ABSTRACT
This study sought to investigate the prognostic potential of layer-specific global longitudinal strain (GLS) in predicting cardiac events among non-ST-segment elevated acute coronary syndrome (NSTE-ACS) patients with preserved LVEF. In this prospective study, we enrolled 160 consecutive NSTE-ACS patients with preserved LVEF (≥ 50%) who underwent successful percutaneous coronary intervention (PCI). Transthoracic two-dimensional echocardiography examinations were performed within 48 h of admission (before PCI). Cardiac events were defined as all-cause death, re-infarction, and hospitalization for heart failure. During a median follow-up of 30.2 months, 23 patients (14.4%) developed cardiac events. GLS for all three myocardial layers were reduced in patients with adverse outcome (all P < 0.001). Yet GLSendo (area under curves = 0.85) and GLSmid (area under curves = 0.83) showed relatively higher predictive power than GLSepi when identifying patients with cardiac events. The best cut-off value of GLSendo was - 20.8%, with a diagnostic sensitivity and specificity of 87% and 71% respectively. A significant increase in the risk of cardiac events development was shown among patients with impaired layer GLS (log-rank test, P < 0.001). In conclusion, NSTE-ACS patients with preserved LVEF, layer GLS assessed before PCI all had good abilities to predict cardiac events, which might provide more prognostic information against conventional echocardiographic risk factors.
Subject(s)
Acute Coronary Syndrome/diagnostic imaging , Echocardiography , Non-ST Elevated Myocardial Infarction/diagnostic imaging , Stroke Volume , Ventricular Function, Left , Acute Coronary Syndrome/mortality , Acute Coronary Syndrome/physiopathology , Aged , Female , Humans , Male , Middle Aged , Non-ST Elevated Myocardial Infarction/mortality , Non-ST Elevated Myocardial Infarction/physiopathology , Non-ST Elevated Myocardial Infarction/therapy , Patient Readmission , Percutaneous Coronary Intervention/adverse effects , Predictive Value of Tests , Prospective Studies , Recurrence , Reproducibility of Results , Risk Assessment , Risk Factors , Time Factors , Treatment OutcomeSubject(s)
Bone Nails , Fracture Fixation, Internal/instrumentation , Radius Fractures/surgery , Skin , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Radius Fractures/diagnostic imaging , Radius Fractures/physiopathology , Radius Fractures/therapy , Treatment OutcomeABSTRACT
OBJECTIVE: To explore the clinical outcome of floating knee injury treated by open reduction and internal fixation. METHODS: The course of treatment of floating knee in 78 cases by open reduction and internal fixation were reviewed. There were 59 males and 19 females, aged from 17 to 58 years old, with an average age of 37.5 years. Intramedullary nail, pressure plate hollow screw, multi-function single side external fixation holder and other internal fixature were used in the operation. Early exercises were followed postoperatively. RESULTS: All patients were followed-up for 8 to 35 months (mean 18.6 months). According to the criterion of Karlström, of the 48 cases with femoral shaft fracture, 45 were excellent and 3 were good. In the 11 cases of bimalleolar fracture, 5 were excellent, 3 good, 1 fair and 2 bad. Of the 19 cases of mixed fracture, 9 were excellent,6 good, 3 fair and 1 bad. CONCLUSION: Strict sterilization, non-invasion and standard internal and external fixation could make the fracture anatomical reduction and firm fixation. It is beneficial to early rehabilitation exercise. Complications such as malunion, and stiff joint could be avoided. The clinical outcome were satisfactory.
