1.Construction of a prediction efficacy model for PD-1 inhibitor in advanced esophageal squamous cell carcinoma
Shanshan WU ; Xiaojie HUANG ; Xiaochun XIE ; Shaokai HUANG ; Lina HUANG ; Xiaofen WANG
China Pharmacy 2025;36(17):2154-2159
OBJECTIVE To develop a prediction model for durable clinical benefit (DCB) in patients with advanced esophageal squamous cell carcinoma (ESCC) receiving programmed death-1 (PD-1) inhibitor. METHODS The clinical data of patients with advanced ESCC who received PD-1 inhibitor in Jieyang People’s Hospital were retrospectively collected between January 2020 to December 2023. Predictors were screened by least absolute shrinkage and selection operator (Lasso) regression, and a multivariable Logistic regression model was developed to predict DCB. A nomogram was constructed based on the model. Internal validation of the prediction model was performed by using the Bootstrap method, and the model was evaluated by the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. RESULTS A total of 91 patients with advanced ESCC were included. The results of Lasso regression combined with Logistic regression analysis indicated that the baseline lymphocyte monocyte ratio (LMR) [odds ratio (OR)=1.97, 95% confidence interval (CI): 1.15-3.36, P=0.013], albumin (ALB) content (OR=1.35, 95%CI: 1.13-1.60, P<0.001), body mass index (BMI) category 1 [normal vs. low: OR= 0.28, 95%CI (0.09-0.96), P=0.042], BMI category 2 [overweight-obesity vs. low: OR=0.08, 95%CI (0.01-0.59), P=0.013], and treatment regimen [monotherapy vs. monotherapy combination therapy: OR=0.07, 95%CI (0.01-0.50), P=0.008] were predictive factors for patients with advanced ESCC to achieve DCB when treated with PD-1 inhibitor. A prediction model was constructed based on the above indicators. Internal validation of the model using the Bootstrap method showed an area under the curve of 0.831 (95%CI: 0.746-0.904), with specificity of 74.4% and sensitivity of 75.0%. The Hosmer-Lemeshow test yielded χ2= 9.930, P=0.270, and the calibration curve slope was close to 1. The decision curve analysis demonstrated that the model exhibited good clinical utility within a threshold range of 0.1 to 1.0. CONCLUSIONS The prediction model based on baseline LMR, ALB content, BMI, and treatment regimen demonstrates robust predictive performance and clinical utility for assessing therapeutic efficacy of PD-1 inhibitor in the treatment of advanced ESCC.
2.Trim72 overexpression alleviates myocardial inflammation and apoptosis in mice with acute viral myocarditis
Junyi WANG ; Shanghua XU ; Yimin XUE ; Jun KE ; Jiuyun ZHANG ; Hui XIE ; Shan LI ; Xiaofen ZHOU
Chinese Journal of Emergency Medicine 2025;34(2):193-199
Objective:To investigate the role and possible mechanism of tripartite motif-containing protein 72 (Trim72) in acute viral myocarditis (AVMC) in mice.Methods:A mouse model of AVMC was established by intraperitoneal injection of Coxsackievirus B3 (CVB3, 2.0 × 10 5 PFU/mouse). Forty mice were randomly divided into the negative control (NC) + phosphate-buffered saline (PBS) group (NC+PBS group), Trim72 overexpression + PBS group (Trim72 + PBS group), NC + CVB3 group, and Trim72 + CVB3 group ( n = 10). Fourteen days before modeling, mice in each group were injected with adeno-associated virus type 9 vector (AAV9) encoding either negative control or Trim72 overexpression (5.0 × 10 11 VG/mouse) via tail vein. Subsequently, PBS or CVB3 was injected intraperitoneally in the PBS and CVB3 groups, respectively. After seven days, the surviving mice were euthanized, and the heart and serum samples were collected. HE and TUNEL staining were used to observe the cardiac pathological changes and cardiomyocyte apoptosis, respectively. The mRNA expression levels of Trim72 and pro-inflammatory cytokines TNF-α, IL-6, and IL-1β in myocardial tissues of each group were detected by RT-qPCR. The protein levels of cTnI, TNF-α, IL-6, and IL-1β in serum were detected by ELISA. The expression levels of Trim72, apoptosis-related proteins (Bax, Bcl-2, Cleaved caspase-3, Caspase-3), TLR4, p-p65, and p65 were detected by Western blot. Results:The protein and mRNA expression levels of Trim72 in myocardial tissues of mice in the NC+CVB3 group were significantly downregulated compared with those in the NC + PBS group ( P<0.05). Compared with the NC + CVB3 group, Trim72 overexpression significantly increased the protein and mRNA expression of Trim72 in myocardial tissues ( P<0.05), ameliorated myocardial inflammatory injury, decreased the apoptotic index of cardiomyocytes ( P<0.05), and reduced the levels of pro-inflammation cytokines TNF-α, IL-6, and IL-1β in the myocardium and serum ( P<0.05). Additionally, Trim72 overexpression also downregulated the protein expression of Bax, Cleaved caspase-3/Caspase-3, TLR4, and p-p65, and upregulated the protein expression of Bcl-2 in myocardial tissues ( P<0.05). There was no significant difference in the indexes of mice between the NC + PBS and Trim72 + PBS groups ( P>0.05). Conclusions:Trim72 overexpression attenuates AVMC in mice by inhibiting myocardial inflammatory injury and apoptotic imbalance, and the mechanism may be related to the negative regulation of the TLR4/NF-κB signaling pathway.
3.Correlation Study on the Odor Spectrum and Gut Microbiota in Chronic Atrophic Gastritis with Yin Deficiency Syndrome
Yuyu XIE ; Long ZHU ; Mengting ZHANG ; Xuejuan LIN ; Shanshan DING ; Xiaofen HOU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(11):163-171
Objective To collect oral exhaled odor spectrum of patients of chronic atrophic gastritis(CAG)with yin deficiency syndrome and detect their gut microbiota;To elucidate the mechanism of odor changes from the perspective of gut microbiota changes;To provide a basic research for the objectification of TCM olfactory diagnosis in CAG.Methods Totally 110 patients with CAG,including 55 patients with CAG yin deficiency syndrome,55 patients with CAG non-yin deficiency syndrome,and 30 healthy individuals were collected.The electronic nose technology was used to collect the oral exhaled odor spectrum of all subjects,and an improved Transformer model was used to identify the breath odor spectrum of CAG yin deficiency syndrome patients and healthy individuals,CAG non-yin deficiency syndrome patients and healthy individuals,CAG yin deficiency syndrome patients and CAG non-yin deficiency syndrome patients.At the same time,16S rRNA high-throughput sequencing method was used to detect the gut microbiota of the subjects'fecal samples,and the correlation analysis between the odor spectrum characteristics of CAG yin deficiency syndrome and gut microbiota was conducted.Results ① Analysis and recognition of odor spectrum characteristic.Amplitude characteristics:The response curves A,C,D,G,H,I and J of the odor spectrum in the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were all lower in amplitude than those in the healthy group(P<0.01,P<0.05).Slope characteristics:The slopes of response curves A,B,C,D,E,G,H,I and J in the odor spectrum of the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were lower than those of the healthy group(P<0.01,P<0.05).Pattern recognition:The accuracy of pattern recognition between the CAG yin deficiency syndrome group and the healthy group reached 0.904,with an area under ROC curve(AUC)of 0.91;the accuracy of pattern recognition between the CAG non-yin deficiency syndrome group and the healthy group reached 0.885,AUC=0.89;the accuracy of pattern recognition between the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group reached 0.747,AUC=0.75.② Species composition:At the genus level,compared with the healthy group,the abundance of Actinomyces,Escherichia-Shigella and Tyzzerella in the CAG yin deficiency syndrome group increased(P<0.05),while the abundance of Prevotella,Sutterella and Subdoligranulum decreased(P<0.05);the abundance of[Ruminococcus]_gnavus_group and Escherichia-Shigella in the CAG non-yin deficiency syndrome group increased significantly(P<0.01),while the abundance of Prevotella and Subdoligranulum decreased(P<0.05).Compared with the CAG yin deficiency syndrome group,the non-yin deficiency syndrome group showed significant enrichment of the Dialister(P<0.05).③ Correlation analysis between odor spectrum characteristics and gut microbiota in CAG yin deficiency syndrome:This study identified 17 bacterial genera that showed positive and negative correlations with the amplitude and slope characteristics of the odor spectrum in CAG yin deficiency syndrome,namely Lachnospiraceae_NK4A136_group,Lachnospiraceae_ND3007_group,Faecalibacterium,UCG-002,UCG-005,Coprococcus,CAG-352,Parabacteroides,Actinomyces,Streptococcus,Anaerostipes,Blautia,Dorea,[Eubacterium]_hallii_group,Phascolarctobacterium,Clostridium_sensu_stricto_1,Enterobacter.The above-mentioned bacterial genera could be classified into the following bacterial families:Trichomonas,Clostridia,Porphyromonas,Actinobacteria,Ruminococcus,Streptococcus,Bacteroidetes,Clostridium,Veillonellaceae and Enterobacteriaceae.Conclusion The use of electronic nose technology can accurately identify the oral exhaled odor of patients with CAG yin deficiency syndrome,CAG non-yin deficiency syndrome,and healthy individuals;the odor spectrum characteristics of patients with CAG yin deficiency syndrome are correlated with multiple bacterial genera,and the changes in related metabolites and gases produced by the disruption of their gut microbiota may be one of the biological bases for the changes in oral exhaled odor in CAG yin deficiency syndrome.
4.Predictive value of stress myocardial perfusion imaging with gated SPECT for cardiac death in patients with chronic kidney disease
Ying ZHANG ; Jian JIAO ; Zhi CHANG ; Xu HAN ; Quan LI ; Junqi LI ; Yehong ZHANG ; Xiaofen XIE ; Wei DONG ; Hongzhi MI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(6):346-351
Objective:To evaluate the clinical predictive value of SPECT myocardial perfusion imaging (MPI) in the occurrence of cardiac death in patients with chronic kidney disease (CKD).Methods:A retrospective follow-up was performed for 160 patients (109 males, 51 females; age: 68.5(61.0, 74.0) years) who underwent MPI in Beijing Anzhen Hospital, Capital Medical University between June 2017 and March 2024. The 17-segment 5-point method was used for image analysis to obtain the left ventricular myocardial perfusion and functional parameters. The patients were followed up for cardiac death, and divided into death group and survival group. Clinical data of those 2 groups were compare by χ2 test, the independent-sample t test or Mann-Whitney U test. Cox proportional hazards regression analysis was used to analyze the predictors related to cardiac death. The ROC curve was used to analyze the performance of predictors. Survival curves were obtained by the Kaplan-Meier method, and log-rank test was performed to compare the difference between 2 groups. Results:The follow-up time of 160 patients with CKD was 26.0(10.0, 46.5) months. Of 160 patients, 17 died and 143 survived. There were statistically significant differences in body mass index (BMI), previous myocardial infarction, previous revascularization, hypersensitive C-reactive protein (hs-CRP), positive MPI, left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) between the death group and the survival group ( χ2 values: 4.58-16.13, t values: -2.34, -3.97, Z values: from -2.81 to 5.02, all P<0.05). Multivariate Cox regression analysis showed that SSS (hazard ratio ( HR)=1.153, 95% CI: 1.062-1.252, P=0.001) and hs-CRP ( HR=1.031, 95% CI: 1.004-1.058, P=0.023) were independent risk factors for cardiac death in patients with CKD. The optimal cut-off value of SSS for predicting cardiac death in those patients was determined to be 8 with the AUC of 0.815, and the incidence of cardiac death in the SSS ≥8 group was significantly higher than that in the SSS<8 group (33.3%(12/36) vs 4.0%(5/124); χ2 = 25.44, P<0.001). Conclusion:MPI is an important imaging method for the evaluation of cardiac death in patients with CKD, SSS and hs-CRP are important risk factors in predicting cardiac death in those patients.
5.Predictive value of stress myocardial perfusion imaging with gated SPECT for cardiac death in patients with chronic kidney disease
Ying ZHANG ; Jian JIAO ; Zhi CHANG ; Xu HAN ; Quan LI ; Junqi LI ; Yehong ZHANG ; Xiaofen XIE ; Wei DONG ; Hongzhi MI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(6):346-351
Objective:To evaluate the clinical predictive value of SPECT myocardial perfusion imaging (MPI) in the occurrence of cardiac death in patients with chronic kidney disease (CKD).Methods:A retrospective follow-up was performed for 160 patients (109 males, 51 females; age: 68.5(61.0, 74.0) years) who underwent MPI in Beijing Anzhen Hospital, Capital Medical University between June 2017 and March 2024. The 17-segment 5-point method was used for image analysis to obtain the left ventricular myocardial perfusion and functional parameters. The patients were followed up for cardiac death, and divided into death group and survival group. Clinical data of those 2 groups were compare by χ2 test, the independent-sample t test or Mann-Whitney U test. Cox proportional hazards regression analysis was used to analyze the predictors related to cardiac death. The ROC curve was used to analyze the performance of predictors. Survival curves were obtained by the Kaplan-Meier method, and log-rank test was performed to compare the difference between 2 groups. Results:The follow-up time of 160 patients with CKD was 26.0(10.0, 46.5) months. Of 160 patients, 17 died and 143 survived. There were statistically significant differences in body mass index (BMI), previous myocardial infarction, previous revascularization, hypersensitive C-reactive protein (hs-CRP), positive MPI, left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) between the death group and the survival group ( χ2 values: 4.58-16.13, t values: -2.34, -3.97, Z values: from -2.81 to 5.02, all P<0.05). Multivariate Cox regression analysis showed that SSS (hazard ratio ( HR)=1.153, 95% CI: 1.062-1.252, P=0.001) and hs-CRP ( HR=1.031, 95% CI: 1.004-1.058, P=0.023) were independent risk factors for cardiac death in patients with CKD. The optimal cut-off value of SSS for predicting cardiac death in those patients was determined to be 8 with the AUC of 0.815, and the incidence of cardiac death in the SSS ≥8 group was significantly higher than that in the SSS<8 group (33.3%(12/36) vs 4.0%(5/124); χ2 = 25.44, P<0.001). Conclusion:MPI is an important imaging method for the evaluation of cardiac death in patients with CKD, SSS and hs-CRP are important risk factors in predicting cardiac death in those patients.
6.Effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis
Jie HAO ; Xiaofen XIE ; Hongping WEN
Chinese Journal of Modern Nursing 2025;31(26):3620-3624
Objective:To explore the effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis.Methods:Convenience sampling was used to select 200 patients with decompensated liver cirrhosis in Shanxi Provincial People's Hospital from March 2024 to September 2024 for the study. The patients were divided into control group ( n=100) and observation group ( n=100) by randomized numerical table method. Control group implemented conventional nursing, and observation group was treated with systematic nursing based on health empowerment theory on the basis of control group. Patients were assessed using the Exercise of Self-Care Agency Scale (ESCA), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Generic Quality of Life Inventory-74 (GQOLI-74), and a self-designed satisfaction rating scale. Results:After intervention, the ESCA scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the SDS and SAS scores of observation group were lower than those of control group, and the differences were statistically significant ( P<0.05). After intervention, the GQOLI-74 scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the overall satisfaction of observation group and control group was 92.00% (92/100) and 82.00% (82/100), respectively, with a statistically significant difference ( P<0.05) . Conclusions:The systematic nursing based on health empowerment theory for patients with decompensated liver cirrhosis can improve patients' self-care ability and quality of life, effectively alleviate depression and anxiety, and enhance patients' overall satisfaction with nursing services, which is worthy of clinical practice.
7.Correlation Study on the Odor Spectrum and Gut Microbiota in Chronic Atrophic Gastritis with Yin Deficiency Syndrome
Yuyu XIE ; Long ZHU ; Mengting ZHANG ; Xuejuan LIN ; Shanshan DING ; Xiaofen HOU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(11):163-171
Objective To collect oral exhaled odor spectrum of patients of chronic atrophic gastritis(CAG)with yin deficiency syndrome and detect their gut microbiota;To elucidate the mechanism of odor changes from the perspective of gut microbiota changes;To provide a basic research for the objectification of TCM olfactory diagnosis in CAG.Methods Totally 110 patients with CAG,including 55 patients with CAG yin deficiency syndrome,55 patients with CAG non-yin deficiency syndrome,and 30 healthy individuals were collected.The electronic nose technology was used to collect the oral exhaled odor spectrum of all subjects,and an improved Transformer model was used to identify the breath odor spectrum of CAG yin deficiency syndrome patients and healthy individuals,CAG non-yin deficiency syndrome patients and healthy individuals,CAG yin deficiency syndrome patients and CAG non-yin deficiency syndrome patients.At the same time,16S rRNA high-throughput sequencing method was used to detect the gut microbiota of the subjects'fecal samples,and the correlation analysis between the odor spectrum characteristics of CAG yin deficiency syndrome and gut microbiota was conducted.Results ① Analysis and recognition of odor spectrum characteristic.Amplitude characteristics:The response curves A,C,D,G,H,I and J of the odor spectrum in the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were all lower in amplitude than those in the healthy group(P<0.01,P<0.05).Slope characteristics:The slopes of response curves A,B,C,D,E,G,H,I and J in the odor spectrum of the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were lower than those of the healthy group(P<0.01,P<0.05).Pattern recognition:The accuracy of pattern recognition between the CAG yin deficiency syndrome group and the healthy group reached 0.904,with an area under ROC curve(AUC)of 0.91;the accuracy of pattern recognition between the CAG non-yin deficiency syndrome group and the healthy group reached 0.885,AUC=0.89;the accuracy of pattern recognition between the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group reached 0.747,AUC=0.75.② Species composition:At the genus level,compared with the healthy group,the abundance of Actinomyces,Escherichia-Shigella and Tyzzerella in the CAG yin deficiency syndrome group increased(P<0.05),while the abundance of Prevotella,Sutterella and Subdoligranulum decreased(P<0.05);the abundance of[Ruminococcus]_gnavus_group and Escherichia-Shigella in the CAG non-yin deficiency syndrome group increased significantly(P<0.01),while the abundance of Prevotella and Subdoligranulum decreased(P<0.05).Compared with the CAG yin deficiency syndrome group,the non-yin deficiency syndrome group showed significant enrichment of the Dialister(P<0.05).③ Correlation analysis between odor spectrum characteristics and gut microbiota in CAG yin deficiency syndrome:This study identified 17 bacterial genera that showed positive and negative correlations with the amplitude and slope characteristics of the odor spectrum in CAG yin deficiency syndrome,namely Lachnospiraceae_NK4A136_group,Lachnospiraceae_ND3007_group,Faecalibacterium,UCG-002,UCG-005,Coprococcus,CAG-352,Parabacteroides,Actinomyces,Streptococcus,Anaerostipes,Blautia,Dorea,[Eubacterium]_hallii_group,Phascolarctobacterium,Clostridium_sensu_stricto_1,Enterobacter.The above-mentioned bacterial genera could be classified into the following bacterial families:Trichomonas,Clostridia,Porphyromonas,Actinobacteria,Ruminococcus,Streptococcus,Bacteroidetes,Clostridium,Veillonellaceae and Enterobacteriaceae.Conclusion The use of electronic nose technology can accurately identify the oral exhaled odor of patients with CAG yin deficiency syndrome,CAG non-yin deficiency syndrome,and healthy individuals;the odor spectrum characteristics of patients with CAG yin deficiency syndrome are correlated with multiple bacterial genera,and the changes in related metabolites and gases produced by the disruption of their gut microbiota may be one of the biological bases for the changes in oral exhaled odor in CAG yin deficiency syndrome.
8.Effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis
Jie HAO ; Xiaofen XIE ; Hongping WEN
Chinese Journal of Modern Nursing 2025;31(26):3620-3624
Objective:To explore the effectiveness of systematic nursing based on health empowerment theory in patients with decompensated liver cirrhosis.Methods:Convenience sampling was used to select 200 patients with decompensated liver cirrhosis in Shanxi Provincial People's Hospital from March 2024 to September 2024 for the study. The patients were divided into control group ( n=100) and observation group ( n=100) by randomized numerical table method. Control group implemented conventional nursing, and observation group was treated with systematic nursing based on health empowerment theory on the basis of control group. Patients were assessed using the Exercise of Self-Care Agency Scale (ESCA), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Generic Quality of Life Inventory-74 (GQOLI-74), and a self-designed satisfaction rating scale. Results:After intervention, the ESCA scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the SDS and SAS scores of observation group were lower than those of control group, and the differences were statistically significant ( P<0.05). After intervention, the GQOLI-74 scores of observation group were higher than those of control group in all dimensions, and the differences were statistically significant ( P<0.05). After intervention, the overall satisfaction of observation group and control group was 92.00% (92/100) and 82.00% (82/100), respectively, with a statistically significant difference ( P<0.05) . Conclusions:The systematic nursing based on health empowerment theory for patients with decompensated liver cirrhosis can improve patients' self-care ability and quality of life, effectively alleviate depression and anxiety, and enhance patients' overall satisfaction with nursing services, which is worthy of clinical practice.
9.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.
10.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.

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