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BACKGROUND: Treatment decisions in patients undergoing non-cardiac surgery are based on clinical assessment. The Revised Cardiac Risk Index (RCRI) is pragmatic and widely used but has only moderate discrimination. We aimed to test the efficacy of the CHA2DS2-VASc score and the combination of CHA2DS2-VASc and RCRI to predict perioperative risks for non-cardiac surgery. METHODS: This pre-specified analysis was performed in a retrospective cohort undergoing intra-abdominal surgery in our center from July 1st, 2007 to June 30th, 2008. The possible association between the baseline characteristics (as defined by CHA2DS2-VASc and RCRI) and the primary outcome of composite perioperative cardiac complications (myocardial infarction, cardiac ischemia, heart failure, arrhythmia, stroke, and/or death) and secondary outcomes of individual endpoints were explored using multivariate Logistic regression. The area under the receiver operating characteristic curve (C-statistic) was used for RCRI, CHA2DS2-VASc, and the combined models, and the net reclassification improvement (NRI) was calculated to assess the additional discriminative ability. RESULTS: Of the 1079 patients (age 57.5 ± 17.0 years), 460 (42.6%) were women. A total of 83 patients (7.7%) reached the primary endpoint. Secondary outcomes included 52 cardiac ischemic events, 40 myocardial infarction, 20 atrial fibrillation, 18 heart failure, four strokes, and 30 deaths. The endpoint events increased with the RCRI and CHA2DS2-VASc grade elevated (P < 0.05 for trend). The RCRI showed a moderate predictive ability with a C-statistics of 0.668 (95%CI 0.610-0.725) for the composite cardiac outcome. The C-statistics for the CHA2DS2-VASc was 0.765 (95% CI 0.709-0.820), indicating better performance than the RCRI (p = 0.011). Adding the CHA2DS2-VASc to the RCRI further increased the C-statistic to 0.774(95%CI 0.719-0.829), improved sensitivity, negative predictive value, and enhanced reclassification in reference to RCRI. Similar performance of the combined scores was demonstrated in the analysis of individual secondary endpoints. The best cut-off of a total of 4 scores was suggested for the combined CHA2DS2-VASc and RCRI in the prediction of the perioperative cardiac outcomes. CONCLUSIONS: The CHA2DS2-VASc score significantly enhanced risk assessment for the composite perioperative cardiovascular outcome in comparison to traditional RCRI risk stratification. Incorporation of CHA2DS2-VASc scores into clinical-decision making to improve perioperative management in patients undergoing non-cardiac surgery warrants consideration.
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Abdome/cirurgia , Doenças Cardiovasculares/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Medição de Risco/métodos , Adulto , Idoso , Estudos de Coortes , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: Perioperative cardiovascular events constitute the majority of complications in noncardiac surgery. Older and female patients have been less investigated. We aimed to evaluate differences in perioperative cardiovascular outcomes by age and sex. METHODS: We enrolled 1079 patients (57.5 ± 17.0 years, 42.6% women) undergoing intra-abdominal surgery from July 2007 to June 2008 and compared occurrence of perioperative cardiac events by age (≥65 vs. <65 years) and sex. Multivariable logistic regression was used to investigate associations between age, sex, and outcomes. RESULTS: Age ≥65 years was associated with perioperative myocardial infarction (MI) (odds ratio [OR] 2.9, 95% confidence interval [CI]: 1.3-6.6) and total cardiovascular events (OR 2.4, 95% CI: 1.3-4.2). Age ≥65 years was associated with higher perioperative MI risks in men (OR 4.7, 95% CI: 1.3-17.6) than in women (OR 3.1, 95% CI: 1.2-8.3). Advanced age was associated with heart failure in women (OR 13.9, 95% CI: 1.7-110.5). Female sex was a risk factor for heart failure in elderly patients (OR 4.2, 95% CI: 1.1-15.7). CONCLUSIONS: Advanced age appeared to be associated with increased perioperative cardiac risk but differed by sex. Tailored strategies should be considered with respect to the patient's sex.
Assuntos
Infarto do Miocárdio , Complicações Pós-Operatórias , Idoso , Feminino , Humanos , Masculino , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Apoptosis induced by oxidative stress is one of the most important cardiomyocytes losses during ischemia-reperfusion (I/R). Catestatin (CST) has been demonstrated to have the anti-oxidative capacity in vitro. We hypothesized that CST intervention could reduce apoptosis of cardiomyocytes induced by oxidative stress in I/R. In Langendorff-perfused rat heart global I/R model, CST was introduced at the reperfusion stage. In comparison to the control group, CST led to preservation on activities of superoxide dismutase and glutathione peroxidase, improvement of hemodynamics, and reduced infarction area in reperfused myocardium. The protection of CST was also shown by less apoptotic cardiomyocytes in TUNEL staining, less caspase-3 activation, and increased phosphorylation of protein kinase B (PKB/Akt) in Western blot. To further demonstrate the benefits of CST and explore the possible underlying mechanism, H2O2-challenged primary-cultured neonatal rat cardiomyocytes were used to simulate the oxidative-stressed scenario. CST incubation with the H2O2-challenged cardiomyocytes led to reduction of apoptosis, which was demonstrated by less Hoechst 33342 positive staining of nuclei, less caspase-3 activation, and DNA fragmentation. The effect of CST was abrogated by pretreatment of the cardiomyocytes with the PI3K inhibitor LY294002. Furthermore, Akt activation and the anti-apoptosis effect of CST were abolished by pretreatment of the cardiomyocytes with ß2 receptor inhibitor ICI118551. Thus, the salvage of oxidative-stress-induced apoptotic cardiomyocytes in I/R by CST might involve activation ß2 receptor and regulation of PI3K/Akt signaling in reperfusion injury salvage kinase (RISK) pathway.
Assuntos
Apoptose/efeitos dos fármacos , Cromogranina A/farmacologia , Traumatismo por Reperfusão Miocárdica/metabolismo , Miocárdio/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Fragmentos de Peptídeos/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Receptores Adrenérgicos beta 2/metabolismo , Transdução de Sinais/efeitos dos fármacos , Animais , Masculino , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , Traumatismo por Reperfusão Miocárdica/patologia , Miocárdio/patologia , Ratos , Ratos Sprague-DawleyRESUMO
Polymorphisms of organic anion transporting polypeptides (OATPs) have been reported to affect trough serum digoxin concentration (SDC). However, the association of these polymorphisms with trough SDC in Chinese heart failure patients has not been studied. We aim to explore whether OATP1B1 388A>G, OATP1B1 521T>C, and OATP1B3 699G>A influence trough SDC in Chinese heart failure patients and to make clinical recommendations.Chinese patients (n = 104) diagnosed with heart failure under long-term digoxin therapy (0.125âmg daily) were enrolled in this study. Blood samples were collected for the analysis of trough SDC (immunofluorescence) and the polymorphisms of OATP1B1 388A>G, OATP1B1 521T>C, and OATP1B3 699G>A (PCR-RFLP and Sanger sequencing).Patients with glomerular filtration rate (GFR) under 30âmL/min had significantly higher trough SDC (1.20â±â0.50âng/mL) than recommended trough SDC for heart failure patients. Trough SDC was not significantly influenced by mutations of OATP1B1 388A>G (Pâ=â.890), 521T>C (Pâ=â.054), and OATP1B3 699G>A (Pâ=â.854). Patients with OATP1B1 521T>C mutant-type carrier had slightly higher trough SDC (0.98â±â0.53âng/mL) than those with wild-type carrier (0.74â±â0.40âng/mL) when they have repaired renal function.Heart failure patients with severe renal dysfunction (GFR<60âmL/min) and/or OATP1B1 521T>C mutant-type carriers are recommended a smaller dosage of digoxin and strict therapeutic drug monitoring.
Assuntos
Cardiotônicos/sangue , Digoxina/sangue , Taxa de Filtração Glomerular/efeitos dos fármacos , Transportador 1 de Ânion Orgânico Específico do Fígado/genética , Mutação , Membro 1B3 da Família de Transportadores de Ânion Orgânico Carreador de Soluto/genética , Idoso , Cardiotônicos/administração & dosagem , Cardiotônicos/efeitos adversos , China , Digoxina/administração & dosagem , Digoxina/efeitos adversos , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Estudos ProspectivosRESUMO
Urotensin II (UII) contributes to cardiovascular diseases by activating vasoactive peptides. The present study aimed to determine the effect of UII on aldosterone (ALD) and its receptor in cultured adventitial fibroblasts (AFs) and the tunica adventitia of rat vessels to explore the possible mechanisms underlying vascular remodeling. Expression levels of aldosterone and its receptor on tunica adventitia were determined using immunohistochemistry. Growtharrested AFs and tunica adventitia from rat vessels were incubated with UII and inhibitors of various signal transduction pathways. ALD receptor (ALDR) mRNA expression levels and ALD protein exoression levels were determined by reverse transcriptionquantitative polymerase chain reaction and ELISA, respectively. Aldosterone and its receptors were expressed on tunica adventitia. UII promoted ALD protein secretion from cells in a dose and timedependent manner. ALDR mRNA expression in cells was also dysregulated. Furthermore, the effects of UII were substantially inhibited by treatment with the inhibitors PD98059, Y27632, H7, CSA and nicardipine. These results were further verified in the tunica adventitia of rat vessels. The present findings indicated that UII stimulated ALD protein secretion and ALDR mRNA expression in AFs and in the tunica adventitia of rat vessels; moreover, this effect may be mediated by signal transduction pathways involving MAPK, Rho, PKC, calcineurin and Ca2+. UII may also contribute to vascular remodeling by stimulating the production of ALD and its receptor.
Assuntos
Túnica Adventícia/citologia , Aldosterona/genética , Aorta/citologia , Fibroblastos/metabolismo , Regulação para Cima , Urotensinas/metabolismo , Túnica Adventícia/metabolismo , Animais , Aorta/metabolismo , Células Cultivadas , Fibroblastos/citologia , Masculino , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley , Receptores de Mineralocorticoides/genéticaRESUMO
OBJECTIVE: Atherosclerosis plays a key role in the inducibility and persistence of coronary heart disease. Clinical evidence, in vitro and in vivo studies have implicated Urotensin II (U-II/UTS2) in the development of atherosclerosis and coronary artery disease, contributing to the (patho) physiological regulation of cardiovascular homeostasis in humans. Increased U-II plasma levels have been reported in patients with atherosclerosis and coronary heart disease. Considering these, our objective was to evaluate possible role of the UTS2 gene polymorphisms (Thr21Met and Ser89Asn) in the genetic susceptibility to coronary heart disease and myocardial infarction in a Chinese population. METHODS: A case-control study was designed to compare the distribution of alleles and genotypes between case group (subjects with myocardial infarction, n=409) and control group (subjects with coronary heart disease, n=830). The detection of UTS2 gene polymorphisms was achieved with PCR-RFLP technique. RESULTS: We did not identify statistically significant differences between the myocardial infarction and coronary heart disease groups, neither with regard to the frequency of genotype/variant at the Ser89Asn locus nor at the Thr21Met locus. When stratified by sex, differences in genotype distribution of polymorphism Ser89Asn were only seen in female subjects in both additive tested inheritance model (OR=0.257, 95% CI: 0.074-0.896, P=0.033) and recessive tested inheritance model (OR=0.280, 95% CI: 0.082-0.955, P=0.042). For subjects with myocardial infarction, we identified statistically significant differences between the ST-segment elevation myocardial infarction and non ST-segment elevation myocardial infarction groups. Differences in genotype distribution of polymorphism Ser89Asn not Thr21Met were seen in both additive tested inheritance model (OR=0.202, 95% CI: 0.049-0.833, P=0.027) and recessive tested inheritance model (OR=0.208, 95% CI: 0.052-0.835, P=0.027). When stratified by sex, differences in genotype distribution of polymorphism Ser89Asn were only seen in male subjects in both additive tested inheritance model (OR=0.208, 95% CI: 0.049-0.890, P=0.034) and recessive tested inheritance model (OR=0.197, 95% CI: 0.047-0.824, P=0.026). CONCLUSIONS: Ser89Asn (S89N) polymorphisms of the UTS2 gene were significantly associated with coronary heart disease and myocardial infarction in Chinese population. Additionally, we demonstrated that Genotype Asn89Asn may imply a potential benefit role for myocardial infarction.
RESUMO
OBJECTIVE: Cardiac hypertrophy is the heart's response to a variety of extrinsic and intrinsic stimuli, some of which might finally lead up to a maladaptive state. Clinical evidence, in vitro and in vivo studies have implicated urotensin II (U-II/UTS2) in the development of cardiac hypertrophy, contributing to the (patho)-physiological regulation of cardiovascular homeostasis in humans. Several genes are associated with left ventricular hypertrophy; considering these, our objective was to evaluate the possible role of UTS2 gene polymorphisms (Thr21Met and Ser89Asn) in the genetic susceptibility to cardiac hypertrophy in a Chinese population. METHODS: A case-control study was designed to compare the distribution of alleles and genotypes between three groups: case group 1 (subjects with hypertension and cardiac hypertrophy, n=265), case group 2 (subjects with hypertension, without cardiac hypertrophy, n=768), and the control group (subjects neither with hypertension nor with cardiac hypertrophy, n=416). The detection of UTS2 gene polymorphisms was achieved with the PCR restriction fragment length polymorphism technique. RESULTS: We did not identify statistically significant differences between the three groups, neither with regard to the frequency of genotype/variant at the Ser89Asn locus nor at the Thr21Met locus. When stratified by sex, differences in genotype distribution of polymorphism Ser89Asn were only seen in female subjects in both the additive tested inheritance model (OR=0.507, 95% CI 0.249 to 1.032, p=0.032) and the recessive tested inheritance model (OR=0.475, 95% CI 0.239 to 0.945, p=0.034) between case group 2 (subjects with hypertension, without cardiac hypertrophy) and the control group (subjects neither with hypertension nor with cardiac hypertrophy). When stratified by sex, for female subjects with cardiac hypertrophy, we identified statistically significant differences in left ventricular posterior wall thickness for variant genotypes at the Ser89Asn locus (AA vs GG: 1.2500 (1.2000, 1.3750) vs 1.2500 (1.2000, 1.3750), p=0.03) and (AG+AA vs GG: 1.2000 (1.2000, 1.3000) vs 1.2000 (1.1000, 1.2000), p=0.01). CONCLUSIONS: Ser89Asn (S89N) polymorphisms of the UTS2 gene were associated with hypertension in a Chinese female population. Additionally, we demonstrated that genotype Asn89Asn was associated with left ventricular posterior wall thickness for subjects with hypertension and cardiac hypertrophy in a Chinese female population.
Assuntos
Cardiomegalia/genética , Hormônios Peptídicos/genética , Polimorfismo de Nucleotídeo Único , Adulto , Alelos , Estudos de Casos e Controles , China , Feminino , Genótipo , Humanos , Hipertensão/genética , Peptídeos e Proteínas de Sinalização Intracelular , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Fatores SexuaisRESUMO
The purpose of this study was to investigate the prevalence of abnormal glucose regulation (AGR) in patients with established coronary artery disease (CAD), and the association of AGR and acute coronary events in Chinese patients.A total of 3441 hospitalized patients with established diagnosis of CAD were recruited from 41 centers in 25 cities of China. Oral glucose tolerance test (OGTT) was performed in 2112 patients without known diabetes. Acute coronary events were recorded for the patients.AGR was detected in 1880 (89%) patients in the OGTT cohort, with 1265 (59.9%) diagnosed with impaired glucose tolerance, 363 (17.2%) diagnosed with diabetes, and 30 (1.4%) diagnosed with isolated impaired fasting glucose. The overall proportion of patients diagnosed with diabetes increased from 30.7% (nâ=â930) at baseline to 42.6% (nâ=â1298) following the OGTT analysis. In total 85% (nâ=â3047) patients in the study was diagnosed with AGR. Multivariate analysis showed that AGR was independently associated with acute coronary events, after adjusting for the traditional risk factors including age, smoking, hypertension, and hyperlipidemia.The prevalence of AGR is increasing in Chinese patients with CAD, as compared with previous report. AGR was independently associated with acute coronary events. Prospective studies are warranted to evaluate the benefit of intervening prediabetes in adult patients with CAD.
Assuntos
Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Intolerância à Glucose/epidemiologia , Idoso , Glicemia , Pressão Sanguínea , China/epidemiologia , Estudos Transversais , Feminino , Teste de Tolerância a Glucose , Hemoglobinas Glicadas , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fumar/epidemiologiaRESUMO
OBJECTIVE: Atrial fibrosis plays a key role in the inducibility and persistence of atrial fibrillation. Urotensin II (U-II/UTS2) induces cardiac fibrosis by increasing fibroblast collagen synthesis and increased U-II plasma levels have been reported in patients with atrial fibrosis. Our objective was therefore to evaluate the possible role of the UTS2 gene polymorphisms Thr21Met and Ser89Asn in the genetic susceptibility to atrial fibrillation in a Chinese population. METHODS: A case-control study was designed to compare the distribution of alleles and genotypes between controls (n=197) and patients with AF (n=197). The detection of UTS2 gene polymorphisms was undertaken using the PCR-restriction fragment length polymorphism technique. RESULTS: We identified statistically significant differences between the atrial fibrillation and control groups with regard to the frequency of genotype variant GA at the Ser89Asn locus (OR 1.955, 95% CI 1.071 to 3.566, p=0.029). When stratified by sex, differences in genotype distribution of polymorphism Ser89Asn was only seen in men in the additive tested inheritance model (OR 2.843, 95% CI 1.273 to 6.348, p=0.011). There was a statistical difference in Met21Met, implying a potential beneficial role for atrial fibrillation in the recessive tested inheritance model among men (OR 0.260, 95% CI 0.075 to 0.89, p=0.033; AA vs GA-GG). For subjects with atrial fibrillation, the Met21Met genotype was associated with a larger anteroposterior left atrial diameter (AA vs GG, 4.12±0.62 vs 3.86±0.51, p=0.028) and a smaller left ventricular end-diastolic diameter (AA vs GG, 4.50±0.48 vs 4.78±0.49, p=0.039). CONCLUSIONS: Ser89Asn polymorphisms of the UTS2 gene are significantly associated with atrial fibrillation in the Chinese population. Additionally, we demonstrated that genotype Met21Met may have a potential beneficial role in atrial fibrillation.
Assuntos
Povo Asiático/genética , Fibrilação Atrial/genética , Predisposição Genética para Doença/genética , Terapia de Alvo Molecular/tendências , Polimorfismo de Nucleotídeo Único , Urotensinas/genética , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/fisiopatologia , Estudos de Casos e Controles , China/epidemiologia , China/etnologia , Feminino , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Masculino , Fatores de RiscoRESUMO
The salt marsh plant communities were investigated with quadrats in the southern Chongming Dongtan. Based on the vegetation coverage and the 2×2 contingency table, 8 common species among the 17 higher plants recorded were analyzed. The variance ratio of overall association, Chi-square test and Spearman rank correlation coefficient were used to describe the relevance and correlations between species pairs. The results showed that W (48.61), a statistical index to test the variance ratio (VR=0.61), fell outside of the range of Chi-square test, indicating that the overall correlation of all vegetation species was significantly negative. According to the environment adaptation mode of dominant species and the main influencing factors, the species were divided into 4 ecological groups, i.e., Phragmites australis, Carex scabrifolia-Scirpus triqueter - Juncellus serotinus, Spartina alterniflora - Scirpus mariqueter, Echinochloa crusgalli - Imperata cylindrica, based on the ranking of Spearman correlation coefficient. The inter-specific relationships in the salt marsh plant community of southern Chongming Dongtan were complicated and extremely unstable with species sensitive to environmental impacts. According to the analysis of relationships between the species and their pre-sent distribution, we suggested using S. mariqueter as target species to provide strategies for protecting native species based habitats.
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Cyperaceae/fisiologia , Estuários , Poaceae/fisiologia , Áreas Alagadas , ChinaRESUMO
Conventional synthetic procedures of strigolactones (SLs) involve the independent synthesis of ring ABC and ring D, followed by a coupling of the two fragments. Here we prepared three kinds of stable, isotopically labelled D-ring analogues productively using a facile protocol. Then, a coupling of the D-rings to ring ABC produced three isotope-labelled SL derivatives. Moreover, (+)-D3-2'-epi-1A and (-)-ent-D3-2'-epi-1A with high enantiomeric purity were obtained via chiral resolution.
Assuntos
Furanos/síntese química , Marcação por Isótopo/métodos , Lactonas/síntese química , Compostos Radiofarmacêuticos/síntese química , Compostos Radiofarmacêuticos/isolamento & purificação , Estabilidade de MedicamentosRESUMO
OBJECTIVE: To evaluate the relationship between left atrial size and the risk of cardiac events in patients with non-obstruction hypertrophic cardiomyopathy. METHODS: In the study, 39 patients who met inclusion criteria were followed up for (28.0±7.7) months. The patients were divided into two groups with or without major adverse cardiac events (a composite of arrhythmia, angina, syncope and congestive heart failure). Clinical and echocardiographic data of the two groups were compared. The predictive value of left atrial diameter (LAD) and left atrial volume index (LAVI) were reviewed by using receive operating characteristic curve (ROC). The events analysis was performed by using the Kaplan-Meier analysis. RESULTS: Cardiac events occurred in 11 patients (28.2%). LAD, LAD index (LADI), LAV and LAVI were significantly greater in the patients with cardiac events than those without cardiac events [LAD: (4.28±0.63) cm vs. (3.85±0.48) cm, P=0.025; LADI: (0.048 9±0.011 1) cm/m(2) vs. (0.040 8±0.005 8) cm/m(2), P=0.005; LAV: (60.8±16.2) mL vs. (46.2±14.0) mL, P=0.008; LAVI: (66.5±23.8) mL/m(2) vs. (49.6±15.9) mL/m(2), P=0.014]. An LAD of >4.29 cm identified patients with cardiac events with a sensitivity of 63.6% and a specificity of 89.3%. An LAVI of >53.1 mL/m(2) identified patients with cardiac events with a sensitivity of 72.7% and a specificity of 71.4%. The Kaplan-Meier analysis indicated that the patients with LAD>4.29 cm or LAVI>53.1 mL/m(2) had higher incidence of cardiac events. CONCLUSION: LAD and LAVI may be effective markers for predicting adverse cardiac events in patients with non-obstruction hypertrophic cardiomyopathy.
Assuntos
Cardiomiopatia Hipertrófica/complicações , Átrios do Coração , Angina Pectoris/complicações , Arritmias Cardíacas/complicações , Ecocardiografia , Insuficiência Cardíaca/complicações , Humanos , Tamanho do Órgão , Valor Preditivo dos Testes , Curva ROC , Sensibilidade e Especificidade , Síncope/complicaçõesRESUMO
OBJECTIVE: To investigate the change of plasma osteopontin level during the progress of acute ST-segment elevation myocardial infarction, as well as its association with the left ventricular remodeling and prognosis. METHODS: In the study, 61 patients with acute ST-segment elevation myocardial infarction were recruited. Blood samples were taken at admission, on the 3rd day and 7th day of admission, while 63 healthy blood donors were employed as normal controls. There plasma osteopontin levels were measured by ELSIA. RESULTS: Compared with the normal controls, the plasma osteopontin levels of the patients with acute ST-segment elevation myocardial infarction were significantly higher at admission [(96.51±37.22) µg/L vs. (54.50±28.17) µ g/L, P<0.001], reached the peak value on the 3rd day, and dropped down on the 7th day. The correlation analysis showed that the plasma osteopontin level positively correlated with age and left ventricular end-systolic volume index 3 months after acute myocardial infarction, and negatively correlated with left ventricular ejection fraction 3 months after acute myocardial infarction. The follow-up study found that the plasma osteopontin level did not predict mortality, re-infarction, stroke, revascularization or hospitalization due to heart failure. CONCLUSION: In patients with acute ST-segment elevation myocardial infarction, the elevated plasma level of osteopontin might be associated with the left ventricular remodeling.
Assuntos
Infarto do Miocárdio/sangue , Osteopontina/sangue , Remodelação Ventricular , Doença Aguda , Seguimentos , Insuficiência Cardíaca , Humanos , Infarto do Miocárdio/patologia , Prognóstico , Volume Sistólico , Função Ventricular EsquerdaRESUMO
OBJECTIVES: To investigate incidence of perioperative cardiovascular events, to analyze related risk factors for the patients undergoing intraperitoneal surgery. METHODS: The data of 1079 patients who underwent intraperitoneal surgery (exclude laparoscope surgery) from July 2007 to June 2008 was reviewed and analyzed. RESULTS: For the patients undergoing intraperitoneal surgery, the incidence of major cardiovascular events was 3.99% (43/1079), all-cause mortality was 1.58% (17/1079). The independent risk factors of major cardiovascular events were age ≥ 60 years, history of coronary heart disease, cardiac insufficiency, arrhythmia, chronic obstructive pulmonary disease, estimated glomerular filtration rate (eGFR) < 60 ml/(min·1.73 m(2)), emergency surgery and duration of surgery > 2.82 h (OR = 2.68 to 5.19, P = 0.001 to 0.031). CONCLUSIONS: The cardiac risk of intraperitoneal surgery is 3.99%. The risk of cardiac complications should be evaluated in elderly patients and those with ischaemic heart disease, chronic obstructive pulmonary disease, and renal disease, more specifically, when emergent or long duration major surgeries are needed.
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Abdome/cirurgia , Doenças Cardiovasculares/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/mortalidade , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: The evaluation of ventricular remodelling and functional recovery is essential in predicting the prognosis of patients with acute myocardial infarction (AMI). OBJECTIVE: To determine the plasma catestatin level in patients with AMI, and investigate the association between plasma catestatin and heart function, and with left ventricular remodelling (LVR). METHODS: Fifty-eight consecutive patients who were admitted within 12 h of the onset of their ST-segment elevation myocardial infarction symptoms between 1 October 2009 and 30 June 2011 were prospectively recruited. Circulating catestatin was measured by ELISA. All patients underwent an echocardiography examination during the first week; 31 patients had a second echocardiography examination 3 months after the myocardial infarction. RESULTS: Plasma catestatin at the time of admission was significantly higher in patients than in normal controls. The level increased further in the first week after AMI. Three months after AMI, the plasma catestatin level of patients was comparable to that of normal controls. The plasma level of catestatin correlated with anterior AMI and left ventricular ejection fraction (LVEF) in the acute stage. Compared with patients without LVR, those with LVR had significantly higher level of plasma brain natriuretic peptide on day 7 and a significantly higher level of plasma catestatin on admission and on days 3 and 7 (p=0.033, p=0.001, p=0.006, p=0.021, respectively). CONCLUSIONS: Plasma catestatin levels were raised after AMI. An early increase of catestatin correlated with anterior AMI and LVEF. Plasma catestatin after the onset of AMI might be associated with the magnitude of progressive ventricular remodelling 3 months after AMI.
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Cromogranina A/sangue , Infarto do Miocárdio/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Disfunção Ventricular Esquerda/sangue , Remodelação Ventricular , Idoso , Biomarcadores/sangue , China/epidemiologia , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Volume Sistólico , Fatores de Tempo , Disfunção Ventricular Esquerda/mortalidade , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
A novel distributed fiber optic pressure sensor based on an all-solid photonic band gap fiber is proposed and experimentally demonstrated. The sensor is fabricated by splicing a piece of the photonic crystal fiber (PCF) with a single-mode fiber (SMF), and the free end face of the PCF is filmed with a reflectivity of 99%. The cladding mode is excited at the fiber splice, resulting in the interference between the cladding mode and the core mode. The pressure position can be located by measuring the phase difference of the interferometer, and the pressure can be interrogated by measuring the height of the valley in the white-light optical spectrum. The experimental results show that the pressure and its position along the PCF can be simultaneously interrogated.