信号平均心电图频谱时间标测检测冠心病及持续性室性心动过速／心室颤动患者结果的分析

目的：本研究观察了频谱时间标测检测心室晚电位心室对冠状动脉粥样硬化性心脏病（冠心病）患者持续性室性心动过速（室速）／心室颤动（室颤）发生的预测价值，并观察了心肌梗死、缺血及心肌梗死部位对心室晚电位的影响。方法：用频谱时间标测法，对２１０例健康人（Ⅰ组）、２０２例冠心病心绞痛患者（Ⅱ组）、１００例陈旧性心肌梗死患者（Ⅲ组）及３９例心肌梗死并持续性室速／室颤患者（Ⅳ组）的信号平均心电图进行分析，根据健康人的正常因子值确定心室晚电位诊断标准，并用Ｘ２检验对各组患者心室晚电位阳性率进行比较。结果：心室晚电位阳性率Ⅰ组与Ⅱ组无显著差异（Ｐ＞０．０５）；Ⅲ组与Ⅳ组显著高于Ⅰ组（Ｐ均＜０．００５）及Ⅱ组（Ｐ均＜０．００５）；Ⅳ组显著高于Ⅲ组（Ｐ＜０．００５）。不同心肌梗死部位无显著差异（Ｐ＞０．０５）；多部位与单部位心肌梗死无显著差异（Ｐ＞０．０５）。预测的敏感性为５１．３％、特异性为９１．０％、阳性预告值为３５．１％、阴性预告值为９５．２％。结论：频谱时间标测检测心室晚电位对预测持续性室速／室颤的发生有重要价值，心肌梗死部位、心肌缺血对心室晚电位的发生无影响。     

明目逍遥颗粒对肝郁血虚型开角型青光眼视神经病变的短期疗效

目的研究明目逍遥颗粒对肝郁血虚型开角型青光眼视神经病变视野进展的影响。方法采用随机、对照的研究方法,以2008年7月—2010年6月在广安门医院眼科就诊的原发性开角型青光眼患者为研究对象,纳入眼压控制在一定范围内,视野损害接近,且辨证为肝郁血虚型者84例,随机分为中药治疗组与对照组。中药治疗组予口服明目逍遥颗粒,18 g,日2次,观察3个月;对照组不给予明目逍遥颗粒。观察内容为:视力、眼压(Goldmann压平眼压计)、眼前段检查、视野平均偏差(Humphrey自动视野计,30-2程序)。结果1.使用独立样本t检验对中药治疗组与对照组的双眼视野进展情况进行比较,2组差异无统计学意义(P>0.05)。2.使用配对样本t检验对中药治疗组治疗前后的视野情况进行比较,差异无统计学意义(P>0.05)。结论明目逍遥颗粒在3个月的观察期间未发现对肝郁血虚性开角型青光眼视神经的保护作用,中药对青光眼视神经的保护作用仍需研究。     

基于VF波形多特征参数的除颤成功率预测研究

目的:基于心室颤动(ventricular fibrillation,VF)波形构建电击除颤成功率预测模型,选择最佳的除颤时机进行电击除颤,以提高除颤成功率.方法:通过建立动物实验模型,测量动物室颤时心电数据,从时域、频域和相空间、联合域4个不同维度提取特征参数,选择4、8、10、12 s作为预测室颤时间长度,利用逻辑...     

Ventricular fibrillation waveform measures combined with prior shock outcome predict defibrillation success during cardiopulmonary resuscitation

Aim

Amplitude Spectrum Area (AMSA) and Median Slope (MS) are ventricular fibrillation (VF) waveform measures that predict defibrillation shock success. Cardiopulmonary resuscitation (CPR) obscures electrocardiograms and must be paused for analysis. Studies suggest waveform measures better predict subsequent shock success when combined with prior shock success. We determined whether this relationship applies during CPR.

A clinical research study on the respective relationships between visfatin and human fetuin A and pregnancy outcomes in gestational diabetes mellitus

ObjectiveThe aim was to determine the role of visfatin (VF) and human fetuin A (AHSG) in the development of gestational diabetes mellitus (GDM) and to explore the association between these variables and adverse outcomes.Materials and methodsWe carried out our study on 68 cases of GDM pregnant women and 42 cases of healthy pregnant women, including 56 cases with diet control and 12 cases with insulin treatment. Enzyme-linked immunoassay (ELISA) was used to test the expression levels of VF and AHSG in maternal and umbilical cord serum. Immunohistochemistry (ICH) was used to test the expression level of the VF protein in placental tissue.ResultsThe expression levels of VF and AHSG in maternal and umbilical cord serum and the expression level of VF in placental tissue in GDM pregnant women were higher than those in healthy pregnant women. The incidence of adverse outcomes in the GDM pregnant women was higher than that in healthy pregnant women, and these differences were statistically significant (P < 0.05). Those who had higher expression levels of VF or AHSG had a higher incidence of adverse outcomes (P < 0.05).ConclusionThe expression of VF and AHSG may participate in the development of GDM. A test of VF and AHSG in GDM pregnant women may have some predictive value for the occurrence of adverse outcomes.     

Myocardial scar characteristics based on cardiac magnetic resonance imaging is associated with ventricular tachyarrhythmia in patients with ischemic cardiomyopathy

Objectives

We hypothesized that myocardial scar characterization using cardiac magnetic resonance imaging (CMR) may be associated with the occurrence of ventricular tachyarrhythmia (VT), appropriate implantable cardioverter-defibrillator (ICD) therapy and mortality.

Background

Since a minority of patients with prophylactic ICD implantation receive appropriate ICD therapy, there is a need for more effective risk stratification for primary prevention in patients with ischemic cardiomyopathy.

Methods and results

In 99 patients with ischemic cardiomyopathy, CMR was performed prior to ICD implantation. We assessed if CMR indices (cardiac mass, LVEF) and CMR scar characteristics (infarct core mass, peri-infarction mass and the ratio's between left ventricular mass, infarct core mass and peri-infarction mass) were associated with outcome. The primary endpoint was sustained VT and/or appropriate ICD therapy. The secondary endpoint was all-cause mortality. During a median follow-up of 5.4 years (IQR 4.5–6.6 years), 34 patients reached the primary end-point (17 appropriate ICD shocks) and 26 patients died. In multivariable Cox regression analysis, peri-infarction to core-infarction ratio (HR 2.01, 95%CI: 1.17–3.44, p = 0.01) was independently and significantly associated with the primary endpoint, whereas NYHA-class and lower LVEF were not. Conversely, age (HR 1.06, 95% CI: 1.01–1.12, p = 0.02) and lower LVEF (HR 0.95, 95% CI: 0.91–1.00, p = 0.04) were independently associated with all-cause mortality, mainly due to heart failure.

Conclusion

A relatively large peri-infarction mass is associated with sustained VT and/or appropriate ICD therapy, whereas age and lower LVEF are associated with mortality. CMR based tissue characterization could aid in the prediction of specific outcome measures and in clinical decision making.