1.Prognostic value of coronary angiography based on CT flow reserve fraction in patients with unstable angina pectoris
Lin LI ; Lingxiang ZHANG ; Yuanzhe WANG
Chinese Journal of Postgraduates of Medicine 2024;47(12):1121-1126
Objective:To analyze the predictive value of CT coronary flow reserve fraction (CT-FFR) combined with coronary angiography in major adverse cardiovascular events (MACE) in patients with unstable angina pectoris (UAP).Methods:A total of 106 UAP patients treated in Wuhan Huangpi District People′s Hospital/Huangpi District People′s Hospital Affiliated to Jianghan University from April 2021 to April 2023 were retrospectively selected, among which 8 cases were lost to follow-up, and a total of 98 cases finally completed follow-up, and the occurrence of MACE within 1 year was counted, and they were classified into the MACE group (21 cases) and the non-MACE group (77 cases) according to whether or not MACE occurred. The general data, stenosis rate, CT-FFR and coronary plaque characteristics of the two groups were analyzed, and the correlation between each parameter index and B-type brain natriuretic peptide (BNP), Canadian angina pectoris (CCS) grade and the number of diseased vessels were analyzed. The predictive value was analyzed by receiver operating characteristic(ROC) curve, and the relationship between each parameter and the occurrence of MACE was analyzed by Logistic.Results:There were statistical differences in BNP, CCS and the number of diseased vessels between the two groups ( P<0.05). The total plaque volume, stenosis rate, calcified plaque volume and plaque load in the MACE group were higher than those in the non-MACE group, the CT-FFR value was lower than that in the non-MACE group: (142.56 ± 18.94) mm 3 vs. (132.78 ± 15.43) mm 3, (68.22 ± 10.78)% vs. (58.42 ± 9.14)%, (9.35 ± 1.85) mm 3 vs. (8.05 ± 2.02) mm 3, 0.75 ± 0.15 vs. 0.62 ± 0.11, 0.68 ± 0.10 vs. 0.84 ± 0.08, there were statistical differences ( P<0.05); the parameters above mentioned were closely correlated with CCS grade and the number of diseased vessels ( P<0.05). The results of ROC curve analysis showed that the area under the curve of MACE in UAP patients predicted by the combination of all parameters was 0.925, the sensitivity and specificity were 90.48% and 83.12%.The results of Logistic analysis showed that the stenosis rate, CT-FFR value, plaque volume, plaque load and calcified plaque volume were the risk factors for the occurrence of MACE in UAP patients ( P<0.05). Conclusions:The CT-FFR, stenosis rate and coronary plaque characteristics are different in UAP patients, and the combination of these parameters has certain clinical value in predicting the occurrence of MACE in patients.
2.Risk factors in blood for attacks of angina in patients with coronavirus disease 2019 and stable angina.
Song GENG ; Donghui ZHOU ; Qi WANG ; Guofeng WANG ; Wei WEI ; Tao YU ; Zhiying DUAN ; Jing LIU ; Fei YU ; Yuanzhe JIN
Chinese Medical Journal 2023;136(11):1373-1375
Humans
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Angina, Stable
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COVID-19
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Risk Factors
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Patients
3.Application of simplified strategy to diffuse long lesions in the elderly
Yong WANG ; Jing LIU ; Yuanzhe JIN
Chinese Journal of Postgraduates of Medicine 2019;42(4):305-308
Objective To evaluate the clinical efficacy of the simplified strategy in the treatment of diffuse long lesions in the elderly. Methods Two hundred and forty patients over 75 years old with diffuse long coronary artery disease and successfully implanted stents were divided into two groups according to whether the stent placement was completed or limited. The clinical features, pathological features, percutaneous coronary intervention (PCI) status and long-term prognosis of the two groups were observed. The success rates of angiography and surgery were compared between the two groups. The medication was followed up. The major adverse cardiovascular events (MACE) and all-cause mortality were compared between the two groups at 1 year after surgery. Results There was no significant difference between the two groups in cardiac death [1.56% (2/128) vs. 1.87% (2/107)], non-lethal acute cardiac muscle infarction (AMI) [1.56% (2/128) vs. 2.80% (3/107)], all-cause death [4.69% (6/128) vs. 4.67%(5/107)], revascularization of target vessels [2.34%(3/128) vs. 5.61%(6/107)] and angina pectoris recurrence [4.69% (6/128) vs. 7.47% (8/107)], P > 0.05. The difference between the two groups was statistically significant only in the follow-up of coronary angiography [18.75%(24/128) vs. 8.41%(9/107)], P < 0.05. Conclusions The long diffuse coronary artery lesions in the elderly can be implanted with point stents by simplified strategy. The long-term clinical effect is generally satisfactory.
4.Relationship between QT interval(QT)and metabolic syndrome
Shuo HAN ; Yuanzhe JIN ; Xiaohong ZHANG ; Zhiying DUAN ; Yingzi LIN ; Jing LIU ; Donghui ZHOU ; Qi WANG ; Jingru WANG ; Guofeng WANG ; Donghan ZHENG
The Journal of Practical Medicine 2018;34(9):1468-1471
Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.
5.Comparison of cryoablation catheter and radiofrequency ablation for treating atrioventricular nodal reentrant tachycardia
Chi MIAO ; Yuanyuan ZHAO ; Guofeng WANG ; Xiangshan XU ; Shaobo ZHOU ; Yuanzhe JIN
Chinese Journal of Interventional Cardiology 2017;25(5):261-265
Objective By comparing the efficacy and complication rates of the 8-mm-tip cryoablation catheter with the normal electrode ablation catheter in the treatment of atrioventricular nodal reentrant tachycardia,this study investigated the efficacy and feasibility of ablation with the 8-mm-tip cryoablation catheter.Methods This is a retrospective case-control study including 122 patients with AVNRT treated with CRYO (n =56) using an 8-mm-tip cryoablation catheter or RF ablation (n =66) from June 2014 to May 2016.The procedure success rate,the recurrence rate,atrioventricular block incidence,procedure time and the difference between the X-ray fluoroscopy dose were compared between the 2 groups.Results The procedure success rate was comparable between the 2 groups(100% for CRYO vs.98.5% for RF,P >0.999)and no AVB was found in both groups.The CRYO group needed shorter procedural time [(66.29±4.72)min vs.(70.00 ± 7.50) min,P =0.001] and less X-ray exposure [(674.14 ± 126.12) mSv vs.(837.52 ± 138.38) mSv,P > 0.001] than the RF group.Conclusions 8-mm-tip cryoablation catheter cryoablation for atrioventricular nodal reentrant tachycardia is as safe and effective as compared to conventional radiofrequency ablation with potential advantages.
6.Observation on therapeutic effect of balloon dilation in acute thrombus disease
Yong WANG ; Jing LIU ; Donghui ZHOU ; Yuanzhe JIN
Chinese Journal of Postgraduates of Medicine 2016;39(3):196-198
Objective To observe the therapeutic effect of balloon dilation in acute thrombus disease. Methods After coronary angiography, 137 patients with acute thrombus disease who were performed percutaneous coronary artery interventional therapy (PCI) from August 2010 to August 2012 were enrolled. In them, 53 patients (control group) didn′t undergo balloon dilation after PCI, and 84 patients(observation group)underwent balloon dilation after PCI. The intraoperative complications and the major adverse cardiac events (MACE) rate were observed. Results The rate of residue stenosis in observation group was lower than that in control group:(6.7 ± 1.3)% vs. (17.1 ± 1.8)%, and there was significant difference (P<0.05). The operation time in observation group was higher than that in control group:(57 ± 26) min vs.(48 ± 32) min, and there was significant difference (P<0.05). The no-reflow or slow flow after PCI in observation group was 3.8%(2/53), in control group was 3.6%(3/84), and there was no significant difference (P>0.05). The follow-up time was (0.9 ± 0.2) years. In control group, myocardial infarction occurred in 2 patients, 7 patients reviewed coronary angiography, and 2 patients underwent revascularization. In observation group, there was no MACE. Five patients reviewed coronary angiography, and no patient underwent revascularization. Conclusions The method of balloon dilation after PCI in acute thrombus disease is safe and feasible. It can reduce the incidence of MACE, and did not increase the rate of no-reflow or slow flow.
7.Clinical Application of Direct Stenting Technique in Emergent PCI for Patients with Acute Myocardial Infarction
Yong WANG ; Qi WANG ; Jing LIU ; Donghui ZHOU ; Yuanzhe JIN
Journal of China Medical University 2015;(5):468-471
Objective To evaluate the efficacy and safety of direct stenting technique in emergent percutaneous coronary intervention(PCI)for pa?tients with acute myocardial infarction(AMI). Methods Totally 460 consecutive patients with acute myocardial infarction who underwent emergent PCI during August 2010 to July 2013 were involved,among whom 346 patients were assigned to the control group(traditional balloon dilation and stenting),114 patients were assigned to the experiment group(direct stenting). The safety and efficacy of direct stenting technique was observed. Results In the control group,7 cases had no reflow during operation,2 cases had reflow after the pre?expansion and 5 cases after stent implanta?tion,no similar cases in the experiment group(P=0.125 9). The follow?ups showed the control group had 2 cases of major adverse cardiac events including 1 case of acute stent thrombosis who required urgent revascularization,and 1 case of cardiac death at four days after operation;the experi?ment group had 1 case of stent thrombosis,there was no statistically significant difference(P=0.730 7). Conclusion Direct stenting technique may be performed selectively for certain coronary diseases when performing emergent PCI for AMI.
8.Relationship between neutrophil to lymphocyte ratio and cardiovascular risk factors among community population
Donghan ZHENG ; Yuanzhe JIN ; Zhiying DUAN ; Yingzi LIN ; Xueying ZHANG ; Jingru WANG ; Shuo HAN ; Guofeng WANG ; Yijing ZHANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):476-480
Objective:To study the relationship between neutrophil to lymphocyte ratio (N/L) and traditional cardio‐vascular risk factors among community 35~64‐year‐old residents .Methods :A total of 1884 residents (548 males and 1336 females) from urban Shenyang city received baseline condition questionnaire on cardiovascular diseases and re‐lated diseases from Apr 2011 to Feb 2012. According to presence of cardiovascular risk factors or not ,subjects were divided into healthy control group (n=675) and risk factor group (n=1209);according to number of risk factors , risk factor group was further divided into one risk factor group (n=491) ,two risk factors group (n=263) and ≥3 risk factors group (n=455) .Morning blood sample and urine sample were retained to measure blood and urine rou‐tine ,blood glucose and blood lipid profile etc in all subjects .N/L was compared and analyzed among all groups .Re‐sults:Among patients with only one of following risk factors [hypertension ,diabetes mellitus (DM) ,dyslipidemia and obesity] ,N/L levels of patients with hypertension or DM were significantly higher than that of healthy control group [1.55(1.15 ,1.95) ,1.60(1.21 ,2.07) vs .1.45(1.09 ,1.91)] , P<0.05 both ,and there were no significant difference between any other one risk factor group and healthy control group , P>0.05 all .Among risk factor sub‐groups ,N/L level of ≥3 risk factors group was significantly higher than that of two risk factors group [1.57(1.16 , 2.04) vs .1.41(1.07 ,1.89) ,P<0.05] ,and there was no significant difference between any other two groups (P>0.05) .Conclusion:N/L significantly related to hypertension or DM ,and N/L level of ≥3 risk factors group was sig‐nificantly higher than that of two risk factors group ,N/L is helpful to assess risk of cardiovascular diseases .
9.Effect of Curing-injury Cataplasma on Analgesia and Expression of Nav1 . 7 in Model Rats with Formaldehyde-induced Inflammatory Pain
Qian LI ; Xianfang SHAO ; Zhijun LIU ; Shaojun CHEN ; Yuanzhe HE ; Wang YAN ; Bo WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2013;(8):1787-1791
This study was aimed to observe the analgesia of curing-injury Cataplasma and discuss the Nav1 . 7 expression in dorsal root ganglion ( DRG ) in model rats with formaldehyde-induced inflammatory pain . A total of 36 Sprague-Dawley rats were divided into three groups, which were the blank control group (n = 12), model group ( n = 12 ) , and treatment group ( n = 12 ) . The blank control group was without any treatment . The model group was injected with 0 . 1 mL 5% saline formalin on the left rear foot . The treatment group was applied with curing-injury Cataplasma on the left rear foot 24 h before the injection of 0 . 1 mL 5% saline formalin in the establishment of animal model . The behavior reactions to pain of model rats were observed . Dubuisson score was recorded and compared . Meanwhile , L3-6 DRG was collected from rats in each group . The expres-sion of Nav1 . 7 was detected by real-time quantitative PCR and western blot . The results showed that the pain reaction integral in the treatment group was lower than the model group ( P < 0 . 05 ) . Results from the real-time quantitative PCR showed that the relative expression of Nav1 . 7 mRNA in the model group was more than the treatment group . And the relative expression of Nav1 . 7 mRNA in the treatment group was more than the blank control group . There was significant difference among three groups ( P < 0 . 05 ) . There was no statistical difference at the three time points within three groups. Results from the western blot showed that the relative expression of Nav1 . 7 in the model group was more than the treatment group . And the expression of Nav1 . 7 in the treatment group was more than the blank control group . There was significant difference among three groups (P < 0.05). There was no statistical difference at the three time points within three groups. It was concluded that the curing-injury Cataplasma can alleviate inflammatory pain response in rats, and have certain analgesia effect . Meanwhile , it can influence Nav1 . 7 expression in DRG in model rats with formaldehyde-induced inflam-matory pain .
10.Comparison of ischemic heart disease incidence between left and right breast cancer treated with post-op radiation therapy
Xueying ZHANG ; Weili WANG ; Dawei LIU ; Genyan GUO ; Jun LIU ; Xiaochun ZHANG ; Yuanzhe JIN
Journal of Chinese Physician 2013;15(10):1346-1348
Objective To compare the difference in ischemic heart disease (IHD) incidence between left and right breast cancer treated with post-op radiation therapy.Methods We retrospectively reviewed electronic database of breast cancer patients treated in our cancer center from October 2006 to December 2011.Clinical data were recorded including clinical features,radiation fraction,and IHD.Statistical analysis was performed to compare the difference in IHD incidence between left and right breast cancer.Results Age on diagnosis was significantly associated with IHD (P < 0.05).Compare to younger patients (≤60),the increased hazard ratio of IHD in older patients (>60) was 3.84.The left breast cancer patients had greater incidence of IHD with the increased hazard ratio of 1.57 although this difference did not reach statistical power (P > 0.05).No patients got IHD in the intensity-modulated radiation therapy group.Conclusions Left-side breast cancer patients may have more probability to get IHD after thoracic radiation therapy compared to right-side patients.We recommend that left-side breast cancer patients should be treated with intensity-modulated radiation therapy to spare heart if they receive prophylactic radiation therapy after surgery.

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