1.Value of right heart longitudinal strain in predicting early death after left ventricular assist device implantation
Yan SONG ; Tao SHI ; Miaomiao LIU ; Chao DENG ; Ying ZHANG ; Fei WANG ; Huirong WU ; Pan LI ; Litao RUAN
Chinese Journal of Ultrasonography 2024;33(12):1037-1042
Objective:To preliminarily investigate the correlation between right atrial and right ventricular myocardial strain, assessed by two-dimensional speckle-tracking echocardiography (2D-STE), and early death in patients after left ventricular assist device (LVAD) implantation.Methods:A total of 39 patients with end-stage heart failure who underwent LVAD implantation were prospectively included in the First Affiliated Hospital of Xi′an Jiaotong University from April 2022 to March 2024. Routine transthoracic echocardiography (TTE) images were obtained within 3 days before LVAD implantation for all patients to comprehensively assess left ventricular and right ventricular function. The right ventricular free wall longitudinal strain (RVFWSL), right ventricular four-chamber longitudinal strain (RV4CSL), right atrial reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct) were measured by using 2D-STE. The primary endpoint was early postoperative mortality. The patients were divided into survival group and death group based on whether died within 3 months after LVAD implantation.Results:Of all the patients, five cases died in hospital after LVAD implantation, with 4 deaths attributed to right heart failure and 1 death to malignant arrhythmia. The RVFWSL and RV4CSL (absolute values) in the death group were significantly lower than those in the survival group (both P<0.05). Cox multivariate regression analysis showed that RVFWSL and RV4CSL were risk factors for death within 3 months [ HR: 0.521(95% CI=0.275-0.986), P=0.045; HR: 0.491(95% CI=0.252-0.958), P=0.037]. Further ROC curve analysis revealed that the diagnostic cutoff value for RVFWSL in predicting death within 3 months was ≤|-12.1|%, with the area under the curve (AUC) of 0.938(0.812-0.990), and the diagnostic cutoff value for RV4CSL was ≤|-14.2|%, with an AUC of 0.926(0.796-0.985). Conclusions:In patients with end-stage heart failure, RVFWSL ≤ |-12.1|% and RV4CSL ≤ |-14.2|% are associated with an increased risk of death within 3 months after LVAD implantation.
2.Value of right heart longitudinal strain in predicting early death after left ventricular assist device implantation
Yan SONG ; Tao SHI ; Miaomiao LIU ; Chao DENG ; Ying ZHANG ; Fei WANG ; Huirong WU ; Pan LI ; Litao RUAN
Chinese Journal of Ultrasonography 2024;33(12):1037-1042
Objective:To preliminarily investigate the correlation between right atrial and right ventricular myocardial strain, assessed by two-dimensional speckle-tracking echocardiography (2D-STE), and early death in patients after left ventricular assist device (LVAD) implantation.Methods:A total of 39 patients with end-stage heart failure who underwent LVAD implantation were prospectively included in the First Affiliated Hospital of Xi′an Jiaotong University from April 2022 to March 2024. Routine transthoracic echocardiography (TTE) images were obtained within 3 days before LVAD implantation for all patients to comprehensively assess left ventricular and right ventricular function. The right ventricular free wall longitudinal strain (RVFWSL), right ventricular four-chamber longitudinal strain (RV4CSL), right atrial reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct) were measured by using 2D-STE. The primary endpoint was early postoperative mortality. The patients were divided into survival group and death group based on whether died within 3 months after LVAD implantation.Results:Of all the patients, five cases died in hospital after LVAD implantation, with 4 deaths attributed to right heart failure and 1 death to malignant arrhythmia. The RVFWSL and RV4CSL (absolute values) in the death group were significantly lower than those in the survival group (both P<0.05). Cox multivariate regression analysis showed that RVFWSL and RV4CSL were risk factors for death within 3 months [ HR: 0.521(95% CI=0.275-0.986), P=0.045; HR: 0.491(95% CI=0.252-0.958), P=0.037]. Further ROC curve analysis revealed that the diagnostic cutoff value for RVFWSL in predicting death within 3 months was ≤|-12.1|%, with the area under the curve (AUC) of 0.938(0.812-0.990), and the diagnostic cutoff value for RV4CSL was ≤|-14.2|%, with an AUC of 0.926(0.796-0.985). Conclusions:In patients with end-stage heart failure, RVFWSL ≤ |-12.1|% and RV4CSL ≤ |-14.2|% are associated with an increased risk of death within 3 months after LVAD implantation.
3.Effect of integrated TCM & western medicine nursing on prognosis and quality of life of dysphagia in patients with stroke after surgery
Qingxia YANG ; Litao PAN ; Wenpeng GUO
Chinese Journal of Modern Nursing 2016;22(27):3902-3905
Objective To explore the effect of integrated traditional Chinese medicine ( TCM) and western medicine on prognosis and quality of life of dysphagia in patients with stroke after surgery. Methods A total of 80 patients who underwent surgical treatment for stroke in our hospital were evaluated by GUSS, and 48 patients were found having dysphagia and were randomly divided into the control group and the observation group. Patients in the control group was given routine nursing, while the observation group was given integrated TCM and western medicine nursing combined with routine nursing. The complication rates, SDS and SAS scores were compared between two groups.Results The complication rates in the observation group was 8.3 %, and was 29.2% in the control group (χ2=4.25, P<0.05); the rehabilitation rate was 70.8% in the observation group and was 50.0% in the control group (χ2=4.18, P<0.05). After nursing intervention, scores of SAS and SDS in the observation group were significantly lower than the control group (t=4.45, 5.01;P<0.05). Conclusions Integrative TCM and western medicine nursing can effectively improve patients′ prognosis, decrease complication rates, alleviate negative emotion and improve quality of life.

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