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1.
Clin Cardiol ; 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34668596

RESUMO

BACKGROUND: Angiotensin receptor neprilysin inhibitor (ARNI) sacubitril-valsartan has been recommended as one of the first-line therapies in heart failure with reduced ejection fraction. However, whether ARNI could benefit patients with ST-segment elevation myocardial infarction (STEMI) by improving left ventricular (LV) remodeling remains unknown. The primary objective of the PERI-STEMI trial is to assess whether sacubitril-valsartan is more effective in preventing adverse LV remodeling for patients with STEMI than enalapril. HYPOTHESIS: We hypothesize that sacubitril/valsartan is superior to enalapril in preventing adverse LV remodeling evaluated by cardiovascular magnetic resonance imaging at the 6-month follow-up. METHODS: PERI-STEMI is an investigator-initiated, prospective, multi-center, randomized, open-label, superiority trial with blinded evaluation of outcomes. A total of 376 first-time STEMI patients with primary percutaneous coronary intervention (PPCI) within 12 h after symptom onset will be randomized to sacubitril-valsartan or enalapril treatment. All the patients will receive a baseline cardiovascular magnetic resonance (CMR) examination at 4-7 days post-PPCI. The primary endpoint is the change of indexed LV mass at the 6-month follow-up CMR. RESULTS: Enrollment of the first patient is planned in November 2021. Recruitment is anticipated to last for 12-18 months and patients will be followed for 5 years after randomization. The study is expected to complete in June 2027. CONCLUSIONS: The results of the PERI-STEMI trial are expected to provide CMR evidence on whether ARNI could benefit patients with STEMI, so as to facilitate the strategy of CMR-based risk stratification and therapy selection for these patients. PERI-STEMI is registered at ClinicalTrials.gov (NCT04912167).

2.
Eur Radiol ; 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477909

RESUMO

OBJECTIVES: To investigate the feasibility of automatic machine learning (autoML) based on native T1 mapping to predict late gadolinium enhancement (LGE) status in hypertrophic cardiomyopathy (HCM). METHODS: Ninety-one HCM patients and 44 healthy controls who underwent cardiovascular MRI were enrolled. The native T1 maps of HCM patients were classified as LGE ( +) or LGE (-) based on location-matched LGE images. An autoML pipeline was implemented using the tree-based pipeline optimization tool (TPOT) for 3 binary classifications: LGE ( +) and LGE (-), LGE (-) and control, and HCM and control. TPOT modeling was repeated 10 times to obtain the optimal model for each classification. The diagnostic performance of the best models by slice and by case was evaluated using sensitivity, specificity, accuracy, and microaveraged area under the curve (AUC). RESULTS: Ten prediction models were generated by TPOT for each of the 3 binary classifications. The diagnostic accuracy obtained with the best pipeline in detecting LGE status in the testing cohort of HCM patients was 0.80 by slice and 0.79 by case. In addition, the TPOT model also showed discriminability between LGE (-) patients and control (accuracy: 0.77 by slice; 0.78 by case) and for all HCM patients and controls (accuracy: 0.88 for both). CONCLUSIONS: Native T1 map analysis based on autoML correlates with LGE ( +) or (-) status. The TPOT machine learning algorithm could be a promising method for predicting myocardial fibrosis, as reflected by the presence of LGE in HCM patients without the need for late contrast-enhanced MRI sequences. KEY POINTS: • The tree-based pipeline optimization tool (TPOT) is a machine learning algorithm that could help predict late gadolinium enhancement (LGE) status in patients with hypertrophic cardiomyopathy. • The TPOT could serve as an adjuvant method to detect LGE by using information from native T1 maps, thus avoiding the need for contrast agent. • The TPOT also detects native T1 map alterations in LGE-negative patients with hypertrophic cardiomyopathy.

3.
Medicine (Baltimore) ; 100(32): e26904, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397921

RESUMO

RATIONALE: Persistent primitive hypoglossal artery (PPHA) is a rare and permanent carotid-vertebrobasilar anastomoses. Patients with PPHA usually have higher changes of developing intracranial aneurysms due the high intracranial hemodynamics. Although cases of PPHA alone and PPHA with aneurysms have been reported in literature, cases of fenestrated PPHA harboring a ruptured aneurysm have seldomly be reported in literature. We present a rare occurrence of a fenestrated PPHA harboring a reputed aneurysm. PATIENTS CONCERNS: A 43-year-old woman was presented with a sudden-onset severe headache and nausea. DIAGNOSIS: Computerized tomography scan showed third, fourth, and bilateral ventricular hemorrhages. Computed tomographic angiogram showed a PPHA with fenestration malformation and a cystic protrusion consistent with an aneurysm. INTERVENTION: The patient underwent a successful stent-assisted coil embolization via the trans-arterial route under general anesthesia. OUTCOMES: Two years follow-up revealed no recurrence of her symptomatology and she is currently well and go about her normal daily life. CONCLUSION: Fenestrated PPHAs harboring aneurysms may be more prone to rupture because of the fenestration and connective tissue weakness of the artery as well as changes in hemodynamics of the already malformed and weak artery.


Assuntos
Aneurisma Roto/diagnóstico , Artéria Basilar , Angiografia Cerebral/métodos , Aneurisma Intracraniano/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Anastomose Cirúrgica/métodos , Aneurisma Roto/cirurgia , Feminino , Humanos , Aneurisma Intracraniano/cirurgia
4.
Clin Biochem ; 96: 19-25, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34245695

RESUMO

BACKGROUND: Red blood cell distribution width (RDW) has emerged as a useful indicator for adverse outcomes in several cardiovascular diseases. The relation between RDW and the prognosis of hypertrophic cardiomyopathy (HCM) remains to be evaluated. We examined the relation between RDW and all-cause mortality and HCM-related death in a population of adult HCM patients. METHODS: We performed clinical evaluation in 414 consecutive adult HCM patients (median age, 57.5 years; male, 54.8%). RESULTS: During a median follow-up of 3.7 years, all-cause mortality and HCM-related death occurred in 75 (18.1%) and 50 (12.1%) patients, respectively. Based on the tertiles of baseline RDW, mortality increased with higher tertile. With the tertile 1 as reference, adjusted all-cause mortality hazard ratios (HRs) were 3.9 for the tertile 2 (95% confidence interval [CI]: 1.5-10.3) and 3.1 for the tertile 3 (95% CI: 1.1-8.2). Adjusted HCM-related death HRs were higher in the tertile 2 (HR: 5.5; 95% CI: 1.2-24.4) and tertile 3 (HR: 6.6; 95% CI: 1.5-29.0) compared with the tertile 1. Further smooth curve fitting exhibited a saturation effect after adjusting for confounders, and there were a two-stage change and an inflection point. Two-piecewise Cox model suggested mortality significantly increased with RDW level up to the inflection point (about 14.0% for both all-cause mortality and HCM-related death), and RDW was not associated with mortality after the point. CONCLUSION: In adult HCM patients, we found increased RDW was a significant risk predictor for all-cause mortality and HCM-related death, and a saturation effect was observed.


Assuntos
Cardiomiopatia Hipertrófica/sangue , Cardiomiopatia Hipertrófica/mortalidade , Índices de Eritrócitos , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
5.
BMC Cardiovasc Disord ; 21(1): 325, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-34217206

RESUMO

BACKGROUND: This study was performed to investigate the clinical significance of combined evaluation of both coronary artery disease (CAD) and high-sensitivity cardiac troponin T (hs-cTnT) for prediction of major adverse cardiovascular events (MACEs) in patients with hypertrophic cardiomyopathy (HCM). METHODS: We performed clinical evaluations, including coronary artery imaging and hs-cTnT measurement, in 162 patients with HCM. RESULTS: The patients were followed up for a median period of 3.7 years (interquartile range 2.4-5.6 years; total of 632.3 person-years [PYs]), during which time MACEs occurred in 24 (14.8%) patients. The incidence of MACEs was 6.4 and 2.7 per 100 PYs for patients with CAD and normal coronary arteries, respectively; similarly, the incidence was 5.8 and 2.1 per 100 PYs in patients with an elevated hs-cTnT concentration (> 14.0 ng/L) and a normal hs-cTnT concentration, respectively. The multivariate analysis suggested that CAD and an elevated hs-cTnT concentration tended to be positively associated with MACEs. When the groups were allocated according to these two markers, the patients were divided into four groups, which further improved the predictive values. The incidence of MACEs was 10.4 per 100 PYs in the CAD and elevated hs-cTnT group, which was much higher than the incidence in all other groups (range, 2.0-3.5 per 100 PYs). With the normal coronary arteries and normal hs-cTnT group serving as a reference, the adjusted hazard ratio was 5.0 (95% confidence interval 1.0-23.8; P = 0.046) for the CAD and elevated hs-cTnT group. In addition, the subgroup analysis showed similar findings among the patients without severe CAD. CONCLUSIONS: In patients with HCM, combined evaluation of both CAD and hs-cTnT might facilitate more reliable prediction of MACEs than evaluation of a single marker. These may serve as clinically useful markers to guide risk management.


Assuntos
Cardiomiopatia Hipertrófica/diagnóstico , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Troponina T/sangue , Adulto , Idoso , Biomarcadores/sangue , Cardiomiopatia Hipertrófica/sangue , Cardiomiopatia Hipertrófica/epidemiologia , China/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Progressão da Doença , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
6.
Environ Res ; 200: 111371, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34081973

RESUMO

Sodium percarbonate (SPC) is considered a potential alternative to liquid hydrogen peroxide (H2O2) in organic compounds contaminated water/soil remediation due to its regularly, transportable, economical, and eco-friendly features. The solid state of SPC makes it more suitable to remediate actual soil and water with a milder H2O2 release rate. Apart from its good oxidative capacity, alkaline SPC can simultaneously remediate acidized solution and soil to the neutral condition. Conventionally, percarbonate-based advanced oxidation process (P-AOPs) system proceed through the catalysis under ultraviolet ray, transition metal ions (i.e., Fe2+, Fe3+, and V4+), and nanoscale zero-valent metals (iron, zinc, copper, and nickel). The hydroxyl radical (•OH), superoxide radical (•O2-), and carbonate radical anion (•CO3-) generated from sodium percarbonate could attack the organic pollutant structure. In this review, we present the advances of P-AOPs in heterogeneous and homogeneous catalytic processes through a wide range of activation methods. This review aims to give an overview of the catalysis and application of P-AOPs for emerging contaminants degradation and act as a guideline of the field advances. Various activation methods of percarbonate are summarized, and the influence factors in the solution matrix such as pH, anions, and cations are thoroughly discussed. Moreover, this review helps to clarify the advantages and shortcomings of P-AOPs in current scientific progress and guide the future practical direction of P-AOPs in sustainable carbon catalysis and green chemistry.


Assuntos
Peróxido de Hidrogênio , Poluentes Químicos da Água , Carbonatos , Oxirredução , Água , Poluentes Químicos da Água/análise
7.
Eur Radiol ; 31(8): 6220-6229, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34156556

RESUMO

OBJECTIVES: We sought to identify the impact of transcatheter aortic valve implantation (TAVI) on changes of fractional flow reserve computed tomography (FFRCT) values and the associated clinical impact. METHODS: A retrospective analysis was done with CT obtained pre-TAVI, prior to hospital discharge and at 1-year follow-up, which provided imaging sources for the calculation of FFRCT values based on an online platform. RESULTS: A total of 190 patients were enrolled. Patients with pre-procedural FFRCT value > 0.80 (i.e., negative) and ≤ 0.80 (i.e., positive) demonstrated a significantly opposite change in the value after TAVI (0.8798 vs. 0.8718, p < 0.001 and 0.7634 vs. 0.8222, p < 0.001, respectively). The history of coronary artery disease (CAD) was identified as an independent predictor for FFRCT changing from negative to positive after TAVI (odds ratio [OR] 2.927, 95% confidence interval [CI] 1.130-7.587, p = 0.027), with lesions more severely stenosed (OR 1.039, 95% CI 1.003-1.076, p = 0.034) and in left anterior descending coronary artery (LAD) (OR 3.939, 95% CI 1.060-14.637, p = 0.041) being prone to change. CONCLUSIONS: TAVI directly brings improvement in FFRCT values in patients with compromised coronary flow. Patients with a history of CAD, especially with lesions more severely stenosed and in LAD, were under risk of FFRCT changing from negative to positive after TAVI. KEY POINTS: •The effect of TAVI on coronary hemodynamics might be influenced by different ischemic severity and coronary territories reflected by FFRCT values. •As different FFRCT variations did not impact outcomes of TAVI patients, AS, but not coronary issues, may be the primary problem to affect, which needs further validation.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Substituição da Valva Aórtica Transcateter , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/diagnóstico por imagem , Hemodinâmica , Humanos , Valor Preditivo dos Testes , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
8.
Toxicology ; 457: 152805, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-33961950

RESUMO

Niclosamide (NIC), a helminthic drug used widely for controlling schistosomiasis, can reportedly disrupt the endocrine system. However, its underlying mechanisms are still unclear. In this study, we revealed the potential endocrine disruption mechanism of NIC by activating estrogen receptors (ERs) and estrogen-related receptors (ERRs). The binding potency of NIC with ERα, ERß and ERRγ were determined by fluorescence competitive binding assays, which shows an IC50 (the concentration of NIC needed to displace 50 % of the probe from the receptor) of 90 ± 4.1, 10 ± 1.7 nM and 0.59 ± 0.07 nM respectively. The IC50 for ERRγ is the lowest one among the three detected receptors, which is three orders of magnitude lower than the known agonist GSK4716.The transcriptional activities of NIC on ERs and ERRs were detected by MVLN cells (stably transfected with ERs reporter gene) and HeLa cells (transiently transfected with ERRs reporter gene)-based luciferase reporter gene assay. The lowest observable effective concentration (LOEC) ranked as follows: ERRγ (0.5 nM) < ERRα (10 nM) < ERs (100 nM). The maximum observed induction rate for ERRγ (294 %) was higher than that for ERRα (191 %). The maximum observed induction rate of NIC for ERs was 30 % relative to 17ß-estradiol. In addition, we simulated the interactions of NIC with ERs and ERRs by molecular docking. NIC could dock into the ligand binding pockets of ERs and ERRs and form hydrogen bonds with different amino acids. The binding energy ranked as follows: ERRγ (-8.90 kcal/mol) < ERß (-7.57 kcal/mol) < ERRα (-7.15 kcal/mol) < ERα (-6.53 kcal/mol), which implied that NIC bound to ERRγ with higher binding affinity than the other receptors. Overall, we clarify that ERRγ might be the dominant target for NIC in cells rather than ERRα and ERs. We reveal potential novel mechanisms for the endocrine disruption effects of NIC by activating both ERRs and ERs at environmentally-related nanomolar levels.


Assuntos
Disruptores Endócrinos/metabolismo , Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Niclosamida/metabolismo , Receptores de Estrogênio/metabolismo , Anticestoides/metabolismo , Anticestoides/toxicidade , Relação Dose-Resposta a Droga , Disruptores Endócrinos/toxicidade , Células HeLa , Humanos , Células MCF-7 , Niclosamida/toxicidade , Ligação Proteica/efeitos dos fármacos , Ligação Proteica/fisiologia , Estrutura Secundária de Proteína
10.
Clin Cardiol ; 44(4): 455-462, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33634478

RESUMO

Primary percutaneous coronary intervention (PPCI), the preferred reperfusion strategy for all acute ST-segment elevation myocardial infarction (STEMI) patients, is not universally available in clinical practice. Pharmacoinvasive strategy has been proposed as a therapeutic option in patients with STEMI when timely PPCI is not feasible. However, pharmacoinvasive strategy has potential delay between clinical patency and complete myocardial perfusion. The optimal reperfusion strategy for STEMI patients with anticipated PPCI delay according to current practice is uncertain. OPTIMAL-REPERFUSION is an investigator-initiated, prospective, multicenter, randomized, open-label, superiority trial with blinded evaluation of outcomes. A total of 632 STEMI patients presenting within 6 hours after symptom onset and with an expected time of first medical contact to percutaneous coronary intervention (PCI) ≥120 minute will be randomized to a reduced-dose facilitated PCI strategy (reduced-dose fibrinolysis combined with simultaneous transfer for immediate invasive therapy with a time interval between fibrinolysis to PCI < 3 hours) or to standard pharmacoinvasive treatment. The primary endpoint is the composite of death, reinfarction, refractory ischemia, congestive heart failure, or cardiogenic shock at 30-days. Enrollment of the first patient is planned in March 2021. The recruitment is anticipated to last for 12 to 18 months and to complete in September 2023 with 1 year follow-up. The OPTIMAL-REPERFUSION trial will help determine whether reduced-dose facilitated PCI strategy improves clinical outcomes in patients with STEMI and anticipated PPCI delay. This study is registered with the ClinicalTrials.gov (NCT04752345).


Assuntos
Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Fibrinólise , Fibrinolíticos , Humanos , Estudos Prospectivos , Reperfusão , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Terapia Trombolítica , Resultado do Tratamento
11.
Int J Cardiol ; 331: 152-157, 2021 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-33529655

RESUMO

AIMS: Nutritional status has been related to clinical outcomes in patients with cardiovascular diseases. The prognostic impact of poor nutritional status in hypertrophic cardiomyopathy (HCM) is not clearly understood. The aim of the present study is to investigate the prognostic value of prognostic nutritional index (PNI), calculated from serum albumin level and total lymphocyte count, in HCM patients. METHODS: A total of 393 HCM patients in a tertiary medical centre were enrolled. The primary and secondary endpoints were all-cause mortality and cardiovascular death. The association between PNI and endpoints was analysed. RESULTS: During a mean follow-up duration of 4.8 years, patients with high PNI values (PNI ≥ 48.8) had significantly lower incidence of all-cause mortality (9.3% vs. 33.1%, P < 0.001) and cardiovascular death (7.1% vs. 21.0%, P < 0.001). After adjusting for potential confounders, PNI was independently associated with all-cause mortality and cardiovascular death (hazard ratio per 1 SD increase: 0.46 [95% CI: 0.34-0.62, P < 0.001] and 0.44 [95% CI: 0.30-0.63, P < 0.001]). In subgroup analysis stratified by age, gender, New York Heart Association class, atrial fibrillation, estimated glomerular filtration rate, left ventricular ejection fraction or left ventricular outflow tract obstruction, PNI was consistently related to mortality. CONCLUSIONS: PNI is an independent prognostic factor for mortality in patients with HCM.


Assuntos
Cardiomiopatia Hipertrófica , Avaliação Nutricional , Cardiomiopatia Hipertrófica/diagnóstico , Humanos , Estado Nutricional , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Volume Sistólico , Função Ventricular Esquerda
12.
Int J Med Sci ; 18(3): 727-735, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33437207

RESUMO

Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disease, which has a marked heterogeneity in clinical expression, natural history, and prognosis. HCM is associated with a high prevalence of thromboembolic events (stroke and systemic embolic events), even if taking no account of atrial fibrillation (AF), leading to unexpected disability and death in patients of all ages. Several risk factors of thromboembolism such as AF, greater age, left atrial diameter, heart failure and others have been confirmed in patients with HCM. Conventional thromboembolic predictive models were estimated by several trials in HCM population but it turned out to be unsatisfactory. Based on those previous explorations, researchers tried to modify or develop novel models suitable for HCM population in thromboembolism prediction. In consideration of catastrophic advent events of thromboembolism, current guidelines have recommended life-long anticoagulant therapy after a single short AF. Therefore, early identification of risk factors for thromboembolism, accurate risk stratification, timely preventive measures and aggressive management may help to avoid serious adverse thromboembolic events in HCM population.


Assuntos
Anticoagulantes/administração & dosagem , Fibrilação Atrial/epidemiologia , Cardiomiopatia Hipertrófica/complicações , Insuficiência Cardíaca/epidemiologia , Tromboembolia/epidemiologia , Fatores Etários , Humanos , Modelos Cardiovasculares , Prevalência , Prognóstico , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Tromboembolia/etiologia , Tromboembolia/prevenção & controle
13.
Endocrine ; 72(1): 124-131, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33433893

RESUMO

PURPOSE: Triglyceride-glucose (TyG) index is an emerging surrogate predictor of incident type 2 diabetes mellitus (T2DM). The study aimed to examine the association between TyG index and incident T2DM in a prospective Chinese cohort. METHODS: The data were collected in 1992 and recollected in 2007 from the same group of 687 participants. The association between TyG index and T2DM was analysed. RESULTS: During follow-up, 74 participants developed T2DM and the risk of T2DM increased with TyG index. The adjusted hazard ratio (HR) was 3.36 (95% CI: 1.52-7.39, P < 0.001) comparing the top TyG quartile to the bottom quartile. Smooth curve fitting revealed a nonlinear association and threshold effect between TyG index and incident T2DM with a nadir of risk when TyG index was around 8.51. For TyG ≤ 8.51, the risk of incident T2DM tended to decrease with per SD increase in TyG but no statistical significance was achieved (adjusted HR: 0.69, 95% CI: 0.43-1.12, P = 0.133). For TyG > 8.51, the risk of incident T2DM significantly increased by 38% with per SD increase in TyG (adjusted HR: 1.38, 95% CI: 1.14-1.67, P = 0.001). Time-dependent receiver operating curve suggested helpful discriminative power of TyG index for T2DM. It also significantly promoted the reclassification ability beyond the baseline risk model with net reclassification index of 0.159 (P = 0.020). Sensitivity analysis excluding participants with prediabetes demonstrated similar results. CONCLUSIONS: The TyG index was a significant and independent predictor for future T2DM development. The shape of relationship will require further studies.


Assuntos
Diabetes Mellitus Tipo 2 , Glicemia , China/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Glucose , Humanos , Estudos Prospectivos , Fatores de Risco , Triglicerídeos
14.
Environ Pollut ; 270: 116221, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33360068

RESUMO

Dissolved organic matter (DOM) and dissolved ions are two integral parameters to affect the environmental fate of As in different ways. Numerous studies chose surrogate of DOM, humic substances (HSs), to investigate the As complexation behavior. However, microbial secretion (protein and polysaccharide) was also considered for a great proportion in surface aquatic system, and its effect was still not fully understood. The present research distinguished the As complexation behavior with different DOM components (HSs, protein, polysaccharide and synthetic organic matter) in natural and simulated water samples. The results indicated that different DOM components exhibited various binding capacities for As. HSs showed the strongest affinity for As, followed by long-chain compounds (polysaccharide and synthetic organic matter) and proteins. In water source, HSs were probably the primary parameter for As complexation. In eutrophic water system, however, polysaccharide maybe the main DOM component to bind As. Cationic bridge function was prone to occur in the presence of HSs, but not observed in the presence of protein. PO43- competed for binding sites with As, consequently decreasing the As complexation with all the DOM components. The research implied that a comprehensive and meticulous analyses of DOM fractions and coexist ions are the prerequisite to understanding the behavior of As (or other pollutants) in different natural aquatic systems.


Assuntos
Arseniatos , Poluentes Químicos da Água , Substâncias Húmicas/análise , Íons , Água
15.
Biomark Med ; 14(18): 1693-1701, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33346698

RESUMO

Aim: We assessed the prognostic value of neutrophil-to-lymphocyte ratio (NLR) for all-cause mortality in patients with hypertrophic cardiomyopathy (HCM). Methods & results: A total of 354 HCM patients were enrolled. There were 44 all-cause mortality in total. Patients in the third tertile of NLR had the highest all-cause mortality rate of 5.2 per 100 person-years. Patients in tertile 3 had a significantly higher risk of all-cause mortality with adjusted hazard ratio of 2.4 (95% CI: 1.0-5.4; p = 0.040) when compared with that of patients in tertile 1. No significant interactions between NLR and other variables were observed during subgroup analysis. Conclusion: NLR was an independent risk factor for all-cause mortality in HCM patients.

17.
Sci Rep ; 10(1): 17026, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046745

RESUMO

The myocardial contraction fraction (MCF: stroke volume to myocardial volume) is a novel volumetric measure of left ventricular myocardial shortening. The purpose of the present study was to assess whether MCF could predict adverse outcomes for HCM patients. A retrospective cohort study of 438 HCM patients was conducted. The primary and secondary endpoints were all-cause mortality and HCM-related mortality. The association between MCF and endpoints was analysed. During a follow-up period of 1738.2 person-year, 76 patients (17.2%) reached primary endpoint and 50 patients (65.8%) reached secondary endpoint. Both all-cause mortality rate and HCM-related mortality rate decreased across MCF tertiles (24.7% vs. 17.9% vs. 9.5%, P trend = 0.003 for all-cause mortality; 16.4% vs. 9.7% vs. 6.1%, P trend = 0.021 for HCM-related mortality). Patients in the third tertile had a significantly lower risk of developing adverse outcomes than patients in the first tertile: all-cause mortality (adjusted HR: 0.26, 95% CI: 0.12-0.56, P = 0.001), HCM-related mortality (adjusted HR: 0.17, 95% CI: 0.07-0.42, P < 0.001). At 1-, 3-, and 5-year of follow-up, areas under curve were 0.699, 0.643, 0.618 for all-cause mortality and 0.749, 0.661, 0.613 for HCM-related mortality (all P value < 0.001), respectively. In HCM patients, MCF could independently predict all-cause mortality and HCM-related mortality, which should be considered for overall risk assessment in clinical practice.


Assuntos
Cardiomiopatia Hipertrófica/mortalidade , Insuficiência Cardíaca/mortalidade , Ventrículos do Coração/fisiopatologia , Contração Miocárdica/fisiologia , Adulto , Idoso , Cardiomiopatia Hipertrófica/fisiopatologia , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
18.
Br J Hosp Med (Lond) ; 81(8): 1, 2020 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-32845758
19.
Drug Test Anal ; 12(8): 1054-1064, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32449841

RESUMO

According to the current Technical Document (TD) for erythropoietin (EPO), SAR-PAGE is the most commonly applied method for both screening and confirmation procedures. Although this method is effective and robust, it lacks an internal standard (IS) to monitor the efficiency of analysis for each sample covering every step of the whole procedure, including preparation, immunopurification, and western blotting. This internal standard needs to be recognized by both anti-EPO antibodies used for immunopurification and western blotting, respectively. Besides that, the band of IS could not be allowed to interfere with the recognition of all types of targeted EPO and analogs. To meet these two principles, rat EPO was selected. In this study, rat EPO was used to spike both urine and blood samples at the beginning of analysis. After preparation and immunopurification, single blotting was performed with biotinylated AE7A5 as the primary antibody, followed by incubation with streptavidin-coupled HRP. Based on the comparison of different immunopurification methods, the AB-286-NA antibody coupled to M-280 magnetic beads was the better choice for urine samples, whereas the MAIIA column was suitable for blood samples. All these methods were validated for selectivity, repeatability, and sensitivity. The modified method in this study could not only eliminate the cross-reactivity between antibodies but also monitor the whole procedure of the analysis of EPO with spiked rat EPO. Besides that, rat EPO could also be used as an indicator for monitoring the presence of protease(s) in urine samples.


Assuntos
Doping nos Esportes/prevenção & controle , Eletroforese em Gel de Poliacrilamida/métodos , Eritropoetina/análise , Detecção do Abuso de Substâncias/métodos , Animais , Anticorpos/imunologia , Biotinilação , Western Blotting , Eritropoetina/sangue , Eritropoetina/urina , Feminino , Humanos , Masculino , Ratos , Reprodutibilidade dos Testes
20.
Coron Artery Dis ; 31(8): 722-732, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32310846

RESUMO

Platelets with high hemostatic activity play a key role during percutaneous coronary interventions (PCI), and in recent years, mean platelet volume (MPV) has been looked upon as a crucial indicator of platelet reactivity. Thus, MPV may emerge as a potential gauge for the measurement of major adverse cardiac event (MACE) risks in PCI patients. This study aimed to conduct a meta-analysis illustrating the association between MPV and long-term MACE in PCI. The Cochrane Library, Pubmed, EMBASE, Ovid MEDLINE, and BIOSIS databases were used to search for relevant studies from their inception to 30 June 2019. All studies reporting incidences of MACE and MPV in PCI patients were retained. Data extraction was performed by three independent reviewers. A total of 33 studies were included in this meta-analysis. The results indicated that patients with MACE had a significantly larger MPV than those without, with an unstandardized mean difference (USMD) of 0.29 fL (95% CI, 0.04-0.54). The USMD of MPV in deceased patients was 0.39 fL (95% CI, 0.09-0.68). The results also indicated that patients with larger MPV were at greater risks of having MACE and higher incidence of mortality than those with smaller MPV, with a pooled risk ratio of 1.81 (95% CI, 1.29-2.55) and 2.34 (95% CI, 1.52-3.60), respectively. These findings indicate a significant association between larger MPV and MACE in PCI patients. Consequently, MPV, an easily accessible indicator, might be helpful in PCI patients' risk assessment and stratification.

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