ABSTRACT
Objective: To establish an echocardiography parameter scoring system for assessing the risk of 1 year re-admission in patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 412 chronic LVSD patients treated in our hospital from 2007-01 to 2016-01 were studied and the end point event was 1 year re-admission. The data included in 280 patients from 2007-01 to 2014-12 for establishing the scoring system and 132 patients from 2015-01 to 2016-01 for verifying the system. Based on 7 echocardiography parameters, the patients were divided into 7 sets of groups: ① Left ventricular diameter (LVD): Group0, n=290 and Group1, n=122;② Mitrial regurgitation (MR): Group0, n=203, Group1, n=138 and Group2, n=71; ③ Tricuspid regurgitation (TR): Group0, n=302, Group1, n=90 and Group2, n=20; ④ LVEF: Group0, n=272 and Group1, n=140; ⑤ Pulmonary artery systolic pressure: Group0, n=282 and Group1, n=130; ⑥ Hydropericardium: Group0, n=347 and Group1, n=65; ⑦ Hydrothorax:Group 0, n=261, Group1, n=86 and Group2, n=65. The parameters were identified by COX regression analysis, weighted value of scoring system was calculate by hazard ratio (HR), predictive value for1 year re-admission was assess by ROC curve and finally, scoring integration was verified by validation data group. Results: The integration score was calculated as follows: LVD>60mm=1 point; TR: Group1=1 point and Group2=3 points; MR: Group1=2 points and Group2=4 points; Hydrothorax: Group1=2 points and Group2=3 points;Hydropericardium=1 point. COX regression analysis indicated that for 1 year re-admission: HR=1.552 in Group1 vs Group0, HR=3.374 in Group2 vs Group0 and HR=4.562 in Group3 vs Group0, all P<0.05. The AUC of ROC for establishing the data was 70.0% (95% CI 0.640-0.761) and for verifying the data was 70.4% (95% CI 0.616-0.792); the best integration score was 4 points. Conclusion: Echocardiography parameter scoring system may better predict the risk of 1 year re-admission in LVSD patients which is superior to single echocardiography parameter.
ABSTRACT
Objective:To explore the prognostic value for circulating monocyte subsets combining left ventricular ejection fraction (LVEF) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:STEMI patients admitted within 24 h of onset received PCI in Pingjin hospital heart center were enrolled.Flow cytometry (FCM) was used to examine 3 subsets of monocyte in peripheral blood as classical CD14++CD16-monocyte,intermediate CD14++CD16+ monocyte and non-classical CD14+CD16++ monocyte.The patients were followedup in 3 years for major adverse cardiac events (MACE) occurrence.The relationship between monocyte subsets,LVEF and MACE occurrence was studied by COX model analysis and MACE prediction model was established by ROC combining multivariate Logistic regression analysis.Results:There were 50/221 patients suffered from MACE during 3-year follow-up period.Compared with Non-MACE patients,MACE patients had the elder age (63.82±11.88) years vs (58.84±11.40) years,P=0.009;more diabetes mellitus (28.0％ vs 18.7％),P＜0.001;higher blood levels of LDL-C (2.77 mmol/L) vs (2.41 mmol/L),P=0.003 and CD14++CD16+ monocyte (47.17 cells/μl) vs (21.47 cells/μl),P＜0.001;lower LVEF (52％ vs 46％),P＜0.001.Multivariate Cox analysis indicated that CD14++CD16+ (HR=2.211,95％ CI 1.211-3.635,P=0.016) and LVEF (HR=2.014,95％ CI 1.038-2.933,P=0.022) were the independent risk factors for MACE occurrence in STEMI patients.ROC combining multivariate Logistic regression analysis presented that MACE predictive value of CD14++CD16+ monocyte combining LVEF (AUC=0.744,95％ CI 0.664-0.823,P＜0.001) was higher than the single value of CD14++CD16+ monocyte (AUC=0.683,95％ CI 0.598-0.768,P＜0.001) and LVEF(AUC=0.640,95％ CI 0.552-0.7291,P=0.003) respectively.Conclusion:Circulating level of CD14++CD16+ monocyte combining LVEF may predict MACE occurrence within 3 years in STEMI patients;it had potential value in clinical practice.
ABSTRACT
Objective:To explore the prognostic value for circulating monocyte subsets combining left ventricular ejection fraction (LVEF) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:STEMI patients admitted within 24 h of onset received PCI in Pingjin hospital heart center were enrolled.Flow cytometry (FCM) was used to examine 3 subsets of monocyte in peripheral blood as classical CD14++CD16-monocyte,intermediate CD14++CD16+ monocyte and non-classical CD14+CD16++ monocyte.The patients were followedup in 3 years for major adverse cardiac events (MACE) occurrence.The relationship between monocyte subsets,LVEF and MACE occurrence was studied by COX model analysis and MACE prediction model was established by ROC combining multivariate Logistic regression analysis.Results:There were 50/221 patients suffered from MACE during 3-year follow-up period.Compared with Non-MACE patients,MACE patients had the elder age (63.82±11.88) years vs (58.84±11.40) years,P=0.009;more diabetes mellitus (28.0％ vs 18.7％),P＜0.001;higher blood levels of LDL-C (2.77 mmol/L) vs (2.41 mmol/L),P=0.003 and CD14++CD16+ monocyte (47.17 cells/μl) vs (21.47 cells/μl),P＜0.001;lower LVEF (52％ vs 46％),P＜0.001.Multivariate Cox analysis indicated that CD14++CD16+ (HR=2.211,95％ CI 1.211-3.635,P=0.016) and LVEF (HR=2.014,95％ CI 1.038-2.933,P=0.022) were the independent risk factors for MACE occurrence in STEMI patients.ROC combining multivariate Logistic regression analysis presented that MACE predictive value of CD14++CD16+ monocyte combining LVEF (AUC=0.744,95％ CI 0.664-0.823,P＜0.001) was higher than the single value of CD14++CD16+ monocyte (AUC=0.683,95％ CI 0.598-0.768,P＜0.001) and LVEF(AUC=0.640,95％ CI 0.552-0.7291,P=0.003) respectively.Conclusion:Circulating level of CD14++CD16+ monocyte combining LVEF may predict MACE occurrence within 3 years in STEMI patients;it had potential value in clinical practice.