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1.
Sleep Breath ; 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31473914

RESUMO

PURPOSE: Obstructive sleep apnea syndrome (OSAS) was suggested to exert an effect on renal function. However, the specific mechanism was still unknown. We try to find the association among OSAS, adiponectin, and cystatin C and the effect of adiponectin on renal function in OSAS patients. METHODS: Seventeen healthy men and seventy-three men which only had OSAS were included in the end. Apnea-hypopnea index (AHI), oxygen desaturation index (ODI), the percentage of total sleep time spent with SpO2 < 90% (T90%), lowest O2 saturation (LaSO2), Epworth Sleepiness Scale (ESS) score, serum adiponectin, and high-sensitive C-reactive protein (hsCRP) were detected in all subjects, and renal function was evaluated with creatinine, cystatin C, and estimated glomerular filtration rate (eGFR). RESULTS: Demographic data, creatinine, and eGFR did not differ among the studied groups. Decreased serum adiponectin levels were associated with severe OSAS. OSAS patients had a higher hsCRP and cystatin C than those without OSAS. Serum adiponectin levels had a negative association with cystatin C. After adjusted for confounders, adiponectin, hsCRP, and ODI had a significant prediction on the cystatin C (ß = - 0.218, p = 0.011; ß = 0.226, p = 0.037; and ß = 0.231, p = 0.029). CONCLUSIONS: Decreased serum adiponectin was associated with increased cystatin C in male OSAS patients. These results suggest that serum adiponectin might be a regulatory factor for renal function in OSAS.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31486262

RESUMO

Supramolecular ensembles adopting ring-in-ring structures are less developed compared with catenanes featuring interlocked rings. While catenanes with inter-ring closed-shell metallophilic interactions, such as d¹°-d¹° Au(I)-Au(I), have been well-documented, the ring-in-ring complexes featuring such metallophilic interactions remain underdeveloped. Herein is described an unprecedented ring-in-ring structure of Au(I)-thiolate Au12 cluster formed by recrystallization of a Au(I)-thiolate Au10 [2]catenane from alkane solvents such as hexane, with use of a bulky dibutyl-fluorene-2-thiolate ligand. The ring-in-ring Au(I)-thiolate Au12 cluster features inter-ring Au(I)-Au(I) interactions and underwent cluster core change to form the thermodynamically more stable Au10 [2]catenane structure upon dissolving in, or recrystallization from, other solvents such as CH2Cl2, CHCl3, and CH2Cl2/MeCN. Both the ring-in-ring and [2]catenane structures have been characterized by NMR spectroscopy, ESI-MS spectrometry, elemental analysis, and  X-ray crystal structure determination. The cluster-to-cluster transformation process in solution was monitored by ¹H NMR and ESI-MS measurements. Density functional theory (DFT) calculations were performed to provide insight into the mechanism of the 'ring-in-ring <--> [2]catenane' interconversions, which could be rationalized by considering various interactions including ligand-ligand and metal-ligand dispersive interaction as well as metallophilic interaction.

3.
Org Lett ; 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31478381

RESUMO

An efficient and convenient cobalt-catalyzed ortho-C(sp2)-H amidation of benzaldehydes employing dioxazolones as the aminating reagent has been developed. The key feature of this protocol is the use of green and economic earth-abundant metals cobalt as the catalyst with the p-chloroaniline as the transient directing group. Further application of our approach was demonstrated by the synthesis of C1r serine protease inhibitor 45 and elastase inhibitor 49.

4.
Methods ; 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31442560

RESUMO

Chromosome Conformation Capture (3C)-based technologies, such as Hi-C, have represented a significant breakthrough in investigating the structure and function of higher-order genome architecture. However, the mapping of global chromatin interactions remains challenging across many biological conditions due to high background noise and financial constraints, especially for small laboratories. Here, we describe the Bridge linker-Alul-Tn5 Hi-C (BAT Hi-C) method, which is a simple and efficient method for delineating chromatin conformational features of mouse embryonic stem (mES) cells and uncover DNA loops. This protocol combines Alul fragmentation and biotinylated linker-mediated proximity ligation to obtain kilobase (kb) resolution with a marked increase in the amount of unique read pairs. The protocol also includes chromatin isolation to reduce background noise and Tn5 tagmentation to cut down on preparation time. Importantly, with only one-fourth sequencing depth, our method revealed the same spectrum of chromatin contacts as in situ Hi-C. BAT Hi-C is an economical (i.e., less than $33 for library preparation) and straightforward (total hands-on time of 3 days) tool that is ideal for the in-depth analysis of long-range chromatin looping events in a genome-wide fashion.

5.
Biomaterials ; 221: 119419, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31421315

RESUMO

An unpredicted side effect of photothermal therapy (PTT) is agitated by hyperthermia which results in damage to healthy tissue. Developing PTT platforms, enabling effective tumor ablation under mild irradiation conditions, is of wide interest, but challenging. Here, we investigated bismuth crystals embedded silica (Bi@SiO2) nanoparticles, loaded with an autophagy inhibitor (chloroquine, CQ). It was found that SiO2 effectively prevented the oxidization of Bi nanocrystals in the physiological environment and could serve as a scatter layer to improve NIR absorption, enabling a high photothermal conversion efficiency (~43%) and excellent photostability. Furthermore, the findings indicated that CQ molecules, delivered intracellularly by the particles, significantly weakened the degradation of autolysosomes by lysosome within the tumor cells, thus inducing suppression effect to autophagy and resistance to photothermia. Both in vitro and in vivo anti-tumor effects were consequently promoted owing to the combined effects enabled by Bi@SiO2-CQ nanoparticles under mild NIR irradiation conditions. This study demonstrates a potential new PTT platform with superior therapeutic efficacy.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31428896

RESUMO

Liver dysfunction is associated with adverse events in infective endocarditis (IE). However, few studies have explored the predictive value of conjugated bilirubin (CB) in IE. We aimed to investigate the nature of the link between CB and adverse prognosis in patients with IE. Consecutive patients with IE between January 2009 and July 2015 were enrolled. Multivariate analysis was performed to confirm whether CB was an independent risk factor for adverse outcomes. In all, 1010 patients were included and divided into two groups according to admission CB level (µmol/L): normal (≤ 7.0, n = 820) and elevated (> 7.0, n = 190) CB groups. In-hospital mortality (5.0% vs. 22.1%, p < 0.001) and major adverse cardiac events (16.8% vs. 36.3%, p < 0.001) were significantly higher in patients with increased CB. A possible J-shaped relationship was found between CB and in-hospital events. Further, CB had more predictive power than total bilirubin in predicting in-hospital death (AUC 0.715 vs. 0.674, p = 0.010). Elevated CB was an independent predictor of in-hospital death (adjusted OR = 2.62, 95%CI 1.40-4.91, p = 0.003). Moreover, CB (increment 1 µmol/L) was independently associated with higher long-term mortality. Kaplan-Meier curves indicated that patients with elevated CB were associated with higher cumulative rate of long-term death (log-rank = 21.47, p < 0.001). CB, a biomarker of liver function, was a relatively powerful predictor of in-hospital and long-term adverse prognosis of IE and could likely comprise a novel risk evaluation strategy.

7.
Org Biomol Chem ; 17(34): 7854-7857, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31408075

RESUMO

A copper-catalyzed DTBP oxidative dual C-H sulfurization has been developed for the direct thiocarbamation of imidazopyridines using a combination of elemental sulfur and formamides as carbamothioyl surrogates. NBS (bromo succinimide) was found to promote the thiocarbamation in good yields. This dual C-H sulfurization strategy enables access to a wide range of carbamothioyl imidazoheterocycles without the use of highly toxic phosgene.

8.
J Invertebr Pathol ; 166: 107231, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31425685

RESUMO

Virus-like particles (VLPs) are potential containers for delivery of therapeutic agents at the nanoscale. In this study, the capsid protein of Infectious hypodermal and hematopoietic necrosis virus (IHHNV) was expressed in a baculovirus insect cell system. The 37-kDa recombinant protein containing the hexahistidine residues (His Tag) at N-terminal was purified using immobilized metal affinity chromatography (IMAC) and assembled into VLPs with a diameter of 23 ±â€¯3 nm analyzed by transmission electron microscopy. We also verified that disassembly/reassembly of IHHNV-VLPs was controlled in the presence and absence of DTT. The efficiency of IHHNV-VLPs to encapsulate plasmid DNA was about 48.2%, and the VLPs encapsulating the pcDNA3.1(+)-EGFP plasmid DNA could recognize the primary shrimp hemocytes and deliver the loaded plasmid into cells by detection of expressed enhanced green fluorescent protein (EGFP). These results implied that the IHHNV-VLPs might be a good candidate for packaging and delivery of expressible plasmid DNA, and may produce an antiviral product in shrimp cells for gene therapy.

9.
Biotechnol Lett ; 41(10): 1105-1110, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407133

RESUMO

Atomic force microscopy (AFM) is a sophisticated imaging tool with nanoscale resolution that is widely used in structural biology, cell biology, and material science, among other fields. However, to date it has rarely been applied to the study of aquatic animals, especially on one of the main cultured species, shrimp. One reason for this is that no shrimp cell line established until now, primary cell is fragile and difficult to be studied under AFM. In this study, we used AFM to image three different types of biological material from shrimp (Litopenaeus vannamei) in air, including hemocytes and two associated pathogens. Without obvious deformations when the cells were imaged in air and in the case for the haemocytes and the cells were fixed as well. The result suggests hydrophobic glass coverslips are a suitable substrate for adhesion of these samples. The method described here can be applied to the preparation of other fragile biological samples from aquatic animals for high-resolution analyses of host-pathogen interactions and other basic physiological processes.

10.
Med Care ; 57(10): 809-814, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31415340

RESUMO

BACKGROUND: Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditions. OBJECTIVE: In a patient-centered research study, we examined how using portal tools affects patient health care experiences among patients with chronic conditions. We also examined barriers among nonportal users. RESEARCH DESIGN: A cross-sectional patient survey. SUBJECTS: Patients with a chronic condition in an integrated delivery system offering a patient portal. MEASURES: Respondents reported barriers, preferences, and experiences in using the patient portal, and whether using the portal changed their overall health. RESULTS: Among all the 1824 respondents (70% response rate), portal nonusers reported preferring in-person health care (54%) or experiencing internet access barriers (41%). Portal users reported that using the portal was convenient (90%), the information available was useful (92%), and that it integrated well with other health care (92%). Among users, 31% reported that using the portal had improved their overall health. After adjustment, patients were significantly more likely to report that portal use improved their health if they had also reported convenience, information usefulness, or integration with other care (P<0.05). Reassuringly, patient-reported impacts on overall health did not vary by patient characteristics (including age, race, sex, education, income, complex conditions). CONCLUSION: Patients with chronic conditions using the portal reported convenience, information usefulness, and integration of the patient portal with their health care; these may act as potential pathways improving health.

11.
J Microbiol ; 57(9): 759-768, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31376108

RESUMO

The cultivation of microbial species remains a primary challenge in microbiology and obtaining pure cultures is essential for the study of microbial physiology and function. When isolating microorganisms from aquaculture environments, Vibrio are the most dominate isolates on the media that are commonly used. In order to expand our ability to study microbial species, an easy-operation and low-cost medium that can reduce the interference of Vibrio strains and increase the cultivability of other bacteria is urgently needed. We compared viable cell counts on conventional media (CM; including Marine Agar 2216 and LB media) and diluted media (DM; including 1/10-Marine Agar 2216, 1/10-LB). We also assessed the diversity of cultivable microorganisms under high and low nutrient conditions by a plate-wash strategy coupled with high-throughput sequencing of the V4 hypervariable region of the 16S rRNA gene. The results show that microbial communities from DM, especially 1/10-Marine Agar 2216, are more diverse than those obtained from CM. Vibrio isolates were reduced on DM. PICRUSt analysis revealed that nutrient composition is a significant contributor to the diversity and function of the cultivable microbial communities. Bacteria grown on CM possess more pathogenic characteristics, whereas DM favors the growth of bacteria that have multiple metabolic functions. Collectively, our data provide strong evidence that dilution of CM influences the cultivability of bacteria from aquaculture seawater. It also supports that DM can expand the range of microbial species that can be cultivated. This study also provides insights for media design in microbial cultivation from aquaculture systems.


Assuntos
Meios de Cultura/metabolismo , Água do Mar/microbiologia , Vibrio/crescimento & desenvolvimento , Bactérias/classificação , Bactérias/genética , Bactérias/crescimento & desenvolvimento , Bactérias/isolamento & purificação , Meios de Cultura/química , DNA Bacteriano/genética , Filogenia , RNA Ribossômico 16S/genética , Vibrio/genética , Vibrio/isolamento & purificação , Vibrio/metabolismo
12.
Artigo em Inglês | MEDLINE | ID: mdl-31392390

RESUMO

PURPOSE: Erlotinib (Tarceva®), a potent small molecule inhibitor of the epidermal growth factor receptor tyrosine kinase, has been evaluated to treat infants and children with primary brain tumors. The pharmacokinetics of erlotinib and its primary metabolite OSI-420 were characterized and exposure-safety associations were investigated. METHODS: This analysis involved patients enrolled in two clinical studies and receiving oral erlotinib once daily as part of treatment. Single-dose and steady-state erlotinib and OSI-420 plasma concentrations were assayed using HPLC-MS/MS methods. Population pharmacokinetic modeling and univariate covariate analysis evaluating demographic, clinical and selected CYP3A5, CYP3A4, ABCB1, and ABCG2 genotypes were performed. Associations between erlotinib and OSI-420 pharmacokinetics, and with toxicities (diarrhea and skin rash) occurring post-dose were explored. RESULTS: Data from 47 patients (0.7-19 years old) were collected and best fitted by one-compartment linear models. Erlotinib and OSI-420 apparent clearances (CL/F and CLm/Fm) were higher in patients < 5 years compared to older patients (mean CL/F: 6.8 vs 3.6 L/h/m2, and mean CLm/Fm: 79 vs 38 L/h/m2, p < 0.001), and were 1.62-fold and 1.73-fold higher in males compared to females (p < 0.01). Moreover, CL/F was 1.53-fold higher in wild-type patients than in patients heterozygous or homozygous mutant for ABCG2 rs55930652 (p < 0.05). Most of the toxicities reported were grade 1. No associations were found between drug pharmacokinetics and drug-induced toxicities. CONCLUSIONS: Erlotinib therapy was well tolerated by pediatric patients with primary brain tumors. No dosing adjustments based on age or patient characteristics are recommended for this patient population.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31392828

RESUMO

BACKGROUND: Postsurgical evaluation of sinus floor elevation regularly involves linear measurements of the elevated volumes in the cone beam computed tomography (CBCT) images. The accuracy of measurements could be compromised due to ill-defined sinus floor outline if implants are placed simultaneously. PURPOSE: The aim was to examine a CBCT superimposition method to improve the measurement accuracy. MATERIALS AND METHODS: Twenty patients who received transalveolar sinus floor elevation with immediate implantation were enrolled. CBCTs before and after surgery were transformed into digital imaging and communications in medicine format and imported into the Dolphin Imaging software. Voxel-based superimposition was automated to merge the files. In the superimposed image, parameters including alveolar bone height, protruded implant length, and total elevated height were measured. The superimposition and measurements were performed independently by two examiners and in two timepoints with 1-week time interval. We used intraclass correlation coefficient (ICC) to analyze the interexaminer and intraexaminer agreements. RESULTS: Of measured parameters, the mean of difference between two timepoints ranged from 0.18 to 0.26 mm by examiner 1, and from 0.16 to 0.20 mm by examiner 2. ICCs were equal or greater than 0.98, indicating perfect intraexaminer agreement. For interexaminer reliability, the largest mean of difference was 0.27 mm in measuring alveolar bone height between two examiners. ICCs were greater than 0.98, showing perfect interexaminer agreement. CONCLUSIONS: The voxel-based superimposition of pre- and post-surgical CBCT images with Dolphin Imaging is an effective and reliable way for linear measurements so as to assess the surgical outcome. There is minimal effect on reproducibility of measured data by different timepoints or performers.

14.
Br J Clin Pharmacol ; 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31396983

RESUMO

AIMS: Type 2 diabetes mellitus (T2DM) is commonly complicated by renal impairment. Polyethylene glycol loxenatide (PEX168) is a novel long-acting glucagon-like peptide-1 receptor agonist for T2DM. PEX168 pharmacokinetics (PK) was studied to identify requirements for dose-modification in T2DM complicated by renal impairment. METHODS: This was a single-center, open-labeled, parallel-group, single-dose, phase I clinical trial of patients with mild and moderate renal impairment, and with or without T2DM. Age-, sex-, and body mass index (BMI)-matched subjects with normal renal function, and with or without T2DM were recruited as controls. Subjects received a single abdominal subcutaneous injection of PEX168 200 µg. Pharmacokinetic samples were taken at 0, 24, 48, 72, 96, 120, 144, 216, 312, 480, 648, and 720 h. RESULTS: Twenty-three patients were included in the pharmacokinetics analysis. Vz/F and CL/F were lower in the moderate impairment group than in the other groups. The mean t1/2 (163 h) in the moderate impairment group was prolonged compared to the mild impairment (117 h) and normal (121 h) groups. AUC0-inf increased by 13% and 100.7% in patients with mild and moderate renal impairment. Most adverse events were mild gastrointestinal disorders, with only one serious adverse event observed. CONCLUSION: A single dose of 200 µg of PEX168 was in general well tolerated in patients with renal impairment. The in vivo clearance rate of PEX168 in patients with moderate renal impairment is slower than in patients with mild renal impairment and normal renal function and dose adjustment might be required (ClinicalTrials.org #NCT02467790).

15.
Aging (Albany NY) ; 11(14): 5008-5034, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31314744

RESUMO

Parkinson's disease (PD) is a common neurodegenerative disease, featured by motor deficits and non-motor symptoms such as cognitive impairment, and malfunction of gamma-aminobutyric acid (GABA) mediated inhibitory transmission plays an important role in PD pathogenesis. The ginsenoside Rb1 molecule, a major constituent of the extract from the Ginseng root, has been demonstrated to ameliorate motor deficits and prevent dopaminergic neuron death in PD. However, whether Rb1 can regulate GABAergic transmission in PD-associated deficits and its underlying mechanisms are still unclear. In this study, we explored the effects of Rb1 on the GABAergic synaptic transmission in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. We demonstrated that Rb1 can bind with GABAARα1 and increase its expression in the SH-SY5Y cells and in the prefrontal cortex (PFC) of MPTP model in vitro and in vivo. Furthermore, Rb1 can promote prefrontal cortical GABA level and GABAergic transmission in MPTP-treated mice. We also revealed that Rb1 may suppress presynaptic GABABR1 to enhance GABA release and GABAA receptor-mediated inhibitory transmission. In addition, Rb1 attenuated MPTP-induced dysfunctional gait dynamic and cognitive impairment, and this neuroprotective mechanism possibly involved regulating prefrontal cortical GABAergic transmission. Thus, Rb1 may serve as a potential drug candidate for the treatment of PD.

16.
J Plant Physiol ; 240: 153003, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279219

RESUMO

Phosphorus (P) deficiency limits rice production. Increasing the remobilization of P stored in the root cell wall is an efficient way to alleviate P starvation in rice. In the current study, we found that the addition of 50 µM H2O2 significantly increased soluble P content in rice. H2O2 stimulated pectin biosynthesis and increased pectin methylesterase (PME) activity, thus stimulating the release of P from the cell wall in roots. H2O2 also regulates internal P homeostasis by increasing the expression of P transporter genes OsPT2, OsPT6, and OsPT8 at different treatment times. In addition, the H2O2 treatment increased the expression of nitrate reductase (NR) genes OsNIA1 and OsNIA2 and the activity of NR, then increased the accumulation of nitric oxide (NO) in the rice root. The application of the NO donor sodium nitroprusside (SNP) and the H2O2 scavenger 4-hydroxy-TEMPO significantly increased soluble P content by increasing pectin levels and PME activity to enhance the remobilization of P from the cell wall. However, the addition of NO scavenger 2-(4-carboxyphenyl)-4, 4, 5, 5-tetramethylimidazoline-1-oxyl-3-oxide (c-PTIO) with and without H2O2 had the opposite effect, suggesting that NO functions downstream of H2O2 to increase the remobilization of cell wall P in rice.

17.
Chem Commun (Camb) ; 55(62): 9104-9107, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31298232

RESUMO

We have developed a photoluminescent membrane for microRNA detection, consisting of chemically modified mesoporous silica nanoparticles (CaF2:Yb/Ho@MSNs) attached, via single stranded DNA probes, to flexible polyurethane fibres coated with graphene oxide (GO). By detecting the release of the luminescent nanoparticles resulting from complementary co-hybridization between target miRNA sequences and the DNA probe, accurate measurements of the miRNA concentration at high sensitivity levels can be obtained. The constructs therefore offer a route to rapid detection and the potential for early cancer diagnosis.


Assuntos
Técnicas Biossensoriais , Grafite/química , MicroRNAs/análise , Nanopartículas/química , Dióxido de Silício/química , Tamanho da Partícula , Porosidade , Propriedades de Superfície
18.
Sci China Life Sci ; 62(8): 1058-1069, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31290096

RESUMO

As the ecologically important recipient channels for riverine ecosystems, tributaries provide unique microhabitats for microorganisms, among which zooplankton constitutes the most important heterotrophic organisms. In particular, the reduced water velocity caused by dams is more favorable for zooplankton development; therefore, dammed rivers are expected to support extremely diverse and abundant zooplankton communities and notably different spatiotemporal distribution patterns. So far, however, only very few molecular studies support these assumptions. Using high-throughput sequencing, a high number of 350 operational taxonomic units (OTUs; 97% cutoff) were retrieved from 30 samples collected in the Xiangxi River, the nearest large tributary upstream of the Three Gorges Dam. Zooplankton did not show significant spatial distribution in the channel. Instead, the community structures varied significantly over sampling dates, corroborating the seasonal patterns found in lakes and ponds in the subtropical zone. As expected, the community compositions were deterministically governed by environmental filtering processes (phylogenetic clustering), in which water velocity appeared to be much less important than other investigated environmental factors. Moreover, most of the detected phylotypes (OTUs) had a relatively high (>90%) sequence similarity to previously deposited sequences, suggesting a mediocre degree of genetic novelty within the zooplankton communities in the Xiangxi River.

19.
Chemistry ; 25(46): 10828-10833, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31271674

RESUMO

Ruthenium(II) complexes bearing a tridentate bis(N-heterocyclic carbene) ligand reacted with iminoiodanes (PhI=NR) resulting in the formation of isolable ruthenium(III)-amido intermediates, which underwent cleavage of a C-N bond of the tridentate ligand and formation of an N-substituted imine group. The RuIII -amido intermediates have been characterized by 1 H NMR, UV/Vis, ESI-MS, and X-ray crystallography. DFT calculations were performed to provide insight into the reaction mechanism.

20.
QJM ; 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31359051

RESUMO

BACKGROUND: Older age, renal dysfunction and low left ventricular ejection fraction are accepted predictors of poor outcome in patients with infective endocarditis (IE). This study aimed to investigate the prognostic significance of the age, creatinine and ejection fraction (ACEF) score in IE. METHODS: The study involved 1,019 IE patients, who were classified into three groups according to the tertiles of ACEF score: low ACEF (<0.6, n = 379), medium ACEF (0.6 to 0.8, n = 259) and high ACEF (>0.8, n = 381). The ACEF score was calculated as follows: age (years)/ejection fraction (%)+1 (if serum creatinine value was >2 mg/dL). The association between ACEF score with adverse events was analyzed. RESULTS: In-hospital mortality was 8.2%, which increased with the ACEF score (4.2% vs. 5.0% vs. 14.4% for the low-, medium- and high-ACEF groups, respectively; p < 0.001). ACEF score had a good discriminative ability for predicting in-hospital death (AUC, 0.706, p < 0.001). The predictive value of ACEF score in surgical treatment was significantly higher than in conservative treatment for predicting in-hospital death (AUC, 0.812 vs. 0.625; p = 0.001). Multivariable analysis revealed that ACEF score was independently associated with in-hospital mortality (adjusted odds ratio, 2.82; p < 0.001) and long-term mortality (adjusted hazard ratio, 2.51; p < 0.001). CONCLUSION: ACEF was an independent predictor for in-hospital and long-term mortality in IE patients, and it could be considered as a useful tool for risk stratification. ACEF score was more suitable for surgical patients in terms of assessing the risk of in-hospital mortality.

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