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OBJECTIVE@#To train convolutional networks using multi-lead ECG data and classify new data accurately to provide reliable information for clinical diagnosis.@*METHODS@#The data were pre-processed with a bandpass filter, and signal framing was adopted to adjust the data of different lengths to the same size to facilitate network training and prediction. The dataset was expanded by increasing the sample size to improve the detection rate of abnormal samples. A depth-wise separable convolution structure was used for more specific feature extraction for different channels of twelve-lead ECG data. We trained the two classifiers for each label using the improved DenseNet to classify different labels.@*RESULTS@#The propose model showed an accuracy of 80.13% for distinguishing between normal and abnormal ECG with a sensitivity of 80.38%, a specificity of 79.91% and a F1 score of 79.35%.@*CONCLUSIONS@#The model proposed herein can rapidly and effectively classify the ECG data. The running time of a single dataset on GPU is 33.59 ms, which allows real-time prediction to meet the clinical requirements.
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Humans , Algorithms , Arrhythmias, Cardiac , Diagnosis , Databases as Topic , Electrocardiography , Classification , Methods , Neural Networks, Computer , Sensitivity and SpecificityABSTRACT
BACKGROUND:A number of studies have shown that bone marrow mesenchymal stem cells can survive in the infarcted myocardium and improve cardiac function. OBJECTIVE:To investigate the effects of al ogeneic rat bone marrow mesenchymal stem cells on heart failure in acute myocardial infarction models of rats and possible mechanisms. METHODS:Rat bone marrow mesenchymal stem cells were isolated from the bone marrow of 39 male Wistar rats by density gradient centrifugation with Percol . After ligating anterior descending coronary artery, 39 female Wistar rats were randomly divided into three groups:control group (Dulbecco’s modified Eagle’s medium, n=12), mesenchyma stem cells group (n=15) and mononuclear cells group (n=12). Eight weeks later, hemodynamics and left ventricular function were measured. Histopathological and immunohistochemical examinations were performed. RESULTS AND CONCLUSION:Compared with the control group, left ventricular end diastolic pressure, left ventricular relative weight, the col agen volume fraction of type I and type III in the infarction zone of the left ventricle were al significantly decreased, in contrast to ±dp/dtmax,-dp/dtmax/left ventricular systolic pressure, body weight and vascular density in infarction zone were al significantly increased both in mesenchymal stem cells group and mononuclear cells group. There were no significant differences between two treatment groups except for interventricular septal thickness and vascular density in non-infarction zone. 5-Bromo-2'-deoxyuridine positive cells were observed in the infarction area of mesenchyma stem cells group but no positive cells in mononuclear cells group. Some bal-like cellmasses were found positively stained with desmin and cardiac troponin T. Results have suggested that embedded bone marrow mesenchymal stem cells survived in exogenous host hearts. The therapy of mononuclear cells and mesenchymal stem cells could limit the left ventricular remodeling after acute myocardial infarction and improve left ventricular function through angiogenesis inducing and col agen deposition decreasing.
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@#ObjectiveTo study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction. Methods130 patients with myocardial infarction were divided into anti-aldosterone group (spironolactone 20～40 mg/d + enalapril 10～20 mg/day, n=61) and control group (enalapril 10～20 mg/d, n=69). The echocardiogram and Doppler tissue imaging (DTI) were performed at enrolling time, and 6, 12 months after treatment. ResultsIn the anti-aldosterone group, the average mitral systolic wave (s) was significantly increased 6 months after treatment （P<0.05） to the enrolling time. LVEF and LVEDD improved 12 months after treatment （P<0.05）. In the control group, the average mitral systolic wave, LVEDD and LVEF did not significantly improve (P>0.05). Ratio of peak early to late diastolic filling velocity (e/a) was no significantly different between the anti-aldosterone group and the control group. ConclusionThe combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months, but cannot to the diastolic function.
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Objective To investigate the relationship between the content of ET-1, CGRP, NO in myocardium and cardiac function in chronic renal ischemia of rats caused by abdominal aortic banding. Methods Male wistar rats (weight 180 - 200g) were randomly divid-ed into 2 groups, operation group (n=30) and sham operation group (n=10). Abdominal aorta ligation between right and left renal ar-tery was made with silk suture in operation group, and the narrow degree of aorta was about 50% which was controlled by ligateing with a syr-inge needle (7#). The aorta was not ligated in sham operation group. After 16 weeks of operation, invasive measurement of blood pressure and cardiac function were performed, and content of ET-1, CGRP and NO in myocardium were determined. Results Compared with sham operation group, the blood pressures of rats in operation group were significantly elevated, with cardiac systolic and diastolic function de-creased and left ventricular mass index increased. After 16 weeks, compared with sham operation group, the content of ET-1 in cardiac tissue were significantly elevated in operation group (P<0.01), while the content of CGRP (P<0.01)and NO (P>0.05)were decreased. There were negative correlation between the content of ET-1 in cardiac tissue and LV +dp/dt max(r = -0.37, P<0. 05). Conclusions In the state of chronic kidney iachemia caused by abdominal aorta ligation, content of ET-1 in cardiac tissues were increased while CGRP and NO were decreased. There were negative correlation between the content of ET-1 in cardiac tissues and LV systolic function.
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@#Objective To investigate the effect of blood glucose levels on lipid-lowering therapy in patients with myocardial infraction (MI).Methods The data of 174 patients with acute or old MI and finished a two-year follow-up were analyzed retrospectively. The patients were divided into four groups: diabetes mellitus (DM) with well blood glucose control (DM+W group), diabetes mellitus with bad blood glucose control (DM+B group), non-diabetes mellitus with well blood glucose control (NDM+W group) and non-diabetes mellitus with bad blood glucose control (NDM+B group). Blood lipids levels, dose and side effects of statins were statistically analyzed.Results All the 174 patients had a mean follow-up period of 28±7 months, and 51 patients (25.9%) had diabetes mellitus. In DM+B group (n=13, 25.5%) and NDM+B group (n=24, 19.5%), there were no statistically difference between enrollment and 2-year follow-up in the mean levels of blood total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c), but the mean level of LDL-c had a trend of elevation. In DM+W group, the mean level of LDL-c was 2.57 mmol/L at 2-year follow-up, which did not achieve the recommended LDL-c goal (2.06 mmol/L). There were no differences in statin therapy between each group. After 2-year follow-up, there were only 93 patients (53.4%) received normal dose of statin, 60 patients (34.5%) took low dose of statin and 16 patients (9.2%) had no statin therapy. There were no differences in hepatic enzyme abnormality between each group.Conclusion The bad control of blood glucose in patients with MI effect the efficacy of statins in lipid-lowering therapy. The doses of statin are insufficient especial in patients with MI and DM.
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@#Objective To investigate the safety and efficacy of protective measures(hydration treatment)during perioperative period of interventional therapy for renal function of gerontic patients with coronary artery disease(CAD)complicated by chronic renal insufficiency(CRI).Methods The relation between hydration therapies and the renal function of 168 CAD patients(≥60 years old)complicated by CRI were analyzed.These patients were divided into three groups:in the group A,patients underwent selective coronary angiography(SCA)with conventional treatment during interventional perioperative period(IPP);in the group B,patients underwent SCA and treated with the NaCl plus low dose NaHCO3 during IPP;in the group C,patients underwent percutaneous coronary intervention(PCI),and meanwhile treated with the same dose NaCl and NaHCO3 as the group B during IPP.Results Coronary interventions were successful in all 168 patients.Contrast medium associated nephropathy(CAN)was found in 30 patients,and incidences of the CAN were 17(27.4%)in the group A,3(7.5%)in the group B and 10(15.2%)in the group C,respectively.The accompanying diseases and characteristics of the patients also effected the incidence of CAN:the CAN incidence of patients with hyperlipidemia was significantly higher than that with normal cholesterol(P<0.001);patients with diabetes was significantly higher than that with normal serum glucose(P<0.001);patients with stenosis of renal artery was significantly higher than that with normal renal artery(P<0.001);patients with heart failure(grade Ⅲ～Ⅳ)was significantly higher than that with the grade Ⅰ～Ⅱ(P<0.001).Conclusion The hydration treatment with the NaCl plus low dose NaHCO3 during IPP can protect renal function and increase tolerance for gernotic CAD patients complicated by CRI during IPP,and improve prognosis.
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@#Objective To observe the curative effects of long term statins treatment on blood lipid and left ventriclar function of myocardial infarction patients. Methods 70 patients with myocardial infarction were randomly divided into two groups: Statins treatment group (n=37) and control group (n=33). The level of blood lipid, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) were mearsured before and 2 years after the treatment. Results The long term applies of statins can bring statistically different (P<0.05) of TC and LDL-C to myocardial infarction patients. LVESD and LVEF were statistically different (P<0.05) before and after statins were used. Conclusion The long term applies of statins can improve the lipidic metabolism and left ventricular function after myocardial infarction.
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Objective:To evaluate the effect of percutaneous coronary intervention(PCI) on mitral regurgitation(MR) in patients with acute myocardial infarction(AMI).Methods: A total of 213 AMI patients were divided into PCI group(n=87,(PCI +) medication) and medication group(n=126,medication) according to the treatments they received.Echocardiographic examination was conducted in patients during admission and 6 months follow-up.Color Doppler was used to determine the degree of MR.Echocardiogram indices included MR degree,left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVEDs),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),and left ventricular ejection fraction(LVEF).Results: The overall incidence of MR was 28.6% in 213 patients during admission.The MR incidence in patients with acute inferior myocardial infarction was higher than that in patients with other parts of infarction((34.5%) vs 22.3%,P0.05),while the incidence in medication group increased significantly than that during admission(43.7% vs 30.2%,P