Percutaneous transluminal renal artery stenting （PTRAS） has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis （ARAS）. Whether PTRAS could improve left ven-...Percutaneous transluminal renal artery stenting （PTRAS） has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis （ARAS）. Whether PTRAS could improve left ven- tricular hypertrophy （LVH） and reduce adverse events when based on percutaneous coronary intervention （PCI） for patients with coronary artery disease （CAD） and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction （HFpEF）. A total of 228 patients meeting inclusion criteria were divided into two groups： （1） the HFpEF-I group, with PCI and PTRAS; （2） the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index （LVMI） and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure （SBP） was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.展开更多
Now the exercise test is not simply a method to determine the likelihood of CAD,but to estimate prognosis,instruct therapy even more.It is used for assessing the functional severity of CAD and the prognosis or potenti...Now the exercise test is not simply a method to determine the likelihood of CAD,but to estimate prognosis,instruct therapy even more.It is used for assessing the functional severity of CAD and the prognosis or potential risk for future cardiac events,determining exercise prescription and effects of therapy for rehabilitative cardiology.In order to meet the needs of reference for cardiovascular rehabilitation medicine,formulate this interpretive criteria in accordance with progress recently in grated exercise test. Results 1 Positive It is positive,if one of following parameters arises during exercise testing 1 1 Typical angina pectoris during exercise 1 2 ECG change 1 2 1 Ischemic ST(horizontal or downsloping ST) segment depression≥0 1mV at 0 08 second after the junction,appearing in QRS with dominated R wave,in duration of 2 minutes or more 1 2 2 Exercise induced ST segment elevation 0 1 mV other than aVR lead 1 2 3 Exerciat induced U wave inversion 1 3 Abnormal blood pressure response 1 3 1 Sustained decrease of systilic BP≥20 mmHg during progressive exercise 1 3 2 Peak systolic BP<130 mmHg,or increase <20(women),<30(men) mmHg than rest during progressive exercise 1 3 3 Systolic BP at 3 minutes after exercise divided by peak systolic BP during exercise≥80% 1 3 4 Diastolic BP rises >15 mmHg during exercise 2 Equivocal The exercise testing response is equivocal positive if one of the following parameters arises during exercise testing 2 1 Is chemic ST segment depression 0.05～0.09 mV 2 2 Ischemic ST segment depression duration <2 minutes 2 3 Exercise induced serious ventricular arrhythmia,such as multifocal premature contraction,paroxysmal supraventricular tachycardia,ventricular tachycardia,2～3 degree atrioventricular block etc. 3 Parameters associated with poor prognosis and /or increased severity of CAD Patients who have an established diagnosis of CAD following parameters indicate poor porgnosis and/or increased severity of CAD 3 1 Ischemic ST ecgment depression≥0 2 mV,the downsloping ST depression possesses further significance 3 2 Exercise induced hypotension Sustained decrease of systolic BP>20 mmHg during progressive exercise 3 3 Parameters change at onset of angina pectoris or ischemic ST depression 3 3 1 Double product <15000 3 3 2 HR <120beat/min,or systolic BP<130mmHg 3 3 3 Exercise capecity <5 METS 3 4 Ischemic ST depression in multiple leads or continues into exercise recovery >6 minutes 3 5 ST\|Segment elevation≥0 2mV 3 6 Angina that limits exercise 3 7 Ptfv <-0 04mm/s or more 3 8 ST T normalization ST T returns to normal during exercise while T wave is inverse or ST segment is depressed at rest 3 9 Exercise\|induced U\|wave inversion 3 10 Exercise induced serious ventricular arrhythmia,such as ventricular tachycardia etc. Author′s address 263,Wusi Road,Fuzhou,350003,P R展开更多
基金Project supported by the Guangdong Provincial Scientific Grant(No.2013B031800024),China
文摘Percutaneous transluminal renal artery stenting （PTRAS） has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis （ARAS）. Whether PTRAS could improve left ven- tricular hypertrophy （LVH） and reduce adverse events when based on percutaneous coronary intervention （PCI） for patients with coronary artery disease （CAD） and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction （HFpEF）. A total of 228 patients meeting inclusion criteria were divided into two groups： （1） the HFpEF-I group, with PCI and PTRAS; （2） the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index （LVMI） and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure （SBP） was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.
文摘Now the exercise test is not simply a method to determine the likelihood of CAD,but to estimate prognosis,instruct therapy even more.It is used for assessing the functional severity of CAD and the prognosis or potential risk for future cardiac events,determining exercise prescription and effects of therapy for rehabilitative cardiology.In order to meet the needs of reference for cardiovascular rehabilitation medicine,formulate this interpretive criteria in accordance with progress recently in grated exercise test. Results 1 Positive It is positive,if one of following parameters arises during exercise testing 1 1 Typical angina pectoris during exercise 1 2 ECG change 1 2 1 Ischemic ST(horizontal or downsloping ST) segment depression≥0 1mV at 0 08 second after the junction,appearing in QRS with dominated R wave,in duration of 2 minutes or more 1 2 2 Exercise induced ST segment elevation 0 1 mV other than aVR lead 1 2 3 Exerciat induced U wave inversion 1 3 Abnormal blood pressure response 1 3 1 Sustained decrease of systilic BP≥20 mmHg during progressive exercise 1 3 2 Peak systolic BP<130 mmHg,or increase <20(women),<30(men) mmHg than rest during progressive exercise 1 3 3 Systolic BP at 3 minutes after exercise divided by peak systolic BP during exercise≥80% 1 3 4 Diastolic BP rises >15 mmHg during exercise 2 Equivocal The exercise testing response is equivocal positive if one of the following parameters arises during exercise testing 2 1 Is chemic ST segment depression 0.05～0.09 mV 2 2 Ischemic ST segment depression duration <2 minutes 2 3 Exercise induced serious ventricular arrhythmia,such as multifocal premature contraction,paroxysmal supraventricular tachycardia,ventricular tachycardia,2～3 degree atrioventricular block etc. 3 Parameters associated with poor prognosis and /or increased severity of CAD Patients who have an established diagnosis of CAD following parameters indicate poor porgnosis and/or increased severity of CAD 3 1 Ischemic ST ecgment depression≥0 2 mV,the downsloping ST depression possesses further significance 3 2 Exercise induced hypotension Sustained decrease of systolic BP>20 mmHg during progressive exercise 3 3 Parameters change at onset of angina pectoris or ischemic ST depression 3 3 1 Double product <15000 3 3 2 HR <120beat/min,or systolic BP<130mmHg 3 3 3 Exercise capecity <5 METS 3 4 Ischemic ST depression in multiple leads or continues into exercise recovery >6 minutes 3 5 ST\|Segment elevation≥0 2mV 3 6 Angina that limits exercise 3 7 Ptfv <-0 04mm/s or more 3 8 ST T normalization ST T returns to normal during exercise while T wave is inverse or ST segment is depressed at rest 3 9 Exercise\|induced U\|wave inversion 3 10 Exercise induced serious ventricular arrhythmia,such as ventricular tachycardia etc. Author′s address 263,Wusi Road,Fuzhou,350003,P R
