ABSTRACT
Objective: To explore assessment value of change of brain natriuretic peptide (BNP) level for cardiac function and prognosis judgment in patients with acute heart failure (AHF).Methods: After standard medicinal treatment, according to whether BNP level after treatment reduced <30% or rose compared with at hospitalization, a total of 91 AHF inpatients were divided into BNP reduction ≥30% group (n=67) and BNP reduction <30% or rise group (n=24).Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd) and 6min walking distance (6MWD) at discharge were compared between two groups.All patients were followed up for 12 months.Multi-factor Logistic regression analysis was used to analyze risk factors for cardiogenic death.and adverse cardiac events were recorded.Results: Compared with BNP reduction ≥30% group, there were significant reductions in LVEF [(46.00±5.46)% vs.(34.54±5.32)%] and 6MWD [(392.64±153.02)m vs.(136.75±56.25)m], and significant rise in LVEDd [(56.33±4.40)mm vs.(65.96±6.13)mm] in BNP reduction <30% group, P<0.01 all.Multi-factor Logistic regression analysis indicated BNP reduction <30% or rise was the only one independent risk factor for cardiogenic death (OR=2.714, P=0.039).Compared with BNP reduction ≥30% group, there was significant rise in incidence rate of adverse cardiac events (40.3% vs.62.5%) in BNP<30% group, and the Log-rank value was 30.264 (P=0.001).Conclusion: Change of plasma BNP level can be used as an important reference index for the evaluation of cardiac function and prognosis in patients with acute heart failure.
ABSTRACT
Objective To investigate the differences of various two-stent techniques in vitro and virtual bench testing. Methods Stent implantation with classic crush, double kissing ( DK) crush and culotte stenting techniques were performed in the silicone simulation model of bifurcation vessels with various distal bifurcation angles. The whole processes were recorded by a micro-focus camera. Results Distal side branch (SB) re-crossing in classical crush technique left a significant gap without stent coverage near the carina in T type bifurcation model after final kissing balloon inflation (FKBI) . The gap was also noted in either classic crush with proximal SB re-crossing or DK crush with two times proximal SB re-crossing in T type bifurcation model. The size of the gap in DK crush technique was smaller than that of classic crush. In Y type bifurcation model, both DK crush and culotte stenting left no gap compared to T type bifurcation model. Two times proximal SB re-crossing in culotte stenting resulted in a new stent carina formation after FKBI. Conclusions Distal bifurcation angle was an anatomatic predictor of gap formation in two-stent technique. In T type bifurcation model, the size of gap in DK crush technique was smaller than that of classic crush. It was suggested to perform two times proximal SB re-crossing for DK crush technique and distal SB re-crossing for culotte stenting.