Objective: To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring.Methods: Data of 677 patients who had functional tricuspid regurgitation ...Objective: To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring.Methods: Data of 677 patients who had functional tricuspid regurgitation and left cardiac valve disease and underwent tricuspid valvuloplasty and left cardiac valve surgery were retrospectively.Among these patients, 353 underwent simple suture annuloplasty(group A) while the rest 324 patients underwent artificial plastic ring annuloplasty(group B).The two-year and more-than-two-year clinical and ultrasonocardiograph(UCG) follow-up data of the two groups were obtained and compared.Results: A total of 600 patients(88.6%) completed the long-term follow-up(more than two years).The two-year follow-up showed no significant difference in the incidence of mild tricuspid regurgitation between the two groups(82.2% vs.92.7%, P=0.37).However, there were significantly more cases that developed into moderate to severe tricuspid regurgitation in group A than in group B(17.8% vs.7.3%, P=0.031).The long-term follow-up revealed that the recurrence rate of tricuspid regurgitation in group B was significantly lower than that in group A(11.0% vs.25.0%, P=0.029), and the ratio of cases developing into moderate to severe tricuspid regurgitation in group A was significantly higher than that in group B(28.9% vs.9.9%, P=0.007).The comparison between the two intra-group time segments showed that the development of tricuspid regurgitation in group A was significantly increased(28.9% vs.17.8%, P=0.022), but in group B it was relatively stable(9.9% vs.7.3%, P=0.52).Conclusions: Artificial ring annuloplasty is associated with significantly less tricuspid regurgitation than simple suture annuloplasty.展开更多
Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventiona...Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods： The Measurement and Improvement Studies of Surgical Coronary Revascularization： Medication Adherence （MISSION-2） study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1 ： 1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage lnedication adherence in the intervention group through a health self management program initiated dnring hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac edticational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion： Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model tor outpatient health self-managenlent that could be translated to various chronic diseases and widely disseminated across resource-limited settings.展开更多
文摘Objective: To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring.Methods: Data of 677 patients who had functional tricuspid regurgitation and left cardiac valve disease and underwent tricuspid valvuloplasty and left cardiac valve surgery were retrospectively.Among these patients, 353 underwent simple suture annuloplasty(group A) while the rest 324 patients underwent artificial plastic ring annuloplasty(group B).The two-year and more-than-two-year clinical and ultrasonocardiograph(UCG) follow-up data of the two groups were obtained and compared.Results: A total of 600 patients(88.6%) completed the long-term follow-up(more than two years).The two-year follow-up showed no significant difference in the incidence of mild tricuspid regurgitation between the two groups(82.2% vs.92.7%, P=0.37).However, there were significantly more cases that developed into moderate to severe tricuspid regurgitation in group A than in group B(17.8% vs.7.3%, P=0.031).The long-term follow-up revealed that the recurrence rate of tricuspid regurgitation in group B was significantly lower than that in group A(11.0% vs.25.0%, P=0.029), and the ratio of cases developing into moderate to severe tricuspid regurgitation in group A was significantly higher than that in group B(28.9% vs.9.9%, P=0.007).The comparison between the two intra-group time segments showed that the development of tricuspid regurgitation in group A was significantly increased(28.9% vs.17.8%, P=0.022), but in group B it was relatively stable(9.9% vs.7.3%, P=0.52).Conclusions: Artificial ring annuloplasty is associated with significantly less tricuspid regurgitation than simple suture annuloplasty.
文摘Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods： The Measurement and Improvement Studies of Surgical Coronary Revascularization： Medication Adherence （MISSION-2） study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1 ： 1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage lnedication adherence in the intervention group through a health self management program initiated dnring hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac edticational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion： Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model tor outpatient health self-managenlent that could be translated to various chronic diseases and widely disseminated across resource-limited settings.
