaging basis for construction of channel theory in the brain.
METHODSSixty healthy student volunteers were randomly divided into a Liver Channel group (I) and a Lung Channel group (II), and the each group was further divided into five subgroups with 6 volunteers in each subgroup, based on five-shu-point principles which, were Dadun (LR 1, I 1), Xingjian (LR 2, I 2), Taichong (LR 3, I 3), Zhongfeng (LR 4, I 4), Ququan (LR 8, I 5), Shaoshang (LU 11, II 1), Yuji (LU 10, II 2), Taiyuan (LU 9, II 3), Jingqu (LU 8, II 4), and Chize (LU 5, II 5), respectively. In order to observe the brain activating patterns during acupuncture at the different acupoints, functional magnetic resonance imaging (fMRI) technique was adopted. All image data were then analyzed with SPM 2 software. The statistical parameter gram was composed of the pixel P < 0.01, and anatomic location was made according to Talairach coordinate, attaining experimentally activated areas, and the commonly activated area of five-shu-point of each channel was considered as the brain distribution of the Liver and Lung Channels.
RESULTSThe common areas activated by the five-shu-points of the Liver Channel were homolateral Brodmann area (BA) 34, BA 47, red nucleus, contralateral BA 19, BA 30, BA 39, the superior parietal lobule, cerebellum decline, and bilateral BA 3 and culmen. The common areas activated by the five-shu-points of the Lung Channels included homolateral BA 2, BA 18, BA 35, and contralateral BA 9 and substania nigra.
CONCLUSIONThere are relatively specific corresponding brain areas for the Liver and Lung Channels, indicating that there is possible relatively specific connection between channels and the brain.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Brain ; anatomy & histology ; Female ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; methods ; Male ; Medicine, Chinese Traditional ; Meridians
6.Establishment of the normal reference values of left ventricular function parameters evaluated by CZT SPECT stress gated myocardial perfusion imaging in low-likelihood of stable coronary artery disease
Jingjing MENG ; Jian JIAO ; Xiaofen XIE ; Tiantian MOU ; Zhi CHANG ; Junqi LI ; Zhiyong SHI ; Yanlin WANG ; Shuang ZHANG ; Mingkai YUN ; Hongzhi MI ; Xiaoli ZHANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2023;43(3):144-149
Objective:To establish the normal reference value of left ventricular function parameters by cadmium-zinc-tellurium (CZT) SPECT stress gated myocardial perfusion imaging (G-MPI) in low-likelihood of stable coronary artery disease (SCAD).Methods:From March 2022 to August 2022, 348 consecutive SCAD patients (146 males, 202 females, age (58±10) years) who underwent exercise or pharmacological stress G-MPI (CZT SPECT) in Beijing Anzhen Hospital, Capital Medical University were retrospectively recruited. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were acquired using quantitative gated SPECT (QGS) analysis. EDV and ESV were corrected by body surface area (BSA) to obtain EDV index (EDVI) and ESV index (ESVI), respectively. Independent-sample t test, one-way analysis of variance and Mann-Whitney U test were used for data analysis. The influences of EDV, ESV, EDVI, ESVI and LVEF were analyzed by multiple regressions for linear models. Results:There were 314 patients with low-likelihood of SCAD (128 males, 186 females, age (58±10) years) and 34 normal controls (18 males, 16 females, age (55±10) years). There were no significant differences of basic clinical characteristics and left ventricular function parameters in different genders between 2 groups ( z values: from -1.74 to -0.02, t values: from -1.16 to 1.17, all P>0.05). Using the 95% CI as the cut-off value for left ventricular function parameters in patients with a low-likelihood of SCAD, the upper limits of EDV, ESV, EDVI and ESVI in females and males were 84 and 111 ml, 30 and 44 ml, 47 and 54 ml/m 2, 17 and 21 ml/m 2, respectively, and the lower limit of LVEF in females and males were 58% and 55%, respectively. In the low-likelihood of SCAD group, the EDV ((58±13) vs (77±17) ml) and ESV ((16±7) vs (26±9) ml) of females were smaller than those of males ( t values: 10.65, 10.35, both P<0.001), while LVEF of females was higher than that of males ((72±7)% vs (67±6)%; t=-6.23, P<0.001). However, there were no significant differences in left ventricular function parameters among different age groups with the same gender ( F values: 0.12-2.19, all P>0.05). Based on multiple regression for linear models, the primary predictors of EDV, ESV and LVEF were gender and weight ( β values: from -0.380 to 0.358, all P<0.05). Conclusions:Normal reference values of left ventricular function parameters are established by CZT SPECT stress G-MPI in low-likelihood of SCAD patients. Left ventricular EDV and ESV of females are smaller than those of males, while LVEF of females is higher than that of males. The influence of gender on left ventricular function parameters should be considered in clinical practice.
7.Gated myocardial perfusion imaging for predicting major adverse cardiovascular events in chronic kidney disease patients
Ying ZHANG ; Wei DONG ; Jian JIAO ; Tiantian MOU ; Zhi CHANG ; Quan LI ; Junqi LI ; Yehong ZHANG ; Xiaofen XIE ; Hongzhi MI
Chinese Journal of Medical Imaging Technology 2024;40(10):1499-1503
Objective To observe the value of semi-quantitative parameters related to gated myocardial perfusion imaging(G-MPI)for predicting occurrence of major adverse cardiovascular events(MACE)in patients with chronic kidney disease(CKD).Methods Totally 148 CKD patients who underwent rest G-MPI(R-GMPI)(R-GMPI group,n=95)or stress/rest G-MPI(S/R-GMPI)(S/R-GMPI group,n=53)were retrospectively included.The patients were categorized into MACE subgroup and non-MACE subgroup according to MACE occurred or not during follow-up.Clinical data and G-MPI parameters were compared between subgroups,and independent predictors of MACE in CKD patients were obtained using multivariate Cox proportional hazards regression analysis.Receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated to assess the efficacy of each independent predictor for predicting MACE.Among patients who underwent only R-GMPI,the optimal cut-off value of each parameter for predicting MACE was obtained by ROC curve analysis,and the risk of MACE was stratified,then Kaplan-Meier curves were drawn and compared with log-rank test.Results Among 95 patients who underwent only R-GMPI,compared with non-MACE subgroup,those in MACE subgroup had smaller body mass index(BMI)and higher proportion of previous myocardial infarction and hemodialysis,as well as higher R-GMPI left ventricle end-diastolic volume(R-LVEDV),left ventricle end-systolic volume(R-LVESV),sum rest score(R-SRS)but lower left ventricle ejection fraction(R-LVEF)(all P<0.05),while R-SRS(HR=1.068,95%CI[1.027,1.110])and R-LVESV(HR=1.011,95%CI[1.005,1.017])were both independent predictors for MACE(both P<0.05).Among 53 patients who underwent S/R-GMPI,compared with non-MACE subgroup,those in MACE subgroup had with higher blood creatinine and lower estimated glomerular filtration rate(eGFR),higher S-LVESV,R-LVEDV,sum stress score(SSS),SRS and sum difference score(SDS)(all P<0.05),and SDS(HR=1.454,95%CI[1.063,1.989])was an independent predictor for MACE(P<0.05).Among 95 CKD patients who underwent only R-GMPI,AUC of R-SRS and R-LVESV alone for predicting MACE was 0.659 and 0.694,respectively,and higher incidence of MACE was found in those w ith R-SRS ≥8 points,also in those with R-LVESV ≥91 ml(both P<0.05).Conclusion G-MPI could be used to evaluate myocardial perfusion and function in CKD patients.For CKD patients just underwent only R-GMPI,R-SRS and R-LVESV were independent predictors for MACE,whereas SDS might be utilized to predict MACE in CKD patients who could undergo S/R-GMPI.
8.Efficacy and safety of Changfu peritoneal dialysis solution: a multi-center prospective randomized controlled trial.
Jian-Hui ZHOU ; Zhao-Hui NI ; Chang-Lin MEI ; Xue-Qing YU ; Fu-You LIU ; Li-Ning MIAO ; Zhi-Hong LIU ; Wei-Jie YUAN ; Ai-Ping ZHANG ; Hong-Li LIN ; Meng-Hua CHEN ; Jiang-Hua CHEN ; Jin-Yuan ZHANG ; Ya-Ni HE ; Jian CHEN ; Jiu-Yang ZHAO ; Xiao-Qiang DING ; Ying LI ; Rong-Shan LI ; Ru-Juan XIE ; Wen-Hu LIU ; Chang-Ying XING ; Rong WANG ; Yue-Yi DENG ; Xue-Ying CAO ; Guang-Yan CAI ; Shan MOU ; Zhi-Guo MAO ; Xiao YANG ; Hong LIU ; Jing SUN ; Yu-Sheng YU ; Jun LIU ; Shu-Mei SHI ; Long-Kai LI ; Na TIAN ; Xiao-Hui ZHANG ; Wei ZHOU ; Jie YANG ; Yong ZHANG ; Jing-di SUN ; Jun JI ; Tao ZHANG ; Yan YAN ; Xiao-Gang LIU ; Gang WANG ; Li ZHANG ; Hong ZHANG ; Jian-Hua LUO ; Xiang-Mei CHEN
Chinese Medical Journal 2013;126(22):4204-4209
BACKGROUNDA multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions. Some researchers believe that 6 L/d is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.
METHODSAdult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices.
RESULTSChanges of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr). Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR). Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L×1.73 m(-2)×w(-1). More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that.
CONCLUSIONSThe domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution. During 48-week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.
Adolescent ; Adult ; Aged ; Dialysis Solutions ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis ; methods ; Young Adult
9.Effect of electroacupuncture on lung dysplasia in rats with intrauterine growth restriction induced by maternal food restriction.
Qiu-Jie MOU ; Bo JI ; Guo-Zhen ZHAO ; Yi-Tian LIU ; Jian DAI ; Ya-Wen LU ; Sakurai REIKO ; Kumar Rehan VIRENDER ; Ya-Na XIE ; Qin ZHANG ; Tian-Yu SHI
Chinese Acupuncture & Moxibustion 2021;41(4):405-410
OBJECTIVE:
To investigate the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) in pregnant rats on lung dysplasia of newborn rats with intrauterine growth restriction (IUGR) induced by maternal food restriction.
METHODS:
Twenty-four female SD rats were randomly divided into a control group, a control+EA group, a model group and a model+EA group, 6 rats in each group. From the 10th day into pregnancy to the time of delivery, the rats in the model group and the model+EA group were given with 50% dietary restriction to prepare IUGR model. From the 10th day into pregnancy to the time of delivery, the rats in the control+EA group and the model+EA group were treated with EA at bilateral "Zusanli" (ST 36), once a day. The body weight of offspring rats was measured at birth, and the body weight and lung weight of offspring rats were measured on the 21st day after birth. The lung function was measured by small animal lung function detection system; the lung tissue morphology was observed by HE staining; the content of peroxisome proliferator activated receptor γ (PPARγ) in lung tissue was detected by ELISA.
RESULTS:
Compared with the control group, the body weight at birth as well as the body weight, lung weight, lung dynamic compliance (Cdyn) and PPARγ at 21 days after birth in the model group were significantly decreased (
CONCLUSION
EA at "Zusanli" (ST 36) may protect the lung function and lung histomorphology changes by regulating the level of PPARγ of lung in IUGR rats induced by maternal food restriction.
Acupuncture Points
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Animals
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Electroacupuncture
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Female
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Fetal Growth Retardation/therapy*
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Lung
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Pregnancy
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Rats
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Rats, Sprague-Dawley
10.Predictive value of the proportion of hibernating myocardium in total perfusion defect on reverse remodeling in patients with HFrEF underwent coronary artery bypass graft.
Yao LU ; Jian CAO ; En Jun ZHU ; Ming Xin GAO ; Tian Tian MOU ; Ying ZHANG ; Xiao Fen XIE ; Yi TIAN ; Ming Kai YUN ; Jing Jing MENG ; Xiu Bin YANG ; Yong Qiang LAI ; Ran DONG ; Xiao Li ZHANG
Chinese Journal of Cardiology 2023;51(4):384-392
Objective: To evaluate the predictive value of the proportion of hibernating myocardium (HM) in total perfusion defect (TPD) on reverse left ventricle remodeling (RR) after coronary artery bypass graft (CABG) in patients with heart failure with reduced ejection fraction (HFrEF) by 99mTc-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) combined with 18F-flurodeoxyglucose (FDG) gated myocardial imaging positron emission computed tomography (PET). Methods: Inpatients diagnosed with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2016 to January 2022 were prospectively recruited. MPI combined with 18F-FDG gated PET was performed before surgery for viability assessment and the patients received follow-up MPI and 18F-FDG gated PET at different stages (3-12 months) after surgery. Δ indicated changes (post-pre). Left ventricular end-systolic volume (ESV) reduced at least 10% was defined as RR, patients were divided into reverse remodeling (RR+) group and the non-reverse group (RR-). Binary logistic regression analysis was used to identify predictors of RR. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to assess the cut-off value for predicting RR. Additionally, we retrospectively enrolled inpatients with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2021 to January 2022 as the validation group, who underwent MPI and 18F-FDG gated PET before surgery. Echocardiography was performed before CABG and after CABG (3-12 months). In the validation group, the reliability of obtaining the cut-off value for the ROC curve was verified. Results: A total of 28 patients with HFrEF (26 males; age (56.9±8.7) years) were included in the prospective cohort. HM/TPD was significantly higher in the RR+ group than in the RR- group ((51.8%±17.9%) vs. (35.7%±13.9%), P=0.016). Binary logistic regression analysis revealed that HM/TPD was an independent predictor of RR (Odds ratio=1.073, 95% Confidence interval: 1.005-1.145, P=0.035). ROC curve analysis revealed that HM/TPD=38.3% yielded the highest sensitivity, specificity, and accuracy (all 75%) for predicting RR and the AUC was 0.786 (P=0.011). Meanwhile, a total of 100 patients with HFrEF (90 males; age (59.7±9.6) years) were included in the validation group. In the validation group, HM/TPD=38.3% predicted RR in HFrEF patients after CABG with the highest sensitivity, specificity and accuracy (82%, 60% and 73% respectively). Compared with the HFrEF patients in the HM/TPD<38.3% group (n=36), RR and cardiac function improved more significantly in the HM/TPD≥38.3% group (n=64) (all P<0.05). Conclusions: Preoperative HM/TPD ratio is an independent factor for predicting RR in patients with HFrEF after CABG, and HM/TPD≥38.3% can accurately predict RR and the improvement of cardiac function after CABG.
Male
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Humans
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Middle Aged
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Aged
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Stroke Volume
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Heart Failure
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Fluorodeoxyglucose F18
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Retrospective Studies
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Reproducibility of Results
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Prospective Studies
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Coronary Artery Bypass
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Ventricular Dysfunction, Left
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Tomography, Emission-Computed, Single-Photon
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Perfusion
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Myocardium