Objective: To investigate the risk factors of death within 7 days in patients with acute myocardial infarction (AMI) complicated by ventricular septal rupture (VSR) based on echocardiography indicators, and to construct a nomogram model of ultrasound indicator risk to predict the risk of death in patients with post-infarction ventricular septal rupture (PIVSR).
Methods: The echocardiographic data of 40 patients with PIVSR admitted to the department of cardiology, Xiangya Third Hospital, Central South University from January 2014 to June 2024 were retrospectively analyzed. The patients were divided into death group and survival group based on their 7-day survival status. The risk factors affecting death within 7 days of PIVSR patients were analyzed by univariate and multivariate analyses, and the risk nomogram model of ultrasound indicators predicting death within 7 days of PIVSR patients was constructed by using R software. Calibration curve and receiver operator characteristic curve (ROC curve) were used to verify the prediction effect of the model.
Results: Among the 40 patients with PIVSR, 18 died at 7 days and 22 survived. Univariate analysis showed that, compared with the survival group, patients in the death group were older (years old: 73.7±6.8 vs. 68.1±7.7), had a larger diameter of VSR (mm: 10.4±4.2 vs. 7.7±3.0), and had a higher peak pressure difference (PPG) in the perforation area [mmHg (1 mmHg≈0.133 kPa): 49.0±11.6 vs. 37.0±16.1], left ventricular ejection fraction (LVEF) and stroke volume (SV) were significantly decreased [LVEF: 0.439±0.134 vs. 0.512±0.094, SV (mL): 46.1±15.6 vs. 62.0±14.3], and the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.212, 95% confidence interval (95%CI) was 1.034-1.420, P = 0.018] and perforation area PPG (OR = 1.248, 95%CI was 1.069-1.457, P = 0.005) were positively correlated with the occurrence of death events within 7 days in PIVSR patients, while SV was negatively correlated with the occurrence of death events within 7 days in PIVSR patients (OR = 0.851, 95%CI was 0.756-0.957, P = 0.007). The predicted value of the nomogram model for predicting the risk of death within 7 days in patients with PIVSR was basically consistent with the actual value, and the Hosmer-Lemeshow goodness of fit test χ 2 = 10.679, P = 0.220. The area under the curve (AUC) predicted by the model was 0.960, 95%CI was 0.913-0.998.
Conclusions: Age and echocardiographic indicators SV and perforation area PPG are risk factors for mortality within 7 days in PIVSR patients. The nomogram model of mortality risk within 7 days in PIVSR patients constructed using the above indicators has good discrimination and consistency.
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis-associated acute kidney injury (SA-AKI) is a common organ dysfunction of sepsis, and its incidence and mortality are increasing,which brings heavy economic burden to patients and society. Early diagnosis and effective intervention can block the occurrence and progression of SA-AKI effectively, improve prognosis, and reduce medical costs. Diagnosis on SA-AKI relies on urine volume and serum creatinine, which has the disadvantages of being easily disturbed and delaying. The identification of biomarkers in blood and urine can facilitate diagnosis and provide targeted therapy to enhance the management of SA-AKI. This article reviews the characteristics of a variety of SA-AKI biomarkers that have been found and validated, including pre-damage biomarkers, damage biomarkers and functional biomarkers, and explore the clinical value of newly discovered biomarkers related to the diagnosis and treatment of SA-AKI, such as blood uncoupling protein 2 (UCP2), Sestrin 2 protein and pannexin 1 (PANX1), to provide reference for the early diagnosis and effective treatment of SA-AKI.
Acute lung injury (ALI) is a common respiratory disease in clinical practice, which can progress to acute respiratory distress syndrome and endanger the patient's life. Pericytes are a class of cells that directly contact the microvascular basement membrane in the microvascular bed and communicate with endothelial cells, and their distribution and interaction with endothelial cells help to define and maintain local microvascular characteristics. In recent years, pericytes have became one of the most important indicators of ALI. This article reviews the important mechanisms of pericellular function in the physiological functions of the respiratory system, immune inflammatory response in the lungs, microvascular permeability, and signaling pathways related to ALI progression, as well as their effective treatment of ALI as targets, by searching relevant literature at home and abroad. It provides a scientific reference for targeted therapy of ALI.
Inflammation reaction is a host defense mechanism that protects the host from harmful external antigens and microorganisms, and the intensification of inflammation reaction can lead to tissue damage and development of systemic inflammatory diseases. As a representative derivative of ω-3 fatty acids, Maresin-1 has been widely explored for its role in regulating innate immune cells (neutrophils and mononuclear/macrophages) and promoting the resolution of infectious inflammation in acute inflammatory diseases. There is now increasing evidence that Maresin-1 also has a direct effect on the adaptive immune system and prevents the transition from acute inflammation to chronic inflammation. By analyzing the literature related to the effect of Maresin-1 on the regulation of inflammation, this paper summarized the role of various immune cells in inflammatory response and the regulatory mechanism of Maresin-1 on various immune cells, so as to deeply understand the research progress of the role of Maresin-1 in regulating immune cells in inflammatory diseases. This study provides a theoretical basis for the basic research and clinical application of Maresin-1 in inflammatory diseases.
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