ABSTRACT
Objective:To investigate the predictive value of serum cystatin C (Cys-C) and renal artery resistance index (RRI) 24 h before coronary CT angiography (CTA) examination in contrast-induced nephropathy(CIN).Methods:Sixty-four patients with coronary heart disease who received coronary CTA examination in Hebei Petro China Central Hospital from January 2020 to March 2021 were selected as the research subjects. According to the incidence of CIN after coronary CTA examination, they were divided into the case group (25 patients) and the normal group(39 patients). Serum Cys-C level was measured by automatic biochemical analyzer at 24 h before CTA examination, and RRI value was measured by color Doppler ultrasound. Risk factors of CIN after CTA examination were analyzed by Logistic regression. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum Cys-C, RRI and the combination of the two indexes in CIN.Results:Compared with the control group, the dosage of contrast agent, patients with hypertension, serum Cys-C level at 24 h before CTA examination and RRI value in the case group were higher than those in the normal group: (85.53 ± 16.27) ml vs. (64.37 ± 15.08) ml, 80.00%(20/25) vs. 56.41%(22/39), (1.36 ± 0.18)mg/L vs.(1.02 ± 0.21) mg/L, 0.743 ± 0.093 vs. 0.632 ± 0.081, there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that the amount of contrast agent, hypertension, serum Cys-C level at 24 h before CTA examination and RRI value were independent risk factor for CIN after CTA examination ( P<0.05). The results of ROC curve analysis showed that serum Cys-C (>1.318 mg/L) combined with RRI value (>0.653) at 24 h before CTA examination predicted CIN with the highest area under the curve was 0.922, sensitivity was 92.5% and specificity was 81.6%. Conclusions:The incidence of CIN after CTA is related to the dosage of contrastant, hypertension, serum Cys-C level and RRI value at 24 h before CTA. The combination of Cys-C level and RRI value has a high predictive value for the occurrence of CIN.
ABSTRACT
Uno de los retos para el cardiólogo es conseguir una volemia óptima, es decir, mejorar el gasto cardiaco, evitando un exceso de volemia que pudiera favorecer un pronóstico negativo. Actualmente se sabe que el balance positivo se asocia con un incremento en la mortalidad; en la actualidad contamos con diversos parámetros para evaluar la precarga; sin embargo, ninguno es altamente fidedigno. El objetivo del presente artículo de revisión es dar un recordatorio de este concepto fisiológico así como sus utilidades en el monitoreo del paciente.
One challenge for the cardiologist is to achieve optimal blood volume for to improve cardiac output, and avoid excessive blood volume that could favor a negative prognosis. Now is known that the positive balance is associated with increased mortality; today we have different standards for assessing preload yet none is highly reliable; the objective of this review is to give a reminder of its physiological concept and profits in patient monitoring.
ABSTRACT
The effects of Panax notoginseng saponins (PNS) and verapamil(Ver)on hemo-dynamics of internal carotid artery and superior mesenteric artery were determined and compared in anesthetized Sprague ~ Dawley strain rats. PNS 30-150 mg ? kg-1 iv was shown to reduce the mean blood pressure, internal carotid arterial resistance and superior mesenteric arterial resistance by 11 % ~19%, 14%~27%,23%~ 39%respectively. Meanwhile, the mesenteric ar-terial blood flow increased.by 16%~51%. Ver showed similar reflects as PNS. The results indicated that the vasodilation effects of PNS and Ver are vascular selective, that is PNS and Ver are more potent in dilating the mesenteric artery than the internal carotid artery.