ABSTRACT
Objective: To explore the predictive value of fractional lfow reserve (FFR) level for long-term prognosis in patients after coronary drug-eluting stent (DES) implantation, and to analyze the relevant factors affecting the level of post-operative FFR. Methods: A total of 135 patients who received DES implantation in our hospital from 2012-01 to 2013-07 with coronary intermediate lesion at (50-80) % were studied. The relevant factors for MACE occurrence were studied by multivariate logistic regression analysis, the post-stent FFR level for predicting the long term prognosis after DES implantation was ifnally analyzed by ROC curve. Results: All patients ifnished 1 year follow-up study including 104 male and 31 female with the mean age of (63 ± 9) years. The post-stent FFR level was lower in MACE group than that in Non-MACE group, (0.82 ± 0.07) vs (0.87 ± 0.06),P=0.004. Multivariate logistic regression analysis presented that the higher level of post-stent FFR was the protective factor for MACE occurrence (OR=0.212,P=0.039); the post-stent FFR level had certain predictive value for MACE occurrence at 1 year after DES implantation (AUC=0.706,P=0.006); Kaplan-Meier survival study showed that the patients with post-stent FFR<0.875 had the less MACE occurrence than those with FFR≥0.875,P=0.012. Multivariate logistic regression analysis also indicated that post-stent FFR≥0.875 was positively related to right coronary target vessel, higher pre-operative FFR level and larger stent diameter.Conclusion: Post-stent FFR level had certain predictive value for MACE occurrence in patients at 1 year after DES implantation, the patients with post-stent FFR≥0.875 had the lower MACE occurrence rate than those with FFR<0.875.
ABSTRACT
PurposeTo investigate the relationship between left atrial volume index (LAVI) and severity of coronary lesions in patients with stable angina pectoris, so as to provide information for the evaluation of the severity of coronary artery disease (CAD). Materials and MethodsAccording to the results of coronary angiography, 279 patients with stable angina pectoris and 92 healthy people were as control group, all subjects were divided into four groups: control group (n=92), single-vessel CAD group (n=116), double-vessel CAD group (n=93) and triple-vessel group (n=70). Each group was compared in the aspects of demographic characteristics, history of illness, liver and kidney functions and parameter's difference in echocardiogram; the correlation between LAVI and Gensini score was analyzed; and the receiver operating characteristic (ROC) curve was used to identify the predictive value of LAVI in severity of coronary lesions.ResultsCompared with the control group, the double-vessel and triple-vessel CAD groups had significantly larger left atrial diameter (P<0.05). In triple-vessel CAD group, the left atrial diameter was significantly larger than that in the single-vessel CAD group (P<0.05), and the left ventricular end-diastolic diameter was significantly larger than that in the control group and in the single-vessel CAD group (P<0.05), and the E/Em and LVMI were significantly higher than those in other groups (P<0.05). The LAVI was higher in patients with CAD compared with those in the control group and the LAVI in the triple-vessel CAD group was significantly higher than that in single-vessel CAD group and double-vessel CAD group (P<0.05); the LAVI was correlated positively with Gensini score (r=0.499,P<0.01). LAVI had certain value in predicting triple-vessel CAD (AUC=0.782,P<0.01). The results of multi-factor Logistic regression analysis showed that male patients with hypertension, mitral reflux, and multi-vessel CAD were more likely to had high LAVI.Conclusion The worsening LV diastolic function is associated with the increasing severity of coronary artery lesions, and LAVI may have predictive value for severity of CAD.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship between the apolipoprotein ApoA1-75 bp polymorphism and risk for dyslipidemia and coronary artery disease (CAD).</p><p><b>METHODS</b>A total of 723 patients (mean age (62.4 ± 10.2) years old) admitted to Guangdong General Hospital from 2011 to 2013 were enrolled. They were subdivided into CAD group (n = 444) and non-CAD (n = 279) group according to the result of coronary angiography (CAG). Clinical data including the profiles of lipids, -75 bp gene polymorphisms and Gensini scores were analyzed to determine the correlation between -75 bp gene polymorphisms, lipid profile and CAD.</p><p><b>RESULT</b>Frequency of male gender, history of diabetes and smoking, TC, TG, LDL-C and ApoB level were significantly higher and HDL-C level was significantly lower in CAD group than in non-CAD group (all P < 0.05). Frequency of A allele was significantly lower in CAD group than in non-CAD group (43.7% (194/444) vs. 56.6% (158/279) , P = 0.003). The ApoA1-75 bp gene polymorphism was significantly correlated with CAD (P < 0.005). Multivariate logistic regression analysis showed that -75 bp gene polymorphism mutation (OR = 0.649, P = 0.021) is an independent protective factor for coronary heart disease.</p><p><b>CONCLUSION</b>ApoA1-75 bp gene polymorphism is linked with risk of dyslipidemia and CAD.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alleles , Apolipoprotein A-I , Genetics , Apolipoproteins B , Coronary Artery Disease , Genetics , Coronary Disease , Diabetes Mellitus , Dyslipidemias , Genetics , Lipids , Mutation , Polymorphism, Genetic , Risk Factors , SmokingABSTRACT
Objective To explore the value of left atrium volume index (LAVI) in the diagnosis of heart failure with preserved ejection fraction (HFPEF). Methods Seventy-seven patients with HFPEF and 33 patients without HFPEF who had been treated from May 2012 to September 2013 in Guangdong General Hospital were en-rolled. The clinical data and a series of ultrasound parameters were collected and analysed. The relationship between LAVI, LAV, and other indexes of diastolic function was determined by Pearson correlation analysis. The value of LAVI and LAV for diagnosing HFPEF was compared by the ROC curve. Results LAVI and LAV of were signifi-cantly greater in HFPEF group than in non-HFPEF group. LAV and LAVI were significantly associated wtih HEPEF. The area under the ROC curve (AUC) of LAVI increased significantly as compared with the AUC of LAV (0.832 vs. 0.799, P<0.05). With a cut-off value of 30 mL/m2, the specificity and sensitivity for diagnosing HEPEF were 64.9%and 84.8%, respectively. Conclusions LAVI may be valuable in the diagnosis of HFPEF.
ABSTRACT
Objective To find out the sensitivity and s pecificity of intravascular ultrasound (IVUS) in identification of unstable atherosclerotic plaques. Methods Fourty-three patients diagnosed coronary heart disease, receiving coronary angiography and intravascular ultrasound examination,were divided into soft plaque and hard plaque group according to the echo reflectivity of atherosclerotic plaque by IVUS. Quantitative determination was performed between the two groups. Results The sensitivity of IVUS in detecting soft plaques from patients with acute coronary artery syndrome was 81.4 %, specificity 75.0 %, accuracy 79.1 %, positive predictive value 84.6 %. The lipid core areas and lipid to plaque ratio of soft plaques were significantly larger than those of hard plaques (P 0.05 ).Conclusions IVUS had higher sensitivity and specificity in detecting coronary vulnerable plaques in live bodies.