Objective:The head-up tilt test(HUTT)is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope(VVS).The present study aims to verify the hypothesis that ambulatory blood p...Objective:The head-up tilt test(HUTT)is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope(VVS).The present study aims to verify the hypothesis that ambulatory blood pressure(BP)monitoring(ABPM)and the simplistic tilt test may be potential alternatives to the HUTT.Methods:The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS.BP),heart rate(HR),and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence,pattern,and stage of syncope during the HUTT.Results:Mixed response was the commonest pattern,and syncope occurred frequently with infusion of isoproterenol at a rate of 3μg/min.During the simplistic tilt test,the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group,while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group.The higher the BP/HR ratio in the tilted position,the higher the isoproterenol dosage needed to induce a positive response.During ABPM,BP/HR ratios were signifi cantly higher in the cardioinhibitory group than in the vasodepressor group.The higher the ABPM-derived BP,the higher the dosage of isoproterenol needed to induce syncope.There were signifi cant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group,while signifi cant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group.The mixed pattern shared correlative features of the other two patterns.Conclusion:ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.展开更多
Objective We aimed to investigate the cumulative effect of high CRP level and apolipoprotein B-to-apolipoprotein A-1（ApoB/ApoA-1） ratio on the incidence of ischemic stroke（IS） or coronary heart disease（CHD） in a...Objective We aimed to investigate the cumulative effect of high CRP level and apolipoprotein B-to-apolipoprotein A-1（ApoB/ApoA-1） ratio on the incidence of ischemic stroke（IS） or coronary heart disease（CHD） in a Mongolian population in China.Methods From June 2003 to July 2012,2589 Mongolian participants were followed up for IS and CHD events based on baseline investigation.All the participants were divided into four subgroups according to C-reactive protein（CRP） level and ApoB/ApoA-1 ratio.Cox proportional hazard models were used to estimate the hazard ratios（HRs） and 95% confidence intervals（CIs） for the IS and CHD events in all the subgroups.Results The HRs（95% CI） for IS and CHD were 1.33（0.84-2.12）,1.14（0.69-1.88）,and 1.91（1.17-3.11） in the ‘low CRP level with high ApoB/ApoA-1＇,‘high CRP level with low ApoB/ApoA-1＇,and ‘high CRP level with high ApoB/ApoA-1＇ subgroups,respectively,in comparison with the ‘low CRP level with low ApoB/ApoA-1＇ subgroup.The risks of IS and CHD events was highest in the ‘high CRP level with high ApoB/ApoA-1＇ subgroup,with statistical significance.Conclusion High CRP level with high ApoB/ApoA-1 ratio was associated with the highest risks of IS and CHD in the Mongolian population.This study suggests that the combination of high CRP and ApoB/ApoA-1 ratio may improve the assessment of future risk of developing IS and CHD in the general population.展开更多
We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group ...We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group （n=397, BMI〈24 kg/m2） and the overweight group （n=400, BMI〉24 kg/m2）. Our results showed that the overweight group had higher blood pressure [（130.15±19.01） mmHg vs （123.66±18.70） mmHg] and higher levels of blood sugar [（7.09±2.89） mmol/L vs （6.21±2.59） mmol/L], triglyceride [（1.93±1.19） mmol/L vs （1.44 ±0.85） mmol/L], total cholesterol [（4.26±1.06） mmol/L vs （4.09±0.99） mmol/L], low-density lipoprotein cholesterol （LDL-C） [（2.56±0.75） mmol/L vs （2.39±0.72） mmol/L], and apoB [（0.83±0.27） mg/L vs （0.78±0.23） mg/L], and a higher apoB/apoA1 ratio （0.83 ±0.27 vs 0.75±0.25） and lower levels high-density lipoprotein cholesterol [（1.10±0.26） mmol/L vs （1.21±0.31） mmol/L] and apoA1 [（1.04±0.20） mg/L vs （1.08±0.22） mg/L] than those of the normal weight group （all P 〈 0.05）. The prevalence of CHD in the over-weight group in the lowest LDL quartile was almost twice greater than that of the highest apoB/apoA1 quartile, compared with the subjects in the lowest apoB/apoA1 quartile. The higher apoB/apoA1 quartile was in agreement with the higher prevalence of CHD. In the overweight and obesity group, the area under ROC curve （AUC） was the highest for apoB/apoA1 （0.655）. The cut-off point of apoB/apoA1 for optimal sensitivity and specificity was at 0.80, with a sensitivity of 57.19% and a specificity of 71.72%. In conclusion, apoB and apoA1 were simple clinical indicators, and the apoB/apoA1 ratio was closely related with CHD in overweight and obese patients. The apoB/apoA1 ratio may provide some useful information in the differential diagnosis.展开更多
Image photoplethysmography can realize low-cost and easy-to-operate non-contact heart rate detection from the facial video, and effectively overcome the limitations of traditional contact method in daily vital sign mo...Image photoplethysmography can realize low-cost and easy-to-operate non-contact heart rate detection from the facial video, and effectively overcome the limitations of traditional contact method in daily vital sign monitoring. However, it is hard to obtain more accurate heart rate detection values under the conditions of subject’s facial movement, weak ambient light intensity and long detection distance, etc. In this article, a non-contact heart rate detection method based on face tracking is proposed, which can effectively improve the accuracy of non-contact heart rate detection method in practical application. The corner tracker algorithm is used to track the human face to reduce the motion artifact caused by the movement of the subject’s face and enhance the use value of the signal. And the maximum ratio combining algorithm is used to weight the pixel space pulse wave signal in the facial region of interest to improve the pulse wave extraction accuracy. We analyzed the facial images collected under different experimental distances and action states. This proposed method significantly reduces the error rate compared with the independent component analysis method. After theoretical analysis and experimental verification, this method effectively reduces the error rate under different experimental variables and has good consistency with the heart rate value collected by the medical physiological vest. This method will help to improve the accuracy of non-contact heart rate detection in complex environments.展开更多
Background: Altered myocardial sympathetic innervation activity (AMSI) is known to be present in systolic heart failure patients (SHF) and recently SPECT imaging using I-123 mIBG heart to mediastinum (H/M) ratio <1...Background: Altered myocardial sympathetic innervation activity (AMSI) is known to be present in systolic heart failure patients (SHF) and recently SPECT imaging using I-123 mIBG heart to mediastinum (H/M) ratio <1.6 has been shown to predict MACE in the ADMIRE-HF trial. Left ventricular mechanical dyssynchrony (LVMD) is known to be present in a substantial number of SHF patients and has been studied mainly to guide CRT therapy. Recently gated SPECT has shown promise to provide an accurate assessment of LVMD. It remains unclear how the combination of AMSI and LVMD collectively affect clinical outcomes and other cardiovascular parameters. Objectives: The objectives are to examine the clinical characteristics and incremental prognostic value for MACE of LVMD determined by SPECT in SHF patients with or without abnormal cardiac MIBG uptake (H/M ratio < 1.6). Methods: Out of 30 SHF patients who participated from our institution in the ADMIRE-HF trial studying MIBG based AMSI, we included 22 patients with abnormal MIBG H/M ratio of <1.6. We performed gated SPECT LVMD analysis on these patients using the Emory Cardiac Toolbox. The 2 SPECT variables for LVMD assessed were histogram bandwidth and phase standard deviation both of which assess the extent of dispersion of LV activation during contraction as a marker of LVMD. Patients were followed up for a mean period of 6 years. The primary end point was mortality from any cause and secondary end point was heart failure admission or myocardial infarction or ICD shock. Results: 2 Groups were defined: Group A: n = 17 with H/M MIBG ratio < 1.6 and +LVMD and Group B, n = 5 H/M MIBG ratio −LVMD. Baseline characteristics, cardiac risk factors and medications were comparable between both groups. LVEF was lower and RBBB was less common in Group A. There was no statistical difference in achievement of primary or secondary end points in the two groups including death heart failure readmissions, ICD shocks or MI. Conclusions: In our pilot study, we did not find definitive value of adding SPECT based LVMD to abnormal cardiac MIBG imaging in SHF patients with regards to predicting outcomes. Although our sample size is too small to make any definitive conclusions, it is possible that LVMD works independently through different pathways in the progression of SHF and hence may not necessarily add incremental value to AMSI determination using MIBG.展开更多
【目的】旨在寻找最适合铁心杉幼苗生长的肥料配比。【方法】采用“3414”试验设计方案,设置14组肥料配比,以每组50盆的1年生铁心杉实生苗为材料,探究不同肥料配比对幼苗生长和生理生化指标的影响。【结果】与不施肥相比,合理施肥的铁...【目的】旨在寻找最适合铁心杉幼苗生长的肥料配比。【方法】采用“3414”试验设计方案,设置14组肥料配比,以每组50盆的1年生铁心杉实生苗为材料,探究不同肥料配比对幼苗生长和生理生化指标的影响。【结果】与不施肥相比,合理施肥的铁心杉幼苗叶片的叶绿素含量最高提高了42.01%,可溶性糖含量最高提高了11.64%,可溶性蛋白含量最高提高了13.81%,游离脯氨酸含量最高提高了211.25%;在N_(2)P_(2)K_(1)的肥料配方下,铁心杉幼苗的苗高、根直径、地上生物量、地下生物量、总生物量及苗木质量指数达到最大值,地径、根表面积和总根长也处于中上水平。【结论】N_(2)P_(2)K_(1)(每盆施1.0 g N、1.0 g P、0.5 g K)是铁心杉幼苗最佳的施肥配方。展开更多
背景随着人口老龄化的加剧,心力衰竭(heart failure,HF)患病率呈上升趋势,老年心力衰竭的预警、风险分层研究对改善预后具有重要意义。目的探讨血尿素氮-白蛋白比值(blood urea nitrogen to albumin ratio,BAR)对老年心力衰竭患者1年内...背景随着人口老龄化的加剧,心力衰竭(heart failure,HF)患病率呈上升趋势,老年心力衰竭的预警、风险分层研究对改善预后具有重要意义。目的探讨血尿素氮-白蛋白比值(blood urea nitrogen to albumin ratio,BAR)对老年心力衰竭患者1年内死亡的预测价值;建立包含BAR在内的列线图,并验证其临床价值。方法建模数据来自解放军总医院2016年1月—2021年10月诊断为心力衰竭的1259例老年患者,验证队列来自2021年10月—2022年10月诊断为心力衰竭的314例老年患者。以1年病死率为结局指标,采用Logistic回归分析筛选预后因素,根据预后因素构建列线图;ROC曲线、校准曲线和临床决策曲线分析(decision curve analysis,DCA)用于评估模型的区分度、一致性和临床效益;通过计算ROC曲线下面积和DCA,比较列线图与N端脑钠肽前体(N-terminal pro-B-type natriureticpeptide,NT-proBNP)及BIOSTATCHF预测模型的性能。结果训练队列和验证队列中分别有27.2%(343/1259)和25.2%(79/314)患者在1年内死亡。多因素Logistic回归结果显示,年龄、D-二聚体、NT-proBNP、BAR、血管紧张素转化酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)/血管紧张素受体阻滞剂(angiotensin receptor blockers,ARB)使用与死亡结局独立关联(P<0.05)。基于以上5个因素构建列线图,列线图展现出良好的区分度(AUC=0.838,P<0.001)、一致性(Hosmer-Lemeshowχ2=4.251,P=0.834)和临床效益。列线图模型与NT-proBNP和欧洲BIOSTAT-CHF预测模型相比预测效能均更佳(0.838 vs 0.703和0.825,P<0.05)。DCA结果提示,列线图相比NT-proBNP、BIOSTAT-CHF预测模型均增加了更多的净获益。结论BAR是老年心力衰竭患者1年内死亡的独立预测因子。包含BAR在内的列线图展现出优异的辨别力和校准能力,为预后评估提供有力支持。展开更多
基金the Guangdong Natural Science Foundation Project(2018A030313531)the Yat-Sen Scholarship for Young Scientists.
文摘Objective:The head-up tilt test(HUTT)is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope(VVS).The present study aims to verify the hypothesis that ambulatory blood pressure(BP)monitoring(ABPM)and the simplistic tilt test may be potential alternatives to the HUTT.Methods:The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS.BP),heart rate(HR),and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence,pattern,and stage of syncope during the HUTT.Results:Mixed response was the commonest pattern,and syncope occurred frequently with infusion of isoproterenol at a rate of 3μg/min.During the simplistic tilt test,the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group,while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group.The higher the BP/HR ratio in the tilted position,the higher the isoproterenol dosage needed to induce a positive response.During ABPM,BP/HR ratios were signifi cantly higher in the cardioinhibitory group than in the vasodepressor group.The higher the ABPM-derived BP,the higher the dosage of isoproterenol needed to induce syncope.There were signifi cant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group,while signifi cant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group.The mixed pattern shared correlative features of the other two patterns.Conclusion:ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.
基金supported by the National Natural Science Foundation of China(grant Nos.30972531 and 81320108026)a project of the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective We aimed to investigate the cumulative effect of high CRP level and apolipoprotein B-to-apolipoprotein A-1（ApoB/ApoA-1） ratio on the incidence of ischemic stroke（IS） or coronary heart disease（CHD） in a Mongolian population in China.Methods From June 2003 to July 2012,2589 Mongolian participants were followed up for IS and CHD events based on baseline investigation.All the participants were divided into four subgroups according to C-reactive protein（CRP） level and ApoB/ApoA-1 ratio.Cox proportional hazard models were used to estimate the hazard ratios（HRs） and 95% confidence intervals（CIs） for the IS and CHD events in all the subgroups.Results The HRs（95% CI） for IS and CHD were 1.33（0.84-2.12）,1.14（0.69-1.88）,and 1.91（1.17-3.11） in the ‘low CRP level with high ApoB/ApoA-1＇,‘high CRP level with low ApoB/ApoA-1＇,and ‘high CRP level with high ApoB/ApoA-1＇ subgroups,respectively,in comparison with the ‘low CRP level with low ApoB/ApoA-1＇ subgroup.The risks of IS and CHD events was highest in the ‘high CRP level with high ApoB/ApoA-1＇ subgroup,with statistical significance.Conclusion High CRP level with high ApoB/ApoA-1 ratio was associated with the highest risks of IS and CHD in the Mongolian population.This study suggests that the combination of high CRP and ApoB/ApoA-1 ratio may improve the assessment of future risk of developing IS and CHD in the general population.
基金supported by National High-Tech Research and Development Program of China (No.2006AA02A406)Natural Science Foundation of China (No.30871042)
文摘We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group （n=397, BMI〈24 kg/m2） and the overweight group （n=400, BMI〉24 kg/m2）. Our results showed that the overweight group had higher blood pressure [（130.15±19.01） mmHg vs （123.66±18.70） mmHg] and higher levels of blood sugar [（7.09±2.89） mmol/L vs （6.21±2.59） mmol/L], triglyceride [（1.93±1.19） mmol/L vs （1.44 ±0.85） mmol/L], total cholesterol [（4.26±1.06） mmol/L vs （4.09±0.99） mmol/L], low-density lipoprotein cholesterol （LDL-C） [（2.56±0.75） mmol/L vs （2.39±0.72） mmol/L], and apoB [（0.83±0.27） mg/L vs （0.78±0.23） mg/L], and a higher apoB/apoA1 ratio （0.83 ±0.27 vs 0.75±0.25） and lower levels high-density lipoprotein cholesterol [（1.10±0.26） mmol/L vs （1.21±0.31） mmol/L] and apoA1 [（1.04±0.20） mg/L vs （1.08±0.22） mg/L] than those of the normal weight group （all P 〈 0.05）. The prevalence of CHD in the over-weight group in the lowest LDL quartile was almost twice greater than that of the highest apoB/apoA1 quartile, compared with the subjects in the lowest apoB/apoA1 quartile. The higher apoB/apoA1 quartile was in agreement with the higher prevalence of CHD. In the overweight and obesity group, the area under ROC curve （AUC） was the highest for apoB/apoA1 （0.655）. The cut-off point of apoB/apoA1 for optimal sensitivity and specificity was at 0.80, with a sensitivity of 57.19% and a specificity of 71.72%. In conclusion, apoB and apoA1 were simple clinical indicators, and the apoB/apoA1 ratio was closely related with CHD in overweight and obese patients. The apoB/apoA1 ratio may provide some useful information in the differential diagnosis.
文摘Image photoplethysmography can realize low-cost and easy-to-operate non-contact heart rate detection from the facial video, and effectively overcome the limitations of traditional contact method in daily vital sign monitoring. However, it is hard to obtain more accurate heart rate detection values under the conditions of subject’s facial movement, weak ambient light intensity and long detection distance, etc. In this article, a non-contact heart rate detection method based on face tracking is proposed, which can effectively improve the accuracy of non-contact heart rate detection method in practical application. The corner tracker algorithm is used to track the human face to reduce the motion artifact caused by the movement of the subject’s face and enhance the use value of the signal. And the maximum ratio combining algorithm is used to weight the pixel space pulse wave signal in the facial region of interest to improve the pulse wave extraction accuracy. We analyzed the facial images collected under different experimental distances and action states. This proposed method significantly reduces the error rate compared with the independent component analysis method. After theoretical analysis and experimental verification, this method effectively reduces the error rate under different experimental variables and has good consistency with the heart rate value collected by the medical physiological vest. This method will help to improve the accuracy of non-contact heart rate detection in complex environments.
文摘Background: Altered myocardial sympathetic innervation activity (AMSI) is known to be present in systolic heart failure patients (SHF) and recently SPECT imaging using I-123 mIBG heart to mediastinum (H/M) ratio <1.6 has been shown to predict MACE in the ADMIRE-HF trial. Left ventricular mechanical dyssynchrony (LVMD) is known to be present in a substantial number of SHF patients and has been studied mainly to guide CRT therapy. Recently gated SPECT has shown promise to provide an accurate assessment of LVMD. It remains unclear how the combination of AMSI and LVMD collectively affect clinical outcomes and other cardiovascular parameters. Objectives: The objectives are to examine the clinical characteristics and incremental prognostic value for MACE of LVMD determined by SPECT in SHF patients with or without abnormal cardiac MIBG uptake (H/M ratio < 1.6). Methods: Out of 30 SHF patients who participated from our institution in the ADMIRE-HF trial studying MIBG based AMSI, we included 22 patients with abnormal MIBG H/M ratio of <1.6. We performed gated SPECT LVMD analysis on these patients using the Emory Cardiac Toolbox. The 2 SPECT variables for LVMD assessed were histogram bandwidth and phase standard deviation both of which assess the extent of dispersion of LV activation during contraction as a marker of LVMD. Patients were followed up for a mean period of 6 years. The primary end point was mortality from any cause and secondary end point was heart failure admission or myocardial infarction or ICD shock. Results: 2 Groups were defined: Group A: n = 17 with H/M MIBG ratio < 1.6 and +LVMD and Group B, n = 5 H/M MIBG ratio −LVMD. Baseline characteristics, cardiac risk factors and medications were comparable between both groups. LVEF was lower and RBBB was less common in Group A. There was no statistical difference in achievement of primary or secondary end points in the two groups including death heart failure readmissions, ICD shocks or MI. Conclusions: In our pilot study, we did not find definitive value of adding SPECT based LVMD to abnormal cardiac MIBG imaging in SHF patients with regards to predicting outcomes. Although our sample size is too small to make any definitive conclusions, it is possible that LVMD works independently through different pathways in the progression of SHF and hence may not necessarily add incremental value to AMSI determination using MIBG.
文摘【目的】旨在寻找最适合铁心杉幼苗生长的肥料配比。【方法】采用“3414”试验设计方案,设置14组肥料配比,以每组50盆的1年生铁心杉实生苗为材料,探究不同肥料配比对幼苗生长和生理生化指标的影响。【结果】与不施肥相比,合理施肥的铁心杉幼苗叶片的叶绿素含量最高提高了42.01%,可溶性糖含量最高提高了11.64%,可溶性蛋白含量最高提高了13.81%,游离脯氨酸含量最高提高了211.25%;在N_(2)P_(2)K_(1)的肥料配方下,铁心杉幼苗的苗高、根直径、地上生物量、地下生物量、总生物量及苗木质量指数达到最大值,地径、根表面积和总根长也处于中上水平。【结论】N_(2)P_(2)K_(1)(每盆施1.0 g N、1.0 g P、0.5 g K)是铁心杉幼苗最佳的施肥配方。
