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Objective To investigate the correlation between non-high density lipoprotein cholesterol(non-HDL-C),homocysteine(Hey)levels and cognitive impairment,prognosis in patients with thalamic infarction.Methods Eighty thalamic infarction patients admitted to Puyang People's Hospital from March 2017 to March 2021 were selected as the research sub-jects.According to Montreal cognitive assessment(MoCA)score,the patients were divided into cognitive impairment group(MoCA score＜26,n=35)and cognitive normal group(MoCA score 26-30,n=45).Another 50 healthy individuals who un-derwent physical examinations during the same period were selected as the control group.The serum cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),Hcy levels of all subjects were detected by fully automated biochemical analyzer,and the non-HDL-C levels were calculated.The correlations between non-HDL-C,Hey levels and MoCA scores were analyzed by Pearson correlation analysis,and the diagnostic efficacy of non-HDL-C,Hcy levels for cognitive impairment of patients with tha-lamic infarction was analyzed by receiver operating characteristic curve.According to the modified Rankin scale(mRS)score,the patients with thalamic infarction were divided into good prognosis group(mRS score ≤2,n=50)and poor prognosis group(mRS score 3-6,n=50).The independent risk factors for poor prognosis of patients with thalamic infarction was analyzed by multivariate logistic regression.Results The serum levels of non-HDL-C and Hcy of patients in the cognitive impairment group were significantly higher than those in the cognitive normal group and control group(P＜0.05);there was no significant difference in the serum non-HDL-C,Hcy levels of subjects between the control group and the cognitive normal group(P＞0.05).The non-HDL-C,Hcy levels were negatively correlated with MoCA scores in thalamic infarction patients(P＜0.05).The area under the curve(AUC)of Hcy level in the diagnosis of cognitive impairment was 0.709,the sensitivity was 0.724 and the specificity was 0.630;the AUC of non-HDL-C level in the diagnosis of cognitive impairment was 0.738,the sensitivity was 0.701 and the specificity was 0.870;the AUC of Hey combined with non-HDL-C in the diagnosis of cognitive impairment was 0.769,the sensitivity was 0.758 and the specificity was 0.889.The diagnostic efficacy of Hey combined with non-HDL-C for cognitive impairment was superior to that of non-HDL-C or Hey alone.Atrial fibrillation,elevated levels of non-HDL-C,Hcy and NIHSS score were independent risk factors for poor prognosis of patients with thalamic infarction(P＜0.05).Conclusion The levels of non-HDL-C and Hey are positively correlated with cognitive impairment in patients with thalamic infarction.The levels of non-HDL-C and Hey can be used to diagnose cognitive impairmnent in patients with thalamic infarction,and the combined detection has a better diagnostic effect.Atrial fibrillation,elevated levels of non-HDL-C,Hcy and NIHSS score are independent risk factors for poor prognosis in patients with thalamic infarction.
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Objective To explore the correlations of evaluations of right heart function parameters in patients with Ebstein anomaly(EA)using echocardiography and cardiac MRI.Methods Data of transthoracic echocardiography and cardiac MRI in 32 patients with EA confirmed by operation were retrospectively analyzed.The correlations of cardiac cavity size,right ventricular function and strain parameters obtained using echocardiography and the functional right ventricular(fRV)ejection fraction(EF)measured using MRI were explored.Results MRI fRV-EF in 32 cases of EA was(23.20± 7.61)％.Among echocardiographic parameters in 32 cases of EA,fractional area change(FAC)of fRV(r=0.347,P=0.015)was slightly,while global longitudinal strain(GLS)of fRV(r=0.801,P＜0.001)was highly positively correlated with MRI fRV-EF,respectively,whereas atrialized right ventricle(aRV)area/fRV area(r=-0.730,P=0.007)was highly negatively,aRV area/left ventricular area(r=-0.450,P=0.042)and right ventricular anterior-posterior diameter(r=-0.650,P=0.022)were both moderately negatively correlated with MRI fRV-EF.Both the left ventricular eccentricity index(r=-0.347,P=0.049)and Glasgow outcome scale extended(r=-0.336,P=0.024)obtained with echocardiography were slightly negatively correlated MRI fRV-EF.Conclusion Right heart function parameters in EA patients obtained with echocardiography were correlated with those of MRI fRV-GLS,among which aRV area/fRV area were highly positively correlated with MRI fRV-EF,hence having great value for evaluating right heart function in EA patients.
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Objective:To evaluate the application value of conventional echocardiography and two-dimensional speckle tracking imaging (2D-STI) in assessing the left ventricular systolic and diastolic functions in patients with restrictive cardiomyopathy (RCM).Methods:Fifteen patients confirmed as RCM by cardiac magnetic resonance imaging or pathological biopsy in Fuwei Cardiovascular Hospital of Yunnan Province from September 2017 to June 2020 were selected. According to left ventricular ejection fraction(LVEF), they were divided into LVEF retention group(LVEF≥50%, 8 cases) and LVEF reduction group (LVEF<50%, 7 cases). Meanwhile, 20 healthy volunteers were selected as the control group. Conventional echocardiography and 2D-STI were used to evaluate left ventricular systolic and diastolic function, including left ventricular end-diastolic diameter (LVEDd), LVEF, mitral valve blood flow spectrum peak E/peak A, peak E deceleration time (EDT), tissue Doppler mitral valve ring average early diastolic peak velocity (e′), E/e′ ratio, isovolumetric relaxation time (IVRT), left atrial volume index (LAVI) and speed of tricuspid regurgitation (TVR), tricuspid annular plane systolic excursion (TAPSE), left ventricular longitudinal strain (LS) and circumferential strain (CS). Then the differences and similarities between the two RCM groups and the control group were compared.Results:There was no significant difference of LVEF between LVEF retention group and the control group ( P>0.05), and LVEF in LVEF reduction group was significantly lower than that in control group ( P<0.05). LVEDd in LVEF retention group was significantly smaller than that of LVEF reduction group ( P<0.05), but was not statistically different from the control group ( P>0.05). Values of E/A, E/e′, LAVI and TVR in LVEF retention group and LVEF reduction group were significantly greater than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups ( P<0.05). Values of e′, EDT, IVRT and TAPSE in LVEF retention group and LVEF reduction group were significantly lower than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups (all P>0.05). The global LS and LS of AP4, AP3, and AP2 showed significantly different among the 3 groups (all P<0.05). The global and basal, middle, apical segmental CS in LVEF retention group were significantly larger than those in LVEF reduction group (all P<0.05), but they were not significantly different from the control group (all P>0.05). Conclusions:All patients with RCM show left ventricular diastolic dysfunction in conventional echocardiography, and show gradually reduced left ventricular systolic function and left ventricular remodeling. RCM patients with normal LVEF demonstrate decreased myocardial systolic function, and left ventricular global LS could be used as a sensitive indicator to predict myocardial systolic function.
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Objective To explore the effect of different hyperbaric oxygen treatment (HBOT) on delayed neuropsychiatric sequelae followed carbon monoxide (CO) poisoning (DNS).Methods Patients diagnosed acute carbon monoxide poisoning (ACOP) or DNS due to CO poisoning in the hospital from October 2015 to October 2016 were included.Patients who died of ACOP or in persisting unconsciousness condition were excluded.Information of the patients were retrospectively collected including personal data,clinical features and treatment course of hyperbaric oxygen (HBO).All subjects were divided into two groups,consisting of cases who developed into DNS and who fully recovered,according toclinical symptoms.The differences of personal data,clinical features and treatment course of HBO were compared between the two groups.After adjusting the confounding factors,hyperbaric oxygen treatment program of the two groups were analyzed.Results DNS occurred in 39 patients with acute CO poisoning,while 130 patients were fully recovery.The ratio of patients over 55 years old or with smoking history in the DNS group were higher than that in the good outcome group (82.1％ vs.60.8％,23.1％ vs.10.8％).Patients who awoke from unconsciousness but left cognitive impairment were more likely to develop into DNS (P=0.017).Patients who treated with HBO within the first 24 hours,risk of developing into DNS were decreased(OR=0.14,P＜0.01).At the same time,2 times per day and within the first 24 hours worked also as well.(OR=0.29,P=0.011).Even if patients who were given 2 times a day of HBO but not in the first 24 hours after poisoning,could not reduce the risk of evolving to DNS(OR=0.06,P＞0.05);The proportion of patients in the good outcome group accepted HBO for more than six days after poisoning was higher than that in the DNS group (68.5％ vs.48.7％).After adjusting confounding factors,patients who treated with HBO within the first 24 hours (OR=0.22,95％CI:0.09-0.52),2 times per day(OR=0.30,95％CI:0.10-0.87)and lasted for more than 6 days(OR=0.30,95％CI:0.10-0.87)were in a lower risk of involving to DNS.Conclusions For patients diagnosed ACOP,HBOT began in the first 24 hours,1 or 2 times per day or early sustaining to give HBO for more than 6 days could reduce the risk of DNS.