Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the m...Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the mortality among octogenarians was as high as 29%regardless of the type of intervention and that re-vascularization was associated with high peripro-cedural mortality.[2]A previous study had already shown that reconstructive surgery for elderly indi-viduals over 80 years old resulted in a significantly higher mortality rate than that for patients between 70 and 80 years old,whereas endovascular inter-vention and primarily conservative treatment had comparable prognoses.[3]Consistently,another study showed that the risks of both overall and am-putation-free survival were significantly lower with endovascular treatment than with bypass surgery in patients with critical limb ischemia.[4]A systematic review and meta-analysis of 27 studies(15 cohort and 12 randomized controlled trials)with 1642 pa-tients suggests that conservative treatment may be considered for nonreconstructable patients with critical limb ischemia;[5]however,because a high risk of bias and serious inconsistencies were found in the included studies,the meta-analysis provided low-quality evidence.In contrast,a small cohort study with 49 patients suggests that amputation im-proved quality of life and health status in fragile elderly individuals.展开更多
Background： Serum soluble ST2 （sST2） levels are elevated early after acute myocardial infarction and are related to adverse left ventricular （LV） remodeling and cardiovascular outcomes in ST-segment elevation myo...Background： Serum soluble ST2 （sST2） levels are elevated early after acute myocardial infarction and are related to adverse left ventricular （LV） remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction （STEMI）. Beta-blockers （BB） have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown. Methods： A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015. All patients received standard treatment and were followed up for 1 year. Serum sST2 was measured at baseline. Patients were divided into four groups according to their baseline sST2 values （high 〉56 ng/ml vs. low ≤56 ng/ml） and final therapeutic BB dose （high ≥47.5 mg/d vs. low 〈47.5 mg/d）. Cox regression analyses were performed to determine whether sST2 and BB were independent risk factors for cardiovascular events in STEMI. Results： Baseline sST2 levels were positively correlated with heart rate （r = 0.327, P = 0.002）, Killip class （r = 0.408, P = 0.000）, lg N-terminal prohormone B-type natriuretic peptide （r = 0.467, P = 0.000）, lg troponin I （r = 0.331, P = 0.000）, and lg C-reactive protein （r = 0.307, P = 0.000） and negatively correlated to systolic blood pressure （r = ？0.243, P = 0.009） and LV ejection fraction （r = ？0.402, P = 0.000）. Patients with higher baseline sST2 concentrations who were not titrated to high-dose BB therapy （P 〈 0.0001） had worse outcomes. Baseline high sST2 （hazard ratio [HR]： 2.653; 95% confidence interval [CI]： 1.201–8.929; P = 0.041） and final low BB dosage （HR： 1.904; 95% CI, 1.084–3.053; P = 0.035） were independent predictors of cardiovascular events in STEMI. Conclusions： High baseline sST2 levels and final low BB dosage predicted cardiovascular events in STEMI. Hence, sST2 may be a useful biomarker in cardiac pathophysiology.展开更多
The double-threshold method has been widely used in ultrasonic flow measurement to determine time-of-flight(TOF)due to its low cost and ease of implementation.Performance of this method is negatively affected by the c...The double-threshold method has been widely used in ultrasonic flow measurement to determine time-of-flight(TOF)due to its low cost and ease of implementation.Performance of this method is negatively affected by the cycle-skip phenomenon which occurs frequently under inconstant working conditions,especially varied fluid temperature.This paper proposes a method to suppress the phenomenon to facilitate reliable determination of TOF in ultrasonic flow measurement.First,the double-threshold method is used to generate a feature point to segment the signal.Second,based on the correlation coefficient and signal power,judgement factors of individual signal periods are calculated to determine signal onset.Finally,a valid zero crossing which has a constant lag from the onset is selected to determine the TOF.Thus,the cycle-skip phenomenon is suppressed.Two additional modifications are proposed to eliminate the influence of varied signal frequency and low sampling rate.The proposed method was validated by an experiment based on an ultrasonic water flow sensor.Results showed that the frequently appearing cycle-skip phenomenon can be successfully suppressed by the proposed method.展开更多
To the Editor： Junctional ectopic tachycardia is uncommon; however, it is one of the most serious incessant supraventricular tachycardia. This tachyarrhythmia has a high association with tachycardia-induced cardiomyo...To the Editor： Junctional ectopic tachycardia is uncommon; however, it is one of the most serious incessant supraventricular tachycardia. This tachyarrhythmia has a high association with tachycardia-induced cardiomyopathy or myocardial depressant.展开更多
文摘Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the mortality among octogenarians was as high as 29%regardless of the type of intervention and that re-vascularization was associated with high peripro-cedural mortality.[2]A previous study had already shown that reconstructive surgery for elderly indi-viduals over 80 years old resulted in a significantly higher mortality rate than that for patients between 70 and 80 years old,whereas endovascular inter-vention and primarily conservative treatment had comparable prognoses.[3]Consistently,another study showed that the risks of both overall and am-putation-free survival were significantly lower with endovascular treatment than with bypass surgery in patients with critical limb ischemia.[4]A systematic review and meta-analysis of 27 studies(15 cohort and 12 randomized controlled trials)with 1642 pa-tients suggests that conservative treatment may be considered for nonreconstructable patients with critical limb ischemia;[5]however,because a high risk of bias and serious inconsistencies were found in the included studies,the meta-analysis provided low-quality evidence.In contrast,a small cohort study with 49 patients suggests that amputation im-proved quality of life and health status in fragile elderly individuals.
文摘Background： Serum soluble ST2 （sST2） levels are elevated early after acute myocardial infarction and are related to adverse left ventricular （LV） remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction （STEMI）. Beta-blockers （BB） have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown. Methods： A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015. All patients received standard treatment and were followed up for 1 year. Serum sST2 was measured at baseline. Patients were divided into four groups according to their baseline sST2 values （high 〉56 ng/ml vs. low ≤56 ng/ml） and final therapeutic BB dose （high ≥47.5 mg/d vs. low 〈47.5 mg/d）. Cox regression analyses were performed to determine whether sST2 and BB were independent risk factors for cardiovascular events in STEMI. Results： Baseline sST2 levels were positively correlated with heart rate （r = 0.327, P = 0.002）, Killip class （r = 0.408, P = 0.000）, lg N-terminal prohormone B-type natriuretic peptide （r = 0.467, P = 0.000）, lg troponin I （r = 0.331, P = 0.000）, and lg C-reactive protein （r = 0.307, P = 0.000） and negatively correlated to systolic blood pressure （r = ？0.243, P = 0.009） and LV ejection fraction （r = ？0.402, P = 0.000）. Patients with higher baseline sST2 concentrations who were not titrated to high-dose BB therapy （P 〈 0.0001） had worse outcomes. Baseline high sST2 （hazard ratio [HR]： 2.653; 95% confidence interval [CI]： 1.201–8.929; P = 0.041） and final low BB dosage （HR： 1.904; 95% CI, 1.084–3.053; P = 0.035） were independent predictors of cardiovascular events in STEMI. Conclusions： High baseline sST2 levels and final low BB dosage predicted cardiovascular events in STEMI. Hence, sST2 may be a useful biomarker in cardiac pathophysiology.
基金Project supported by the Science Fund for Creative Research Groups of National Natural Science Foundation of China(No.51821093)。
文摘The double-threshold method has been widely used in ultrasonic flow measurement to determine time-of-flight(TOF)due to its low cost and ease of implementation.Performance of this method is negatively affected by the cycle-skip phenomenon which occurs frequently under inconstant working conditions,especially varied fluid temperature.This paper proposes a method to suppress the phenomenon to facilitate reliable determination of TOF in ultrasonic flow measurement.First,the double-threshold method is used to generate a feature point to segment the signal.Second,based on the correlation coefficient and signal power,judgement factors of individual signal periods are calculated to determine signal onset.Finally,a valid zero crossing which has a constant lag from the onset is selected to determine the TOF.Thus,the cycle-skip phenomenon is suppressed.Two additional modifications are proposed to eliminate the influence of varied signal frequency and low sampling rate.The proposed method was validated by an experiment based on an ultrasonic water flow sensor.Results showed that the frequently appearing cycle-skip phenomenon can be successfully suppressed by the proposed method.
文摘To the Editor： Junctional ectopic tachycardia is uncommon; however, it is one of the most serious incessant supraventricular tachycardia. This tachyarrhythmia has a high association with tachycardia-induced cardiomyopathy or myocardial depressant.
