Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated ...Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term follow-up.Methods This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were enrolled.The QFR of the entire target vessel was measured offline.The primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had TVF.The QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF group.Multivariable Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.展开更多
A space-borne synthetic aperture radar (SAR), a high frequency surface wave radar (HFSWR), and a ship automatic identification system (AIS) are the main remote sensors for vessel monitoring in a wide range. Thes...A space-borne synthetic aperture radar (SAR), a high frequency surface wave radar (HFSWR), and a ship automatic identification system (AIS) are the main remote sensors for vessel monitoring in a wide range. These three sensors have their own advantages and weaknesses, and they can complement each other in some situations. So it would improve the capability of vessel target detection to use multiple sensors including SAR, HFSWR, and A/S to identify non-cooperative vessel targets from the fusion results. During the fusion process of multiple sensors' detection results, point association is one of the key steps, and it can affect the accuracy of the data fusion and the efficiency of a non-cooperative target's recognition. This study investigated the point association analyses of vessel target detection under different conditions: space- borne SAR paired with AIS, as well as HFSWR, paired with AIS, and the characteristics of the SAR and the HFSWR and their capability of vessel target detection. Then a point association method of multiple sensors was proposed. Finally, the thresholds selection of key parameters in the points association (including range threshold, radial velocity threshold, and azimuth threshold) were investigated, and their influences on final association results were analyzed.展开更多
Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents (DES) compared to bare-metal stents (BMS) for patients with large coronary vessels. Methods From April 2004 to October 2006...Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents (DES) compared to bare-metal stents (BMS) for patients with large coronary vessels. Methods From April 2004 to October 2006, 2407 consecutive patients undergoing de novo lesion percutaneous coronary intervention with reference vessel diameter greater than or equal to 3.5 mm at Fu Wai Hospital in Beijing, China, were prospectively enrolled into this study. We obtained 9-year clinical outcomes including death, myocardial infarction (MI), thrombosis, target lesion revascularization (TLR), target vessel revascularization (TVR), and major adverse cardiac events (MACE, the composite of death, MI, and TVR). We performed Cox's proportional-hazards models to assess relative risks of all the outcome measures after propensity match. Results After propensity scoring, 514 DES-treated patients were matched to 514 BMS-treated patients. The patients treated with BMS were associated with higher risk ofTLR (HR: 2.55, 95%CI: 1.520-4.277, P = 0.0004) and TVR (HR: 1.889, 95%CI: 1.185-3.011, P = 0.0075), but the rates of death/MI and MACE were not statistically different. All Academic Research Consortium definition stent thrombosis at 9-year were comparable in the two groups. Conclusions During long-term follow-up through nine years, use of DES in patients with large coronary arteries was still associated with significant reductions in the risks of TLR and TVR.展开更多
目的对比研究三维定量冠状动脉造影(3D QCA)、二维定量冠状动脉造影(2D QCA)与目测法在评估冠脉X射线造影靶病变血管的差异性。方法回顾性随机抽取2009年5月~2009年11月于我院接受冠状动脉造影并行介入治疗的60位患者65处靶病变血管段...目的对比研究三维定量冠状动脉造影(3D QCA)、二维定量冠状动脉造影(2D QCA)与目测法在评估冠脉X射线造影靶病变血管的差异性。方法回顾性随机抽取2009年5月~2009年11月于我院接受冠状动脉造影并行介入治疗的60位患者65处靶病变血管段的影像资料。分析比较Medis 3D QCA、西门子2D QCA、专家目测对靶病变管腔面积狭窄率、病变血管长度、参考血管直径的测量值,分析比较3D QCA、2DQCA的直径狭窄率测量值。结果冠脉X射线造影三维定量分析、二维定量分析、目测定量分析在成功三维重建62处(3例因靶血管少一个投照体位无法实现三维重建)靶病变中最窄处管腔面积狭窄率(%)(73.87±8.98 vs 79.10±8.06 vs 83.53±8.19,P<0.001)、长度(mm)(28.95±17.31 vs 26.20±16.04vs 27.21±16.58,P<0.001)、参考血管直径(mm)(2.67±0.29 vs 2.64±0.26 vs 2.76±0.29,P<0.001)有显著性差异,三维与二维对靶血管病变最窄处直径狭窄率(%)(54.21±9.48 vs 57.84±10.17,P=0.016)有显著性差异。结论 Medis 3D QCA对冠状动脉造影能成功实现三维重建,与专家目测和二维定量分析相比,三维定量分析系统能够恢复三维血管形态从而更准确地分析冠状动脉病变。展开更多
基金supported by the Nanjing Municipal Science and Technology Bureau(No.201803008)the Cardiocare Sponsored Optimized Antithrombotic Research Fund(No.BJUHFCSOARF201801-13).
文摘Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term follow-up.Methods This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were enrolled.The QFR of the entire target vessel was measured offline.The primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had TVF.The QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF group.Multivariable Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.
基金The Special Funds for Fundamental Research Project of China under contract No.2008T04the Marine Scientific Research Special Funds for Public Welfare of China under contract No.200905029
文摘A space-borne synthetic aperture radar (SAR), a high frequency surface wave radar (HFSWR), and a ship automatic identification system (AIS) are the main remote sensors for vessel monitoring in a wide range. These three sensors have their own advantages and weaknesses, and they can complement each other in some situations. So it would improve the capability of vessel target detection to use multiple sensors including SAR, HFSWR, and A/S to identify non-cooperative vessel targets from the fusion results. During the fusion process of multiple sensors' detection results, point association is one of the key steps, and it can affect the accuracy of the data fusion and the efficiency of a non-cooperative target's recognition. This study investigated the point association analyses of vessel target detection under different conditions: space- borne SAR paired with AIS, as well as HFSWR, paired with AIS, and the characteristics of the SAR and the HFSWR and their capability of vessel target detection. Then a point association method of multiple sensors was proposed. Finally, the thresholds selection of key parameters in the points association (including range threshold, radial velocity threshold, and azimuth threshold) were investigated, and their influences on final association results were analyzed.
文摘Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents (DES) compared to bare-metal stents (BMS) for patients with large coronary vessels. Methods From April 2004 to October 2006, 2407 consecutive patients undergoing de novo lesion percutaneous coronary intervention with reference vessel diameter greater than or equal to 3.5 mm at Fu Wai Hospital in Beijing, China, were prospectively enrolled into this study. We obtained 9-year clinical outcomes including death, myocardial infarction (MI), thrombosis, target lesion revascularization (TLR), target vessel revascularization (TVR), and major adverse cardiac events (MACE, the composite of death, MI, and TVR). We performed Cox's proportional-hazards models to assess relative risks of all the outcome measures after propensity match. Results After propensity scoring, 514 DES-treated patients were matched to 514 BMS-treated patients. The patients treated with BMS were associated with higher risk ofTLR (HR: 2.55, 95%CI: 1.520-4.277, P = 0.0004) and TVR (HR: 1.889, 95%CI: 1.185-3.011, P = 0.0075), but the rates of death/MI and MACE were not statistically different. All Academic Research Consortium definition stent thrombosis at 9-year were comparable in the two groups. Conclusions During long-term follow-up through nine years, use of DES in patients with large coronary arteries was still associated with significant reductions in the risks of TLR and TVR.
文摘目的对比研究三维定量冠状动脉造影(3D QCA)、二维定量冠状动脉造影(2D QCA)与目测法在评估冠脉X射线造影靶病变血管的差异性。方法回顾性随机抽取2009年5月~2009年11月于我院接受冠状动脉造影并行介入治疗的60位患者65处靶病变血管段的影像资料。分析比较Medis 3D QCA、西门子2D QCA、专家目测对靶病变管腔面积狭窄率、病变血管长度、参考血管直径的测量值,分析比较3D QCA、2DQCA的直径狭窄率测量值。结果冠脉X射线造影三维定量分析、二维定量分析、目测定量分析在成功三维重建62处(3例因靶血管少一个投照体位无法实现三维重建)靶病变中最窄处管腔面积狭窄率(%)(73.87±8.98 vs 79.10±8.06 vs 83.53±8.19,P<0.001)、长度(mm)(28.95±17.31 vs 26.20±16.04vs 27.21±16.58,P<0.001)、参考血管直径(mm)(2.67±0.29 vs 2.64±0.26 vs 2.76±0.29,P<0.001)有显著性差异,三维与二维对靶血管病变最窄处直径狭窄率(%)(54.21±9.48 vs 57.84±10.17,P=0.016)有显著性差异。结论 Medis 3D QCA对冠状动脉造影能成功实现三维重建,与专家目测和二维定量分析相比,三维定量分析系统能够恢复三维血管形态从而更准确地分析冠状动脉病变。