Pub Date : 2022-09-05eCollection Date: 2022-01-01DOI: 10.1155/2022/2835485
Shan Wang, You Zhang, Qianqian Cheng, Datun Qi, Xianpei Wang, Zhongyu Zhu, Muwei Li, Junhui Zhang, Dayi Hu, Chuanyu Gao, On Behalf Of Henan Stemi Registry Study Group
Background: Women hospitalized with ST-elevation myocardial infarction (STEMI) experience higher risk of early mortality than men. We aimed to investigate the potential impact of risk factors, clinical characteristics, and management among gender-related risk differences.
Method: We analyzed 5063 STEMI patients prospectively enrolled from 66 hospitals during 2016-2018 and compared sex differences in mortality, death, or treatment withdrawal and main adverse cardiovascular and cerebrovascular events (MACCE) using the generalized linear mixed model, following sequential adjustment for covariates.
Results: Women were older and had a higher prevalence of hypertension (53.3% vs. 41.1%, P < 0.001) and diabetes (24.5% vs. 15.2%, P < 0.001). Eligible women were less likely to receive reperfusion therapy (56.1% vs. 62.4%, P < 0.001); the onset to first medical contact (FMC) (255 vs. 190 minutes, P < 0.001), onset to fibrinolysis (218 vs. 185 minutes, P < 0.001), and onset to percutaneous coronary intervention (PCI) (307 vs. 243 minutes, P < 0.001) were significantly delayed in women. The incidence of in-hospital death (6.8% vs. 3.0%, P < 0.001), death or treatment withdrawal (14.5% vs. 5.6%, P < 0.001), and MACCE (18.5% vs. 9.4%, P < 0.001) were notably higher. The gender disparities persist in death (OR: 1.61, 95% CI: 1.12-2.33), death or treatment withdrawal (OR: 1.68, 95% CI: 1.26-2.24), and MACCE (OR: 1.37, 95% CI: 1.08-1.74) after adjustment for covariates. Among possible explanatory factors, age (-58.46%, -59.04%, -62.20%) and cardiovascular risk factors (-40.77%, -39.36%, -41.73%) accounted for most of the gender-associated risk differences.
Conclusions: Women experienced worse in-hospital outcomes, and age and cardiovascular risk factors were major factors influencing sex-related differences. The sex disparity stressed the awareness and importance of quality improvement efforts against female patients in clinical practice.
{"title":"Sex Disparity in Characteristics, Management, and In-Hospital Outcomes of Patients with ST-Segment Elevated Myocardial Infarction: Insights from Henan STEMI Registry.","authors":"Shan Wang, You Zhang, Qianqian Cheng, Datun Qi, Xianpei Wang, Zhongyu Zhu, Muwei Li, Junhui Zhang, Dayi Hu, Chuanyu Gao, On Behalf Of Henan Stemi Registry Study Group","doi":"10.1155/2022/2835485","DOIUrl":"10.1155/2022/2835485","url":null,"abstract":"<p><strong>Background: </strong>Women hospitalized with ST-elevation myocardial infarction (STEMI) experience higher risk of early mortality than men. We aimed to investigate the potential impact of risk factors, clinical characteristics, and management among gender-related risk differences.</p><p><strong>Method: </strong>We analyzed 5063 STEMI patients prospectively enrolled from 66 hospitals during 2016-2018 and compared sex differences in mortality, death, or treatment withdrawal and main adverse cardiovascular and cerebrovascular events (MACCE) using the generalized linear mixed model, following sequential adjustment for covariates.</p><p><strong>Results: </strong>Women were older and had a higher prevalence of hypertension (53.3% vs. 41.1%, <i>P</i> < 0.001) and diabetes (24.5% vs. 15.2%, <i>P</i> < 0.001). Eligible women were less likely to receive reperfusion therapy (56.1% vs. 62.4%, <i>P</i> < 0.001); the onset to first medical contact (FMC) (255 vs. 190 minutes, <i>P</i> < 0.001), onset to fibrinolysis (218 vs. 185 minutes, <i>P</i> < 0.001), and onset to percutaneous coronary intervention (PCI) (307 vs. 243 minutes, <i>P</i> < 0.001) were significantly delayed in women. The incidence of in-hospital death (6.8% vs. 3.0%, <i>P</i> < 0.001), death or treatment withdrawal (14.5% vs. 5.6%, <i>P</i> < 0.001), and MACCE (18.5% vs. 9.4%, <i>P</i> < 0.001) were notably higher. The gender disparities persist in death (OR: 1.61, 95% CI: 1.12-2.33), death or treatment withdrawal (OR: 1.68, 95% CI: 1.26-2.24), and MACCE (OR: 1.37, 95% CI: 1.08-1.74) after adjustment for covariates. Among possible explanatory factors, age (-58.46%, -59.04%, -62.20%) and cardiovascular risk factors (-40.77%, -39.36%, -41.73%) accounted for most of the gender-associated risk differences.</p><p><strong>Conclusions: </strong>Women experienced worse in-hospital outcomes, and age and cardiovascular risk factors were major factors influencing sex-related differences. The sex disparity stressed the awareness and importance of quality improvement efforts against female patients in clinical practice.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The objective is to investigate the relationship between sepsis complicated with heart failure and the expression levels of CXC chemokine ligand 8 (CXCL8) and endothelin-1 (ET-1).
Methods: A total of 128 sepsis patients accepted by the Ganzhou People's Hospital from March 2019 to December 2021 were collected as observation objects, and they were separated into a simple sepsis group (86 cases) and a complicated heart failure group (42 cases) according to whether they were accompanied by heart failure or not. General data such as Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) were collected; the expression levels of serum CXCL8 and ET-1 were detected by enzyme-linked immunosorbent assay (ELISA); the cardiac function parameters such as left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), and cardiac index (CI) were measured by color Doppler ultrasound; the correlation between serum CXCL8 and ET-1 expression levels with clinical data and cardiac function parameters in patients with sepsis complicated with heart failure was analyzed by the Pearson correlation; and the influencing factors of sepsis complicated with heart failure were analyzed by the logistic regression analysis.
Results: The serum CXCL8 and ET-1 expression levels, SOFA score, and APACHE II score in the complicated heart failure group were higher than those in the simple sepsis group (P < 0.05), and LVEF, SV, CO, and CI in the complicated heart failure group were lower than those in the simple sepsis group (P < 0.05). Serum CXCL8 was positively correlated with ET-1 in patients with sepsis complicated with heart failure (r = 0.531, P < 0.05), and the two were positively correlated with SOFA score and APACHE II score (P < 0.05) and were negatively correlated with LVEF, SV, CO, and CI (P < 0.05). CXCL8 and ET-1 were independent risk factors for sepsis complicated with heart failure (P < 0.05).
Conclusion: The expression levels of serum CXCL8 and ET-1 in sepsis patients with heart failure are significantly increased, and both are risk factors for heart failure in sepsis patients.
{"title":"The Relationship between Serum CXCL8 and ET-1 Expression Levels and Sepsis Complicated with Heart Failure.","authors":"Jianlong Zhu, Changjun Song, Tingting Cai, Lulu Yi, Wei Zhang, Jing Zhong, Meirong Shen","doi":"10.1155/2022/8570486","DOIUrl":"https://doi.org/10.1155/2022/8570486","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to investigate the relationship between sepsis complicated with heart failure and the expression levels of CXC chemokine ligand 8 (CXCL8) and endothelin-1 (ET-1).</p><p><strong>Methods: </strong>A total of 128 sepsis patients accepted by the Ganzhou People's Hospital from March 2019 to December 2021 were collected as observation objects, and they were separated into a simple sepsis group (86 cases) and a complicated heart failure group (42 cases) according to whether they were accompanied by heart failure or not. General data such as Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) were collected; the expression levels of serum CXCL8 and ET-1 were detected by enzyme-linked immunosorbent assay (ELISA); the cardiac function parameters such as left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), and cardiac index (CI) were measured by color Doppler ultrasound; the correlation between serum CXCL8 and ET-1 expression levels with clinical data and cardiac function parameters in patients with sepsis complicated with heart failure was analyzed by the Pearson correlation; and the influencing factors of sepsis complicated with heart failure were analyzed by the logistic regression analysis.</p><p><strong>Results: </strong>The serum CXCL8 and ET-1 expression levels, SOFA score, and APACHE II score in the complicated heart failure group were higher than those in the simple sepsis group (<i>P</i> < 0.05), and LVEF, SV, CO, and CI in the complicated heart failure group were lower than those in the simple sepsis group (<i>P</i> < 0.05). Serum CXCL8 was positively correlated with ET-1 in patients with sepsis complicated with heart failure (<i>r</i> = 0.531, <i>P</i> < 0.05), and the two were positively correlated with SOFA score and APACHE II score (<i>P</i> < 0.05) and were negatively correlated with LVEF, SV, CO, and CI (<i>P</i> < 0.05). CXCL8 and ET-1 were independent risk factors for sepsis complicated with heart failure (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The expression levels of serum CXCL8 and ET-1 in sepsis patients with heart failure are significantly increased, and both are risk factors for heart failure in sepsis patients.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40352863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24eCollection Date: 2022-01-01DOI: 10.1155/2022/6192053
Yezhou Qian, Menghui Mao, Feige Nian
Tumor necrosis factor-alpha (TNF-α) plays an important role in coronary heart disease (CHD), a chronic inflammatory process. Meanwhile, this pro-inflammatory factor is also involved in the pathogenesis of autoimmune diseases such as rheumatoid arthritis (RA). Patients with RA correspond to a higher risk of CHD. TNF-α antagonist, one of the main treatments for RA, may reduce the risk of CHD in patients with RA. This review summarizes the pathogenesis of TNF-α in CHD and discusses the relationship between TNF-α antagonist and CHD in patients with RA.
{"title":"The Effect of TNF-<i>α</i> on CHD and the Relationship between TNF-<i>α</i> Antagonist and CHD in Rheumatoid Arthritis: A Systematic Review.","authors":"Yezhou Qian, Menghui Mao, Feige Nian","doi":"10.1155/2022/6192053","DOIUrl":"10.1155/2022/6192053","url":null,"abstract":"<p><p>Tumor necrosis factor-alpha (TNF-<i>α</i>) plays an important role in coronary heart disease (CHD), a chronic inflammatory process. Meanwhile, this pro-inflammatory factor is also involved in the pathogenesis of autoimmune diseases such as rheumatoid arthritis (RA). Patients with RA correspond to a higher risk of CHD. TNF-<i>α</i> antagonist, one of the main treatments for RA, may reduce the risk of CHD in patients with RA. This review summarizes the pathogenesis of TNF-<i>α</i> in CHD and discusses the relationship between TNF-<i>α</i> antagonist and CHD in patients with RA.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9433296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-23eCollection Date: 2022-01-01DOI: 10.1155/2022/1638209
Yu Ma, Lei Zha, Qi Zhang, Lu Cao, Ru Zhao, Jing Ma, Kai Hou, Yue Pan, Hongliang Cong, Ximing Li
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to inhibit pyroptosis and apoptosis, which play important roles in the development and progression of contrast-induced acute kidney injury (CI-AKI). However, to the best of our knowledge, no studies have investigated the potential effect of PCSK9 inhibitors on the prevalence of CI-AKI after percutaneous coronary intervention (PCI). This study aimed to determine whether PCSK9 inhibitors are associated with the prevalence of CI-AKI. The medical records of 309 (mean age, 63.35 years; 71.84% male) patients with acute myocardial infarction who underwent PCI at our institution were retrospectively analyzed. Overall, 149 and 160 patients were assigned to the evolocumab and control groups, respectively. Serum creatinine levels were examined preoperatively and 24-72 h postoperatively and compared between groups. Data were grouped according to the occurrence of CI-AKI, and a univariate analysis was conducted to exclude suspected influencing factors that led to CI-AKI occurrence. After adjusting for confounding factors, a logistic regression analysis was performed to assess the association between evolocumab administration (independent variable) and CI-AKI occurrence (dependent variable). The prevalence of CI-AKI was significantly lower in the evolocumab group (6.7%) than in the control group (20.0%; p < 0.01).We further evaluated the correlation between exposure factor and outcome. The relative risk(RR) between the use of evolocumab and the occurrence of CI-AKI was 0.34(95% CI 0.17-0.66,p<0.01).This result indicate a significant association between the use of evolocumab and a reduction in the incidence of CI-AKI.The logistic regression analysis results revealed that evolocumab was significantly associated with CI-AKI. The use of PCSK9 inhibitors, hydration therapy, and statin administration appears promising for preventing CI-AKI in patients with acute myocardial infarction undergoing PCI.
{"title":"Effect of PCSK9 Inhibitor on Contrast-Induced Acute Kidney Injury in Patients with Acute Myocardial Infarction Undergoing Intervention Therapy.","authors":"Yu Ma, Lei Zha, Qi Zhang, Lu Cao, Ru Zhao, Jing Ma, Kai Hou, Yue Pan, Hongliang Cong, Ximing Li","doi":"10.1155/2022/1638209","DOIUrl":"10.1155/2022/1638209","url":null,"abstract":"<p><p>Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to inhibit pyroptosis and apoptosis, which play important roles in the development and progression of contrast-induced acute kidney injury (CI-AKI). However, to the best of our knowledge, no studies have investigated the potential effect of PCSK9 inhibitors on the prevalence of CI-AKI after percutaneous coronary intervention (PCI). This study aimed to determine whether PCSK9 inhibitors are associated with the prevalence of CI-AKI. The medical records of 309 (mean age, 63.35 years; 71.84% male) patients with acute myocardial infarction who underwent PCI at our institution were retrospectively analyzed. Overall, 149 and 160 patients were assigned to the evolocumab and control groups, respectively. Serum creatinine levels were examined preoperatively and 24-72 h postoperatively and compared between groups. Data were grouped according to the occurrence of CI-AKI, and a univariate analysis was conducted to exclude suspected influencing factors that led to CI-AKI occurrence. After adjusting for confounding factors, a logistic regression analysis was performed to assess the association between evolocumab administration (independent variable) and CI-AKI occurrence (dependent variable). The prevalence of CI-AKI was significantly lower in the evolocumab group (6.7%) than in the control group (20.0%; <i>p</i> < 0.01).We further evaluated the correlation between exposure factor and outcome. The relative risk(RR) between the use of evolocumab and the occurrence of CI-AKI was 0.34(95% CI 0.17-0.66,p<0.01).This result indicate a significant association between the use of evolocumab and a reduction in the incidence of CI-AKI.The logistic regression analysis results revealed that evolocumab was significantly associated with CI-AKI. The use of PCSK9 inhibitors, hydration therapy, and statin administration appears promising for preventing CI-AKI in patients with acute myocardial infarction undergoing PCI.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40343514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Acute ST-segment elevation myocardial infarction (STEMI) is a serious cardiovascular disease that poses a great threat to the life and health of patients. Therefore, early diagnosis is important for STEMI patient treatment and prognosis. The purpose of this study was to investigate the value of serum YKL-40 and TNF-α in the diagnosis of STEMI.
Methods: From October 2020 to February 2022, 120 patients with STEMI were admitted to the Chest Pain Center of the Second People's Hospital of Hefei, and 81 patients with negative coronary angiography were selected as the control group. Serum YKL-40 and TNF-α concentrations were measured by sandwich ELISA. Pearson correlation was used to analyze the correlation between serum YKL-40, TNF-α, and serum troponin I (cTnI) in STEMI patients; multivariate logistic regression analysis was used to screen independent risk factors for STEMI. Three diagnostic models were constructed: cTnI univariate model (model A), combined serum YKL-40 and TNF-α model other than cTnI (model B), and combined cTnI and serum YKL-40 and TNF-α model (model C). We assessed the clinical usefulness of the diagnostic model by comparing AUC with decision curve analysis (DCA).
Results: Serum YKL-40 and TNF-α in the STEMI group were significantly higher than those in the control group (P < 0.001). On Pearson correlation analysis, there was a significant positive correlation between serum YKL-40, TNF-α, and cTnI levels in STEMI patients. Multivariate logistic regression analysis showed that serum YKL-40 and TNF-α were independent risk factors for the development of STEMI. The results of ROC analysis showed that the area under the curve (AUC) of serum YKL-40 for predicting the occurrence of STEMI was 0.704. The AUC of serum TNF-α for predicting the occurrence of STEMI was 0.852. The AUC of cTnI as a traditional model, model A, for predicting the occurrence of STEMI was 0.875. Model B predicted STEMI with an AUC of 0.851. The addition of serum YKL-40 and serum TNF-α to the traditional diagnostic model composed of cTnI constituted a new diagnostic model; that is, the AUC of model C for predicting the occurrence of STEMI was 0.930. Model C had a better net benefit between a threshold probability of 70-95% for DCA.
Conclusion: In this study, we demonstrate the utility of serum YKL-40 and TNF-α as diagnostic markers for STEMI and the clinical utility of diagnostic models by combining serum YKL-40 and TNF-α with cTnI.
{"title":"The Value of Serum YKL-40 and TNF-<i>α</i> in the Diagnosis of Acute ST-Segment Elevation Myocardial Infarction.","authors":"Caoyang Fang, Zhenfei Chen, Jing Zhang, Jianyuan Pan, Xiaoqin Jin, Mengsi Yang, Luyao Huang","doi":"10.1155/2022/4905954","DOIUrl":"https://doi.org/10.1155/2022/4905954","url":null,"abstract":"<p><strong>Background: </strong>Acute ST-segment elevation myocardial infarction (STEMI) is a serious cardiovascular disease that poses a great threat to the life and health of patients. Therefore, early diagnosis is important for STEMI patient treatment and prognosis. The purpose of this study was to investigate the value of serum YKL-40 and TNF-<i>α</i> in the diagnosis of STEMI.</p><p><strong>Methods: </strong>From October 2020 to February 2022, 120 patients with STEMI were admitted to the Chest Pain Center of the Second People's Hospital of Hefei, and 81 patients with negative coronary angiography were selected as the control group. Serum YKL-40 and TNF-<i>α</i> concentrations were measured by sandwich ELISA. Pearson correlation was used to analyze the correlation between serum YKL-40, TNF-<i>α</i>, and serum troponin I (cTnI) in STEMI patients; multivariate logistic regression analysis was used to screen independent risk factors for STEMI. Three diagnostic models were constructed: cTnI univariate model (model <i>A</i>), combined serum YKL-40 and TNF-<i>α</i> model other than cTnI (model <i>B</i>), and combined cTnI and serum YKL-40 and TNF-<i>α</i> model (model <i>C</i>). We assessed the clinical usefulness of the diagnostic model by comparing AUC with decision curve analysis (DCA).</p><p><strong>Results: </strong>Serum YKL-40 and TNF-<i>α</i> in the STEMI group were significantly higher than those in the control group (<i>P</i> < 0.001). On Pearson correlation analysis, there was a significant positive correlation between serum YKL-40, TNF-<i>α</i>, and cTnI levels in STEMI patients. Multivariate logistic regression analysis showed that serum YKL-40 and TNF-<i>α</i> were independent risk factors for the development of STEMI. The results of ROC analysis showed that the area under the curve (AUC) of serum YKL-40 for predicting the occurrence of STEMI was 0.704. The AUC of serum TNF-<i>α</i> for predicting the occurrence of STEMI was 0.852. The AUC of cTnI as a traditional model, model <i>A</i>, for predicting the occurrence of STEMI was 0.875. Model <i>B</i> predicted STEMI with an AUC of 0.851. The addition of serum YKL-40 and serum TNF-<i>α</i> to the traditional diagnostic model composed of cTnI constituted a new diagnostic model; that is, the AUC of model <i>C</i> for predicting the occurrence of STEMI was 0.930. Model <i>C</i> had a better net benefit between a threshold probability of 70-95% for DCA.</p><p><strong>Conclusion: </strong>In this study, we demonstrate the utility of serum YKL-40 and TNF-<i>α</i> as diagnostic markers for STEMI and the clinical utility of diagnostic models by combining serum YKL-40 and TNF-<i>α</i> with cTnI.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40343515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the clinical utility of synthesized V7-V9 ST-segment elevation (sV7-9 STE) in patients with 12-lead-electrocardiogram (ECG)-based non-STE myocardial infarction (NSTEMI) in diagnosing left circumflex artery (LCx) STEMI-equivalent acute coronary syndrome (ACS).
Background: The 12-lead-ECG is insufficient for diagnosing patients with ACS, especially those with an LCx culprit.
Methods: We retrospectively examined 219 patients with NSTEMI who underwent synthesized 18-lead ECG acquisition on admission and urgent catheterization. Associations between baseline variables, including sV7-9 STE and LCx STEMI-equivalent ACS, were analyzed using logistic regression models and receiver operating characteristics. LCx-culprit ACS was defined as thrombolysis in myocardial infarction (TIMI) 0-1 flow. The association between sV7-9 STE and myocardial damage was also assessed.
Results: The mean (SD) age of the population was 68.8 (12.0) years, and 81.7% were men. LCx-culprit NSTEMI occurred in 58 (26.5%) patients and 15 (6.8%) were LCx STEMI-equivalent. SV7-9 STE was observed in 16 patients (7.9%). SV7-9 STE was the sole significant predictor of LCx STEMI-equivalent ACS with an odds ratio of 19.0 (95% CI: 5.6-63.9, p < 0.001), area under the curve of 0.71 (95% CI: 0.58-0.84), sensitivity of 46.7%, and specificity of 95.6%. After adjustment for confounders, sV7-9 STE was significantly associated with a 308% (95% CI: 78-834%) increase in peak high-sensitivity cardiac troponin I (p=0.001).
Conclusions: SV7-9 STE had sole preprocedural diagnostic utility in detecting LCx STEMI-equivalent ACS with greater myocardial damage among patients with 12 ECG-based NSTEMI. The use of synthesized extra leads on admission may help identify patients with NSTEMI requiring primary revascularization.
{"title":"Synthesized 18-Lead Electrocardiogram in Diagnosing Posterior Stemi-Equivalent Acute Coronary Syndrome in Patients with NSTEMI.","authors":"Tomoki Horie, Rikuta Hamaya, Tomoyo Sugiyama, Hidenori Hirano, Masahiro Hoshino, Yoshihisa Kanaji, Tetsumin Lee, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1155/2022/9582174","DOIUrl":"https://doi.org/10.1155/2022/9582174","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical utility of synthesized V7-V9 ST-segment elevation (sV7-9 STE) in patients with 12-lead-electrocardiogram (ECG)-based non-STE myocardial infarction (NSTEMI) in diagnosing left circumflex artery (LCx) STEMI-equivalent acute coronary syndrome (ACS).</p><p><strong>Background: </strong>The 12-lead-ECG is insufficient for diagnosing patients with ACS, especially those with an LCx culprit.</p><p><strong>Methods: </strong>We retrospectively examined 219 patients with NSTEMI who underwent synthesized 18-lead ECG acquisition on admission and urgent catheterization. Associations between baseline variables, including sV7-9 STE and LCx STEMI-equivalent ACS, were analyzed using logistic regression models and receiver operating characteristics. LCx-culprit ACS was defined as thrombolysis in myocardial infarction (TIMI) 0-1 flow. The association between sV7-9 STE and myocardial damage was also assessed.</p><p><strong>Results: </strong>The mean (SD) age of the population was 68.8 (12.0) years, and 81.7% were men. LCx-culprit NSTEMI occurred in 58 (26.5%) patients and 15 (6.8%) were LCx STEMI-equivalent. SV7-9 STE was observed in 16 patients (7.9%). SV7-9 STE was the sole significant predictor of LCx STEMI-equivalent ACS with an odds ratio of 19.0 (95% CI: 5.6-63.9, <i>p</i> < 0.001), area under the curve of 0.71 (95% CI: 0.58-0.84), sensitivity of 46.7%, and specificity of 95.6%. After adjustment for confounders, sV7-9 STE was significantly associated with a 308% (95% CI: 78-834%) increase in peak high-sensitivity cardiac troponin I (<i>p</i>=0.001).</p><p><strong>Conclusions: </strong>SV7-9 STE had sole preprocedural diagnostic utility in detecting LCx STEMI-equivalent ACS with greater myocardial damage among patients with 12 ECG-based NSTEMI. The use of synthesized extra leads on admission may help identify patients with NSTEMI requiring primary revascularization.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33454703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective There can be extreme variability between individual responses to exercise training, and the identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We aimed to screen the exercise-related gene sensitivity of patients with acute myocardial infarction after PCI by establishing the gene spectrum of aerobic exercise and cardiopulmonary function sensitivity, test the effect of individualized precision exercise therapy, and provide evidence for the establishment of a precision medicine program for clinical research. Methods Aerobic exercise- and cardiopulmonary function-related genes and single-nucleotide polymorphisms (SNPs) were obtained by data mining utilizing a major publicly available biomedical repository, the NCBI PubMed database. Biological samples from all participants underwent DNA testing. We performed SNP detection using Samtools. A total of 122 patients who underwent PCI were enrolled in the study. We screened the first 24 cases with a high mutation frequency for aerobic exercise- and cardiopulmonary function-related genes and the last 24 cases with a low mutation frequency and separated them into two groups for the exercise intervention experiment. Results In both the low mutation frequency group and the high mutation frequency group, after 8 weeks of exercise intervention, 6 MWT distance, 6 MWT%, VO2/kg at peak, and VO2/kg at AT were significantly improved, and the effect in the high mutation frequency group was significantly higher than that in the low mutation frequency group (6 MWT distance: 468 vs. 439, P=0.003; 6 MWT%: 85 vs. 77, P=0.002, VO2/kg at peak: 14.7 vs. 13.3, P=0.002; VO2/kg at AT: 11.9 vs. 13.3, P=0.003). Conclusions There is extreme variability between individual responses to exercise training. The identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We found that the subjects with a high mutation frequency in aerobic exercise and cardiopulmonary function-related genes achieved more cardiorespiratory fitness benefits in the aerobic exercise rehabilitation program and provided evidence for the establishment of a precision medicine program for clinical research.
目的:个体对运动训练的反应可能存在极大的可变性,识别与运动相关特征的个体可变性相关的遗传变异可以指导个性化的运动计划。我们旨在通过建立有氧运动和心肺功能敏感性基因谱,筛选PCI术后急性心肌梗死患者运动相关基因敏感性,检验个体化精准运动治疗的效果,为建立精准医学方案进行临床研究提供依据。方法:有氧运动和心肺功能相关基因和单核苷酸多态性(snp)通过数据挖掘利用主要的公共生物医学存储库,NCBI PubMed数据库获得。所有参与者的生物样本都进行了DNA测试。我们使用Samtools进行SNP检测。共有122名接受PCI治疗的患者参加了这项研究。我们筛选了前24例高突变频率的有氧运动和心肺功能相关基因和后24例低突变频率的有氧运动和心肺功能相关基因,并将其分为两组进行运动干预实验。结果:在低突变频率组和高突变频率组中,运动干预8周后,6 MWT距离、6 MWT%、峰值VO2/kg、at时VO2/kg均显著改善,且高突变频率组效果显著高于低突变频率组(6 MWT距离:468 vs. 439, P=0.003;6 MWT%: 85 vs. 77, P=0.002,峰值VO2/kg: 14.7 vs. 13.3, P=0.002;at: 11.9 vs. 13.3, P=0.003)。结论:个体对运动训练的反应存在极大的差异性。识别与运动相关特征的个体变异相关的遗传变异可以指导个性化的运动计划。我们发现有氧运动和心肺功能相关基因突变频率高的受试者在有氧运动康复项目中获得了更多的心肺健康益处,为建立精准医学项目进行临床研究提供了依据。
{"title":"Outcomes of Genetic Testing-Based Cardiac Rehabilitation Program in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention.","authors":"Xing Yu, Yuxuan Fan, Xiaopeng Sun, Xiaojing Wang, Qi Guo, Zhiqing Fan","doi":"10.1155/2022/9742071","DOIUrl":"https://doi.org/10.1155/2022/9742071","url":null,"abstract":"Objective There can be extreme variability between individual responses to exercise training, and the identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We aimed to screen the exercise-related gene sensitivity of patients with acute myocardial infarction after PCI by establishing the gene spectrum of aerobic exercise and cardiopulmonary function sensitivity, test the effect of individualized precision exercise therapy, and provide evidence for the establishment of a precision medicine program for clinical research. Methods Aerobic exercise- and cardiopulmonary function-related genes and single-nucleotide polymorphisms (SNPs) were obtained by data mining utilizing a major publicly available biomedical repository, the NCBI PubMed database. Biological samples from all participants underwent DNA testing. We performed SNP detection using Samtools. A total of 122 patients who underwent PCI were enrolled in the study. We screened the first 24 cases with a high mutation frequency for aerobic exercise- and cardiopulmonary function-related genes and the last 24 cases with a low mutation frequency and separated them into two groups for the exercise intervention experiment. Results In both the low mutation frequency group and the high mutation frequency group, after 8 weeks of exercise intervention, 6 MWT distance, 6 MWT%, VO2/kg at peak, and VO2/kg at AT were significantly improved, and the effect in the high mutation frequency group was significantly higher than that in the low mutation frequency group (6 MWT distance: 468 vs. 439, P=0.003; 6 MWT%: 85 vs. 77, P=0.002, VO2/kg at peak: 14.7 vs. 13.3, P=0.002; VO2/kg at AT: 11.9 vs. 13.3, P=0.003). Conclusions There is extreme variability between individual responses to exercise training. The identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We found that the subjects with a high mutation frequency in aerobic exercise and cardiopulmonary function-related genes achieved more cardiorespiratory fitness benefits in the aerobic exercise rehabilitation program and provided evidence for the establishment of a precision medicine program for clinical research.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33442178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Considered an effective supplementary therapy, traditional Chinese medicine (TCM) has been widely applied in the treatment of coronary heart disease (CHD). In this study, we aim to investigate the effects and mechanisms of Huo-Tan-Chu-Shi decoction (HTCSD, an in-hospital TCM prescription) in the treatment of CHD with the phlegm-damp syndrome in mice by non-targeted metabolomics with liquid chromatography-mass spectrometry (LC-MS)/MS.
Methods: A CHD with phlegm-damp syndrome model was established with ApoE-/- mice by subcutaneous injection with isoproterenol combined with high temperature, high humidity, and a high-fat diet, and divided into the HTCSD and Tanshi groups. C57BL/6 mice were set as the control group with an ordinary environment and diet. After administration, electrocardiogram (ECG), interventricular septum thickness (IVS) and left ventricular posterior wall thickness (LVPW), serum levels of creatine phosphokinase-Mb (CK-MB), cardiac troponin T (cTnT), lactic dehydrogenase (LDH) and oxidized low-density lipoprotein (oxLDL), and myocardial histopathological changes were recorded to assess myocardial damage. LC-MS/MS was applied to demonstrate the serum metabolic profile and explore potential mechanisms.
Results: The obvious depressions of the ST segment and T wave presented in the ECG of Tanshi mice, while the depressions in ECG of HTCSD mice were significantly reduced. Compared with the control group, IVS, LVPW, and serum levels of CK-MB, cTnT, LDH, and oxLDL increased greatly in the Tanshi group, while these indicators decreased remarkably in the HTCSD group compared with those of the Tanshi group. Histopathology showed severe structural disorder, necrosis, and fibrosis of myocardial cells in Tanshi mice, which were alleviated in HTCSD mice. Metabonomics analysis showed obvious metabolic alterations among the experimental mice and revealed that the relevant metabolic pathways mainly included phospholipid metabolism, necroptosis, and autophagy.
Conclusions: HTCSD has a certain therapeutic effect in mice with CHD with phlegm-damp syndrome via reducing myocardial ischemia, hypertrophy, and fibrosis. The underlying mechanisms involve the regulation of phospholipid metabolism, necroptosis, and autophagy.
{"title":"Nontargeted Metabolomic Profiling of Huo-Tan-Chu-Shi Decoction in the Treatment of Coronary Heart Disease with Phlegm-damp Syndrome.","authors":"Zhaoying Liang, Qiaohuang Zeng, Xiaomin Ou, Jing Cai, Taohua Lan, Weihui Lu","doi":"10.1155/2022/6532003","DOIUrl":"https://doi.org/10.1155/2022/6532003","url":null,"abstract":"<p><strong>Background: </strong>Considered an effective supplementary therapy, traditional Chinese medicine (TCM) has been widely applied in the treatment of coronary heart disease (CHD). In this study, we aim to investigate the effects and mechanisms of Huo-Tan-Chu-Shi decoction (HTCSD, an in-hospital TCM prescription) in the treatment of CHD with the phlegm-damp syndrome in mice by non-targeted metabolomics with liquid chromatography-mass spectrometry (LC-MS)/MS.</p><p><strong>Methods: </strong>A CHD with phlegm-damp syndrome model was established with ApoE<sup>-/-</sup> mice by subcutaneous injection with isoproterenol combined with high temperature, high humidity, and a high-fat diet, and divided into the HTCSD and Tanshi groups. C57BL/6 mice were set as the control group with an ordinary environment and diet. After administration, electrocardiogram (ECG), interventricular septum thickness (IVS) and left ventricular posterior wall thickness (LVPW), serum levels of creatine phosphokinase-Mb (CK-MB), cardiac troponin T (cTnT), lactic dehydrogenase (LDH) and oxidized low-density lipoprotein (oxLDL), and myocardial histopathological changes were recorded to assess myocardial damage. LC-MS/MS was applied to demonstrate the serum metabolic profile and explore potential mechanisms.</p><p><strong>Results: </strong>The obvious depressions of the ST segment and T wave presented in the ECG of Tanshi mice, while the depressions in ECG of HTCSD mice were significantly reduced. Compared with the control group, IVS, LVPW, and serum levels of CK-MB, cTnT, LDH, and oxLDL increased greatly in the Tanshi group, while these indicators decreased remarkably in the HTCSD group compared with those of the Tanshi group. Histopathology showed severe structural disorder, necrosis, and fibrosis of myocardial cells in Tanshi mice, which were alleviated in HTCSD mice. Metabonomics analysis showed obvious metabolic alterations among the experimental mice and revealed that the relevant metabolic pathways mainly included phospholipid metabolism, necroptosis, and autophagy.</p><p><strong>Conclusions: </strong>HTCSD has a certain therapeutic effect in mice with CHD with phlegm-damp syndrome via reducing myocardial ischemia, hypertrophy, and fibrosis. The underlying mechanisms involve the regulation of phospholipid metabolism, necroptosis, and autophagy.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-31eCollection Date: 2022-01-01DOI: 10.1155/2022/7845108
Jiao Wang, Yuchun Yang, Lei Zhang, Pengyi He, Huyati Mu
Background: Stent restenosis after PCI seriously affects the efficacy and prognosis; therefore, the study of ISR risk factors has become an urgent topic to be solved.
Objective: To investigate the risk factors for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in Han and Uygur patients with coronary heart disease.
Methods: The clinical data of 345 Han and 127 Uygur patients who underwent intracoronary stent implantation were divided into an ISR group and a non-ISR group. The general clinical data, laboratory indicators, and coronary artery lesions were compared.
Results: Age (OR = 1.040, 95% CI: 1.006∼1.075), triglycerides (OR = 1.440, 95% CI: 1.050∼1.973), total cholesterol (OR = 5.256, 95% CI: 2.826∼9.773), and ApoB (OR = 137.540, 95% CI: 11.364∼899.455) were independent risk factors for ISR after PCI in the Han patients, while ApoAI (OR = 0.002, 95% CI: 0.001∼0.011), MCV (OR = 0.824, 95% CI: 0.744∼0.911), MCH (OR = 0.421, 95% CI: 0.324∼0.548), and MCHC (OR = 0.934, 95% CI: 0.903∼0.965) were protective factors of ISR after PCI in Han patients, and the logistic regression equation composed of various factors predicted that the area under the ROC curve of ISR was 0.905. ApoB (OR = 11.571, 95% CI: 1.667∼80.340), Gensini score (OR = 1.017, 95% CI: 1.003∼1.031), and diabetes history (OR = 3.474, 95% CI: 1.189∼10.151) were independent risk factors for ISR after PCI in Uygur patients, and the area under ROC curve of ISR predicted by logistic regression equation is 0.807. The predictive efficiency of the Gensini score and ApoB level for ISR in Uygur patients was higher than that in Han, while the predictive efficiency of levels of ApoAI and MCH for ISR in Han patients was higher than that in Uygur (P < 0.05).
Conclusion: The independent risk factors for ISR after PCI in Han and Uygur patients in Xinjiang are different.
{"title":"Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region.","authors":"Jiao Wang, Yuchun Yang, Lei Zhang, Pengyi He, Huyati Mu","doi":"10.1155/2022/7845108","DOIUrl":"https://doi.org/10.1155/2022/7845108","url":null,"abstract":"<p><strong>Background: </strong>Stent restenosis after PCI seriously affects the efficacy and prognosis; therefore, the study of ISR risk factors has become an urgent topic to be solved.</p><p><strong>Objective: </strong>To investigate the risk factors for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in Han and Uygur patients with coronary heart disease.</p><p><strong>Methods: </strong>The clinical data of 345 Han and 127 Uygur patients who underwent intracoronary stent implantation were divided into an ISR group and a non-ISR group. The general clinical data, laboratory indicators, and coronary artery lesions were compared.</p><p><strong>Results: </strong>Age (OR = 1.040, 95% CI: 1.006∼1.075), triglycerides (OR = 1.440, 95% CI: 1.050∼1.973), total cholesterol (OR = 5.256, 95% CI: 2.826∼9.773), and ApoB (OR = 137.540, 95% CI: 11.364∼899.455) were independent risk factors for ISR after PCI in the Han patients, while ApoAI (OR = 0.002, 95% CI: 0.001∼0.011), MCV (OR = 0.824, 95% CI: 0.744∼0.911), MCH (OR = 0.421, 95% CI: 0.324∼0.548), and MCHC (OR = 0.934, 95% CI: 0.903∼0.965) were protective factors of ISR after PCI in Han patients, and the logistic regression equation composed of various factors predicted that the area under the ROC curve of ISR was 0.905. ApoB (OR = 11.571, 95% CI: 1.667∼80.340), Gensini score (OR = 1.017, 95% CI: 1.003∼1.031), and diabetes history (OR = 3.474, 95% CI: 1.189∼10.151) were independent risk factors for ISR after PCI in Uygur patients, and the area under ROC curve of ISR predicted by logistic regression equation is 0.807. The predictive efficiency of the Gensini score and ApoB level for ISR in Uygur patients was higher than that in Han, while the predictive efficiency of levels of ApoAI and MCH for ISR in Han patients was higher than that in Uygur (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The independent risk factors for ISR after PCI in Han and Uygur patients in Xinjiang are different.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-15eCollection Date: 2022-01-01DOI: 10.1155/2022/1647809
Tao Chen, Huiying Zhu, Qingyuan Su
Methods: A retrospective study was conducted on all patients with CHD who were admitted to CR and completed cardiopulmonary exercise tests (CPET) in Guangdong Hospital of traditional Chinese medicine. According to the risk stratification method of CHD, all participants were divided into three groups: low, moderate, and high risk. The training target heart rates (HRt) of each participant were calculated according to the formula of heart-rate-reserve (HRR), maximum-heart-rate (MHR), target-heart-rate (THR), and anaerobic threshold (AT) method provided in the guideline. Among them, the HRR method using the maximum-heart-rate obtained by the age formula was named "HRR method A," and that using the actual measured peak heart rate was named "HRR method B." For the three groups, the effectiveness and safety indexes at the target-heart-rate zone set by the different formulas above are counted and compared using CPET data.
Results: A total of 324 patients were included in the analysis. There was no significant difference between the target-heart-rate set by the HRR method A and AT method among the three groups (P > 0.05). The mean value of HRt set by other methods was lower than the AT heart rate (P < 0.05). The HRt set by the THR method was close to the AT, while that set by the MHR method was the lowest. The frequency of patients whose HRt was set by the MHR method was lower than the AT one, which was the highest. None of the participants had serious adverse events. There were no risks of ECG abnormalities in the low- and moderate-risk groups. The HRR method A had the highest incidence of various risks of ECG abnormalities, while the MHR method had the lowest one, and the safety of the THR method is close to that of the AT method (P < 0.05).
Conclusion: The heart rate calculated by HRR method A is more consistent with the actual AT. All four techniques are safe in low- and moderate-risk patients. In high-risk patients, using HRR method A has certain risks. It is recommended to use the MHR method for safety reasons, but its effectiveness is low. If considering both effectiveness and safety, the THR method can be conservatively selected at the beginning of the CR program.
方法:对广东省中医院收治的所有冠心病患者进行回顾性研究,这些患者均接受了心肺运动测试(CPET)。根据心脏病风险分层方法,所有参与者被分为三组:低风险组、中度风险组和高度风险组。根据指南中提供的心率储备法(HRR)、最大心率法(MHR)、目标心率法(THR)和无氧阈值法(AT)公式计算出每位参与者的训练目标心率(HRt)。其中,使用年龄公式得出的最大心率的 HRR 方法被命名为 "HRR 方法 A",使用实际测量的峰值心率的 HRR 方法被命名为 "HRR 方法 B"。利用 CPET 数据对三组患者在上述不同公式设定的目标心率区的有效性和安全性指标进行统计和比较:结果:共有 324 名患者参与了分析。结果:共纳入 324 例患者进行分析,三组患者在 HRR 法 A 和 AT 法设定的目标心率之间无明显差异(P>0.05)。其他方法设定的心率均值低于 AT 心率(P < 0.05)。THR 方法设定的 HRt 接近 AT,而 MHR 方法设定的 HRt 最低。用 MHR 方法设定 HRt 的患者频率低于 AT,而 AT 的患者频率最高。所有参与者均未发生严重不良事件。低风险组和中等风险组均无心电图异常风险。HRR方法A的各种心电图异常风险发生率最高,而MHR方法最低,THR方法的安全性与AT方法接近(P < 0.05):结论:HRR 方法 A 计算出的心率与实际 AT 更为一致。这四种方法对于低危和中危患者都是安全的。对于高危患者,使用 HRR 方法 A 有一定风险。出于安全考虑,建议使用 MHR 方法,但其有效性较低。如果同时考虑有效性和安全性,可以在 CR 计划开始时保守地选择 THR 方法。
{"title":"Effectiveness and Safety of Four Aerobic Exercise Intensity Prescription Techniques in Rehabilitation Training for Patients with Coronary Heart Disease.","authors":"Tao Chen, Huiying Zhu, Qingyuan Su","doi":"10.1155/2022/1647809","DOIUrl":"10.1155/2022/1647809","url":null,"abstract":"<p><strong>Methods: </strong>A retrospective study was conducted on all patients with CHD who were admitted to CR and completed cardiopulmonary exercise tests (CPET) in Guangdong Hospital of traditional Chinese medicine. According to the risk stratification method of CHD, all participants were divided into three groups: low, moderate, and high risk. The training target heart rates (HRt) of each participant were calculated according to the formula of heart-rate-reserve (HRR), maximum-heart-rate (MHR), target-heart-rate (THR), and anaerobic threshold (AT) method provided in the guideline. Among them, the HRR method using the maximum-heart-rate obtained by the age formula was named \"HRR method A,\" and that using the actual measured peak heart rate was named \"HRR method B.\" For the three groups, the effectiveness and safety indexes at the target-heart-rate zone set by the different formulas above are counted and compared using CPET data.</p><p><strong>Results: </strong>A total of 324 patients were included in the analysis. There was no significant difference between the target-heart-rate set by the HRR method A and AT method among the three groups (<i>P</i> > 0.05). The mean value of HRt set by other methods was lower than the AT heart rate (<i>P</i> < 0.05). The HRt set by the THR method was close to the AT, while that set by the MHR method was the lowest. The frequency of patients whose HRt was set by the MHR method was lower than the AT one, which was the highest. None of the participants had serious adverse events. There were no risks of ECG abnormalities in the low- and moderate-risk groups. The HRR method A had the highest incidence of various risks of ECG abnormalities, while the MHR method had the lowest one, and the safety of the THR method is close to that of the AT method (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The heart rate calculated by HRR method A is more consistent with the actual AT. All four techniques are safe in low- and moderate-risk patients. In high-risk patients, using HRR method A has certain risks. It is recommended to use the MHR method for safety reasons, but its effectiveness is low. If considering both effectiveness and safety, the THR method can be conservatively selected at the beginning of the CR program.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40621947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}