AIM: To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG). METH...AIM: To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG). METHODS: This study was a retrospective analysis of consecutive patients referred for MPI during a 2-year period from 2006-2007 at one clinic. All eligible patients were suspected of suffering from CAD, and had performed a satisfactory bicycle exercise test (i.e. , peak heart rate > 85% of the expected, age-predicted maximum) within 6 mo of referral, their exercise ECG was had no signs of ischemia, there was no exercise-limiting angina, and no cardiac events occurred between the exercise test and referral. The patients subsequently underwent a standard 2-d, stress-rest exercise MPI. Ischemia was defined based on visual scoring supported by quantitative segmental analysis (i.e. , sum of stress score > 3). The results of cardiac catheterizationwere analyzed, and clinical follow up was performed by review of electronic medical files. RESULTS: A total of 56 patients fulfilled the eligibility criteria. Most patients had a low or intermediate ATPⅢ pretest risk of CAD (6 patients had a high pre-test risk). The referral exercise test showed a mean Duke score of 5 (range: 2 to 11), which translated to a low postexercise risk in 66% and intermediate risk in 34%. A total of seven patients were reported with ischemia by MPI. Three of these patients had high ATPⅢ pre-test risk scores. Six of these seven patients underwent cardiac catheterization, which showed significant stenosis in one patient with a high pre-test risk of CAD, and indeterminate lesions in three patients (two of whom had high pre-test risk scores). With MPI as a gate keeper for catheterization, no significant, epicardial stenosis was observed in any of the 50 patients (0%, 95% confidence interval 0.0 to 7.1) with low to intermediate pre-test risk of CAD and a negative exercise test. No cardiac events occurred in any patients within a median follow up period of > 1200 d. CONCLUSION: The added diagnostic value of MPI in patients with low or intermediate risk of CAD and a recent, normal exercise test is marginal.展开更多
The seismic performance of a self-centering precast reinforced concrete （RC） frame with shear walls was investigated in this paper. The lateral force resistance was provided by self-centering precast RC shear walls ...The seismic performance of a self-centering precast reinforced concrete （RC） frame with shear walls was investigated in this paper. The lateral force resistance was provided by self-centering precast RC shear walls （SPCW）, which utilize a combination ofunbonded prestressed post-tensioned （PT） tendons and mild steel reinforcing bars for flexural resistance across base joints. The structures concentrated deformations at the bottom joints and the unbonded PT tendons provided the self-centering restoring force. A 1/3-scale model of a five-story self-centering RC frame with shear walls was designed and tested on a shake-table under a series of bi-directional earthquake excitations with increasing intensity. The acceleration response, roof displacement, inter-story drifts, residual drifts, shear force ratios, hysteresis curves, and local behaviour of the test specimen were analysed and evaluated. The results demonstrated that seismic performance of the test specimen was satisfactory in the plane of the shear wall; however, the structure sustained inter-story drift levels up to 2.45%. Negligible residual drifts were recorded after all applied earthquake excitations. Based on the shake-table test results, it is feasible to apply and popularize a self-centering precast RC frame with shear walls as a structural system in seismic regions.展开更多
文摘AIM: To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG). METHODS: This study was a retrospective analysis of consecutive patients referred for MPI during a 2-year period from 2006-2007 at one clinic. All eligible patients were suspected of suffering from CAD, and had performed a satisfactory bicycle exercise test (i.e. , peak heart rate > 85% of the expected, age-predicted maximum) within 6 mo of referral, their exercise ECG was had no signs of ischemia, there was no exercise-limiting angina, and no cardiac events occurred between the exercise test and referral. The patients subsequently underwent a standard 2-d, stress-rest exercise MPI. Ischemia was defined based on visual scoring supported by quantitative segmental analysis (i.e. , sum of stress score > 3). The results of cardiac catheterizationwere analyzed, and clinical follow up was performed by review of electronic medical files. RESULTS: A total of 56 patients fulfilled the eligibility criteria. Most patients had a low or intermediate ATPⅢ pretest risk of CAD (6 patients had a high pre-test risk). The referral exercise test showed a mean Duke score of 5 (range: 2 to 11), which translated to a low postexercise risk in 66% and intermediate risk in 34%. A total of seven patients were reported with ischemia by MPI. Three of these patients had high ATPⅢ pre-test risk scores. Six of these seven patients underwent cardiac catheterization, which showed significant stenosis in one patient with a high pre-test risk of CAD, and indeterminate lesions in three patients (two of whom had high pre-test risk scores). With MPI as a gate keeper for catheterization, no significant, epicardial stenosis was observed in any of the 50 patients (0%, 95% confidence interval 0.0 to 7.1) with low to intermediate pre-test risk of CAD and a negative exercise test. No cardiac events occurred in any patients within a median follow up period of > 1200 d. CONCLUSION: The added diagnostic value of MPI in patients with low or intermediate risk of CAD and a recent, normal exercise test is marginal.
基金National Natural Science Foundation of China(NSFC)under Grant Nos.51638012 and 51578401
文摘The seismic performance of a self-centering precast reinforced concrete （RC） frame with shear walls was investigated in this paper. The lateral force resistance was provided by self-centering precast RC shear walls （SPCW）, which utilize a combination ofunbonded prestressed post-tensioned （PT） tendons and mild steel reinforcing bars for flexural resistance across base joints. The structures concentrated deformations at the bottom joints and the unbonded PT tendons provided the self-centering restoring force. A 1/3-scale model of a five-story self-centering RC frame with shear walls was designed and tested on a shake-table under a series of bi-directional earthquake excitations with increasing intensity. The acceleration response, roof displacement, inter-story drifts, residual drifts, shear force ratios, hysteresis curves, and local behaviour of the test specimen were analysed and evaluated. The results demonstrated that seismic performance of the test specimen was satisfactory in the plane of the shear wall; however, the structure sustained inter-story drift levels up to 2.45%. Negligible residual drifts were recorded after all applied earthquake excitations. Based on the shake-table test results, it is feasible to apply and popularize a self-centering precast RC frame with shear walls as a structural system in seismic regions.
