Effect of Right Heart Systolic Function on Outcomes in Patients with Constrictive Pericarditis Undergoing Pericardiectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To determine the influence of right ventricular function in patients with constrictive pericarditis (CP) undergoing surgery and to compare the outcomes of patients who received surgery with those managed medically.</p><p><b>METHODS</b>Patients with the diagnosis of CP and healthy volunteers were recruited from January 2006 to November 2011. Patients with CP chose to either receive pericardiectomy or medical management. Echocardiographic measurements were performed to evaluate heart function, and survival was recorded.</p><p><b>RESULTS</b>A total of 58 patients with CP (36 received pericardiectomy, 22 managed medically), and 43 healthy volunteers were included. CP patients who received surgery had a higher survival rate than those managed medically (P = 0.003), and higher survival was also seen in the subgroup of CP patients with severely impaired right systolic function. Albumin level, left ventricular end-diastolic dimension, and tricuspid regurgitation velocity were associated with survival in CP patients who received surgery.</p><p><b>CONCLUSIONS</b>Preoperative right heart function does not affect surgical outcomes. Patients with severely impaired preoperative right systolic function obtain a greater survival advantage with surgery than with medical treatment.</p>

Cardiovascular risk profile of patients with glycogen storage disease type I / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the cardiovascular risk profile in patients with glycogen storage disease (GSD) type I.</p><p><b>METHOD</b>The clinical information of 62 patients with GSD type I who admitted to Peking Union Medical Hospital were reviewed and the cardiovascular risk profile was analyzed.</p><p><b>RESULTS</b>The age of the patient cohort was (8.4 ± 6.9) years and the ratio of male vs. female was 36:26. The median disease duration was (6.7 ± 6.2) years and treatment duration was (38.3 ± 35.2) months. The rate of abnormal change in electrocardiogram and echocardiography was 17.7% and 24.2%, respectively. The serum concentration of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and uric acid in patient before and after treatment were (6.18 ± 2.47) mmol/L vs. (5.61 ± 1.84) mmol/L (P = 0.020), (11.17 ± 9.85) mmol/L vs. (6.81 ± 5.97) mmol/L (P = 0.010), (2.55 ± 1.27) mmol/L vs. (2.78 ± 1.07) mmol/L (P = 0.617), (0.98 ± 0.37) mmol/L vs. (0.96 ± 0.23) mmol/L (P = 0.005), (526.53 ± 127.09) µmol/L vs. (490.78 ± 129.79) µmol/L (P = 0.977), respectively. The high-sensitivity C-reactive protein levels tended to be higher after therapy compared before treatment (2.33 ± 3.30) mg/L vs. (3.35 ± 3.39) mg/L, P = 0.431.</p><p><b>CONCLUSION</b>Patients with GSD I are associated with an increased risk for cardiovascular disease.</p>

Gender specific association of neonatal characteristics and cardiovascular risk factors on carotid intima-media thickness in a Chinese cohort / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Multiple neonatal characteristics and adult cardiovascular risk factors are associated with the development of atherosclerosis, however little conclusive evidence exists characterizing the relative strength of these factors. In a large retrospective study, we investigated the association between both objective neonatal measurements and comprehensive adult cardiovascular risk factors with the development of atherosclerosis, quantified by carotid intima-media thickness (CIMT). Further, we assessed the impact of gender on the relative impact of these risk factors.</p><p><b>METHODS</b>CIMT, a measure of atherosclerosis, was determined by carotid ultrasound on 1568 participants (age 50-85) whose birth records were obtained from Peking Union Medical College Hospital. In addition, each participant was given a physical examination, and completed a medical questionnaire to identify a panel of cardiovascular risk factors. Multiple regression analysis was performed on the population and on the male and female cohorts individually, to identify the relative contribution of these risk factors to increased CIMT.</p><p><b>RESULTS</b>For the total population the Framingham score, renal function, adult abdominal circumference and mother's gestational age were associated with CIMT, accounting for 14.7%, 1.4%, 0.9%, and 0.2% of total variance, respectively. In the male population the Framingham score, renal function, abdominal circumference and hemoglobin were the most significant risk factors for CIMT. Risk in the female population was associated with Framingham score, renal function, insulin resistance and gestational age. No relationship between birth weight or head circumference and CIMT were observed.</p><p><b>CONCLUSIONS</b>Adult cardiovascular risk factors were the most significantly associated with the development of atherosclerosis; however mother's age at birth was associated with CIMT, particularly in the female cohort. The relative contribution of the risk factors analyzed varied between the male and female populations.</p>

Cardiovascular manifestations in Chinese patients with hypereosinophilic syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the cardiovascular involvements in Chinese patients with hypereosinophilic syndrome.</p><p><b>METHOD</b>We respectively reviewed 149 inpatients with hypereosinophilic syndrome admitted to Peking Union Medical College Hospital and analyzed the cardiovascular involvements in these patients.</p><p><b>RESULTS</b>Cardiac abnormalities was evidenced in 32.9% patients (49/149). The ratio of male vs female was 34:15. The average age of the patients was (41.3 ± 16.9) years and course of disease was (26.4 ± 72.3) months. Cardiovascular involvements included ST segment and/or T wave (ST-T) ischemic changes, arrhythmia, myocardial injury, cardiac thrombosis, pericardial effusion, pulmonary hypertension, valve disorder, vein or artery thrombosis. After glucocorticoid and/or chemotherapeutic agents and treatment for symptoms, 11 (22.4%) patients achieved remission but have recurrent attacks and 3 (6.1%) patients died from failure in treatment. The prognosis in patients with echocardiogram abnormalities were poorer than those only with electrocardiogram abnormalities (P < 0.05).</p><p><b>CONCLUSIONS</b>Cardiovascular involvements are common in patients with hypereosinophilic syndrome and the manifestation of these involvement is various. Cardiovascular complications of HES are a major source of morbidity and mortality in these disorders.</p>

Comparison of radiography and magnetic resonance imaging in detecting arthropathies in patients with hemophilia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare magnetic resonance imaging (MRI) and radiography in detecting arthropathies in patients with hemophilia.</p><p><b>METHODS</b>Of 41 symptomatic joint images in the 14 patients with hemophilia, each joint was examined with both radiography and MRI within the same day. Imaging findings with both two modes were compared.</p><p><b>RESULTS</b>Soft tissue swelling or joint effusion was observed in 33 joints by radiographs and in 34 joints by MRI. Joint erosions were demonstrated in 34 joints by MRI and in 20 joints by radiographs. Joint cysts were shown in 21 joints by MRI and in 9 joints by radiographs. Significant differences in the detection of erosion and cyst were found between radiography and MRI (P < 0. 05). MRI showed improvement for detecting more foci of both erosion and cyst than radiography. Bone marrow edema in 14 joints, hemorrhage in 34 joints, and synovial hypertrophy in 27 joints were revealed only by MRI.</p><p><b>CONCLUSION</b>MRI is superior to conventional radiography in detecting the abnormal changes, and should be considered as the imaging mode of choice in evaluating hemophilic arthropathies.</p>

Comparison of radiography,CT and MR imaging in detection of arthropathies in patients with hemophilia / 中华放射学杂志

Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.