BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 pati...BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.展开更多
NiMo-based nanostructures are among the most active hydrogen evolution reaction(HER)catalysts under an alkaline environment due to their strong water dissociation ability.However,these nanostructures are vulnerable to...NiMo-based nanostructures are among the most active hydrogen evolution reaction(HER)catalysts under an alkaline environment due to their strong water dissociation ability.However,these nanostructures are vulnerable to the destructive effects of H_(2) production,especially at industry-standard current densities.Therefore,developing a strategy to improve their mechanical strength while maintaining or even further increasing the activity of these nanocatalysts is of great interest to both the research and industrial communities.Here,a hierarchical interconnected NiMoN(HW-NiMoN-2h)with a nanorod-nanowire morphology was synthesized based on a rational combination of hydrothermal and water bath processes.HW-NiMoN-2h is found to exhibit excellent HER activity due to the accomodation of abundant active sites on its hierarchical morphology,in which nanowires con-nect free-standing nanorods,concurrently strengthening its structural stability to withstand H_(2) production at 1 A cm^(−2).Seawater is an attractive feedstock for water electrolysis since H_(2) generation and water desalination can be addressed simultaneously in a single process.The HER performance of HW-NiMoN-2h in alkaline seawater suggests that the presence of Na+ions interferes with the reation kinetics,thus lowering its activity slightly.However,benefiting from its hierarchical and interconnected characteristics,HW-NiMoN-2h is found to deliver outstanding HER activity of 1 A cm^(−2) at 130 mV overpotential and to exhibit excellent stability at 1 A cm^(−2) over 70 h in 1 M KOH seawater.展开更多
BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controv...BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controversial.The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension(CH)patients.METHODS PubMed,Embase,Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN.The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure(SBP)from baseline.We used the fixed effects model to calculate weighted mean difference(WMD)with 95%confidence interval(CI).RESULTS Six trials were included,with 1405 participants,including 597 patients with ISH and 808 patients with CH.Mean follow-up was five months.The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients(WMD=3.89,95%CI:2.32–5.45,P<0.0001).RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients(WMD=10.24,95%CI:4.24–15.74,P=0.0003).And the effect was independent of age,length of follow-up,and ablation device.CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients,and the CH patients may be the best suitable population for which RDN is indicated.展开更多
Ventricular arrhythmia(VA)is a life-threatening cardiac emergency.When VA occurs three times or more within 24 h and interventions are required,it is defined as an electrical storm(ES)characterized by refractoriness a...Ventricular arrhythmia(VA)is a life-threatening cardiac emergency.When VA occurs three times or more within 24 h and interventions are required,it is defined as an electrical storm(ES)characterized by refractoriness and recurrence.[1]For patients with implantable cardioverter defibrillator(ICD),the notion is redefined as no fewer than three appropriate and separate(at least 5 min for each interval)ICD interventions given within 24 h.展开更多
基金supported by the CAMS Central Public Welfare Scientific Research Institute Basal Research Expenses (No.2021-XCGC09-1&No.2022-I2M-C&T-B-045)the Beijing Municipal Science&Technology Commission (Z191100006619019)the High-level Hospital Clinical Scientific Research Business Fees (No.2022-GSP-QZ-4)
文摘BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.
基金Element Resources,LLC,and Shell through UHETI,funded part of this work
文摘NiMo-based nanostructures are among the most active hydrogen evolution reaction(HER)catalysts under an alkaline environment due to their strong water dissociation ability.However,these nanostructures are vulnerable to the destructive effects of H_(2) production,especially at industry-standard current densities.Therefore,developing a strategy to improve their mechanical strength while maintaining or even further increasing the activity of these nanocatalysts is of great interest to both the research and industrial communities.Here,a hierarchical interconnected NiMoN(HW-NiMoN-2h)with a nanorod-nanowire morphology was synthesized based on a rational combination of hydrothermal and water bath processes.HW-NiMoN-2h is found to exhibit excellent HER activity due to the accomodation of abundant active sites on its hierarchical morphology,in which nanowires con-nect free-standing nanorods,concurrently strengthening its structural stability to withstand H_(2) production at 1 A cm^(−2).Seawater is an attractive feedstock for water electrolysis since H_(2) generation and water desalination can be addressed simultaneously in a single process.The HER performance of HW-NiMoN-2h in alkaline seawater suggests that the presence of Na+ions interferes with the reation kinetics,thus lowering its activity slightly.However,benefiting from its hierarchical and interconnected characteristics,HW-NiMoN-2h is found to deliver outstanding HER activity of 1 A cm^(−2) at 130 mV overpotential and to exhibit excellent stability at 1 A cm^(−2) over 70 h in 1 M KOH seawater.
基金the National Natural Science Foundation of China(No.81970285).
文摘BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controversial.The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension(CH)patients.METHODS PubMed,Embase,Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN.The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure(SBP)from baseline.We used the fixed effects model to calculate weighted mean difference(WMD)with 95%confidence interval(CI).RESULTS Six trials were included,with 1405 participants,including 597 patients with ISH and 808 patients with CH.Mean follow-up was five months.The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients(WMD=3.89,95%CI:2.32–5.45,P<0.0001).RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients(WMD=10.24,95%CI:4.24–15.74,P=0.0003).And the effect was independent of age,length of follow-up,and ablation device.CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients,and the CH patients may be the best suitable population for which RDN is indicated.
基金supported by a grant (Z191100006619019) from the Capital Municipal Science and Technology Commissiona grant (2022-GSP-QZ-4) from the Chinese Academy of Medical Sciences Fuwai Hospital Top-level Hospital Clinical Scientific Research Funds
文摘Ventricular arrhythmia(VA)is a life-threatening cardiac emergency.When VA occurs three times or more within 24 h and interventions are required,it is defined as an electrical storm(ES)characterized by refractoriness and recurrence.[1]For patients with implantable cardioverter defibrillator(ICD),the notion is redefined as no fewer than three appropriate and separate(at least 5 min for each interval)ICD interventions given within 24 h.
