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Objective To investigate the association between atrial fibrillation (AF) and epicardial adipose tissue (EAT) by echocardiography.Methods One hundred and thirty-eight patients of AF in First Affiliated Hospital of Chinese People's Liberation Army General Hospital from March 2014 to June 2016 were divided into two groups,including paroxysmal AF group with 87 casesand persistent AF group with 51 cases,and 112 cases of sinus rhythm were chosen as control group.Epicardial adipose tissue was measured using echocardiography in all patients,and the conventional parameters were recorded.One-way analysis of variance was used to compare the thickness of EAT in patients with paroxysmal AF group,persistent AF group and sinus rhythm group,and LSD-t test was used in further comparison between two groups.Multivariable logistic regression analysis was used to analyze the risk factors of AF.The receiver-operating characteristic (ROC) cure of EAT and left atrium diameter (LAD) were drawn to predict the incidence of AF.The correlation between EAT thickness and LAD was analyzed by Pearson correlation analysis.Results The thickness of EAT in patients with persistent AF,paroxysmal AF and sinus rhythm group were (4.75± 1.83),(4.32 ± 1.76) and (1.38 ± 0.68) mm,respectively.Epicardial adipose tissue was significantly larger in paroxysmal AF and persistent AF patients compared with that of sinus rhythm group,and the differences were statistically significant (t=-9.541,11.439,both P ＜ 0.01).Logistic regression analysis indicated that EAT thickness and LAD were independent risk factors of atrial fibrillation (odds ratio:3.17,95％ confidence interval:1.31-7.68,P ＜ 0.01;odds ratio:2.65,95％ confidence interval 1.69-4.15,P ＜ 0.05).The area under the curve (AUC) of EAT and LAD to predict presence of AF were 0.784 and 0.865,and the best threshold value were 4.45 mm and 40.00 mm,respectively.Pearson correlation analysis showed that the EAT thickness and LAD had significantly positive correlation (r=0.512,P ＜ 0.01).Conclusions The increase of EAT thickness is significantly correlated with the incidence of AF and is independent to traditional risk factors.Therefore,the increase of EAT thickness has certain clinical value to predict AF.
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Coronary fistulae and ventricular septal perforation are very rare clinically, and even less caused by cardiac leiomyosarcoma. A case is reported that a 67-year-old female had cardiac leiomyosarcoma with progressive heart failure and coronary fistulae and ventricular septal perforation. This case was special since all ante-mortem examinations and cardiac surgery failed to detect the presence of any abnormal car-diac mass. Therefore, the malignant cardiac tumors could appear in an invasive form without mass and be one of the causes of the coronary fistulae and ventricular septal perforation.
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Objective To investigate the clinical features of acute coronary syndrome (ACS) combined with low T3 syndrome and its prognosis.Method Eighty-seven ACS patients with low free triiodothyronine (FT3) level (low FT3 group) and additional 64 ACS patients with normal FT3 level(control group) were selected in parallel; all the patients underwent coronary angiography.The contents of FT3,N-terminal pro-brain natriuretic peptide (NT-proBNP),cardiac troponin I (cTnI) and high sensitivity-C reactive protein (hs-CRP) were recorded,and the related factors were evaluated.The number of stenotic vessels was calculated.Results The contents of NT-proBNP,cTnI and hs-CRP in low FT3 group were elevated significantly compared with those in control group [(1242.14 ± 226.32) ng/L vs.(1126.36 ±195.55) ng/L,(0.92 ± 0.23) ng/L vs.(0.84 ± 0.19) ng/L,(6.46 ± 2.25) mg/L vs.(5.71 ± 1.78) mg/L],and there were significant differences (P ＜ 0.01 or ＜ 0.05).The contents of FT3 were negatively correlated with NT-proBNP,cTnI and hs-CRP in two groups (P ＜ 0.05).There was no significant difference in the number of stenotic vessels between two groups (x2 =4.512,P =0.105).Conclusion In patients with ACS,there is a negative correlation between contents of FT3 and the prognosis,but there is no correlation between contents of FT3 and the number of stenotic vessels.
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<p><b>OBJECTIVE</b>To investigate the value of serum inflammatory markers in the diagnosis of acute appendicitis (AA) in children.</p><p><b>METHODS</b>Blood samples were collected from 51 children with AA and 16 children with nonsurgical abdominal pain (NSAP) to examine white blood cell count (WBC), serum C-reactive protein (CRP), interleukin-6, and tumor necrosis factor-α (TNF-α).</p><p><b>RESULTS</b>WBC count, CRP, IL-6 and TNF-α increased significantly in children with severe AA (phlegmonous or gangrenous, and perforated appendicitis). ROC curves showed that IL-6 or TNF-α had a greater contribution than WBC count to the diagnosis of severe appendicitis.</p><p><b>CONCLUSION</b>IL-6 and TNF-α can provide complementary information to assist the clinical decision of emergency operation for children with AA.</p>
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Niño , Preescolar , Femenino , Humanos , Masculino , Apendicitis , Sangre , Diagnóstico , Biomarcadores , Sangre , Proteína C-Reactiva , Metabolismo , Inflamación , Sangre , Diagnóstico , Interleucina-6 , Sangre , Recuento de Linfocitos , Factor de Necrosis Tumoral alfa , SangreRESUMEN
Objective To observe the characteristics of the two-dimensional global strain index in patients with different degrees heart failure with speckle tracking echocardiography. Methods Totally 35 myocardial infarction patients with heart failure and 28 healthy subjects (control group) were enrolled in the study. The patients were divided into mild (n=14), moderate (n=13), and severe heart failure subgroup (n=8) according to left ventricular ejection fraction (LVEF). The systolic longitudinal strain (LS), radial strain (RS) and circumferential strain (CS) were measured of left ventricular with two-dimensional speckle tracking technique. The average value of left ventricular 18 segmental LS, RS and CS was calculated as the global longitudinal strain (GLS), the global radial strain (GRS) and the global circumference strain (GCS), respectively. LVEF and left ventricular end diastolic volume (LVEDV) were also measured with conventional two-dimensional echocardiography. The global two-dimensional strain and heart function between two groups were compared. The change of GLS, GRS and GCS of different heart failure and the relationship between them and LVEF were analyzed. Results Compared with control group, GLS, GRS and GCS reduced in heart failure groups (P0.05). There was no significant difference in GRS among heart failure subgroups (P>0.05). GLS was closely correlated to LVEF (r=-0.65, P<0.01), GCS was also correlated to LVEF (r=-0.55, P<0.01). Conclusion The changes of GLS, GRS and GCS is different in different degrees of heart failure. GLS is closely correlated to the change of LVEF. The change of GLS, GRS and GCS may reflect degrees of myocardial injury.
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Objective To explore the application of association rules with Constraints in medical data analysis.Methods Constraints were applied in mining association rules of medical data by analyzing the characteristics of the data.An effective algorithm for mining association rules with constraints from medical data called CAMD was developed.The algorithm was applied to the analysis ofcoronary heart disease dataset.Results Assigning minimum support and minimum confidence as 0.20 and 0.60,respectively,with data from 303 cases of coronary heart dieses analyzed,8 association rules were tained.Crrelations between age,sex,electrocardiograph results,pathogeny and diagnosis of coronary heart disease were discovered.Conclusion Results from our experiments show that CAMD scans the database fewer times and has no need of pruning candidate itemsets.Thus,it greatly decrease the amount of useless rules produced and rapidly discover interesting association rules of medical data.
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Objective To evaluate the role of intra-aortic balloon pumping(IABP) in high risk patients with acute myocardial(AMI).Methods The clinical data of all patients with acute myocardial infarction treated with IABP admitted into the first affiliated hospital to PLA General Hospital from January 2004 to May 2008 was collected.The efficacy of the IABP was evaluated. Results A total number of 23 patients with acute myocardial infarction were treated with IABP.17patients received revascularization therapy. Death rate was 30.4%.Conclusion IABP is safe in high risk patients with AMI who represented poor hemodynamic status or cardiogenic shock,and it can sufficiently stablieze the hemodynamic status,improve cardiac function and can decrease in-hospital mortality.
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Objective To evaluate the clinical and coronary angiographic features of non-Q wave and Q wave myocardial infarction in the elderly. Methods The clinical history(including hypertension and diabetes), complication and in-hospital mortality, blood lipid, serum CK-Mb, LVEF, and the record of the coronary stenosis by angiography 3-4 weeks after infarction were investigated in non-Q wave and Q wave myocardial infarction patients. Results The clinical history and blood lipid did not differ significantly between the NQMI and QMI patients. NQMI patients had a significantly lower maximal peak 〔(68.7?18.6) mmol/L vs (108.6?17.3)mmol/L, P0.05), but occlusion rate of infarct-related vessels in NQMI patients were lower. Conclusions Prognosis of NQMI patients is better than that of QMI patients in acute-phase, and the occlusion rate of infarct-related vessels in NQMI patients were lower.
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Objective To determine the pattern and incidence of congenital coronary anomalies (CCA) in adults undergoing coronary angiography. Methods The diagnostic angiographic data collected from October 2000 to October 2006 were reviewed, from which congenital coronary anomalies were found, and their angiographic features were studied. Results Among 1520 adults undergone coronary angiography, anomalous coronary arteries were found in 58 cases (3.82%). Depending on the anatomic characteristics of anomalous coronary arteries, these 58 cases were classified as following. Anomalies of origin and distribution were found in 26 cases (1.71%), among them separated origin of left anterior descending and left circumflex from left coronary sinus were found in 14 cases, left main trunk and left circumflex arising from right coronary sinus in 1 case for each, single left coronary artery in 2 cases, right coronary arteries arising from ascending aorta in 4 cases, from left coronary sinus in 3 cases, and from posterior coronary sinus in 1 case, respectively. Anomalies of coronary termination were observed in 11 cases (0.72%), and all of them were coronary artery fistulas. Anomalies of intrinsic coronary arterial anatomy in 21 cases (1.38%), among them myocardial bridge in 18 cases, hypoplasia of left circumflex artery in 2 cases, and sinus node artery arising from left posterior ventricular branch in 1 case. No anomalous collateral vessels were found. Conclusion Coronary angiography is one of the important methods of detecting anomalous coronary arteries. Classification based on the anatomic characteristics can help clarify the pattern and incidence of congenital anomalies of coronary arteries in adalts.