ABSTRACT
<p><b>OBJECTIVE</b>To assess the value of detecting the compositional features of carotid atherosclerotic plaques by 3.0T high resolution magnetic resonance imaging (MRI) in patients with coronary artery disease (CAD).</p><p><b>METHODS</b>Consecutive 104 patients with coronary atherosclerosis confirmed by coronary angiography were prospectively recruited from January 2013 to January 2015 in Tiantan hospital. All patients were imaged with 3.0T high resolution MRI system. After exclusion patients with poor image quality, 97 patients were divided into 3 groups according to the degree of coronary artery stenosis: coronary atherosclerosis group (coronary stenosis between 1%-49%, n=16); single-vessel lesion group (single vessel lesion with stenosis between 50%-100%, n=48); multi-vessel lesion group (two or three vessel lesions with stenosis between 50%-100% or left main stem disease, n=33). The prevalence of total carotid plaque, calcified plaque, lipid-rich necrotic core, intra-plaque hemorrhage, plaque ulcer and rupture were compared among 3 groups.</p><p><b>RESULTS</b>The prevalence of total carotid plaque (81.3%(13/16), 72.9%(35/48), and 93.9%(31/33)) and calcified plaque (50.0%(8/16), 35.4%(17/48), and 42.4%(14/33)) were similar among the 3 groups (both P>0.05). The prevalence of carotid lipid-rich necrotic core in coronary atherosclerosis group was significantly lower than in single-vessel lesion group (18.8%(3/16) vs. 64.6%(31/48), P<0.01) and multi-vessel lesion group(18.8%(3/16) vs. 69.7%(23/33), P<0.01), but there was no significant difference between single-vessel lesion group and multi-vessel lesion group(P>0.05). Intra-plaque hemorrhage was detected in 2 patients of multi-vessel lesion group. There was no plaque ulcer or rupture in this cohort.</p><p><b>CONCLUSION</b>Carotid plaque features are associated with the severity of coronary atherosclerosis in CAD patients.</p>
Subject(s)
Humans , Coronary Artery Disease , Hemorrhage , Magnetic Resonance Imaging , Necrosis , Plaque, Atherosclerotic , Prevalence , Prospective StudiesABSTRACT
Objective To explore the safety and feasibility of coronary angiography (CAG) via percutaneous left radial artery approach (LRA) compared with right radial artery approach (RRA) in aged patients, and determine whether LRA is a valid alternative for CAG. Methods A total of 502 consecutive patients who were aged 65 or older underwent diagnostic CAG were recruited and randomized to the LRA group (240 patients) or RRA group (262 patients). The study end points included total procedural duration, coronary time, fluoroscopy time, dose of radiation including cumulative air kerma and dose area product, contrast volume, and the incidence of vascular complications. Results Coronary procedural success rate was 96.2%(231/240) in LRA group and 96.2%(252/262) in RRA group. There was no significant difference (P>0.05). The radial cannulation time, fluoroscopy time, look through time, dose of radiation, contrast volume and the percentage of hydrophilic wire used in two group had no significant difference (P > 0.05). The catheter in place time in LRA was significantly shorter than that in RRA group:(2.7 ± 2.5) min vs. (3.3 ± 3.3) min, P=0.036). There was a trend toward shorter procedural duration in LRA group than that in RRA group, but there was no significant difference: (13.3 ± 6.1) min vs. (14.3 ± 6.2) min, P=0.075. Conclusions LRA approach has similar safety and feasibility in terms of performing coronary angiography compared with RRA.It seems to be a feasible alternative for CAG in aged patients.
ABSTRACT
Objective To observe the changes of eosinophils (EOS) in peripheral blood in patients with acute myocardial infarction (AMI).To investingate the association of EOS in peripheral blood and acute myocardial infarction.Methods The single-centre study enrolled 50 acute myocardial infarction patients (23 cases were NSTEMI and 27 cases were STEMI) who were treated in Beijing Tiantan Hospital from January 2014 to July 2014.Fifty medical individuals who were randomly chosen from the same period of time.White blood cell counts,EOS counts and percentages, levels of Troponin Ⅰ of all individuals were determined.Compare White blood cell counts,EOS counts and percentages between two groups.Association of EOS in peripheral blood and Troponin Ⅰ in patients with acute myocardial infarction was evaluated by Pearson correlation.Results The levels of eosinophils counts ((0.02±0.01) × 109/L vs.(0.24±0.14) × 109/L) and percentages ((0.40±0.49) ％ vs.(1.25±0.54)％) in AMI patients were significantly lower than those in the control group (t =11.083, P＜0.01;t=8.242,P＜0.01).There was significant inverse correlation between EOS counts and percentage and levels of Troponin Ⅰ(r=-0.390,-0.387;P＜0.05).Conclusion Patients with acute myocardial infarction presented decreased eosinophils counts and percentages.EOS counts and percentage and levels of Troponin Ⅰ presented negative correlation.It was close relation of EOS and acute myocardial infarction.
ABSTRACT
Objectives To analyze the characteristics of serum protein electrophoresis(SPE)in chronic heart failure(CHF) patients,evaluate prognostic value and explore the reason of it preliminarily.Methods Retrospective exploration of 6 1 8 chronic heart failure patients in study cohort (CHF cohort)and 70 patients with normal cardiac function in control cohort was made to comp are the difference of serum protein electrophoresis.Then,CHF Patients were tracked down by phone to discuss the correlation between adverse event rate (re-hospitalization rate or mortality rate)and their SPE.Last,the multiple linear regression analysis of SPE and biochemical indicators was made to explore the reason of the abnormality.Results Pa-tients of CHF cohort appeared to have significantly rising beta 1-gobulin(6.01±1.06)%,compared with control cohort(t=3.417,P<0.001).Post-discharge adverse event rate displayed by the curve demonstrated that patients with beta 1-gobulin higher than or equal to 6% had much more adverse event rate than those with beta 1-gobulin less than 6%,in 7 to 24 months after discharged from the hospital,which had been proved by the Chi-square test of 0.031(P<0.05).Multiple linear regres-sion analysis showed that beta 1-globulin and serum creatinine,uric acid,and sodium were significantly correlated.Conclusion CHF patients had higher beta 1-gobulin of SPE probably because of immunoactivation,which may increase their re-hospi-talization rate ormortality rate after hospital discharge.Meanwhile,growing beta 1-gobulin is closely correlated with blood creatinine,uric acid and blood natrium and becomesa risk of kidney dysfunction due to hypoperfusion and accumulation of se-rum immunoglobulin.