1.Role of cardiopulmonary ultrasound in predicting the occurrence of heart failure with preserved ejection fraction in patients with acute myocardial infarction
Runyu TIAN ; Weiwei ZHU ; Qizhe CAI ; Yunyun QIN ; Mingming LIN ; Shan JIN ; Wanwei ZHANG ; Xiuzhang LYU
Chinese Journal of Ultrasonography 2023;32(2):111-116
Objective:To evaluate the left ventricular diastolic function and pulmonary congestion in patients with acute myocardial infarction (AMI) with preserved left ventricular ejection fraction (LVEF) by cardiopulmonary ultrasound (CPUS), and to explore the value of CPUS in predicting the occurrence of heart failure with preserved ejection fraction (HFpEF) in AMI patients with preserved LVEF during hospitalization.Methods:A total of eighty-four patients with AMI with preserved LVEF (≥50%) who received optimal emergency reperfusion therapy on admission at Beijing Chaoyang Hospital Affiliated to Capital Medical University from August 2021 to March 2022 were enrolled. All patients completed comprehensive cardiopulmonary ultrasonography within 12 hours after reperfusion therapy and LVEF, left atrial maximum volume(LAV), peak flow velocity of tricuspid valve regurgitation (V TR), peak flow velocity of mitral valve in early diastole (E), peak velocity of mitral valve annulus on septal side and left ventricular lateral side in early diastole and other conventional echocardiography parameters were obtained, and then the left atrial volume index (LAVI), the mean peak velocity of the mitral valve annulus on the septal side and left ventricular lateral side in early diastole (e′) and E/e′ were calculated; lung ultrasound parameters(the number of B lines) were obtained; the left ventricular global long-axis strain (GLS) was obtained using speckle tracking imaging (STE). The predictive power of CPUS parameters for HFpEF during hospitalization in AMI patients with preserved LVEF were analyzed. Results:①The incidence of HFpEF during hospitalization was 40.4% (34/84). ②The number of B lines and LAVI were independently correlated with the occurrence of HFpEF during hospitalization( P<0.05). ③The ROC curve analysis showed that the area under the curve (AUC) of the number of B lines and LAVI for predicting the occurrence of HFpEF during hospitalization were 0.766 and 0.690, respectively. The number of B lines combined with LAVI had the best predictive performance in predicting the occurrence of HFpEF during hospitalization, with the largest AUC of 0.903, which was significantly better than the number of B lines and LAVI ( P<0.05). Conclusions:The number of B lines combined with LAVI can effectively predict the occurrence of HFpEF during hospitalization in AMI patients with preserved LVEF, which is helpful to further improve the clinical management of AMI patients at risk of HFpEF.
2.Curative Effect and Mechanism of Traditional Chinese Medicine in Treatment of Diabetic Gastroenteropathy: A Review
Ruiyang YIN ; Yuxin ZHANG ; Yanjiao ZHANG ; Xinyi FANG ; Runyu MIAO ; Huifang GUAN ; Jiaxing TIAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):239-247
Diabetic gastroenteropathy is a serious chronic complication that accompanies the progression of diabetes mellitus, severely impacting patients' quality of life and overall health. Nearly half of diabetic patients experience symptoms such as nausea, vomiting, early satiety, abdominal distension, and abdominal pain, which increases their anxiety and depression, prompting frequent medical visits and further burdening the healthcare system. In-depth research into the pathogenesis of diabetic gastroenteropathy has identified several core mechanisms, including hyperglycemia, autonomic and enteric nervous system dysfunction, abnormal secretion of gastrointestinal hormones, macrophage polarization, brain-gut axis dysregulation, microRNA deficiency, and oxidative stress-induced damage and apoptosis of interstitial cells of Cajal (ICC). Current clinical treatments mainly rely on prokinetic and antiemetic drugs. However, their notable adverse effects and diminishing efficacy with long-term use remain pressing issues. Traditional Chinese medicine (TCM), with its unique theoretical framework and extensive practical experience, potent in prescription formulation and acupoint selection guided by holistic concepts and syndrome differentiation, has gradually become an important option for treating diabetic gastroenteropathy. Numerous studies have confirmed that mechanisms include improving gastrointestinal hormone secretion, repairing ICC damage, regulating the nervous system, reducing oxidative stress, and modulating the brain-gut axis. These findings provide new insights into the treatment of diabetic gastroenteropathy. This article summarized the pathogenesis of diabetic gastroenteropathy and reviewed recent research on Chinese medicine and acupuncture-moxibustion therapy in improving gastrointestinal motility for diabetic gastroenteropathy treatment, aiming to offer clinical treatment insights and highlight the need for further research to explore comprehensive and individualized treatment approaches, providing better strategies for managing diabetic gastroenteropathy.