Objective:To explore the influencing factors on the outcome of rheumatic mitral valve repair, to screen suitable patients for rheumatic mitral valve repair.Methods:A total of 876 patients who planned to undergo rheumatic mitral valve repair between January 2016 and March 2022 were included in the study. Preoperative echocardiography and cardiac CT imaging were used to evaluate mitral valve disease in patients. Successful completion of rheumatic mitral valve repair without over mild stenosis or regurgitation was defined as satisfactory repair. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors on the outcome of rheumatic mitral valve repair. Results:493 patients (56.2%) completed satisfactory rheumatic mitral valve repair. BMI, NYHA classification, left atrial diameter, degree of mitral stenosis, degree of mitral regurgitation, Agatston score, and papillary tendon fusion were independent influencing factors on the outcome of rheumatic mitral valve repair.Conclusion:Nearly 60% of patients with rheumatic mitral valve disease could complete satisfactory rheumatic mitral valve repair, and the degree of mitral valve calcification was an independent risk factor affecting the outcome of rheumatic mitral valve repair.

Objective To compare the value of ultrashort echo time(UTE)and T1W sequences for detecting bone erosions of gouty arthritis.Methods Forty-four gouty patients were prospectively enrolled,including 32 cases with affected feet and 12 cases with affected knee.MR UTE and T1W sequence scanning of the affected area were performed,and subjectively scoring of imaging quality of 2 kinds of MRI were evaluated,respectively.Then total number and total score of bone erosions of each case were calculated according to all affected bones.Taken DECT as reference standard,the efficacy of UTE and T1WI for detecting bone erosions was assessed through comparing with DECT using Kappa coefficient.Results The imaging quality score of T1WI was lower than that of DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).There was high agreement between UTE and DECT for detecting bone erosions(κ=0.949),while the agreement between T1WI and DECT ranged from good to high(κ=0.718 to 0.805).The total number and total score of bone erosions based on T1WI were significantly lower than those based on DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).Conclusion UTE was better than T1WI for detecting bone erosions of gouty arthritis.

Objective To analyze the clinical efficacy of valve surgeries for infective endocarditis and the affecting factors, and compare the early- and long-term postoperative outcomes of different surgery approaches. Methods The patients with infective endocarditis who underwent valve replacement/valvuloplasty in our hospital from 2010 to 2022 were retrospectively collected. The clinical data of the patients were analyzed. Results A total of 343 patients were enrolled, including 197 patients with mechanical valve replacement, 62 patients with bioprosthetic valve replacement, and 84 patients with valvuloplasty. There were 238 males and 105 females with an average age of (44.2±14.8) years. Single-valve endocarditis was present in 200 (58.3%) patients, and multivalve involvement was present in 143 (41.7%) patients. Sixty (17.5%) patients had suffered thrombosis before surgery, including cerebral embolisms in 32 patients. The mean follow-up time was (60.6±43.8) months. Early mortality within one month after the surgery occurred in 17 (5.0%) patients, while later mortality occurred in 19 (5.5%) patients. Eight (2.3%) patients underwent postoperative dialysis, 13 (3.8%) patients suffered postoperative stroke, 6 patients underwent reoperation, and 3 patients suffered recurrence of infective endocarditis. Smoking (P=0.002), preoperative embolisms (P=0.001), duration of surgery (P=0.001), and postoperative dialysis (P=0.001) were risk factors for early mortality, and left ventricular ejection fraction ≥60% (P=0.022) was protective factor for early mortality. New York Heart Association classification Ⅲ-Ⅳ (P=0.010) and ≥3 valve procedures (P=0.028) were risk factors for late mortality. The rate of composite endpoint events was significantly lower in the valvuloplasty group than that in the valve replacement group. Conclusion For patients with infective endocarditis, smoking and preoperative embolisms are associated with high postoperative mortality, multiple-valve surgery is associated with a poorer prognosis, and valvuloplasty has advantages over valve replacement and should be attempted in the surgical management of patients with infective endocarditis.

Objective To explore the differences in the radiological features,clinical,and laboratory indicators of frequent versus infrequent gout flares in the feet and ankles using dual-energy computed tomography(DECT).Methods A retrospective selection was made on 385 gout patients,who were divided into the frequent flare group(≥2 gout attacks per year,219 cases)and the infre-quent flare group(<2 gout attacks per year,166 cases).Clinical data,laboratory indicators,and DECT imaging findings were col-lected for statistical analysis.Binary logistic regression was used to analyze the independent risk factors for frequent gout flares and receiver operating characteristic(ROC)curve was plotted.Results Statistically significant differences were found between the fre-quent flare group and the infrequent flare group in terms of disease duration,body mass index(BMI),blood pressure,triglyceride(TG),serum uric acid(SUA),monosodium urate(MSU)crystal deposition,total volume of MSU crystals,maximum diameter of individ-ual tophi,number of affected joints,bone erosion,maximum depth of bone erosion,soft tissue swelling,bone proliferation and sclero-sis,and joint space narrowing(P<0.05).SUA levels,MSU crystal deposition,total volume of MSU crystals,and maximum depth of bone erosion were identified as independent risk factors for frequent gout(P<0.05).Both the combination of four factors model and the maximum depth of bone erosion model had better diagnostic efficacy.Conclusion Gout patients with high SUA levels,MSU crystal deposition,larger total volume of MSU crystals,and greater maximum depth of bone erosion are more likely to experience frequent gout attacks.Patients with bone erosion depth>3.200 mm are more likely identified early as having frequent gout.

Objective To retrospectively analyze the clinical outcomes of mitral valve repair MVR for treating rheumatic mitral valve disease.Methods A total of 537 patients with rheumatic mitral valve disease who underwent surgical repair at the Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,from January 2016 to August 2022 were retrospectively included.Clinical and follow-up data were collected.Kaplan-Meier survival curves were constructed to calculate event-free survival rates for the cohort.Additionally,multivariate Cox regression analysis was employed to identify independent risk factors affecting patient prognosis.Results The mean age of all patients was(57.8±7.5)years,with 144(26.8%)males and 393(73.2%)females.The median follow-up time for the cohort was 36.7 months.Survival analysis revealed that the 5-year composite endpoint-free survival rate was 94.1%,the 5-year overall survival rate was 96.7%,and the 5-year freedom from mitral valve reoperation rate was 97.2%.Multivariate Cox regression analysis identified systolic pulmonary artery pressure as an independent risk factor for adverse prognosis(P<0.05).Conclusion Mitral valve repair can achieve favorable outcomes in appropriately selected patients with rheumatic mitral valve disease,while systolic pulmonary artery pressure serves as an independent risk factor for an adverse prognosis.

Objective To retrospectively analyze the clinical outcomes of mitral valve repair MVR for treating rheumatic mitral valve disease.Methods A total of 537 patients with rheumatic mitral valve disease who underwent surgical repair at the Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,from January 2016 to August 2022 were retrospectively included.Clinical and follow-up data were collected.Kaplan-Meier survival curves were constructed to calculate event-free survival rates for the cohort.Additionally,multivariate Cox regression analysis was employed to identify independent risk factors affecting patient prognosis.Results The mean age of all patients was(57.8±7.5)years,with 144(26.8%)males and 393(73.2%)females.The median follow-up time for the cohort was 36.7 months.Survival analysis revealed that the 5-year composite endpoint-free survival rate was 94.1%,the 5-year overall survival rate was 96.7%,and the 5-year freedom from mitral valve reoperation rate was 97.2%.Multivariate Cox regression analysis identified systolic pulmonary artery pressure as an independent risk factor for adverse prognosis(P<0.05).Conclusion Mitral valve repair can achieve favorable outcomes in appropriately selected patients with rheumatic mitral valve disease,while systolic pulmonary artery pressure serves as an independent risk factor for an adverse prognosis.

Objective To explore the differences in the radiological features,clinical,and laboratory indicators of frequent versus infrequent gout flares in the feet and ankles using dual-energy computed tomography(DECT).Methods A retrospective selection was made on 385 gout patients,who were divided into the frequent flare group(≥2 gout attacks per year,219 cases)and the infre-quent flare group(<2 gout attacks per year,166 cases).Clinical data,laboratory indicators,and DECT imaging findings were col-lected for statistical analysis.Binary logistic regression was used to analyze the independent risk factors for frequent gout flares and receiver operating characteristic(ROC)curve was plotted.Results Statistically significant differences were found between the fre-quent flare group and the infrequent flare group in terms of disease duration,body mass index(BMI),blood pressure,triglyceride(TG),serum uric acid(SUA),monosodium urate(MSU)crystal deposition,total volume of MSU crystals,maximum diameter of individ-ual tophi,number of affected joints,bone erosion,maximum depth of bone erosion,soft tissue swelling,bone proliferation and sclero-sis,and joint space narrowing(P<0.05).SUA levels,MSU crystal deposition,total volume of MSU crystals,and maximum depth of bone erosion were identified as independent risk factors for frequent gout(P<0.05).Both the combination of four factors model and the maximum depth of bone erosion model had better diagnostic efficacy.Conclusion Gout patients with high SUA levels,MSU crystal deposition,larger total volume of MSU crystals,and greater maximum depth of bone erosion are more likely to experience frequent gout attacks.Patients with bone erosion depth>3.200 mm are more likely identified early as having frequent gout.

Objective To compare the value of ultrashort echo time(UTE)and T1W sequences for detecting bone erosions of gouty arthritis.Methods Forty-four gouty patients were prospectively enrolled,including 32 cases with affected feet and 12 cases with affected knee.MR UTE and T1W sequence scanning of the affected area were performed,and subjectively scoring of imaging quality of 2 kinds of MRI were evaluated,respectively.Then total number and total score of bone erosions of each case were calculated according to all affected bones.Taken DECT as reference standard,the efficacy of UTE and T1WI for detecting bone erosions was assessed through comparing with DECT using Kappa coefficient.Results The imaging quality score of T1WI was lower than that of DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).There was high agreement between UTE and DECT for detecting bone erosions(κ=0.949),while the agreement between T1WI and DECT ranged from good to high(κ=0.718 to 0.805).The total number and total score of bone erosions based on T1WI were significantly lower than those based on DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).Conclusion UTE was better than T1WI for detecting bone erosions of gouty arthritis.

Objective:To explore the influencing factors on the outcome of rheumatic mitral valve repair, to screen suitable patients for rheumatic mitral valve repair.Methods:A total of 876 patients who planned to undergo rheumatic mitral valve repair between January 2016 and March 2022 were included in the study. Preoperative echocardiography and cardiac CT imaging were used to evaluate mitral valve disease in patients. Successful completion of rheumatic mitral valve repair without over mild stenosis or regurgitation was defined as satisfactory repair. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors on the outcome of rheumatic mitral valve repair. Results:493 patients (56.2%) completed satisfactory rheumatic mitral valve repair. BMI, NYHA classification, left atrial diameter, degree of mitral stenosis, degree of mitral regurgitation, Agatston score, and papillary tendon fusion were independent influencing factors on the outcome of rheumatic mitral valve repair.Conclusion:Nearly 60% of patients with rheumatic mitral valve disease could complete satisfactory rheumatic mitral valve repair, and the degree of mitral valve calcification was an independent risk factor affecting the outcome of rheumatic mitral valve repair.

Objective To explore the effect of aortic valve neo-cuspidization (AVNeo) for patients with severe aortic valve lesions simultaneously. Methods Patients who underwent AVNeo combined valve repair surgery for multiple valve diseases were included in Beijing Anzhen Hospital from May 2016 to September 2023. Results We included 11 patients with 7 males and 4 females at a median age of 38 (36, 49) years. Rheumatic heart disease was found in 5 (45.5%) patients and non-rheumatic heart disease in 6 (54.5%) patients. The median EuroSCORE Ⅱ score was 1.62 (1.18, 1.75) points. Eight patients underwent AVNeo plus mitral and tricuspid valve repair, and 3 patients underwent AVNeo plus mitral valve repair. The median operative time was 356 (315, 415) min, and the median cardiopulmonary bypass time and aortic clamping time were 203 (174, 231) min and 168 (131, 188) min, respectively. In the early stage, 2 patients underwent combined valve repair surgery, and 1 patient underwent in-hospital reoperation for aortic valve replacement because of severe aortic regurgitation. There were 9 patients in the mature stage of AVNeo, and no perioperative adverse events or moderate or above residual valvular disease occurred. All patients recovered and were discharged from the hospital. The follow-up period was 3-99 months, and no reoperation, severe valve disease, bleeding, cerebral infarction, or other adverse events occurred in all patients. Conclusion For non-elderly patients whose mitral and tricuspid valves can be repaired successfully with severe aortic valve lesions, AVNeo can be attempted after proficiency. But the operation time and cardiopulmonary bypass time will inevitably be prolonged, and the patient's basic situation should be carefully evaluated before surgery.