Diagnostic Value of the Padua Score Combined with Thrombotic Biomarker Tissue Plasminogen Activator Inhibitor-1 (tPAI-1) Detection for the Risk of Deep Vein Thrombosis in Patients with Pulmonary Heart Disease

This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.

Salvia Polyphenolates Combined with Doxophylline in the Treatment of Patients with Chronic Pulmonary Heart Disease in the Compensated Stage

Objective:To statistically determine the effect of salvia polyphenolates combined with doxophylline treatment in patients with chronic pulmonary heart disease in the compensated stage.Methods:From January 2023 to January 2024,76 patients with chronic pulmonary heart disease in the compensated stage were selected as research subjects.The patients were divided into a research group and a reference group using a randomized numerical table method.The research group was treated with salvia polyphenolates combined with doxophylline,while the reference group received conventional therapy.The treatment effects of the two groups were compared.Results:The patients in the research group,treated with salvia polyphenolates combined with doxophylline,showed maximal ventilation of 73.26±4.83 L/min,left ventricular ejection fraction of 56.14±1.98%,and total effective treatment rate of 94.74%.These results were better than those of the reference group.The differences between the data of the research group and the reference group were statistically significant(P<0.05).Conclusion:For patients with chronic pulmonary heart disease in the compensated stage,treatment with salvia polyphenolates combined with doxophylline significantly improves maximum ventilation and left ventricular ejection fraction,and also results in a higher total effective treatment rate.

Role of Voltage-gated Potassium Channels in Pathogenesis of Chronic Pulmonary Heart Disease

The influence of hypoxia on the activity of voltage-gated potassium channel in pulmonary artery smooth muscle cells （PASMCs） of rats and its roles in the pathogenesis of chronic pulmonary heart disease were investigated. Eighty male Sprague-Dawley rats were randomly allocated into control group （n=10）, acute hypoxic group （n=10）, and chronic hypoxic groups （n=60）. The chronic hypoxic groups were randomly divided into 6 subgroups （n=10 each） according to the chronic hypoxic periods. The rats in the control group were kept in room air and those in acute hypoxic group in hypoxia envi- ronmental chamber for 8 h. The rats in chronic hypoxic subgroups were kept in hypoxia environmental chamber for 8 h per day for 5, 10, 15, 20, 25, and 30 days, respectively. The mean pulmonary arterial pressure （mPAP）, right ventricular hypertrophy index （RVHI）, and the current of voltage-gated potas- sium channel （IK） in PASMCs were measured. Results showed that both acute and chronic hypoxia could decrease the IK in PASMCs of rats and the I-V relationship downward shifted to the right. And the peak Ir density at ＋60mV decreased with prolongation of hypoxia exposure. No significant difference was noted in the density oflK （at ＋60 mV） and I-V relationship between control group and chronic hy- poxic subgroup exposed to hypoxia for 5 days （P〉0.05）, but there was a significant difference between control group and chronic hypoxic subgroup exposed to hypoxia for 10 days （P〈0.05）. Significant dif- ferences were noted in the IK density （at ＋60 mV） and I-V relationships between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Compared with con- trol rats, the mPAP and RVHI were significantly increased after chronic exposure to hypoxia for 10 days （P〈0.05）, which were further increased with prolongation of hypoxia exposure, and there were signifi- cant differences between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Both the mPAP and the RVHI were negatively correlated with the density OflK （r---0.89769 and -0.94476, respectively, both P〈0.01）. It is concluded that exposure to hypoxia may cause decreased activity of voltage-gated potassium channel, leading to hypoxia pulmonary vasocon- striction （HPV）. Sustained HPV may result in chronic pulmonary hypertension, even chronic pulmonary heart disease, contributing to the pathogenesis of chronic pulmonary heart disease.

Animal models of pulmonary hypertension due to left heart disease

Pulmonary hypertension due to left heart disease(PH-LHD) is regarded as the most prevalent form of pulmonary hypertension(PH). Indeed, PH is an independent risk factor and predicts adverse prognosis for patients with left heart disease(LHD). Clinically, there are no drugs or treatments that directly address PH-LHD, and treatment of LHD alone will not also ameliorate PH. To target the underlying physiopathological alterations of PH-LHD and to develop novel therapeutic approaches for this population, animal models that simulate the pathophysiology of PH-LHD are required. There are several available models for PH-LHD that have been successfully employed in rodents or large animals by artificially provoking an elevated pressure load on the left heart, which by transduction elicits an escalated pressure in pulmonary artery. In addition, metabolic derangement combined with aortic banding or vascular endothelial growth factor receptor antagonist is also currently applied to reproduce the phenotype of PH-LHD. As of today, none of the animal models exactly recapitulates the condition of patients with PH-LHD. Nevertheless, the selection of an appropriate animal model is essential in basic and translational studies of PH-LHD. Therefore, this review will summarize the characteristics of each PH-LHD animal model and discuss the advantages and limitations of the different models.

Effects of Huang Qi Wu Wu Decoction on Plasma Proteins in 70 Cases of Chronic Pulmonary Heart Disease

Simple immune agar diffusion test was used to assay the contents of 12 plasma proteins in 70 cases of chronic pulmonary heart disease treated by Huang Qi Wu Wu Decoction (黄芪五物汤), with the other 70 cases who were not given Huang Qi Wu Wu Decoction as the control group. The total clinical effective rate in the treatment group was 90.0%, while that in the control group was 75.7%, with a statistically significant difference between the two groups (P<0.05). In the treatment group, the levels of prealbumin, transferrin and fibronectin elevated obviously after treatment, and the contents of C-reactive protein, ceruloplasmin, haptoglobin, a 1-antitrypsin and a 1-acid glycoprotein decreased markedly (P<0.01). In the control group, only the levels of ceruloplasmin and C-reactive protein decreased significantly (P<0.05). It is shown that Huang Qi Wu Wu Decoction may enhance the therapeutic effects for pulmonary heart disease, regulate the metabolism of plasma proteins, and improve the life quality of the patients.

Assessment of Reversibility in Pulmonary Hypertension Related to Congenital Heart Disease by Using Biomarkers and Clinical Features

Background:Reversibility of pulmonary hypertension(PH)is closely related to the treatment options for and prognosis of children with congenital heart disease.Objective:We combined patient-specific clinical features including diagnosis,age and echocardiographic results,and biomarkers of pulmonary vascular dysfunction to explore the noninvasive methods that can be used to accurately evaluate the reversibility of pulmonary hypertension in congenital heart disease(PH-CHD).Methods:Based on the preoperative systolic pulmonary arterial pressure(sPAP),70 CHD patients were divided into normal,PH-CHD suspected,and confirmed groups.Additionally,biomarkers of circulating endothelial cells(CECs),endothelin-1(ET-1),and endothelial nitric oxide synthase(eNOS)were detected.Patients were categorized into reversible(RPH)and irreversible(IRPH)groups according to the sPAP 6 months after surgery.Risk stratification was performed according to the clinical features and biomarkers.Results:CECs and ET-1 levels in the confirmed group were significantly higher.eNOS was higher in the confirmed and suspected groups than that in the normal group.CECs in the IRPH group were significantly higher compared to the RPH group.No such intergroup differences were observed with respect to ET-1 and eNOS levels.The ROC curve showed that the risk stratification was of high diagnostic value to evaluate reversibility.Conclusion:The CECs,eNOS,and ET-1 were closely related with PH-CHD.CECs and risk stratification have high practical value in assessing the reversibility of PH-CHD.

Treatment of patients with bosentan in postoperation of congenital heart disease with pulmonary arterial hypertension:a double-blind,randomized controlled trial

Objective Endothelin is a key role in the pathogenic of pulmonary arterial hypertension. High concentrations of endothelin 1 have been recorded in plasma and lungs of patients with pulmonary artery hypertension associated with congenital heart disease,and the concentrations of endothelin-1 was correlated with severity degree

Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.

Surgical Treatment of 144 Children with Ventricular Septal Defect and Severe Pulmonary Hypertension

Objective To report the result of surgical treatment for 144 children with ventricular septal defect and severe pulmonary hypertension. Method The diagnosis had been confirmed by cardiac catheter before the operation, Pp/Ps (0. 81±0.09) and Rp (9.41 ±5.37 ) wood. Ventricular septal prothesis was performed under cardiopulmonary bypass. Transthoracic intracardiac monitoring line inserted into pulmonary artery in 117 cases. Results Fourteen cases died of the 144 postoperatively, with mortality of 9.12% . Preoperative Pp/Ps≥0. 8 and Rp≥10 wood made the mortality higher than that of others ( P < 0. 05 ) . 32 persons had post - operative SpPA > 50 mmHg among the survivors and among the children with preoperative Pp/Ps ≥0. 8 and Rp≥10 wood the mortality was 28. 6 % being higher than that among those with Pp/Ps≥0. 8 and Rp < 10 wood. Conclusion The higher the preoperative Pp/Ps and Rp are, the higher the surgical mortality is. The prevention and treatment of postoperative pulmonary hypertension crisis should be given more attention. The placement of transthoracic intracardiac monitoring lines plays an important role in the prevention and treatment of the complications occurring postoperationally in children with pulmonary hypertension.

Multicenter clinical efficacy observation of integrated Traditional Chinese Medicine-Western Medicine treatment in acute onset period of pulmonary heart disease

OBJECTIVE: To evaluate the efficacy of integrated Traditional Chinese Medicine-Western Medicine(TCM-WM) in the treatment of acute onset pulmonary heart disease(PHD).METHODS: A total of 240 patients met the inclusion criteria and were enrolled. These inpatients were divided into group A(treatment group) and B(control group) in order of admission according to the principles of randomization and control. The research was performed simultaneously in three hospitals. Two groups were given basic treatment that included: controlled oxygen therapy, active and effective anti-infection, maintaining airway patency,correcting O_2 deficiency and CO_2 retention, correcting acid-base imbalance and electrolyte disturbance, reducing pulmonary hypertension and treating right heart failure, nutritional support and treatment of complications. Group A was given basic treatment and integrated Traditional Chinese Medi-cine(TCM) differentiating therapy; group B was given basic therapy and a placebo that was similar in appearance and taste to TCM medicinal broth of pharmaceutical preparations, provided by Yibin Pharmaceutical Company(Yibin, China, Wuliangye Group).RESULTS: The mortality in the treatment group decreased by 4.98% compared with the control group. The treatment group reported improved ventilation, corrected hypoxemia, improved nutritional status and promoted digestive functions. It also significantly improved the patient's self-life skills, improved the patient's quality of life and could shorten the length of hospital stay.CONCLUSION: Comprehensive integrated TCMWM treatment showed good clinical efficacy toward the acute onset period of PHD patients.

PLATELET ACTIVATION IN PATIENTS WITH CHRONIC PULMONARY HEART DISEASE EFFECT OF DIPYRIDAMOLE TREATMENT

Plasma levels of /f-thromboglobulin (/?-TG), platelet fac-tor 4(P and platelet aggregation rate (PAR) were measured in remission phase of 15 patients affected with chronic pulmonary heart disease (CPHD). 0-TG, /?-TG / PF4, PF4 and PAR were significantly higher in the patients than in controls (/3<0.01 and 0.05, respectively). After 10 days of treatment with Dipyridamole lOOtng tid, fi-TG, /?-TG / PF4 and PF4 decreased significantly compared with pretreatment values (/><0.01 and 0.05, respectively). The results suggest that in vivo platelet activation is indeed present in patients with CPHD and that dipyridamole can antagonize platelet activation in vivo.

A 7-year-old boy with recurrent cyanosis and tachypnea:A case report

BACKGROUND Brain tumors are the most common solid tumors in children and comprise 25%of all malignancies in children.Common presentations include headache,nausea and vomiting,gait abnormality,papilledema,and epileptic seizure;however,some symptoms can be very insidious,with atypical and misleading manifestations.CASE SUMMARY Here,we report a 7-year-old boy who presented with recurrent cyanosis and tachypnea after exercise for 2 years.His body mass index was 26.43 kg/m2.Hepatosplenomegaly,blood gas analysis,biochemical parameters,chest computed tomography scan,and echocardiograph suggested type II respiratory failure,pulmonary heart disease,and mild liver injury.Non-invasive breathing support,antibiotics,and anti-heart failure therapy were given.The patient’s pulse oxygen saturation increased to over 95%when he was awake but dropped to 50%-60%,accompanied by cyanosis,during sleep while receiving high-flow nasal cannula oxygen.Sleep-related breathing disorder was suspected.In the intensive care unit,however,polysomnography was unavailable.Brain magnetic resonance imaging revealed a space-occupying(cerebellum and brainstem)lesion,which was later confirmed to be pleomorphic xanthoastrocytoma by surgery and histopathology by tissue biopsy.CONCLUSION When treating patients with cyanosis and tachypnea,a broad differential diagnosis should be considered,including brain tumor.

Characteristics of biochemical markers in patients with pulmonary hypertension related to left heart disease

Objective To investigate the differences of biochemical markers between the patients with pulmonary hypertension related to left heart disease(PH-LHD)and LHD;to explore the sensitive biomarkers which may predict PH in LHD patients.Methods A total of 355 LHD patients admitted to our hospital from 2014-01 to

MA XING ER SAN TANG FOR TREATMENT OF COR PULMONALE AT ACUTE ONSET STAGE -A Report Of 250 Cases

Ma Xing Er San Tang (麻杏二三汤) is a compound recipe derived from Ma Xing Shi Gan Tang (麻杏石甘汤 Decoction of Ephedra, Apricot Kernel, Gypsum and Licorice), Er Chen Tang (二陈汤 Decoction of Two Old Drugs) and San Zi Yang Qin Tang (三子养亲汤 Decoction of Three Kinds of Seeds for the Aged). Since 1990, the authors have used Ma Xing Er San Tang for treatment of 250 cases of Cor Pulmonale (CP) with satisfactory therapeutic results as reported below.