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BACKGROUND: Cardiac involvement in patients with immunoglubin light-chain amyloidosis (AL) is a major determinant of treatment choice and prognosis, and early identification of high-risk patients can initiate intensive treatment strategies to achieve better survival. This study aimed to investigate the prognostic value of native T1 and ECV in patients with AL-cardiac amyloidosis (CA). METHODS: A total of 38 patients (mean age 59 ± 11 years) with AL diagnosed histopathologically from July 2017 to October 2021 were collected consecutively. All patients were performed 3.0-T cardiac magnetic resonance (CMR) including cine, T1 mapping, and late gadolinium enhancement (LGE). Pre- and post-contrast T1 mapping images were transferred to a dedicated research software package (CVI42 v5.11.3) to create parametric T1 and ECV values. In addition, clinical and laboratory data of all patients were collected, and patients or their family members were regularly followed up by telephone every 3 months. The starting point of follow-up was the time of definitive pathological diagnosis, and the main endpoint was all-cause death. Kaplan-Meier analysis and Cox proportional risk model were used to evaluate the association between native T1 and ECV and death in patients with CA. RESULTS: After a median follow-up of 27 (16, 37) months, 12 patients with CA died. Kaplan-Meier analysis showed that elevated native T1 and ECV were closely associated with poor prognosis in patients with CA. The survival rate of patients with ECV > 44% and native T1 > 1389ms were significantly lower than that of patients with ECV ≤ 44% and native T1 ≤ 1389ms (Log-rank P < 0.001), and was not associated with the presence of LGE. After adjusting for clinical risk factors and CMR measurements in a stepwise multivariate Cox regression model, ECV [risk ratio (HR):1.37, 95%CI: 1.09-1.73, P = 0.008] and native T1 (HR:1.01, 95%CI: 1.00-1.02, P = 0.037) remained independent predictors of all-cause mortality in patients with CA. CONCLUSIONS: Both native T1 and ECV were independently prognostic for mortality in patients with CA, and can be used as important indicators for clinical prognosis assessment of AL.
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Amiloidosis , Miocardio , Humanos , Persona de Mediana Edad , Anciano , Pronóstico , Miocardio/patología , Medios de Contraste , Gadolinio , Amiloidosis/patología , Valor Predictivo de las Pruebas , Imagen por Resonancia CinemagnéticaRESUMEN
OBJECTIVE: To evaluate the feasibility of low radiation exposure and low contrast medium volume for coronary CT angiography with High- pitch spiral acquisition mode of dual source CT. METHODS: 135 patients whose BMI <23 kg/m² and heart rates <65 bpm selected from 291 patients diagnosed of suspected CHD at our institution from September 2013 to February 2014 were randomly divided into 3 groups before CCTA, and there were 45 patients in each group. 80 kV , Iodixanol (320 mgI/ml) and sinogram affirmed iterative reconstruction (SAFIRE) were used in A group. 80 kV , Iopamidol (370 mgI/ml) and SAFIRE were used in B group. 100 kV, Iodixanol and filtered back projection (FBP) were used in C group. Two radiologists assessed image quality with 5-piont scale subjectively and double-blind. Independent-Sample Test was used to analyze statistical significance of image quality including signal to noise ratio(SNR) and contrast to noise ratio (CNR) between A and B group or between A and C group. At the same time, Contrast medium dose statistical significance between A and B group and mean effective Radiation dose (ED)statistical significance between A and C were analyzed by the same way. RESULTS: There were no significant difference of image quality including SNR and CNR of aortic root (AO), left main coronary artery (LM), left anterior descending artery (LAD), circumflex coronary artery (CX) and right coronary artery (RCA) Between A and B group (P = non-significant for all comparison), whereas Iodine in taken of A group decreased 14% (17 600 mg vs 20 350 mg). There were no significant difference of image quality including SNR and CNR of AO, LM, LAD, CX and RCA Between A and C group (P = non-significant for all comparison), whereas mean ED of A group decreased 50% (0.41 ± 0.05 mSv vs 0.79 ± 0.15 mSv). CONCLUSION: The double low dose application which use High-pitch spiral mode, 80 kV, SAFIRE, and Iodixanol (320 mgI/ml) can be used in those patients whose BMI <23 kg/m² and heart rates <65 bpm to reduce the burden of radiation and contrast medium significantly, without compromising the image quality.
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Medios de Contraste , Tomografía Computarizada por Rayos X/métodos , Angiografía Coronaria , Método Doble Ciego , Frecuencia Cardíaca , Humanos , Dosis de Radiación , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
Numerous studies have demonstrated that multiple intrinsic and extrinsic factors shape the structure and composition of gut microbiota in a host. The disorder of the gut microbiota may trigger various host diseases. Here, we collected fecal samples from wild-caught Japanese geckos (Gekko japonicus) and captive conspecifics fed with mealworms (mealworm-fed geckos) and fruit flies (fly-fed geckos), aiming to examine the dietary and sexual correlates of the gut microbiota. We used 16S rRNA gene sequencing technology to determine the composition of the gut microbiota. The dominant phyla with a mean relative abundance higher than 10% were Verrucomicrobiota, Bacteroidota, and Firmicutes. Gut microbial community richness and diversity were higher in mealworm-fed geckos than in wild geckos. Neither community evenness nor beta diversity of gut microbiota differed among wild, mealworm-fed, and fly-fed geckos. The beta rather than alpha diversity of gut microbiota was sex dependent. Based on the relative abundance of gut bacteria and their gene functions, we concluded that gut microbiota contributed more significantly to the host's metabolic and immune functions. A higher diversity of gut microbiota in mealworm-fed geckos could result from higher chitin content in insects of the order Coleoptera. This study not only provides basic information about the gut microbiota of G. japonicus but also shows that gut microbiota correlates with dietary habits and sex in the species.
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Animals in captivity undergo a range of environmental changes from wild animals. An increasing number of studies show that captivity significantly affects the abundance and community structure of gut microbiota. The northern grass lizard (Takydromus septentrionalis) is an extensively studied lacertid lizard and has a distributional range covering the central and southeastern parts of China. Nonetheless, little is known about the gut microbiota of this species, which may play a certain role in nutrient and energy metabolism as well as immune homeostasis. Here, we examined the differences in the gut microbiota between two groups (wild and captive) of lizards through 16S rRNA sequencing using the Illumina HiSeq platform. The results demonstrated that the dominant microbial components in both groups consisted of Proteobacteria, Firmicutes, and Tenericutes. The two groups did not differ in the abundance of these three phyla. Citrobacter was the most dominant genus in wild lizards, while Morganella was the most dominant genus in captive lizards. Moreover, gene function predictions showed that genes at the KEGG pathway levels2 were more abundant in wild lizards than in captive lizards but, at the KEGG pathway levels1, the differences in gene abundances between wild and captive lizards were not significant. In summary, captivity exerted a significant impact on the gut microbial community structure and diversity in T. septentrionalis, and future work could usefully investigate the causes of these changes using a comparative approach.