Weighted gene co-expression network analysis reveals similarities and differences of molecular features between dilated and ischemic cardiomyopathies

Cardiomyopathies represent the most common clinical and genetic heterogeneous group of diseases that affect the heart function.Though progress has been made to elucidate the process,molecular mechanisms of different classes of cardiomyopathies remain elusive.This paper aims to describe the similarities and differences in molecular features of dilated cardiomyopathy(DCM)and ischemic cardiomyopathy(ICM).We firstly detected the co-expressed modules using the weighted gene co-expression network analysis(WGCNA).Significant modules associated with DCM/ICM were identified by the Pearson correlation coefficient(PCC)between the modules and the phenotype of DCM/ICM.The differentially expressed genes in the modules were selected to perform functional enrichment.The potential transcription factors(TFs)prediction was conducted for transcription regulation of hub genes.Apoptosis and cardiac conduction were perturbed in DCM and ICM,respectively.TFs demonstrated that the biomarkers and the transcription regulations in DCM and ICM were different,which helps make more accurate discrimination between them at molecular levels.In conclusion,comprehensive analyses of the molecular features may advance our understanding of DCM and ICM causes and progression.Thus,this understanding may promote the development of innovative diagnoses and treatments.

Plasma hemoglobin concentration was related to estimated glomerular filtration rate in elderly patients with ischemic cardiomyopathy

Objectives To study the relationship between plasma hemoglobin concentration and estimated glomerular filtration rate （eGFR） in elderly patients with ischemic cardiomyopathy （ICM）.Methods Clinical data of patients with coronary heart disease who were discharged from The First Affiliated Hospital,Chongqing Medical University between 2005 and 2007 were analyzed retrospectively. Echocardiography results,plasma hemoglobin and creatinine concentration were abstracted from the medical records.The study included 235 Chinese Hart patients with age 60 years and older with angiography confirmed coronary heart disease,silent myocardial ischemia or angina pectoris,of whom 154 had ICM defined as left ventricular end-diastolic diameter （LVDd）,male≥56 mm,female≥51 mm （63. 51±7.70 mm） measured by M-mode echocardiography.The differences in plasma hemoglobin concentration were analyzed retrospec- tively between patients with and without ICM,and between patients with an eGFR【60 ml·min-1·1.73m-2 and those with an eGFR≥60 ml·min-1·1.73m-2.Results There were no significant differences in plasma hemoglobin concentration and eGFR between ICM and non-ICM group (118.49±20.52 g·L-1 vs.115.80±23.32 g·L-1 and 75.13±24.21 ml·min-1·1.73m-2 vs.79.09±28.41 ml·min- 1·1.73m-2,respectively,both P】0.05).However,in both ICM and non-ICM groups,plasma hemoglobin concentration was lower in those with an eGFR【60 ml·min-1·1.73m-2 compared with compared with those with an eGFR≥60 ml·min-1·1.73m-2 group (112. 29±18.61 g·L-1 vs.119.92±20.74L-1,P【0.05);plasma hemoglobin concentration was related positively to eGFR.Conclusions There were no significant changes in plasma hemoglobin concentration and eGFR;however,plasma hemoglobin concentration was related to eGFR significantly positively in elderly patients with ICM due to coronary heart

Endoventricular Spiral Plication for Ischemic Dilated Cardiomyopathy

Surgical ventricular restoration (SVR) procedures have been developed;however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown;this method has a unique concept of left ventricular (LV) restoration without artificial patch materials. Here, we describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting. ESP was effective in papillary muscle approximation for avoiding heart failure;however, the noted improvement of LV wall thickening might be temporary.

Hypoglycemic myocardial stunning as cause of cardiogenic shock in a patient with ischemic cardiomyopathy: A case report and review of literature

Hypoglycemia is a common complication seen in patients with diabetes mellitus and has been proven to have adverse effects on cardiovascular mortality. Hypoglycemia can potentially lead to worsening of cardiac function in patients with ischemic heart disease. We present a case of cardiogenic shock in a patient with hypoglycemia secondary to insulin accumulation due to worsening renal function with dramatic recovery of shock once his sugars normalized.

Analysis about the effect of trimetazidine combined with atorvastation calcium on myocardin i level, cardiac and renal function in patients with ischemic cardiomyopathy

Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admitted in our hospital from January 2013 to May 2016 were selected and divided them randomly into the research group and the control group. All subjects were treated with conventional therapy after admission. On this basis, the control group was given atorvastation calcium, meanwhile the research group was given trimetazidine combined with atorvastation calcium. Then analyzed the cTnI level, evaluated their cardiac and renal function (cardiac function indexes: LVEF, LVESD, LVEDD, renal function indexes: Scr, BUN and mALB) after three months treatment.Results: After treatment, the level of cTnI, LVESD and LVEDD in this two groups were decreased dramatically, the level of cTnI, LVESD and LVEDD in the research group were (0.51±0.24) ng/mL, (38.35±3.94) mm and (51.43±4.56) mm respectively, compared with the control group, these levels were significantly decreased;the level of LVEF was (51.10±4.07)% in research group, increased more obviously than the control group, and the difference was statistical significant. The Scr, BUN and mALB in two groups were decreased after treatment, the research group was significantly reduced, in addition, these levels in research group were (80.14±10.21) μmol/L, (5.89±1.06) mmol/L and (51.35±20.94) mg/24 h respectively, lower than the control group.Conclusion: The therapy of trimetazidine combined with atorvastation calcium in patients with Ischemic cardiomyopathy, was worthy of clinical application, seeing that can ameliorate effectively myocardial injury , the cardiac and renal function.

Effect of Danhong injection on neuroendocrine molecules and ventricular remodeling in patients with ischemic cardiomyopathy heart failure

Objective:To study the effect of Danhong injection on neuroendocrine molecules and ventricular remodeling in patients with ischemic cardiomyopathy heart failure.Methods: 80 cases of patients with ischemic cardiomyopathy heart failure who were treated in our hospital between March 2014 and December 2016 were collected and divided into control group (n=40) and observation group (n=40) according to random number table. The control group received regular treatment, the observation group received regular + Danhong injection treatment, and both therapies lasted for 14 d a course, two sessions. Serum contents of neuroendocrine molecules and ventricular remodeling-related indexes, Doppler ultrasonic ventricular remodeling parameter levels, and so on were compared between two groups of patients before and after treatment.Results: Before treatment, serum contents of neuroendocrine molecules and ventricular remodeling-related indexes as well as Doppler ultrasonic ventricular remodeling parameter levels were not statistically different between two groups of patients. After treatment, serum neuroendocrine molecules NT-proBNP, ANP, AngⅡ, ALD and NE contents of observation group were lower than those of control group, serum ventricular remodeling indexes TGF-β1, NF-κB, CysC and FGF23 contents were lower than those of control group, and ultrasonic ventricular remodeling parameters LVMI, LVRI, RVEDV and RVESV levels were lower than those of control group.Conclusion: Adjuvant Danhong injection therapy helps optimize the neuroendocrine molecule contents and inhibit the ventricular remodeling process in patients with ischemic cardiomyopathy heart failure.

Improvement of increased cQTd is associated with heart function in patients with ischemic heart failure

Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class （NYHA） III-IV with a left ventricular ejection fraction （LVEF） 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy （DCM） group （n = 120） and an ischemic cardiomyopathy （ICM） group （n = 120）. Then, based on the cQTd width, the ICM group was divided into two subgroups： a QS group （cQTd ≤60 ms, n = 70） and a QL group （cQTd 〉 60 ms, n = 50）. All patients were examined by echocardiography and 12-lead electrocardiography （ECG） at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.

Left Ventricular Dysfunction in Ischemic Heart Disease

Ischemic heart disease is a growing cause of heart failure owing to the increasing prevalence of diabetes,hypertension,and obesity.It is important to understand the concepts of myocardial stunning and hibernation so we as physicians can order appropriate testing on patients with ischemic heart disease,such as myocardial viability studies.Ventricular remodeling is associated with an elevated risk of death after myocardial infarction.The extent of myocardial viability determines the clinical outcome of patients after myocardial infarction.Multiple impactful clinical trials have changed the way we manage ischemic cardiomyopathy over the past few decades,and medications such as angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,beta-blockers,and aldosterone antagonists have improved outcomes in this patient population.Similarly,much has been reported on the effect of coronary artery bypass surgery on outcomes in patients with ischemic heart disease and heart failure,but further research studies are needed on the role of percutaneous coronary intervention.

Decellularized extracellular matrix materials for treatment of ischemic cardiomyopathy

Ischemic cardiomyopathy(ICM)affect millions of patients globally.Decellularized extracellular matrix materials(dECM)have components,microstructure and mechanical properties similar to healthy cardiac tissues,and can be manufactured into various forms of implantable biomaterials including injectable hydrogels or epicardial patches,which have been extensively reported to attenuate pathological left ventricular remodeling and maintain heart function.Recently,dECM medical devices for ICM treatment have been approved for clinical use or studied in clinical trials,exhibiting considerable translation potential.Cells,growth factors and other bioactive agents have been incorporated with different dECM materials to improve the therapeutic outcomes.In addition,more detailed aspects of the biological effects and mechanisms of dECM treatment are being revealed.This review summarized recent advances in dECM materials from variable sources for cardiac repair,including extraction of extracellular matrix,cell integration,smart manufacturing of injectable hydrogels and cardiac patch materials,and their therapeutic applications.Besides,this review provides an outlook on the cutting-edge development directions in the field.

地奥心血康软胶囊联合沙库巴曲缬沙坦治疗缺血性心肌病的疗效及对心室重构、生存质量的影响

目的探讨地奥心血康软胶囊联合沙库巴曲缬沙坦治疗缺血性心肌病的疗效及对心室重构、生存质量的影响。方法回顾性选取2018年9月到2023年9月滁州市中西医结合医院收治的80例缺血性心肌病患者,依据治疗方法的不同将其分为对照组与观察组,每组各40例。对照组应用沙库巴曲缬沙坦治疗,观察组应用地奥心血康软胶囊联合沙库巴曲缬沙坦治疗。治疗3个月后,比较两组患者临床疗效,比较两组患者治疗前、治疗3个月后的血液生化指标[B型脑钠肽(BNP)、高敏C反应蛋白(hs-CPP)、超氧化物歧化酶(SOD)]、Killip心功能分级、心室重构相关指标[左心室重构指数(LVRI)、左心室质量指数(LVMI)]水平,以及明尼苏达心力衰竭生存质量问卷(MLHFQ)评分。结果治疗3个月后,观察组治疗总有效率为95.00%,高于对照组(75.00%),差异有统计学意义(P<0.05)。治疗3个月后,两组患者BNP、hs-CPP水平均较治疗前降低,SOD水平均较治疗前升高,且观察组BNP、hs-CPP水平分别为(93.28±8.62)pg/L、(29.12±4.12)mg/L,均明显低于对照组[(125.61±10.69)pg/L、(37.12±4.25)mg/L],SOD水平为(108.27±10.69)nU/mL,高于对照组[(93.67±15.45)nU/mL],差异均有统计学意义(P<0.05)。观察组治疗3个月后,患者Ⅰ级比率为47.50%,高于对照组(25.00%),Ⅲ级、Ⅳ级比率为7.50%、0,明显低于对照组(25.00%、10.00%),差异均有统计学意义(P<0.05)。观察组LVRI、LVMI为(2.52±0.43)g/mL、(93.43±7.17)g/m^(2),均低于对照组[(2.94±0.24)g/mL、(110.31±11.28)g/m^(2)],差异有统计学意义(P<0.05)。治疗3个月后,两组患者MLHFQ中身体领域、情绪领域、其他领域各分值及MLHFQ总分均较治疗前升高,且观察组身体领域、情绪领域、其他领域各分值及MLHFQ总分分别为(32.56±7.11)、(20.36±4.25)、(33.93±5.13)、(86.87±8.37)分,均高于对照组[(27.87±5.13)、(17.56±4.46)、(30.01±4.05)、(75.44±5.66)分],差异均有统计学意义(P<0.05)。结论地奥心血康软胶囊联合沙库巴曲缬沙坦治疗缺血性心肌病临床疗效显著,可降低BNP表达水平,同时能够抑制脂质过氧化反应,减轻机体炎症反应水平,提升心功能,改善心室重构情况,进而提升患者生存质量。

左房功能对老年缺血性心肌病患者冠脉搭桥术后远期预后的评估价值

目的研究左房功能对老年缺血性心肌病患者冠脉搭桥术后远期预后的评估价值。方法选取2012年1月—2017年1月在阜外医院行冠脉搭桥手术,并术前完善心脏磁共振检查左室射血分数≤35%的老年缺血性心肌病患者131例作为研究对象,中位随访时间63.8个月。根据是否发生主要终点事件(MACE),分为MACE组和无MACE组,比较2组患者基线特征、心脏磁共振参数。生存分析采用Kaplan-Meier曲线,生存率比较采用Log-rank检验。采用多变量COX回归分析评估老年缺血性心肌病患者发生主要终点事件的危险因素。结果MACE组最大左房容积指数(LAVmax/BSA)高于无MACE组,左房储存期射血分数(LAEFreservoir)、左房泵血期射血分数(LAEFpump)均低于无MACE组,差异均有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析结果显示,LAVmax/BSA≥46.72 mL/m 2组和LAEFreservoir<29.94%组无事件生存率较低(P<0.05)。多变量COX回归分析显示,LAEFreservoir[HR 0.964;95%CI(0.94,0.989),P=0.006]与老年缺血性心肌病患者冠脉搭桥术后远期主要终点事件独立相关。结论LAEFreservoir是老年缺血性心肌病患者冠脉搭桥术后远期主要终点事件的独立预测因子。

心脏MRI预测扩张性心肌病中心脏猝死风险的临床研究

目的本研究旨在确定心脏MRI心肌组织特征预测心源性猝死(sudden cardiac death,SCD)的相关因素,并探讨非缺血性扩张型心肌病(dilated cardiomyopathy,DCM)的SCD分层算法。方法纳入了在2020年1月至2021年12月期间接受心脏MRI检查的非缺血型扩张型心肌病成人患者。与SCD相关的事件包括SCD、适当的植入性心律转复除颤器休克和心脏骤停后的复苏。竞争风险回归分析和Kaplan-Meier分析用于确定心肌组织特征与预后的关系。结果858名参与者中,70名(8%)参与者在中位数33.0个月的随访中经历了SCD相关事件。在多变量竞争风险分析中,晚期Gd增强(LGE)(危险比[HR],1.87;95%CI:1.07,3.27;P=0.03)、自然T1(每10毫秒增加一次:HR,1.07;95%CI:1.04,1.11;P<0.001)和细胞外体积分数(每增加3%:HR,1.26;95%CI:1.11,1.44;P<0.001)是调整收缩压、房颤和左心室射血分数后SCD相关事件的独立预测因素。结合本地T1和LGE制定了SCD风险分层类别。自然T1值高于平均值(1382毫秒)4或以上的参与者每年SCD相关事件的发生率最高,为9.3%,而天然T1值为2,低于平均值(1292毫秒)且LGE为负值的参与者的SCD相关事件发生率最低,为0.6%。这一类别具有良好的预测能力(C=0.74),可用于区分SCD风险和竞争性心力衰竭风险。结论来自心脏MRI的心肌组织特征是非缺血性扩张型心肌病患者心源性猝死(SCD)相关事件的独立预测因子,可用于根据不同的SCD风险类别对参与者进行分层。

缺血性心力衰竭患者N端脑钠肽前体与新发房颤的相关性研究

目的:分析缺血性心力衰竭(心衰)患者的血浆N端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平,及其与患者新发心房颤动(房颤)间的关系。方法:本研究纳入120例射血分数降低(<40%)的窦性心律的缺血性心衰患者,分别在基线0 d、6个月和12个月测定其血浆NT-proBNP水平,并在入组时行超声心动图检查,于入组后1、3、6、12个月时进行24 h动态心电图检查,根据随访12个月中是否发生房颤,将患者分为房颤组(n=44)和无房颤组(n=76)。分析2组患者的临床资料和心动超声图资料,应用受试者操作特征(receiver operating characteristic,ROC)曲线,分析NT-proBNP检测对新发房颤的预测作用及其最佳临界值。采用多因素logistic回归分析NT-proBNP与缺血性心衰患者新发房颤间的关系。结果:在12个月的随访期间,缺血性心衰患者中新发房颤率为36.7%。与无房颤组相比,房颤组的纽约心功能分级、NT-proBNP水平(入组当天、6个月和12个月)、心动超声检查中二尖瓣口舒张早期/舒张晚期峰值速度比值(E/A)、二尖瓣口/二尖瓣环速度比值(E/E’)、肺动脉收缩压(pulmonary artery systolic pressure,PASP)、肺毛细血管楔嵌压(pulmonary capillary wedge pressure,PCWP)、左心房容量(left atrial volume,LAV)和左心房容量指数(left atrial volume index,LAVI)更高(P<0.05)。NT-proBNP与E/A、E/E’、PASP、PCWP、LAV和LAVI呈显著正相关(P<0.05)。ROC曲线显示,基线0 d的NT-proBNP水平对新发房颤的预测能力最强,临界值取NT-proBNP≥2357.5 pg/mL时,其预测新发房颤的灵敏度为69%,特异度为83%,ROC曲线下面积为0.825(95%CI为0.722~0.924,P<0.001)。回归分析发现,仅NT-proBNP是缺血性心衰患者新发房颤的独立预测因子(OR=1.24,95%CI为1.08~1.43)(P=0.001)。结论:血浆NT-proBNP水平检测在预测缺血性心衰患者新发房颤中有一定的临床价值。

互动达标模式干预对缺血性心肌病患者负性情绪和健康行为的影响

目的:探究互动达标模式干预对缺血性心肌病患者负性情绪和健康行为的影响。方法:将2020年5月-2022年7月某院收治的120例缺血性心肌病患者随机分为两组。对照组60例予以常规临床干预,干预组60例在对照组基础上予以互动达标模式干预。比较两组干预前后的负性情绪、健康行为、自护能力,评价两组的治疗依从性及生活质量。结果:干预后,干预组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组(t=-7.231,-9.451;P<0.05);干预后,干预组的健康促进生活量表(HPLP-Ⅱ)中人际关系、健康责任、压力管理、营养、体育运动、精神成长评分均高于对照组(t=9.801,8.168,8.590,10.423,8.449,8.765;P<0.05);干预后,干预组的自我护理能力量表(ESCA)中护理技能、自护责任感、自护知识、自我概念评分均高于对照组(t=7.819,8.116,10.147,13.442;P<0.05);干预组的治疗依从率高于对照组(χ^(2)=6.536,P<0.05);干预后,干预组的生活质量量表(WHOQOL-BREF)各维度评分均高于对照组(t=9.086,9.056,6.451,9.755;P<0.05)。结论:互动达标模式干预对缺血性心肌病患者的干预效果显著,能有效缓解患者的负性情绪,改善其健康行为,提升其自护能力及治疗依从性,有助于提高患者的生活质量。

冻干重组人脑利钠肽对缺血性心肌病心力衰竭患者NT⁃proBNP、AngⅡ、NE水平、心室重构和炎症因子的影响

目的探讨缺血性心肌病(ICM)心力衰竭(HF)患者应用冻干重组人脑利钠肽治疗对N末端脑钠肽前体(NT⁃proBNP)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)水平、心室重构和炎症因子的影响。方法于2020年10月至2023年2月从宿松县人民医院选择86例ICM HF患者分为对照组和试验组,均43例,以随机数字表法分组。对照组和试验组分别予以常规治疗和冻干重组人脑利钠肽联合常规治疗,均治疗2周。比较两组疗效(治疗2周后)、血清NT⁃proBNP、AngⅡ、NE、心室重构指标和炎症因子水平(治疗前和治疗2周后)。结果治疗2周后,较对照组(74.42%),试验组总有效率(93.02%)更高,差异有统计学意义(χ^(2)=5.460,P<0.05)。两组治疗2周后的血清NT⁃proBNP、AngⅡ、NE、TNF⁃α、IL⁃6、IL⁃8和LVTWP、PWS、IVSS较治疗前降低,试验组更低,差异有统计学意义(t=5.672、20.016、55.416、6.742、5.851、5.258、5.940、6.681、5.865,P<0.05)。结论ICM HF患者应用冻干重组人脑利钠肽治疗可降低血清NT⁃proBNP、AngⅡ、NE水平,改善神经分泌功能,同时可抑制心室重构及机体炎症,疗效显著。

磁共振弥散加权成像及延迟强化技术评估缺血性心肌病预后的应用价值

目的探讨磁共振弥散加权成像(DWI)及延迟强化技术(LGE-CMR)评估缺血性心肌病(ICM)预后的应用价值。方法选择2018年6月-2021年6月在我院诊断为ICM的患者84例作为研究对象。根据LGE-CMR有无心肌延迟强化分为LGE阳性组和LGE阴性组。LGE阳性组再根据LGE阳性节段数分为瘢痕心肌节段数<6和瘢痕心肌节段数≥6两个亚组。分析比较LGE阳性组和阴性组患者心功能参数值及ADC值,LGE阳性两个亚组患者延迟强化情况,并分析比较LGE阳性组和阴性组患者不良心血管事件发生率。不良心血管事件发生的危险因素采用多因素Logistic回归分析。采用ROC曲线分析预测ICM患者发生不良心血管事件的AUC、最佳诊断分界点、敏感度、特异度以及95%CI。结果LGE阳性组患者的心功能参数比LGE阴性组差,LGE阳性组患者的ADC值比LGE阴性组低,且在LGE阳性组中瘢痕心肌节段数≥6亚组的患者心功能参数和ADC值进一步降低(P<0.05)。瘢痕心肌节段数<6亚组患者瘢痕质量、瘢痕质量百分比、灰区质量和灰区质量百分比均小于瘢痕心肌节段数≥6亚组患者(P<0.05)。LGE阳性组发生不良心血管事件的概率高于LGE阴性组(P<0.05)。多因素Logistic回归分析结果显示LVEF、ADC值和瘢痕质量是不良心血管事件发生的危险因素。LVEF、ADC值和瘢痕质量联合预测ICM患者发生不良心血管事件的AUC为0.875(95%CI:0.775-0.976,P<0.001)。结论DWI及LGE-CMR可对ICM患者进行诊断及预后危险分层,可为治疗方案的制定提供参考。

冠状动脉支架对缺血性心肌病心力衰竭患者心功能的影响

目的:分析冠状动脉支架对缺血性心肌病(ICM)心力衰竭(HF)患者心功能的影响。方法:选取2022年1月至2023年12月商丘市第一人民医院收治的ICMHF患者88例,随机分为对照组和观察组,各44例。对照组予以常规药物治疗,观察组在对照组常规药物治疗2周后行冠状动脉支架治疗。比较两组患者临床疗效、纽约心脏病协会(NYHA)分级、X线心胸比、心功能指标、运动耐力、不良心血管事件发生情况。结果:观察组患者临床总有效率高于对照组,差异具有统计学意义(P<0.05)。观察组患者NYHA分级优于对照组,差异具有统计学意义(χ^(2)=2.530,P=0.011)。治疗后,观察组患者X线心胸比低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者左心室舒张末期内径(LVEDD)低于对照组,左心室射血分数(LVEF)、6 min步行距离(6MWD)高于对照组,差异具有统计学意义(P<0.05)。观察组患者不良心血管事件总发生率低于对照组,差异具有统计学意义(P<0.05)。结论:冠状动脉支架治疗ICM HF患者,能够提高心功能,增强治疗效果和运动耐力,减少不良心血管事件的发生。

瑞舒伐他汀联合曲美他嗪治疗老年ICM心衰的疗效

目的观察瑞舒伐他汀联合曲美他嗪治疗老年缺血性心肌病(ICM)心力衰竭的短期疗效。方法选择老年ICM心力衰竭患者92例,随机分为对照组和观察组,各46例。所有患者均接受利尿剂、β受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)、抗凝制剂、抗血小板制剂、洋地黄类、硝酸酯类药物等的常规抗心衰治疗,对照组在此基础上加用曲美他嗪20 mg(3次/d,口服),观察组在此基础上联用瑞舒伐他汀10 mg(1次/d,口服)和曲美他嗪20 mg(3次/d,口服)。疗程均为6个月。观察两组治疗前后临床疗效及左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)及6 min步行距离测试(6MWT)。结果观察组的LVESD、LVEDD、LVEF、6MWT均明显优于对照组(P<0.05);观察组整体疗效明显优于对照组(P<0.05);两组均无肝肾功能异常。结论瑞舒伐他汀联合曲美他嗪治疗老年ICM心力衰竭短期疗效显著,且无明显不良反应。

缺血性卒中患者心脏磁共振检查专家共识

卒中是我国居民致死、致残的首要原因,缺血性卒中(ischemic stroke,IS)约占卒中患者的70%。在IS中,心源性栓塞性卒中和来源不明的栓塞性卒中分别占20%~30%和30%~40%。心脏磁共振(cardiac magnetic resonance,CMR)检查作为一种重要的补充检查手段,不仅有助于IS病因的确认,还可以揭示IS新的发病机制。本文阐述了IS患者CMR检查的必要性、CMR检查技术的价值及在IS患者中的应用适应证,并推荐了IS患者的CMR检查流程,以便更好地为IS的病因诊断、治疗及二级预防提供帮助。

心脏磁共振影像组学在非缺血性心肌病中的应用研究进展

非缺血性心肌病的病因复杂,主要由遗传、心肌代谢、心肌结构改变等所致,而非冠状动脉病变引起。心脏磁共振(CMR)能够高分辨显示心肌组织特征,并能够提供客观的心功能参数。传统CMR图像观察及分析手段对图像的利用十分有限,而CMR影像组学技术的出现为非缺血性心肌病的研究提供了新的方法。本文将综述CMR影像组学在非缺血性心肌病中的应用研究进展,主要包括其在肥厚型心肌病、扩张型心肌病、心肌淀粉样变性诊断及预后预测中的应用价值。