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The Value of Soluble ST2 in Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients. 可溶性ST2在预测急性心肌梗死患者1型心肾综合征中的价值。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-25 DOI: 10.59958/hsf.6669
Ying Hua, Wei Zhang, Xiaofei Li

Objective: To investigate the predictive value of soluble growth stimulation expressed gene 2 (sST2) for the development of Cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction during hospitalization.

Methods: A retrospective study included 202 patients with acute myocardial infarction, divided into the CRS1 group (n = 61) and the Non-CRS1 group (n = 141) by the CRS1 occurrence. A logistic regression analysis was applied to find independent predictors of the CRS1 occurrence during hospitalization. Receiver operating characteristic (ROC) curves were applied to analyze the predictive values of sST2, N-terminal pro-B type natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate (eGFR).

Result: The multivariate logistic regression analysis revealed that sST2, NT-proBNP, eGFR, Multivessel coronary artery disease, and diuretic use were independent predictors of the CRS1 occurrence during hospitalization. Application of ROC curve analysis displayed that sST2 had the largest area under the curve (AUC) value of 0.874, sensitivity of 0.770, and specificity of 0.894; sST2, eGFR, and NT-proBNP as combined predictors had an AUC value of 0.908, sensitivity of 0.820, and specificity of 0.908. The ROC curves of sST2 and the combined predictive indices were compared using MedCalc software (version 19.6.3), and no statistically significant difference was found between the two (p = 0.142). The cutoff values of the three indicators were determined by the maximum Youden index. When sST2 ≥61.8 ng/mL, eGFR ≤80.6 mL/min/1.73 m2 and NT-proBNP ≥1525 pg/mL were classified as abnormal range, it was found that more number of abnormal indicators may be more advantageous of risk stratification in CRS1.

Conclusions: sST2 can be used as a novel predictor of the CRS1 occurrence in patients with acute myocardial infarction during hospitalization. sST2, eGFR, and NT-proBNP combined may have better predictive value.

目的:探讨可溶性生长刺激表达基因2(sST2)对急性心肌梗死患者住院期间发生1型心肾综合征(CRS1)的预测价值。方法:对202例急性心肌梗死患者进行回顾性研究,按CRS1发生率分为CRS1组(n=61)和非CRS1组(n=141)。应用逻辑回归分析来寻找住院期间CRS1发生的独立预测因素。应用受试者操作特征(ROC)曲线分析sST2、N-末端B型钠尿肽原(NT-proBNP)和估计肾小球滤过率(eGFR)的预测值,和利尿剂的使用是CRS1在住院期间发生的独立预测因素。ROC曲线分析显示,sST2的曲线下面积最大(AUC)值为0.874,敏感性为0.770,特异性为0.894;sST2、eGFR和NT-proBNP作为联合预测因子的AUC值为0.908,敏感性为0.820,特异性为0.908。使用MedCalc软件(19.6.3版)比较sST2的ROC曲线和组合预测指数,两者之间没有统计学显著差异(p=0.142)。三个指标的临界值由最大Youden指数确定。当sST2≥61.8 ng/mL、eGFR≤80.6 mL/min/1.73 m2和NT-proBNP≥1525 pg/mL被归类为异常范围时,发现更多的异常指标可能更有利于CRS1的风险分层。sST2、eGFR和NT-proBNP联合应用可能具有更好的预测价值。
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引用次数: 1
Research and Prediction of Factors Related to High Degree Atrioventricular Block after TAVI Surgery Based on Logistic Regression Model. 基于Logistic回归模型的TAVI术后高度房室传导阻滞相关因素的研究与预测。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-25 DOI: 10.59958/hsf.5869
Ping Hu, Ningning Lin, Zhihong Wu

Objective: Based on the logistic regression model, analyze the risk factors for high degree atrioventricular block after transcatheter aortic valve replacement (TAVI) surgery and further analyze its predictive value.

Methods: 402 patients who underwent TAVI surgery at Henan Thoracic Hospital for "aortic stenosis" between January 2020 and January 2023 were selected as the study subjects. The study subjects were divided into A group (N = 89) and B group (N = 313) based on whether high degree atrioventricular block occurred after surgery. The age, biochemistry and other general data of patients were systematically collected through inpatient cases, and the preoperative Right bundle branch block, I degree atrioventricular block, QRS duration, and indoor block were collected through our hospital's electrocardiogram (ECG) system, Calcification integral of Aortic valve was calculated by computed tomography (CT) results. Logistic regression analysis was performed on the clinical data, and the predictive value of related factors was further analyzed through the Receiver operating characteristic.

Results: The preoperative QRS wave duration in the A group (165.06 ± 61.25) was significantly higher than that in the B group (108.30 ± 16.30), and the difference was statistically significant (p < 0.05). Compared with the B group, the incidence of Right bundle branch block in the A group was significantly higher before operation. The calcification score of Aortic valve in the A group (97.58 ± 61.25) was significantly higher than that in the B group (43.59 ± 7.56), with a statistically significant difference (p < 0.05). Further multivariate logistic regression analysis showed that the duration of QRS wave before operation and Aortic valve calcification score were independent risk factors for high atrioventricular block after TAVI (p < 0.05). Through Receiver operating characteristic analysis, it was found that preoperative QRS wave duration and Aortic valve calcification score had a high predictive value for the occurrence of high atrioventricular block after TAVI. The optimal cutoff value of QRS wave duration for predicting high atrioventricular block was 152, area under curve (AUC): 0.780 (95% CI: 0.718-0.841, p < 0.001). The optimal cutoff value for predicting high degree atrioventricular block with aortic calcification score is 61.5, AUC: 0.997 (95% CI: 0.992-1.000, p < 0.001).

Conclusions: Preoperative QRS wave duration and Aortic valve calcification score are independent risk factors for high degree atrioventricular block after TAVI, and they have high predictive value. In clinical work, risk factors should be found early and responded in time.

目的:基于logistic回归模型,分析经导管主动脉瓣置换术后高度房室传导阻滞的危险因素,进一步分析其预测价值。方法:选择2020年1月至2023年1月期间在河南省胸科医院因“主动脉瓣狭窄”接受TAVI手术的402名患者作为研究对象。根据术后是否发生高度房室传导阻滞,将研究对象分为A组(N=89)和B组(N=313)。通过住院病例系统收集患者的年龄、生化等一般数据,通过我院心电图系统收集术前右束支传导阻滞、I度房室传导阻滞、QRS波持续时间和室内传导阻滞,通过计算机断层扫描(CT)结果计算主动脉瓣钙化积分。对临床数据进行Logistic回归分析,并通过受试者的操作特点进一步分析相关因素的预测价值。结果:A组术前QRS波持续时间(165.06±61.25)明显高于B组(108.30±16.30),差异有统计学意义(p<0.05),术前A组右束支传导阻滞的发生率显著高于B组。A组主动脉瓣钙化评分(97.58±61.25)明显高于B组(43.59±7.56),进一步的多元logistic回归分析显示术前QRS波持续时间和主动脉瓣钙化评分是TAVI后高房室传导阻滞的独立危险因素(p<0.05),术前QRS波持续时间和主动脉瓣钙化评分对TAVI后高房室传导阻滞的发生具有较高的预测价值。QRS波持续时间预测高度房室传导阻滞的最佳截止值为152,曲线下面积(AUC):0.780(95%可信区间:0.718-0.841,p<0.001),AUC:0.997(95%CI:0.992-1.000,p<0.001)。结论:术前QRS波持续时间和主动脉瓣钙化评分是TAVI后高度房室传导阻滞的独立危险因素,具有较高的预测价值。在临床工作中,应尽早发现危险因素并及时做出反应。
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引用次数: 0
Prediction of Acute Kidney Injury after Extracorporeal Cardiac Surgery (CSA-AKI) by Machine Learning Algorithms. 用机器学习算法预测体外心脏手术后急性肾损伤。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-25 DOI: 10.59958/hsf.5673
Yefeng Tong, Xiaoguang Niu, Feng Liu

Background: Acute renal failure after extracorporeal cardiac surgery under general anesthesia is high and unpredictable, but machine learning algorithms could change this. A feasible approach is to use machine learning models to construct models to predict acute kidney injury after extracorporeal cardiac surgery (CSA-AKI) and screen for the best predictive model.

Method: From January 2014 to December 2021, 2187 patients undergoing extracorporeal cardiac surgery at the third hospital of Hebei Medical University and the first medical centre of Chinese PLA General Hospital were collected in this study. After excluding 923 patients who did not meet the inclusion criteria, a dataset of 1264 patients with 125 clinical indexes was constructed. After screening the feature variables using Least absolute shrinkage (LASSO) regression, the dataset was randomly divided into a training set (70%), test set (30%), and six machine learning algorithms, including extreme gradient boosting (XGBoost), logistic regression (LRC), light gradient boosting machine (LGBM), random forest classifier (RFC), adaptive boosting (AdaBoost), and K-nearest neighbor (KNN), were used in training set for predicting the CSA-AKI. The machine learning model with the best predictive performance was selected to complete external validation of the test set. The SHapley Additive exPlanations (SHAP) algorithm was used to interpret the model.

Results: Of all 1264 patients, 372 (29.43%) patients presented with CSA-AKI. The LASSO regression eliminated 22 feature variables out of 125 before model development. Among the six prediction models, the RFC prediction model has the best prediction performance, with an Area Under Curve (AUC) value of 0.778 (95% CI: 0.726-0.830) in the test set and the best net benefit compared to the other tools. SHAP explained the impact of different feature variables on the predicted outcome, where the three most influential feature variables were creatinine clearance (CRC), intraoperative urine output (mL/kg/h) and age.

Conclusion: We developed an RFC prediction model to predict the CSA-AKI, which has good predictive performance and can explain the factors affecting the prediction results of cases by integrating the SHAP method.

背景:全身麻醉下体外心脏手术后的急性肾功能衰竭很高,而且不可预测,但机器学习算法可以改变这一点。一种可行的方法是使用机器学习模型来构建预测体外心脏手术后急性肾损伤的模型,并筛选最佳预测模型。方法:收集2014年1月至2021年12月在河北医科大学第三医院和中国人民解放军总医院第一医学中心接受体外心脏手术的2187例患者。在排除923名不符合纳入标准的患者后,构建了一个由1264名患者组成的数据集,其中包括125项临床指标。在使用最小绝对收缩(LASSO)回归筛选特征变量后,将数据集随机分为训练集(70%)、测试集(30%)和六种机器学习算法,包括极限梯度提升(XGBoost)、逻辑回归(LRC)、光梯度提升机(LGBM)、随机森林分类器(RFC)、自适应提升(AdaBoost),和K近邻(KNN)用于训练集中预测CSA-AKI。选择具有最佳预测性能的机器学习模型来完成测试集的外部验证。SHapley加性规划(SHAP)算法用于解释该模型。结果:在1264例患者中,372例(29.43%)患者出现CSA-AKI。在模型开发之前,LASSO回归消除了125个特征变量中的22个。在六个预测模型中,RFC预测模型具有最好的预测性能,在测试集中的曲线下面积(AUC)值为0.778(95%CI:0.726-0.830),与其他工具相比,净收益最好。SHAP解释了不同特征变量对预测结果的影响,其中三个最具影响力的特征变量是肌酸酐清除率(CRC)、术中尿量(mL/kg/h)和年龄。结论:我们开发了一个预测CSA-AKI的RFC预测模型,该模型具有良好的预测性能,可以通过整合SHAP方法来解释影响病例预测结果的因素。
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引用次数: 0
Application Effects of NNN-link Care Model in Patients with Coronary Heart Disease. NNN-link护理模式在冠心病患者中的应用效果。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-25 DOI: 10.59958/hsf.5837
Wenjuan Duan, Baojun Ren

Objective: To investigate the effect of a NNN-linked care model applied in elderly patients with coronary heart disease.

Methods: A total of 120 elderly patients with coronary heart disease admitted to the hospital from January, 2023 to May, 2023 were randomly divided into two groups of 60 cases respectively. The control group received routine intervention, and the observation group received the NNN-linked care model. Changes in cardiac function, the ability for self-care, and quality of life were recorded between the groups before and after the intervention.

Results: Indices of cardiac function in the observation group were higher than those of the control group after 3 weeks (p < 0.05). Compared with the control group, the total score for the ability for self-care and the scores of each dimension of the observation group were higher after 3 weeks of intervention (p < 0.05). The scores of quality of life of the observation group were higher in comparison with the control group after 3 weeks of intervention (p < 0.05).

Conclusion: The application of the NNN-linked care model to elderly patients with coronary heart disease can improve the ability for self-care, increase cardiac function and improve the quality of life.

目的:探讨NNN关联护理模式在老年冠心病患者中的应用效果。方法:将2023年1月至2023年5月收治的120例老年冠心病患者随机分为两组,每组60例。对照组接受常规干预,观察组接受NNN连锁护理模式。干预前后记录两组患者的心功能、自我护理能力和生活质量的变化。结果:3周后观察组心功能指标明显高于对照组(p<0.05),干预3周后,观察组的生活自理能力总分和各维度得分均高于对照组(p<0.05),生活质量得分高于对照组,差异有统计学意义(p<0.05)心脏病可以提高自我保健能力,增强心脏功能,提高生活质量。
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引用次数: 0
Sex-Based Differences in Early Outcomes Following Mitral Valve Surgery for Degenerative Disease. 退行性疾病二尖瓣手术后早期结果的性别差异。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-25 DOI: 10.59958/hsf.6741
Fadi I Al-Zubaidi, Maria Pufulete, Mohammad Yousuf Salmasi, Gianni D Angelini, Hunaid A Vohra

Objectives: To determine whether sex-based differences exist following surgery for degenerative mitral valve disease.

Methods: Using a national database, we analysed data on mitral valve surgery for degenerative disease (n = 22,658) between January 2000 and March 2019 in the UK. We split the cohort into men (n = 14,681) and women (n = 7977) and compared background characteristics, intraoperative variables and early postoperative outcomes. Our primary outcome was hospital mortality; secondary outcomes included re-exploration for bleeding, prolonged admission (>10 days) and mitral replacement. We used binary logistic regression models for all outcomes, with multiplicative interaction terms to determine the nature of any differences.

Results: Women presented older (70 ± 11 years vs. 67 ± 11 years, p < 0.001) with worse symptom profiles (New York Heart Association Class III-IV 57% vs. 44%, p < 0.001). They had higher rates of preoperative atrial fibrillation (39% vs. 35%, p < 0.001) and tricuspid disease requiring surgery (21% vs. 15%, p < 0.001). They had lower repair rates (66% vs. 76%, p < 0.001), higher mortality (3% vs. 2%, p < 0.001) and were more likely to have a prolonged admission (48% vs. 40%, p < 0.001). Female sex was an independent predictor of mortality (odds ratio (OR): 1.52, 95% CI: 1.21-1.90, p < 0.001). Age and Canadian Cardiovascular Society (CCS) score showed significant interactions with sex. The relationship between advancing age and mortality was found to be more pronounced in women.

Conclusions: (1) Female sex is an independent predictor of hospital mortality, prolonged hospital admission and mitral valve replacement. (2) The relationship between female sex and mortality is exacerbated by worsening CCS score and advancing age. (3) Women have significantly lower repair rates.

目的:确定退行性二尖瓣疾病手术后是否存在基于性别的差异。方法:使用国家数据库,我们分析了2000年1月至2019年3月期间英国退行性疾病二尖瓣手术的数据(n=22658)。我们将队列分为男性(n=14681)和女性(n=7977),并比较了背景特征、术中变量和术后早期结果。我们的主要结果是住院死亡率;次要结果包括再次探查出血、延长入院时间(>10天)和二尖瓣置换术。我们对所有结果使用了二元逻辑回归模型,并使用乘法交互项来确定任何差异的性质。结果:女性年龄较大(70±11岁vs.67±11岁,p<0.001),症状更差(纽约心脏协会III-IV级57%vs.44%,p<0.01)。她们术前心房颤动发生率较高(39%vs.35%,p<001),三尖瓣疾病需要手术治疗(21%vs.15%,p<.001)。她们的修复率较低(66%vs.76%,p<0.001%),死亡率更高(3%对2%,p<0.001),住院时间更长(48%对40%,p<001)。女性是死亡率的独立预测因素(优势比(OR):1.52,95%可信区间:1.21-1.90,p<0.01)。年龄和加拿大心血管学会(CCS)评分显示与性别有显著的相互作用。研究发现,年龄增长与死亡率之间的关系在女性中更为明显。结论:(1)女性是医院死亡率、住院时间延长和二尖瓣置换术的独立预测因素。(2) CCS评分的恶化和年龄的增长加剧了女性性别与死亡率之间的关系。(3) 女性的修复率明显较低。
{"title":"Sex-Based Differences in Early Outcomes Following Mitral Valve Surgery for Degenerative Disease.","authors":"Fadi I Al-Zubaidi,&nbsp;Maria Pufulete,&nbsp;Mohammad Yousuf Salmasi,&nbsp;Gianni D Angelini,&nbsp;Hunaid A Vohra","doi":"10.59958/hsf.6741","DOIUrl":"10.59958/hsf.6741","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether sex-based differences exist following surgery for degenerative mitral valve disease.</p><p><strong>Methods: </strong>Using a national database, we analysed data on mitral valve surgery for degenerative disease (n = 22,658) between January 2000 and March 2019 in the UK. We split the cohort into men (n = 14,681) and women (n = 7977) and compared background characteristics, intraoperative variables and early postoperative outcomes. Our primary outcome was hospital mortality; secondary outcomes included re-exploration for bleeding, prolonged admission (>10 days) and mitral replacement. We used binary logistic regression models for all outcomes, with multiplicative interaction terms to determine the nature of any differences.</p><p><strong>Results: </strong>Women presented older (70 ± 11 years vs. 67 ± 11 years, p < 0.001) with worse symptom profiles (New York Heart Association Class III-IV 57% vs. 44%, p < 0.001). They had higher rates of preoperative atrial fibrillation (39% vs. 35%, p < 0.001) and tricuspid disease requiring surgery (21% vs. 15%, p < 0.001). They had lower repair rates (66% vs. 76%, p < 0.001), higher mortality (3% vs. 2%, p < 0.001) and were more likely to have a prolonged admission (48% vs. 40%, p < 0.001). Female sex was an independent predictor of mortality (odds ratio (OR): 1.52, 95% CI: 1.21-1.90, p < 0.001). Age and Canadian Cardiovascular Society (CCS) score showed significant interactions with sex. The relationship between advancing age and mortality was found to be more pronounced in women.</p><p><strong>Conclusions: </strong>(1) Female sex is an independent predictor of hospital mortality, prolonged hospital admission and mitral valve replacement. (2) The relationship between female sex and mortality is exacerbated by worsening CCS score and advancing age. (3) Women have significantly lower repair rates.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E566-E576"},"PeriodicalIF":0.6,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Total Ropivacaine Concentration in Blood after Bilateral Pecto-Intercostal Fascial Block Combined with Rectus Sheath Block in Cardiac Surgery Patients. 心脏外科患者双侧肋间筋膜阻滞联合直肠鞘管阻滞后血液中罗哌卡因总浓度的评估。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-17 DOI: 10.59958/hsf.6721
Lu Wang, Bailin Jiang, Yi Shi, Boyu Liu, Luyang Jiang, Yi Feng

Objectives: Pecto-intercostal fascial block (PIFB) and rectus sheath block (RSB) have been combined to offer better analgesia for cardiac surgery patients, but safety of the analgesic protocol with a large volume of ropivacaine is uncertain.

Methods: This is a prospective observational study at Peking University People's Hospital to investigate the pharmacokinetic profile of ropivacaine after combined regional blocks. Patients undergoing elective cardiac surgery by a median sternotomy were enrolled to receive bilateral PIFB and RSB with 70 mL 0.3% ropivacaine (total dose 210 mg). Blood was sampled at 5, 10, 15, 30, 60, 90 and 120 mins after blocks. Total blood concentration of ropivacaine for patients were measured.

Results: Ten patients were enrolled and analyzed. The peak total ropivacaine concentration varied from 0.67 to 2.42 µg/mL. Time to reach the peak values mainly located between 10 and 30 mins after the performance. No patients had ropivacaine concentration values above toxic threshold (4.3 µg/mL), and there were no systemic toxicity symptoms during the perioperative period.

Conclusions: PIFB combined with RSB in a general injection of 70 mL 0.3% ropivacaine does not give rise to toxic levels, and it is an effective and safe analgesic protocol for cardiac surgery patients.

目的:胸肋间筋膜阻滞(PIFB)和直肌鞘阻滞(RSB)已被联合使用,为心脏手术患者提供更好的镇痛效果,但使用大容量罗哌卡因的镇痛方案的安全性尚不确定。方法:这是一项在北京大学人民医院进行的前瞻性观察性研究,旨在研究联合区域阻断后罗哌卡因的药代动力学特征。通过正中胸骨切开术接受选择性心脏手术的患者被纳入接受70 mL 0.3%罗哌卡因(总剂量210 mg)的双侧PIFB和RSB。在阻断后5、10、15、30、60、90和120分钟采集血液。测定患者罗哌卡因的总血药浓度。结果:对10例患者进行了入组和分析。罗哌卡因的峰值总浓度在0.67至2.42µg/mL之间。达到峰值的时间主要位于演出后10到30分钟之间。没有患者的罗哌卡因浓度值超过毒性阈值(4.3µg/mL),围手术期也没有出现全身毒性症状。结论:PIFB与RSB联合全身注射70 mL 0.3%罗哌卡因不会产生毒性,是一种有效、安全的心脏手术患者镇痛方案。
{"title":"Assessment of Total Ropivacaine Concentration in Blood after Bilateral Pecto-Intercostal Fascial Block Combined with Rectus Sheath Block in Cardiac Surgery Patients.","authors":"Lu Wang, Bailin Jiang, Yi Shi, Boyu Liu, Luyang Jiang, Yi Feng","doi":"10.59958/hsf.6721","DOIUrl":"10.59958/hsf.6721","url":null,"abstract":"<p><strong>Objectives: </strong>Pecto-intercostal fascial block (PIFB) and rectus sheath block (RSB) have been combined to offer better analgesia for cardiac surgery patients, but safety of the analgesic protocol with a large volume of ropivacaine is uncertain.</p><p><strong>Methods: </strong>This is a prospective observational study at Peking University People's Hospital to investigate the pharmacokinetic profile of ropivacaine after combined regional blocks. Patients undergoing elective cardiac surgery by a median sternotomy were enrolled to receive bilateral PIFB and RSB with 70 mL 0.3% ropivacaine (total dose 210 mg). Blood was sampled at 5, 10, 15, 30, 60, 90 and 120 mins after blocks. Total blood concentration of ropivacaine for patients were measured.</p><p><strong>Results: </strong>Ten patients were enrolled and analyzed. The peak total ropivacaine concentration varied from 0.67 to 2.42 µg/mL. Time to reach the peak values mainly located between 10 and 30 mins after the performance. No patients had ropivacaine concentration values above toxic threshold (4.3 µg/mL), and there were no systemic toxicity symptoms during the perioperative period.</p><p><strong>Conclusions: </strong>PIFB combined with RSB in a general injection of 70 mL 0.3% ropivacaine does not give rise to toxic levels, and it is an effective and safe analgesic protocol for cardiac surgery patients.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E519-E524"},"PeriodicalIF":0.6,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Common Gene Signatures Between Myocardial Infarction-Reperfusion Injury and the Gut Microbiome Using Bioinformatics. 利用生物信息学探讨心肌梗死再灌注损伤与肠道微生物组之间的常见基因特征。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-15 DOI: 10.59958/hsf.5775
Xiao Jiang, Caiyun Li, Xuting Xia, Jiangbo Tong, Jin Cheng, Xinhui Li

Background: This bioinformatics report attempts to explore the cross-talk genes, transcription factors (TFs), and pathways related to myocardial ischemia-reperfusion injury (MIRI) as well as the gut microbiome.

Method: The datasets GSE61592 (three MIRI and three sham samples) and GSE160516 (twelve MIRI and four sham samples) were selected in the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) identification (p < 0.05 and |log FC (fold change)| ≥1) together with functional annotation (p < 0.05) was implemented. The Cytoscape platform established the protein-protein interaction (PPI) network. Genes associated with gut microbiome disorder were extracted based on the DisGeNET database, and those associated with MIRI were overlapped. The Recursive Feature Elimination (RFE) algorithm was adopted for selecting features, and cross-talk genes were predicted by the Support Vector Machine (SVM) models. A network encompassing cross-talk genes along with the TFs was thereby established.

Result: The MIRI datasets comprised 138 shared DEGs, with 101 showing up-regulation whereas 37 showing down-regulation. Notably, the PPI interwork for MIRI contained 2517 edges along with 1818 nodes. By using RFE and SVM methods, six feature genes with the highest prediction were identified: B2m, VCAM-1, PDIA4, Ptgds, Mlxipl, and ACADS. Among these genes, B2m and PDIA4 were most highly expressed in MIRI and the gut microbiome disorder.

Conclusion: B2m and PDIA4 were identified to be significantly correlated with candidate cross-talk genes of MIRI with gut microbiome disorder, implying a similarity between MIRI and Gut microbiome disorder (GMD). These genes can serve as an experimental research basis for future studies.

背景:本生物信息学报告试图探索与心肌缺血再灌注损伤(MIRI)相关的串扰基因、转录因子(TF)、途径以及肠道微生物组。方法:在基因表达综合数据库(GEO)中选择数据集GSE61592(三个MIRI和三个假样本)和GSE160516(十二个MIRI,四个假样品)。实施差异表达基因(DEGs)鉴定(p<0.05和|log FC(倍数变化)|≥1)和功能注释(p<0.05)。Cytoscape平台建立了蛋白质-蛋白质相互作用(PPI)网络。基于DisGeNET数据库提取与肠道微生物组紊乱相关的基因,并将与MIRI相关的基因重叠。采用递归特征消除(RFE)算法进行特征选择,并利用支持向量机(SVM)模型对串扰基因进行预测。由此建立了包含串扰基因和TF的网络。结果:MIRI数据集包括138个共享的DEG,其中101个显示上调,而37个显示下调。值得注意的是,MIRI的PPI交织包含2517个边以及1818个节点。利用RFE和SVM方法,鉴定出6个预测最高的特征基因:B2m、VCAM-1、PDIA4、Ptgds、Mlxipl和ACADS。在这些基因中,B2m和PDIA4在MIRI和肠道微生物组紊乱中表达最高。结论:B2m和PDIA4与肠道微生物组紊乱的MIRI候选串扰基因显著相关,表明MIRI与肠道微生物群紊乱(GMD)相似。这些基因可以作为未来研究的实验研究基础。
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引用次数: 0
Modified Transannular Patching Palliation versus Modified Blalock-Taussig-Thomas Shunt in Infants with Severe Tetralogy of Fallot with Diminutive Pulmonary Arteries. 改良经环补片姑息治疗与改良Blalock-Taussig-Thomas分流治疗重度法洛四联症合并肺动脉收缩的婴儿。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-15 DOI: 10.59958/hsf.5807
Yuehu Han, Yanjie Guo, Le Duan, Tianjiang Li, Hailong Zhu, Guocheng Sun, Chunhu Gu

Objective: The purpose of this study was to compare pulmonary arterial (PA) growth and morbidity, mortality, reintervention and complete repair rates after modified transannular patching palliation (mTAP) versus modified Blalock-Taussig-Thomas shunt (mBTS) for palliation in infants with severe tetralogy of Fallot (TOF) with diminutive pulmonary arteries.

Methods: This was a retrospective case review study of 107 patients (64 males) with severe TOF who underwent staged repair with either mTAP (n = 55) or mBTS (n = 52) over an 8-year period. Procedure-related PA growth and morbidity, mortality, reintervention and complete repair rates were compared.

Results: Two deaths occurred in the mBTS group due to sudden cardiac arrest, and five patients needed reintervention after the mBTS procedure because of shunt thrombosis or stenosis. Postoperative complications of mBTS included sudden cardiac arrest, shunt thrombosis/stenosis, vocal cord palsy and diaphragmatic palsy. Unlike in the mBTS group, no death, severe complications or reintervention occurred in the mTAP group. Oxygen saturations post mTAP and mBTS were significantly higher, which improved from 67.73 ± 4.36% to 94.33 ± 2.19% in the mTAP group and from 68.24 ± 3.87% to 86.87 ± 3.38% in the mBTS group. The increase in oxygen saturation and pulmonary artery growth (from pre- to post palliation) was significantly better with mTAP than with mBTS palliation (p < 0.01). All 55 patients showed complete repair after mTAP, and the time from palliation to complete repair was significantly shorter in the mTAP group.

Conclusions: In a severe form of TOF with the hypoplastic PA tree, mTAP seems to be a better strategy that is safe and better facilitates satisfactory pulmonary arterial growth until complete repair than the mBTS procedure.

目的:本研究的目的是比较改良经环修补术(mTAP)与改良Blalock-Taussig-Thomas分流术(mBTS)对患有严重法洛四联症(TOF)且肺动脉狭窄的婴儿的肺动脉(PA)生长和发病率、死亡率、再干预和完全修复率。方法:这是一项对107名严重TOF患者(64名男性)的回顾性病例回顾性研究,这些患者在8年内接受了mTAP(n=55)或mBTS(n=52)分期修复。比较与手术相关的PA生长和发病率、死亡率、再干预和完全修复率。结果:mBTS组有2例因心脏骤停死亡,5例因分流血栓形成或狭窄需要在mBTS手术后再次干预。mBTS的术后并发症包括心脏骤停、分流血栓形成/狭窄、声带麻痹和膈肌麻痹。与mBTS组不同,mTAP组未发生死亡、严重并发症或再干预。mTAP和mBTS后的氧饱和度显著升高,mTAP组从67.73±4.36%提高到94.33±2.19%,mBTS组从68.24±3.87%提高到86.87±3.38%。mTAP缓解后氧饱和度和肺动脉生长的增加(从缓解前到缓解后)明显好于mBTS缓解(p<0.01)。55名患者在mTAP后均表现出完全修复,mTAP组从缓解到完全修复的时间明显更短。结论:在PA树发育不全的严重TOF中,与mBTS手术相比,mTAP似乎是一种更好的策略,它是安全的,并且更好地促进令人满意的肺动脉生长,直到完全修复。
{"title":"Modified Transannular Patching Palliation versus Modified Blalock-Taussig-Thomas Shunt in Infants with Severe Tetralogy of Fallot with Diminutive Pulmonary Arteries.","authors":"Yuehu Han,&nbsp;Yanjie Guo,&nbsp;Le Duan,&nbsp;Tianjiang Li,&nbsp;Hailong Zhu,&nbsp;Guocheng Sun,&nbsp;Chunhu Gu","doi":"10.59958/hsf.5807","DOIUrl":"10.59958/hsf.5807","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare pulmonary arterial (PA) growth and morbidity, mortality, reintervention and complete repair rates after modified transannular patching palliation (mTAP) versus modified Blalock-Taussig-Thomas shunt (mBTS) for palliation in infants with severe tetralogy of Fallot (TOF) with diminutive pulmonary arteries.</p><p><strong>Methods: </strong>This was a retrospective case review study of 107 patients (64 males) with severe TOF who underwent staged repair with either mTAP (n = 55) or mBTS (n = 52) over an 8-year period. Procedure-related PA growth and morbidity, mortality, reintervention and complete repair rates were compared.</p><p><strong>Results: </strong>Two deaths occurred in the mBTS group due to sudden cardiac arrest, and five patients needed reintervention after the mBTS procedure because of shunt thrombosis or stenosis. Postoperative complications of mBTS included sudden cardiac arrest, shunt thrombosis/stenosis, vocal cord palsy and diaphragmatic palsy. Unlike in the mBTS group, no death, severe complications or reintervention occurred in the mTAP group. Oxygen saturations post mTAP and mBTS were significantly higher, which improved from 67.73 ± 4.36% to 94.33 ± 2.19% in the mTAP group and from 68.24 ± 3.87% to 86.87 ± 3.38% in the mBTS group. The increase in oxygen saturation and pulmonary artery growth (from pre- to post palliation) was significantly better with mTAP than with mBTS palliation (p < 0.01). All 55 patients showed complete repair after mTAP, and the time from palliation to complete repair was significantly shorter in the mTAP group.</p><p><strong>Conclusions: </strong>In a severe form of TOF with the hypoplastic PA tree, mTAP seems to be a better strategy that is safe and better facilitates satisfactory pulmonary arterial growth until complete repair than the mBTS procedure.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E512-E518"},"PeriodicalIF":0.6,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of m6A Regulator Genes can Facilitate the Diagnosis of Chronic Heart Failure. m6A调节基因的表达可促进慢性心力衰竭的诊断。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-11 DOI: 10.59958/hsf.6335
Fang Zhou, Yang Yu, Yukun Li, Jessica Chen, Songnan Wen, Nian Liu, Xin Li, Rong Bai, Wanyao Yan

Background: RNA N6-methyladenosine (m6A) is the most common type of modification in eukaryotic mRNA. The relationship between m6A modification and disease has been studied extensively, but there have been few studies on chronic heart failure (CHF). This study investigated a possible role for m6A in the diagnosis of CHF.

Methods: Seven candidate m6A regulators (writers: WTAP and ZC3H13; readers: YTHDF3, FMR1, IGFBP1, and ELAVL1; eraser: FTO) were identified using a random forest (RF) model and the GSE5406 dataset from the Gene Expression Omnibus database. A nomogram model was developed to predict the risk of CHF, while consensus clustering methodology assigned CHF samples into two m6A patterns (cluster A and cluster B) according to the 7 candidate m6A regulators. Principal component analysis was used to calculate an m6A score for each sample and to quantify m6A patterns.

Results: Decision curve analysis and the nomogram model were used to obtain predictions that may be of clinical use. Patients in cluster B had higher m6A scores than patients in cluster A. Cluster B patients also had higher expression levels (ELs) of IL-4, IL-5, IL-10 and IL-13 than patients in cluster A, whereas cluster A patients had a higher EL for IL-33. The m6A cluster B pattern likely represents the ischemic heart failure (HF) disease group.

Conclusion: m6A regulators are important in the pathogenesis of CHF associated with ischemic and idiopathic dilated cardiomyopathy, and may prove useful for the diagnosis and treatment of CHF.

背景:核糖核酸N6-甲基腺苷(m6A)是真核细胞信使核糖核酸中最常见的修饰类型。m6A修饰与疾病之间的关系已被广泛研究,但对慢性心力衰竭(CHF)的研究很少。本研究调查了m6A在CHF诊断中的可能作用。方法:使用随机森林(RF)模型和基因表达综合数据库中的GSE5406数据集鉴定了七种候选m6A调节因子(作者:WTAP和ZC3H13;读者:YTHDF3、FMR1、IGFBP1和ELAVL1;擦除器:FTO)。开发了一个列线图模型来预测CHF的风险,而共识聚类方法根据7个候选m6A调节因子将CHF样本分配为两个m6A模式(聚类A和聚类B)。主成分分析用于计算每个样本的m6A得分,并量化m6A模式。结果:决策曲线分析和列线图模型用于获得可能具有临床应用价值的预测。集群B中的患者比集群A中的患者具有更高的m6A评分。集群B中患者的IL-4、IL-5、IL-10和IL-13的表达水平(EL)也比集群A的患者更高,而集群A中患者的IL-13的EL更高。m6A簇B模式可能代表缺血性心力衰竭(HF)疾病组。结论:m6A调节因子在CHF合并缺血性和特发性扩张型心肌病的发病机制中具有重要作用,可用于CHF的诊断和治疗。
{"title":"Expression of m6A Regulator Genes can Facilitate the Diagnosis of Chronic Heart Failure.","authors":"Fang Zhou,&nbsp;Yang Yu,&nbsp;Yukun Li,&nbsp;Jessica Chen,&nbsp;Songnan Wen,&nbsp;Nian Liu,&nbsp;Xin Li,&nbsp;Rong Bai,&nbsp;Wanyao Yan","doi":"10.59958/hsf.6335","DOIUrl":"10.59958/hsf.6335","url":null,"abstract":"<p><strong>Background: </strong>RNA N6-methyladenosine (m6A) is the most common type of modification in eukaryotic mRNA. The relationship between m6A modification and disease has been studied extensively, but there have been few studies on chronic heart failure (CHF). This study investigated a possible role for m6A in the diagnosis of CHF.</p><p><strong>Methods: </strong>Seven candidate m6A regulators (writers: WTAP and ZC3H13; readers: YTHDF3, FMR1, IGFBP1, and ELAVL1; eraser: FTO) were identified using a random forest (RF) model and the GSE5406 dataset from the Gene Expression Omnibus database. A nomogram model was developed to predict the risk of CHF, while consensus clustering methodology assigned CHF samples into two m6A patterns (cluster A and cluster B) according to the 7 candidate m6A regulators. Principal component analysis was used to calculate an m6A score for each sample and to quantify m6A patterns.</p><p><strong>Results: </strong>Decision curve analysis and the nomogram model were used to obtain predictions that may be of clinical use. Patients in cluster B had higher m6A scores than patients in cluster A. Cluster B patients also had higher expression levels (ELs) of IL-4, IL-5, IL-10 and IL-13 than patients in cluster A, whereas cluster A patients had a higher EL for IL-33. The m6A cluster B pattern likely represents the ischemic heart failure (HF) disease group.</p><p><strong>Conclusion: </strong>m6A regulators are important in the pathogenesis of CHF associated with ischemic and idiopathic dilated cardiomyopathy, and may prove useful for the diagnosis and treatment of CHF.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E485-E497"},"PeriodicalIF":0.6,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Moracizine Combined with Metoprolol on Hemodynamic Indices of the Left Atrium and Quality of Life in Patients with Atrial Fibrillation. 莫拉西嗪联合美托洛尔对心房颤动患者左心房血流动力学指标及生活质量的影响。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-07 DOI: 10.59958/hsf.5683
Gongzhu Han, Ting Fu, Yichao Zhang
BACKGROUND Drugs are the first choice of treatment for atrial fibrillation (AF), but there is currently a lack of efficient drug treatment options. The aim of this study was to investigate a combination drug treatment plan which may serve as a reference for the treatment of AF. METHODS A total of 316 AF patients admitted to Jiaozhou Central Hospital in Qingdao from October 2020 to October 2022 were selected for this retrospective study. They were divided into a control group (CG, metoprolol, n = 156) and an observation group (OG, moracizine combined with metoprolol, n = 160) based on the treatment they received. The CG and OG groups were compared for clinical efficacy, occurrence of AF, cardiac output (CO), cardiac indexes (CI), stroke volume (SV), stroke indexes (SI) and improvement in QOL. RESULTS The OG had a better effective rate of treatment, higher levels of CO, CI, SV and SI, and higher QOL scores compared to the CG, as well as a lower AF recurrence rate and AF burden (all p < 0.05). CONCLUSION Moracizine combined with metoprolol is an effective treatment for AF patients. This drug combination was found to reduce the AF recurrence rate and burden in AF patients, and to improve their hemodynamic indices and QOL.
背景:药物是治疗心房颤动(AF)的首选药物,但目前缺乏有效的药物治疗方案。本研究的目的是探讨一种可作为AF治疗参考的联合药物治疗方案。方法:选择2020年10月至2022年10月在青岛胶州市中心医院住院的316名AF患者进行回顾性研究。根据他们接受的治疗,将他们分为对照组(CG,美托洛尔,n=156)和观察组(OG,莫拉西嗪联合美托洛尔(n=160))。比较CG组和OG组的临床疗效、房颤发生率、心输出量(CO)、心脏指数(CI)、卒中量(SV)、卒中指数(SI)和生活质量改善情况。结果:OG治疗房颤有效率较高,CO、CI、SV、SI水平较高,生活质量评分较高,房颤复发率和负担较低(均p<0.05)。该药物组合被发现可以降低房颤患者的房颤复发率和负担,并改善他们的血液动力学指标和生活质量。
{"title":"Effects of Moracizine Combined with Metoprolol on Hemodynamic Indices of the Left Atrium and Quality of Life in Patients with Atrial Fibrillation.","authors":"Gongzhu Han,&nbsp;Ting Fu,&nbsp;Yichao Zhang","doi":"10.59958/hsf.5683","DOIUrl":"10.59958/hsf.5683","url":null,"abstract":"BACKGROUND Drugs are the first choice of treatment for atrial fibrillation (AF), but there is currently a lack of efficient drug treatment options. The aim of this study was to investigate a combination drug treatment plan which may serve as a reference for the treatment of AF. METHODS A total of 316 AF patients admitted to Jiaozhou Central Hospital in Qingdao from October 2020 to October 2022 were selected for this retrospective study. They were divided into a control group (CG, metoprolol, n = 156) and an observation group (OG, moracizine combined with metoprolol, n = 160) based on the treatment they received. The CG and OG groups were compared for clinical efficacy, occurrence of AF, cardiac output (CO), cardiac indexes (CI), stroke volume (SV), stroke indexes (SI) and improvement in QOL. RESULTS The OG had a better effective rate of treatment, higher levels of CO, CI, SV and SI, and higher QOL scores compared to the CG, as well as a lower AF recurrence rate and AF burden (all p < 0.05). CONCLUSION Moracizine combined with metoprolol is an effective treatment for AF patients. This drug combination was found to reduce the AF recurrence rate and burden in AF patients, and to improve their hemodynamic indices and QOL.","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E463-E469"},"PeriodicalIF":0.6,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Heart Surgery Forum
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