Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 202...Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected.All patients underwent both 64-slice spiral CT and digital subtraction angiography(DSA).DSA is considered the gold standard for diagnosis,so it was used to analyze the diagnostic performance of 64-slice spiral CT.Results:(1)The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other.The 64-slice spiral CT had an accuracy of 96.67%(29/30),a sensitivity 96.55%(28/29),and a specificity of 100.00%(1/1)in diagnosing coronary artery stenosis.(2)There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion,the positive detection rate of left main lesion,the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion(P>0.05).(3)There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis,moderate stenosis,and severe stenosis of coronary arteries(P>0.05).Conclusion:64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries,which allows for the accurate diagnosis of coronary artery stenosis.展开更多
Aim:Intracoronary murmur results from turbulent flow due to coronary artery narrowing.This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery ste...Aim:Intracoronary murmur results from turbulent flow due to coronary artery narrowing.This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery stenosis in coronary artery disease(CAD)in Chinese populations.Method:Patients admitted to the cardiovascular department of the Sixth Medical Center of the Chinese People’s Liberation Army General Hospital between September 2021 and June 2022 for elective coronary angiography were prospectively enrolled.A digital electronic stethoscope was used to record heart sounds before angiography.Quantitative coronary angiography(QCA)served as the“gold standard”for CAD diagnosis to evaluate the diagnostic performance of the acoustic analysis method for CAD.Results:A total of 452 patients had complete QCA and heart sound data.The final interpretation results of the acoustic analysis method indicated 310 disease cases and 142 normal results.Increasing the cut-off values of coronary artery diameter stenosis from 30%to 50%,70%,and 90%increased the sensitivity and NPV of the acoustic analysis method;the sensitivity was 75.6%,81.9%,83.3%,and 85.7%,respectively;the NPV was 33.1%,57.0%,69.7%,and 88.0%,respectively;the specificity and PPV decreased(specificity of 75.8%,70.4%,51.0%,and 37.5%,respectively;PPV of 95.2%,89.0%,69.4%,and 32.9%,respectively);and the AUC values were 0.757,0.762,0.672,and 0.616,respectively.The sensitivity of the acoustic analysis method for one-vessel disease was 86.6%when the cut-off value was 50%.The sensitivity for identifying left anterior descending coronary artery lesions was best,at 90.7%.The sensitivity for identifying isolated coronary artery branch lesions was 66.7%,whereas the sensitivity for identifying three-vessel disease in multi-vessel coronary artery lesions was better,at 82.9%.Conclusion:Acoustic analysis of turbulent murmur caused by coronary artery stenosis for diagnosis of CAD may have favorable performance in the Chinese population.This method has good performance in CAD diagnosis with a cut-off coronary artery diameter for stenosis of 50%.展开更多
Background Elabela(ELA) was newly discovered as a novel endogenous ligand of the apelin receptor(APJ) which has demonstrated to be crucial for cardiovascular disease such as myocardial infarction, hypertension and hea...Background Elabela(ELA) was newly discovered as a novel endogenous ligand of the apelin receptor(APJ) which has demonstrated to be crucial for cardiovascular disease such as myocardial infarction, hypertension and heart failure. Previous experiments have revealed that ELA reduced arterial pressure and exerted positive inotropic effects on the heart. However, the role of plasma ELA levels in patients with acute coronary syndrome(ACS) and its relationship with severity of coronary arteries have not been investigated. Methods Two hundred and one subjects who were hospitalized for chest pain and underwent coronary angiography were recruited in this study. One hundred and seventy five patients were diagnosed with ACS and twenty-six subjects with negative coronary angiography were included in the control group. Plasma ELA levels, routine blood test, blood lipid, liver and kidney functions were measured. The number of coronary arteries and SYNTAX(Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score of coronary lesions were used to evaluate the extent of coronary artery stenosis. Results ELA in patients with ACS was significantly higher than that in the control group(P < 0.01). There was no significant difference in plasma ELA levels among patients with single-, double-and triple-vessel diseases. However, in the generalized additive model(GAM), there was a threshold nonlinear correlation between the ELA levels and Syntax I score(P < 0.001). Plasma ELA levels were positively correlated with the Syntax I score when the ELA levels ranged from 63.47 to 85.49 ng/m L. There was no significant association between the plasma ELA levels and the extent of coronary artery stenosis when the ELA levels were less than 63.47 ng/m L or higher than 85.49 ng/m L. Conclusion The present study demonstrates for the first time that plasma ELA levels are increased in patients with ACS. The rise in endogenous ELA levels was associated with severity of coronary stenosis and may be involved in the pathogenesis of ACS.展开更多
Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for id...Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.展开更多
Lipoprotein(a) [Lp(a)] is composed of a low density lipoprotein(LDL)-like particle to which apolipoprotein(a)[apo(a)] is linked by a single disulfide bridge. Lp(a) is considered a causal risk factor for is...Lipoprotein(a) [Lp(a)] is composed of a low density lipoprotein(LDL)-like particle to which apolipoprotein(a)[apo(a)] is linked by a single disulfide bridge. Lp(a) is considered a causal risk factor for ischemic cardiovascular disease(CVD) and calcific aortic valve stenosis(CAVS). The evidence for a causal role of Lp(a) in CVD and CAVS is based on data from large epidemiological databases, mendelian randomization studies, and genome-wide association studies. Despite the well-established role of Lp(a) as a causal risk factor for CVD and CAVS, the underlying mechanisms are not well understood. A key role in the Lp(a) functionality may be played by its oxidized phospholipids(OxPL) content. Importantly, most of circulating OxPL are associated with Lp(a); however, the underlying mechanisms leading to this preferential sequestration of OxPL on Lp(a) over the other lipoproteins,are mostly unknown. Several studies support the hypothesis that the risk of Lp(a) is primarily driven by its OxPL content.An important role in Lp(a) functionality may be played by the lipoprotein-associated phospholipase A_2(Lp-PLA_2),an enzyme that catalyzes the degradation of OxPL and is bound to plasma lipoproteins including Lp(a). The present review article discusses new data on the pathophysiological role of Lp(a) and particularly focuses on the functional role of OxPL and Lp-PLA_2 associated with Lp(a).展开更多
ABSTRACT Objectives This study sought to investigate the clinical and imaging characteristics associated with diagnostic inaccuracy of computed tomography angiography (CTA) for detecting obstructive coronary artery...ABSTRACT Objectives This study sought to investigate the clinical and imaging characteristics associated with diagnostic inaccuracy of computed tomography angiography (CTA) for detecting obstructive coronary artery disease (CAD) defined by quantitative coronary angiography (QCA).展开更多
文摘Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected.All patients underwent both 64-slice spiral CT and digital subtraction angiography(DSA).DSA is considered the gold standard for diagnosis,so it was used to analyze the diagnostic performance of 64-slice spiral CT.Results:(1)The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other.The 64-slice spiral CT had an accuracy of 96.67%(29/30),a sensitivity 96.55%(28/29),and a specificity of 100.00%(1/1)in diagnosing coronary artery stenosis.(2)There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion,the positive detection rate of left main lesion,the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion(P>0.05).(3)There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis,moderate stenosis,and severe stenosis of coronary arteries(P>0.05).Conclusion:64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries,which allows for the accurate diagnosis of coronary artery stenosis.
基金supported by research grants from the Innovation and Cultivation Fund of the Sixth Medical Center of Chinese People’s Liberation Army General Hospital(grant number:CXPY201925).
文摘Aim:Intracoronary murmur results from turbulent flow due to coronary artery narrowing.This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery stenosis in coronary artery disease(CAD)in Chinese populations.Method:Patients admitted to the cardiovascular department of the Sixth Medical Center of the Chinese People’s Liberation Army General Hospital between September 2021 and June 2022 for elective coronary angiography were prospectively enrolled.A digital electronic stethoscope was used to record heart sounds before angiography.Quantitative coronary angiography(QCA)served as the“gold standard”for CAD diagnosis to evaluate the diagnostic performance of the acoustic analysis method for CAD.Results:A total of 452 patients had complete QCA and heart sound data.The final interpretation results of the acoustic analysis method indicated 310 disease cases and 142 normal results.Increasing the cut-off values of coronary artery diameter stenosis from 30%to 50%,70%,and 90%increased the sensitivity and NPV of the acoustic analysis method;the sensitivity was 75.6%,81.9%,83.3%,and 85.7%,respectively;the NPV was 33.1%,57.0%,69.7%,and 88.0%,respectively;the specificity and PPV decreased(specificity of 75.8%,70.4%,51.0%,and 37.5%,respectively;PPV of 95.2%,89.0%,69.4%,and 32.9%,respectively);and the AUC values were 0.757,0.762,0.672,and 0.616,respectively.The sensitivity of the acoustic analysis method for one-vessel disease was 86.6%when the cut-off value was 50%.The sensitivity for identifying left anterior descending coronary artery lesions was best,at 90.7%.The sensitivity for identifying isolated coronary artery branch lesions was 66.7%,whereas the sensitivity for identifying three-vessel disease in multi-vessel coronary artery lesions was better,at 82.9%.Conclusion:Acoustic analysis of turbulent murmur caused by coronary artery stenosis for diagnosis of CAD may have favorable performance in the Chinese population.This method has good performance in CAD diagnosis with a cut-off coronary artery diameter for stenosis of 50%.
基金supported by the National Natural Science Foundation of China [8187031081770253+2 种基金81200194]the Sub project of Beijing Municipal Administration of Hospitals Digestion project key projects [XXZ0607]the National Major Research Plan Training Program of China [91849111]。
文摘Background Elabela(ELA) was newly discovered as a novel endogenous ligand of the apelin receptor(APJ) which has demonstrated to be crucial for cardiovascular disease such as myocardial infarction, hypertension and heart failure. Previous experiments have revealed that ELA reduced arterial pressure and exerted positive inotropic effects on the heart. However, the role of plasma ELA levels in patients with acute coronary syndrome(ACS) and its relationship with severity of coronary arteries have not been investigated. Methods Two hundred and one subjects who were hospitalized for chest pain and underwent coronary angiography were recruited in this study. One hundred and seventy five patients were diagnosed with ACS and twenty-six subjects with negative coronary angiography were included in the control group. Plasma ELA levels, routine blood test, blood lipid, liver and kidney functions were measured. The number of coronary arteries and SYNTAX(Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score of coronary lesions were used to evaluate the extent of coronary artery stenosis. Results ELA in patients with ACS was significantly higher than that in the control group(P < 0.01). There was no significant difference in plasma ELA levels among patients with single-, double-and triple-vessel diseases. However, in the generalized additive model(GAM), there was a threshold nonlinear correlation between the ELA levels and Syntax I score(P < 0.001). Plasma ELA levels were positively correlated with the Syntax I score when the ELA levels ranged from 63.47 to 85.49 ng/m L. There was no significant association between the plasma ELA levels and the extent of coronary artery stenosis when the ELA levels were less than 63.47 ng/m L or higher than 85.49 ng/m L. Conclusion The present study demonstrates for the first time that plasma ELA levels are increased in patients with ACS. The rise in endogenous ELA levels was associated with severity of coronary stenosis and may be involved in the pathogenesis of ACS.
文摘Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.
文摘Lipoprotein(a) [Lp(a)] is composed of a low density lipoprotein(LDL)-like particle to which apolipoprotein(a)[apo(a)] is linked by a single disulfide bridge. Lp(a) is considered a causal risk factor for ischemic cardiovascular disease(CVD) and calcific aortic valve stenosis(CAVS). The evidence for a causal role of Lp(a) in CVD and CAVS is based on data from large epidemiological databases, mendelian randomization studies, and genome-wide association studies. Despite the well-established role of Lp(a) as a causal risk factor for CVD and CAVS, the underlying mechanisms are not well understood. A key role in the Lp(a) functionality may be played by its oxidized phospholipids(OxPL) content. Importantly, most of circulating OxPL are associated with Lp(a); however, the underlying mechanisms leading to this preferential sequestration of OxPL on Lp(a) over the other lipoproteins,are mostly unknown. Several studies support the hypothesis that the risk of Lp(a) is primarily driven by its OxPL content.An important role in Lp(a) functionality may be played by the lipoprotein-associated phospholipase A_2(Lp-PLA_2),an enzyme that catalyzes the degradation of OxPL and is bound to plasma lipoproteins including Lp(a). The present review article discusses new data on the pathophysiological role of Lp(a) and particularly focuses on the functional role of OxPL and Lp-PLA_2 associated with Lp(a).
文摘ABSTRACT Objectives This study sought to investigate the clinical and imaging characteristics associated with diagnostic inaccuracy of computed tomography angiography (CTA) for detecting obstructive coronary artery disease (CAD) defined by quantitative coronary angiography (QCA).