Short report: depression and anxiety symptoms as predictors of adverse cardiovascular events in Chinese patients after percutaneous coronary intervention.

Depression and anxiety often co-occur in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). This study was conducted to examine the predictive value of depression, anxiety, and their combination on the prognosis of Chinese PCI patients. A multicenter prospective study was undertaken with a sample of 309 primary PCI patients. The Hospital Anxiety and Depression Scale (HADS) was completed at baseline to assess anxiety and depression symptoms. Major adverse cardiovascular events (MACEs) were recorded for 12 months after PCI . Days from baseline to the first MACE was the outcome variable. MACEs occurred in 26 (8.4%) patients. After adjustments for socio-demographic and clinical characteristics, a Cox proportional hazards regression model revealed that depression (HR = 2.70, 95% confidence interval [CI] 1.22-5.95; p =.014) and anxiety (HR = 2.56, 95% CI 1.18-5.54; p =.017) symptoms were independent predictors of MACEs. A subanalysis showed that the cumulative event-free survival curves did not differ among depressed and anxious patients and depressed but non-anxious patients (Log Rank p =.52). In conclusion, depression is associated with an increased risk for MACEs post-PCI, independent of anxiety. Although anxiety is associated with MACEs, it has no additional predictive value when co-occurring with depression.

Predictors of late recurrence of atrial fibrillation after catheter ablation.

BACKGROUND: To predict the recurrence of atrial fibrillation is important for selecting patients who will be undergoing catheter ablation, several studies respectively evaluated the risk factor of the recurrence of atrial fibrillation post-ablation. OBJECTIVE: To investigate the factors predicting the recurrence of atrial fibrillation (AF) after catheter ablation. METHODS: 186 patients (55.12 ± 12.06 years, 123 male) including 161 paroxysmal AF and 25 non-paroxysmal AF who underwent catheter ablation were studied. Clinical datum before and during ablation were recorded, and systematic follow-up was conducted after ablation. Univariate and multivariate analyses were carried out to determine the factors predicting late recurrence of AF (LRAF) which means AF recurrence after 3 months. RESULTS: There were 47(25.27%) patients who experienced LRAF. Multivariate Logistic regression analysis was carried out to the parameters that P<0.10 in the univariate analysis, which includes overweight/obesity, metabolic syndrome (MetS), AF categories, duration of AF history, left atrial diameter (LAD), diabetes mellitus, ablation strategies, procedural failure and early recurrence of AF after ablation (ERAF). Ultimately, the results demonstrated that overweight/obesity (OR=4.71, 95% CI 1.71-12.98, P=0.003), MetS (OR=4.41, 95% CI 1.56-12.46, P=0.005), procedural failure (OR=58.34, 95% CI 6.83-498.34, P<0.001), and ERAF (OR=3.18, 95% CI 1.07-9.44, P=0.037) were independent predictors of AF recurrence after ablation. CONCLUSION: Overweight/obesity, metabolic syndrome, procedural failure and ERAF are independent predictors of late recurrence of atrial fibrillation in this group of patients.

Protective effect of glutamine-enriched early enteral nutrition on intestinal mucosal barrier injury after liver transplantation in rats.

BACKGROUND: The effect of glutamine-enriched early enteral nutrition (Gln-EEN) on intestinal mucosal barrier injury after liver transplantation (LT) remains uncertain. METHODS: The Wistar-to-Wistar rat LT model was used to explore the protective effect of Gln-EEN. Morphologic changes of intestinal mucosa, levels of intestinal malondialdehyde and secretory immunoglobulin (sIgA), plasma endotoxin, D-lactic acid, serum tumor necrosis factor-alpha (TNF-alpha), rates of bacterial translocation, and expression of intestinal nuclear factor-kappaB, TNF-alpha, and intercellular adhesion molecule-1 were determined. RESULTS: After LT, intestinal mucosa was damaged seriously. At 12, 24, and 48 hours posttransplantation, levels of intestinal sIgA were decreased; levels of malondialdehyde, endotoxin, D-lactic acid, and TNF-alpha, the ratio of bacterial translocation, and the expression of intestinal nuclear factor-kappaB, TNF-alpha, and intercellular adhesion molecule-1 all were increased. However, changes in earlier-mentioned parameters in recipients treated with Gln-EEN were attenuated remarkably at 24 to 48 hours. CONCLUSIONS: Our data show that Gln-EEN is a potent protectant against intestinal mucosal barrier injury after LT.

The role of radionuclide lymphoscintigraphy in extremity lymphedema.

The characteristics of lymphedema on radionuclide lymphoscintigraphy were studied, and the diagnostic value of radionuclide lymphoscintigraphy in lymphedema was evaluated. In this report radionuclide lymphoscintigraphy was performed in 110 cases of clinically suspected lymphedema. A retrospective study method was used to analyze the imaging results. The typical pattern of lymphedema on radionuclide lymphoscintigraphy was summarized. It was found that the characteristics of lymphedema on radionuclide lymphoscintigraphy were diverse. The most common pattern was increased radiotracer accumulation in the soft tissue and lymphatic webs. Surgery and infection dominated as the causes of lymphedema in this study. It was concluded that radionuclide lymphoscintigraphy is a useful noninvasive method for diagnosing lymphedema. It is easy to operate and provides reliable results.