Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively de- spite clear indications for surgical intervention. However, little is known about how...Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively de- spite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment deci-sion-making and therapeutic outcomes. Methods Patients （n = 234, mean age： 78.5 ± 3.7 years） with symptomatic severe heart valve dis- ease hospitalized in our center were included. One hundred and fifty-one patients （65%） were treated surgically （surgical group） and 83 （35%） were treated conservatively （conservative group）. Factors that affected therapeutic decision-making and treatment outcomes were investi- gated and long-term survival was explored. Results Isolated aortic valve disease, female sex, chronic renal insufficiency, aged _〉 80 years, pneumonia, and emergent status were independent factors associated with therapeutic decision-making. In-hospital mortality for the surgical group was 5.3% （8/151）. Three patients （3.6%） in the conservative group died during initial hospitalization. Low cardiac output syndrome and chronic renal insufficiency were identified as predictors of in-hospital mortality in the surgical group. Conservative treatment was identi- fied as the single risk factor for late death in the entire study population. The surgical group had better 5-year （77.2% vs. 45.4%, P 〈 0.0001） and 10-year （34.5% vs. 8.9%, P 〈 0.0001） survival rates than the conservative group, even when adjusted by propensity score-matched analysis. Conclusions Advanced age and geriatric comorbidities profoundly affect treatment decision-making for severe heart valve disease. Valve surgery in the elderly was not only safe but was also associated with good long-term survival while conservative treatment was unfavorable for patients with symptomatic severe valve disease.展开更多
Objective To compare the distribution ofKCNJll polymorphisms between elderly Chinese population with and without hypertension. Methods We examined the mutation of KCNJll gene by directly sequencing. Data for the prese...Objective To compare the distribution ofKCNJll polymorphisms between elderly Chinese population with and without hypertension. Methods We examined the mutation of KCNJll gene by directly sequencing. Data for the present study were obtained from 250 hypertensive subjects （60 to 83 years old） as well as 250 normotensive subjects （60 to 86 years old）. Results We found nine different mutations in KCNJ11, including six novel mutations （1131M, L1471, L147V, L147L, Q235H, G245C）. None of the novel mutations were found in the normotensive subjects, and all the residues were conserved in other species. These sequence variants in Chinese population indicate the diversity of the human library and the complexity of hypertension. Conclusions The consistent finding of our present study provided a basis for the development of new strategies to diagnosis and treat hypertension in the elderly.展开更多
OBJECTIVE: To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China. METHODS: Bone mineral density (BMD) was measured and questionnaires were taken for 5593 ...OBJECTIVE: To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China. METHODS: Bone mineral density (BMD) was measured and questionnaires were taken for 5593 people aged above 40 years in five administrative areas in China selected by the stratified - multi - steps - cluster sampling method. RESULTS: The total prevalence rate of osteoporosis was 16.1%. The prevalence rate among males was 11.5% and among females was 19.9% (P展开更多
文摘Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively de- spite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment deci-sion-making and therapeutic outcomes. Methods Patients （n = 234, mean age： 78.5 ± 3.7 years） with symptomatic severe heart valve dis- ease hospitalized in our center were included. One hundred and fifty-one patients （65%） were treated surgically （surgical group） and 83 （35%） were treated conservatively （conservative group）. Factors that affected therapeutic decision-making and treatment outcomes were investi- gated and long-term survival was explored. Results Isolated aortic valve disease, female sex, chronic renal insufficiency, aged _〉 80 years, pneumonia, and emergent status were independent factors associated with therapeutic decision-making. In-hospital mortality for the surgical group was 5.3% （8/151）. Three patients （3.6%） in the conservative group died during initial hospitalization. Low cardiac output syndrome and chronic renal insufficiency were identified as predictors of in-hospital mortality in the surgical group. Conservative treatment was identi- fied as the single risk factor for late death in the entire study population. The surgical group had better 5-year （77.2% vs. 45.4%, P 〈 0.0001） and 10-year （34.5% vs. 8.9%, P 〈 0.0001） survival rates than the conservative group, even when adjusted by propensity score-matched analysis. Conclusions Advanced age and geriatric comorbidities profoundly affect treatment decision-making for severe heart valve disease. Valve surgery in the elderly was not only safe but was also associated with good long-term survival while conservative treatment was unfavorable for patients with symptomatic severe valve disease.
基金Acknowledgements The authors declare no conflict of interest. This work was supported by the grant from the National Natural Science Foundation of China （81170249, 30700305 and 30400549）, the Key Project of National Natural Science Foundation of China （81030002）, the 10th Five-Year Plan for Scientific and Technological Progress of the military （01MA104）, Chinese Postdoctoral Science Foundation （20080431356）, and Beijing Nova Program （2008A064）.
文摘Objective To compare the distribution ofKCNJll polymorphisms between elderly Chinese population with and without hypertension. Methods We examined the mutation of KCNJll gene by directly sequencing. Data for the present study were obtained from 250 hypertensive subjects （60 to 83 years old） as well as 250 normotensive subjects （60 to 86 years old）. Results We found nine different mutations in KCNJ11, including six novel mutations （1131M, L1471, L147V, L147L, Q235H, G245C）. None of the novel mutations were found in the normotensive subjects, and all the residues were conserved in other species. These sequence variants in Chinese population indicate the diversity of the human library and the complexity of hypertension. Conclusions The consistent finding of our present study provided a basis for the development of new strategies to diagnosis and treat hypertension in the elderly.
文摘OBJECTIVE: To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China. METHODS: Bone mineral density (BMD) was measured and questionnaires were taken for 5593 people aged above 40 years in five administrative areas in China selected by the stratified - multi - steps - cluster sampling method. RESULTS: The total prevalence rate of osteoporosis was 16.1%. The prevalence rate among males was 11.5% and among females was 19.9% (P
