ABSTRACT
Objective@#To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). @*Materials and Methods@#This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. @*Results@#A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). @*Conclusion@#The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.
ABSTRACT
Objective@#To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). @*Materials and Methods@#This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. @*Results@#A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). @*Conclusion@#The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.
ABSTRACT
Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.
ABSTRACT
Objective To investigate the changes in the percentages of CD4+T lymphocyte subsets and the homeostasis of T lymphocytes among MSM ( men who have sex with men) population with different stages of HIV-1 infection. Methods A total of 166 untreated MSM with HIV infection were enrolled and di-vided into three groups including early HIV infection (EHI, n=38) , HIV (n=94) and AIDS (n=34) groups. Sixty-two MSM negative for anti-HIV antibody were selected as healthy controls. Blood samples were collected into EDTA tubes and detected to analyze the changes in the distribution of CD4+ T cells and CD8+T lymphocyte subsets ( CD4+ CD45RA+, CD8+ CD28+, CD4+ CD25+ CD127-) and the percentages of activated (CD38, HLA-DR) and apoptotic cells (CD95) with disease progression by flow cytometry. Re-sults The expression of CD4+CD45RA+ T lymphocytes gradually decreased with the progression of AIDS. The percentage of CD4+CD45RA+ T lymphocytes in HIV group was lower than that of the control group, but higher than that of the AIDS group (P=0. 015, P=0. 000). No significant difference was found between the EHI and the control groups (P>0. 05). CD8+CD28+T cells were significantly reduced in the EHI group and remained at a low level with disease progression. No significant difference in the proportion of CD4+CD25+CD127- T cells was observed among all groups (P>0. 05). The percentage of CD4+CD38+HLA-DR+T cells increased gradually and the highest level was detected in the AIDS group, followed by those in the HIV, EHI and control groups (P<0. 01). The percentages of CD8+CD38+, CD8+HLA-DR+, CD8+ CD38+HLA-DR+and CD8+CD95+T cells in the EHI, HIV and AIDS groups were significantly higher than those in the control group (P<0. 01), but there was no significant difference among the former three groups (P>0. 05). Con-clusion HIV infection caused the changes in the numbers and functions of T lymphocyte subsets and accel-erated the activation and apoptosis of T lymphocytes, which aggravated the T lymphocyte immune dysfunction even further. A comprehensive analysis of the alterations in different T cell subsets would be conducive to re-flect the immune deficiency and the severity of disease. CD4+ and CD8+ T cells were activated in the early stage of HIV infection, which indicated that studying the immune response during that stage might help to understand their roles in disease progression.
ABSTRACT
Objective To investigate the effect of complete revascularization strategy on the prognosis of elderly patients suffering from acute ST-segment elevated myocardial infarction(STEMI)complicated with multivessel disease(MVD). Methods A total of 390 elderly patients(over 60 years old)suffering from acute STEMI with MVD treated by clinical revascularization administration were enrolled for the study and divided into complete revascularization group(CR group,n=139)and non-complete revascularization group(NCR group,n=251). The effect of complete re-vascularization strategy on the prognosis was then analyzed by COX regression analysis. Results Compared with the NCR group,the patients of the CR group are younger and with a higher ratio of old myocardial infarction ,as well as the average number of stents ,and the mean value of total stent length is larger. The application of calcium channel blocker for post-operation patients is rarer as well. No significant difference can be found between the two groups on the ratio of post-operation all-cause mortality,cardiac mortality,nonfatal myocardial infarction,unplanned repeat revas-cularization. Multivariate COX analysis showed that the complete revascularization had no obvious difference on the prognosis of these patients be-tween the two groups. Conclusion There is individual diversity in the revascularization strategy choosing for elderly patients of acute STEMI alongside MVD;however,the prognosis is not significantly improved.
ABSTRACT
Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45,n=1 356) and systolic heart failure group (EF<0.45,n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia?stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi?ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com?pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi?um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lower RAS blocker andβ-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper?uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ?ent treatment and prevention programs for the two kinds of heart failures.
ABSTRACT
Objective To investigate the clinical features and risk factors for chronic heart failure in elderly patients.Methods The 2,407 chronic heart failure patients were enrolled,including 1,513 elderly patients (62.9％) (aged≥≥65 years).Risk factors for chronic heart failure,clinical features,biochemical and physical examination were retrospectively analyzed.The effects of different factors on patients with different age were analyzed by Logistic regression analysis.Results Compared with the young and middle-aged patients,the higher prevalences of New York Heart Association functional classification (NAFC),diabetes,ischemic heart disease,hypertension,anemia,renal insufficiency and hyperuricemia were found,but the percentages of males,smoker,patients with dilated cardiomyopathy,valvular heart disease and hyperlipidemia were reduced in elderly patients.The levels of blood creatinine,high density lipoprotein (HDL),serum potassium,hemoglobin,albumin,pre-albumin,total cholesterol (TC),lower density lipoprotein (LDL),triglyceride (TG) and diastolic blood pressure were lower,but left ventricular ejection fraction (LVEF) and systolic blood pressure were higher,in the elderly patients than in young and middle-aged patients.Elderly patients had higher usage rates of stain and angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB),but lower usage rate of β-blocker as compared with young and middle-aged patients.In elderly patients,logistic regression analysis revealed that gender (OR=1.89,95％CI:1.566-2.285),a history of ischemic heart disease (OR=1.81,95％ CI:1.457-2.243),hypertension (OR=1.87,95％CI:1.462-2.389),anemia (OR=2.66,95％ CI:2.197-3.211),hyperuricemia (OR =1.41,95％ CI:1.186-1.678) were significantly related with chronic heart failure,whilein young and middle-aged patients,dilated cardiomyopathy (OR=0.49,95％ CI 0.351-0.689),hyperlipidemia (OR=0.53,95 ％ CI:0.433-0.641),smoking (OR=0.79,95 ％ C I:0.652 0.966) were significantly related with chronic heart failure.Conclusions Gender,ischemic heart? disease,hypertension,anemia,hyperuricemia are the independent risk factors for chronic heart failure in elderly patients.