Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively...Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors（sPE,t-PA, MCP-1, IL-8,1L-6,sVCAM-1, and sCD40L） was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction （AMI） and ustable angina （UA） patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-lsPE, sVCAM-I-sCD40L, sCD40L-sPE, IL-6-ILS,ILS-MCP1, and MCPI-sVCAM-1; CRP （18.868±4.907mg/L vs 5.806±3.553 mg/L）and IL-6 （19.5 pg/ml [9.2 - 44.6 pg/ml]vs 5.3 pg/ml [2.3- 13.4 pg/ml]）were elevated in the vulnerable plaque group（P 〈0.05）. sCD40L（473.82± 126.11 vs 237.94± 34.78 pg/ml）,sPE （107.21±39.90 vs 49.06 ±5.61ug/L） and MCP-1（132.42 ± 17.85 vs 127.17±13.27 pg/ml） were increased in the plaque rupture group（P 〈 0.05）;There was correlation between tPA and plaque morphology（P 〈 0.05）. Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.展开更多
OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （...OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.展开更多
文摘Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome（ACS）. Methods Intravascular ultrasound（lVUS） was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors（sPE,t-PA, MCP-1, IL-8,1L-6,sVCAM-1, and sCD40L） was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction （AMI） and ustable angina （UA） patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-lsPE, sVCAM-I-sCD40L, sCD40L-sPE, IL-6-ILS,ILS-MCP1, and MCPI-sVCAM-1; CRP （18.868±4.907mg/L vs 5.806±3.553 mg/L）and IL-6 （19.5 pg/ml [9.2 - 44.6 pg/ml]vs 5.3 pg/ml [2.3- 13.4 pg/ml]）were elevated in the vulnerable plaque group（P 〈0.05）. sCD40L（473.82± 126.11 vs 237.94± 34.78 pg/ml）,sPE （107.21±39.90 vs 49.06 ±5.61ug/L） and MCP-1（132.42 ± 17.85 vs 127.17±13.27 pg/ml） were increased in the plaque rupture group（P 〈 0.05）;There was correlation between tPA and plaque morphology（P 〈 0.05）. Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.
基金Supported by Innovation Program of Shanghai Municipal Education Commission(No.11YZ71)the 3rd Shanghai Leading Academic Discipline Project(No.S30302)the National Natural Science Foundation of China(No. 81173199)
文摘OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.
