48 results on '"Hua-yan Xu"'
Search Results
2. Association of diabetes mellitus and glycemic control with left ventricular function and deformation in patients after acute myocardial infarction: a 3 T cardiac magnetic resonance study
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Yue Gao, Rui Shi, Yuan Li, Ying-kun Guo, Hua-Yan Xu, Ke Shi, and Zhi-gang Yang
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Endocrinology, Diabetes and Metabolism ,Cardiology and Cardiovascular Medicine - Abstract
Background Diabetes mellitus (DM) is considered a major risk factor for myocardial infarction (MI), and MI patients with DM have a poor prognosis. Accordingly, we aimed to investigate the additive effects of DM on LV deformation in patients after acute MI. Materials and methods One hundred thirteen MI patients without DM [MI (DM−)], 95 with DM [MI (DM+)] and 71 control subjects who underwent CMRscanning were included. LV function, infarct size and LV global peak strains in the radial, circumferential and longitudinal directions were measured. MI (DM+) patients were divided into two subgroups based on the HbA1c level ( Results Compared with control subjects, both MI (DM−) and MI (DM+) patients presented higher LV end-diastolic and end-systolic volume index and lower LV ejection fraction. LV global peak strains progressively declined from the control group to the MI(DM−) group to the MI(DM+) group (all p p p p = 0.025) and longitudinal PS (β = 0.221, p = 0.010) in MI (DM+) patients. Conclusions DM has an additive deleterious effect on LV function and deformation in patients after acute MI, and HbA1c was independently associated with impaired LV myocardial strain.
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- 2023
3. Clinical utilisation of multimodal quantitative magnetic resonance imaging in investigating muscular damage in Duchenne muscular dystrophy: a study on the association between gluteal muscle groups and motor function
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Yu Song, Hua-yan Xu, Ke Xu, Ying-kun Guo, Lin-jun Xie, Fei Peng, Rong Xu, Hang Fu, Wei-feng Yuan, Zi-qi Zhou, Bo-chao Cheng, Chuan Fu, Hui Zhou, Xiao-tang Cai, and Xue-sheng Li
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Pediatrics, Perinatology and Child Health ,Radiology, Nuclear Medicine and imaging - Abstract
Background Duchenne muscular dystrophy (DMD) is a neuromuscular disease characterised by progressive muscular weakness and atrophy. Currently, studies on DMD muscle function mostly focus on individual muscles; little is known regarding the effect of gluteal muscle group damage on motor function. Objective To explore potential imaging biomarkers of hip and pelvic muscle groups for measuring muscular fat replacement and inflammatory oedema in DMD with multimodal quantitative magnetic resonance imaging (MRI). Materials and methods One hundred fifty-nine DMD boys and 32 healthy male controls were prospectively included. All subjects underwent MRI examination of the hip and pelvic muscles with T1 mapping, T2 mapping and Dixon sequences. Quantitatively measured parameters included longitudinal relaxation time (T1), transverse relaxation time (T2) and fat fraction. Investigations were all based on hip and pelvic muscle groups covering flexors, extensors, adductors and abductors. The North Star Ambulatory Assessment and stair climbing tests were used to measure motor function in DMD. Results T1 of the extensors (r = 0.720, P r = 0.558, P r = 0.697, P r = -0.711, P r = -0.753, P b = 0.013, t = 2.052, P = 0.042), T2 of the adductors (b = -0.234, t = -2.554, P = 0.012) and fat fraction of the extensors (b = -0.637, t = − 4.096, P Conclusion Magnetic resonance biomarkers of hip and pelvic muscle groups (particularly T1 values of the abductor muscles) have the potential to be used as independent risk factors for motor dysfunction in DMD.
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- 2023
4. Distinguishing Cardiac Amyloidosis and Hypertrophic Cardiomyopathy by Thickness and Myocardial Deformation of the Right Ventricle
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Hui Liu, Peng Bai, Hua-Yan Xu, Zhen-Lin Li, Chun-Chao Xia, Xiao-Yue Zhou, Liang-Geng Gong, and Ying-Kun Guo
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Article Subject ,RC666-701 ,cardiovascular system ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,behavioral disciplines and activities - Abstract
Objectives. To compare right ventricular thickness (RVT) and deformation of cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) patients. Methods. Sixty CA (mean age 58 ± 10 years; 33 males (55%)) and sixty HCM patients (mean age 55 ± 14 years; 27 males (45%)) were retrospectively enrolled. RVT, global radical peak strain (GRPS), global longitudinal peak strain (GLPS), and global circumferential peak stain (GCPS) were analyzed. To determine the cutoff values of the RVT and RV strain parameters for distinguishing CA from HCM, the areas under the receiver operating characteristic curve (AUCs) were analyzed. Results. RVT of CA patients was significantly thicker than that of HCM patients (7.8 ± 2.1 vs 5.9 ± 1.3, p p p p p = 0.0001). Conclusions. Right ventricular myocardial thickness and deformation of CA patients was more severe than HCM patients. RV-GLPS combined with RVT presents an excellent diagnostic performance in distinguishing CA and HCM.
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- 2022
5. Early longitudinal changes in left ventricular function and morphology in diabetic pigs: evaluation by 3.0T magnetic resonance imaging
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Wei-Feng Yan, Hua-Yan Xu, Li Jiang, Lu Zhang, Ying-Kun Guo, Yuan Li, Li-Ting Shen, Chen-Yan Min, and Zhi-Gang Yang
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Endocrinology, Diabetes and Metabolism ,Cardiology and Cardiovascular Medicine - Abstract
Background Previous researches on large animal models of diabetic cardiomyopathy were insufficient. The aim of this study was to evaluate early changes in left ventricular (LV) function and morphology in diabetic pigs using a cardiac magnetic resonance (CMR) time-volume curve and feature tracking technique. Methods Streptozotocin (STZ) was used to induce diabetic in sixteen pigs. 3.0T MRI scanned the pig’s heart before and 2, 6, 10 and 16 months after modelling. CMR biomarkers, including time-volume curve and myocardial strain, were compared to analyse the longitudinal changes in LV function and morphology. Pearson correlation was used to evaluate the relationship between LV strain and remodelling. Cardiac specimens were obtained at 6, 10, and 16 months after modelling to observe the myocardial ultrastructural and microstructure at different courses of diabetes. Results Twelve pigs developed diabetes. The 80% diastolic volume recovery rate (DVR) at 6 months after modelling was significantly higher than that before modelling (0.78 ± 0.08vs. 0.67 ± 0.15). The LV global longitudinal peak strain (GLPS) (− 10.21 ± 3.15 vs. − 9.74 ± 2.78 vs. − 9.38 ± 3.71 vs. − 8.71 ± 2.68 vs. − 6.59 ± 2.90%) altered gradually from the baseline data to 2, 6, 10 and 16 months after modelling. After 16 months of modelling, the LV remodelling index (LVRI) of pigs increased compared with that before modelling (2.19 ± 0.97 vs. 1.36 ± 0.45 g/ml). The LVRI and myocardial peak strain were correlated in diabetic pigs (r= − 0.40 to − 0.54), with GLPS being the most significant. Electron microscopy and Masson staining showed that myocardial damage and fibrosis gradually increased with the progression of the disease. Conclusion Intravenous injection of STZ can induce a porcine diabetic cardiomyopathy model, mainly characterized by decreased LV diastolic function and strain changes accompanied by myocardial remodelling. The changes in CMR biomarkers could reflect the early myocardial injury of diabetic cardiomyopathy.
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- 2023
6. Inflammation in Remote Myocardium and Left Ventricular Remodeling After Acute Myocardial Infarction: A Pilot Study Using <scp>T2</scp> Mapping
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Ke Shi, Chuan Fu, Hong Li, Xue-Sheng Li, Hua-yan Xu, Meng-Xi Yang, Xiaoyue Zhou, Lu Zhang, Ying-kun Guo, Yong He, Z G Yang, Jun-Long Wang, Min Ma, Zhi-gang Yang, and Bin Zhou
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medicine.medical_specialty ,Swine ,T2 mapping ,Myocardial Infarction ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Pilot Projects ,Inflammation ,Animal model ,Internal medicine ,medicine ,Animals ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Prospective Studies ,Myocardial infarction ,Ventricular remodeling ,Ventricular Remodeling ,business.industry ,Myocardium ,medicine.disease ,Pathophysiology ,Cardiology ,Analysis of variance ,medicine.symptom ,business - Abstract
BACKGROUND The pathophysiological changes in the remote myocardium after acute myocardial infarction (MI) remains less understood. PURPOSE To assess the inflammation in the remote myocardium post-MI and its association with left ventricular (LV) remodeling using T2 mapping. STUDY TYPE Prospective. ANIMAL MODEL AND SUBJECTS Twelve pigs at 3-day post-MI, 6 pigs at 3-month post-MI, 6 healthy pigs; 54 patients at 3-day and 3-month post-MI, 31 healthy volunteers; FIELD STRENGTH/SEQUENCE: A 3 T MRI/ steady-state free-precession sequence for T2 mapping (animals: 0, 30, and 55 msec; human: 0, 25, and 55 msec), phase-sensitive inversion recovery gradient echo for late gadolinium enhancement (LGE), balanced steady free-precession sequence for cine. ASSESSMENT Infarcted myocardium was defined on LGE, remote T2 was measured on T2 maps. LV remodeling was evaluated as LV end-diastolic volume change index between two scans using cine. CD68 staining was conducted to detect monocyte/macrophage. STATISTICAL TESTS Student-t test and one-way ANOVA were used to compare remote T2 with normal controls. The association of remote T2 with LV remodeling was assessed using linear regression. P values of
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- 2021
7. Risk stratification of cardiac sequelae detected using cardiac magnetic resonance in late convalescence at the six-month follow-up of recovered COVID-19 patients
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Keke Hou, Rong Xu, Hua-yan Xu, Ying-kun Guo, Yongli Zheng, Nan Jiang, Hang Fu, Zhongqin Zhou, Tao Li, Lin-jun Xie, Jun Lin, Xiaoyu Niu, Tao Zeng, Bennan Zhao, Na Zhang, and Bin Kang
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Microbiology (medical) ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Convalescence ,media_common.quotation_subject ,Follow up studies ,COVID-19 ,Risk Assessment ,Infectious Diseases ,Internal medicine ,Risk stratification ,medicine ,Humans ,Cardiac magnetic resonance ,business ,Risk assessment ,Letter to the Editor ,Follow-Up Studies ,Month follow up ,media_common - Published
- 2021
8. Effect of Obesity on Left Ventricular Remodeling and Clinical Outcome in Chinese Patients With Hypertrophic Cardiomyopathy: Assessed by Cardiac MRI
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Ke Shi, Shan Huang, Xiang Li, Hua‐Yan Xu, Meng‐Xi Yang, Yuan Li, Ying‐Kun Guo, and Zhi‐Gang Yang
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Radiology, Nuclear Medicine and imaging - Abstract
Obesity is highly prevalent in patients with hypertrophic cardiomyopathy (HCM) and believed to influence its phenotype.To explore the effects of obesity on left ventricular (LV) remodeling and long-term clinical course in Chinese patients with HCM.Longitudinal.A total of 247 patients with HCM classified according to body mass index (BMI) (normal weight: BMI = 18.0-22.9 kg/m3.0 T/Balanced steady-state free precession sequence and phase-sensitive inversion recovery late gadolinium enhancement (LGE) sequence.LV function and geometry were measured. LV peak strain analysis was performed. The presence and percentage of LGE in the LV were recorded. The endpoints including heart failure, sudden cardiac death, and overall composite outcome were assessed during a median follow-up of 4.1 years (interquartile range, 3.0-6.2 years).One-way analysis of variance, Kruskal-Wallis test, or chi-square test; Pearson correlation coefficient (r); multivariable linear regression analysis; Kaplan-Meier survival analysis; and Cox proportional hazards model analysis were conducted. A two-tailed P-value0.05 was considered statistically significant.Obese patients exhibited a significant progressive increase in LV mass compared with normal-weight patients. The magnitude of all LV strain indices gradually and significantly decreased as BMI increased, whereas LV ejection fraction was not significantly different among BMI groups (P = 0.364). Multivariable linear regression analysis showed that obesity had a significant association with impaired strain indices as well as with indexed LV mass. Multivariable Cox model analysis retained obesity as an independent marker for future endpoints, and conveyed a3-fold increase in risk compared with patients with normal weight (hazard ratio, 3.04; 95% confidence interval, 1.07-6.57).Obesity is an important environmental modifier that is associated with adverse LV remodeling and is independently associated with future clinical outcomes in Chinese patients with HCM.3 TECHNICAL EFFICACY: Stage 2.
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- 2022
9. Prognostic value of multiple cardiac magnetic resonance imaging parameters in patients with idiopathic dilated cardiomyopathy
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Rong Xu, Lingyi Wen, Ran Sun, Kun Zhang, Hui Liu, Hua-yan Xu, Lu Zhang, Lin-jun Xie, Hang Fu, Zhi-gang Yang, and Ying-kun Guo
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Cardiomyopathy, Dilated ,Cardiac function curve ,medicine.medical_specialty ,medicine.medical_treatment ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Cardiac magnetic resonance imaging ,Internal medicine ,Idiopathic dilated cardiomyopathy ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,End-systolic volume ,Retrospective Studies ,Heart transplantation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Heart failure ,cardiovascular system ,Cardiology ,End-diastolic volume ,Cardiology and Cardiovascular Medicine ,business - Abstract
Our study aimed to comprehensively explore efficient prognostic indicators in idiopathic dilated cardiomyopathy (IDCM) patients with reduced left ventricular ejection fraction (LVEF40%).Prognostic value of cardiac magnetic resonance(CMR) parameters for IDCM have been inconsistent.126 IDCM patients with reduced LVEF (40%) were retrospectively enrolled. Cardiac function parameters, myocardial strain indices and myocardial fibrosis were evaluated. Laboratory data also were analyzed. The endpoint was a combination of major adverse cardiac events (MACEs), including cardiac death, heart transplantation, and rehospitalization. Prognostic value was evaluated by the Kaplan-Meier method and Cox regression.During a median follow-up of 31 months, 44 patients experienced MACEs, including 9 deaths, 1 heart transplantation, and 34 rehospitalizations due to heart failure. Univariate and multivariate Cox analyses showed that cardiac function and myocardial strain indexes were not associated with the prognosis of IDCM (all p0.05). NT-proBNP (HR 1.5, 95%CI: 1.053 to 2.137), Late‑gadolinium enhancement(LGE) mass (HR 1.022, 95%CI: 1.005 to 1.038), and LGE mass/left ventricle mass were significant predictors (HR 1.027, 95%CI: 1.007 to 1.046) for MACEs, all p 0.05. Besides, poorest prognosis was observed in IDCM patients with positive LGE combined with NT-proBNP (log-rank = 27.261, p ≤ 0.001).NT-proBNP and extent of LGE were reliable predictors in IDCM patients with reduced LVEF. Additionally, presence of LGE combined with NT-proBNP showed the strongest prognostic value in IDCM with reduced LVEF. Myocardial strain parameters seemed to have no prognostic value in IDCM patients with reduced LVEF.
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- 2021
10. Myocardial perfusion assessment in the infarct core and penumbra zones in an in-vivo porcine model of the acute, sub-acute, and chronic infarction
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Hui Liu, Lin Chen, Liu Keling, Hua-yan Xu, Hang Fu, Hong Li, Rong Xu, Chuan Fu, Meng-Xi Yang, Xiaoyue Zhou, Xue-Sheng Li, Ying-kun Guo, Zhi-gang Yang, and Lu Zhang
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medicine.medical_specialty ,Swine ,Myocardial Infarction ,Infarction ,Perfusion scanning ,030218 nuclear medicine & medical imaging ,Microcirculation ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Coronary Circulation ,Internal medicine ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,business.industry ,Penumbra ,Myocardial Perfusion Imaging ,Microvascular Density ,General Medicine ,Blood flow ,medicine.disease ,Perfusion ,030220 oncology & carcinogenesis ,cardiovascular system ,Cardiology ,Radiology ,Tomography, X-Ray Computed ,business ,circulatory and respiratory physiology - Abstract
To assess the longitudinal changes of microvascular function in different myocardial regions after myocardial infarction (MI) using myocardial blood flow derived by dynamic CT perfusion (CTP-MBF), and compare CTP-MBF with the results of cardiac magnetic resonance (CMR) and histopathology. The CTP scanning was performed in a MI porcine model 1 day (n = 15), 7 days (n = 10), and 3 months (n = 5) following induction surgery. CTP-MBF was measured in the infarcted myocardium, penumbra, and remote myocardium, respectively. CMR perfusion and histopathology were performed for validation. From baseline to follow-up scans, CTP-MBF presented a stepwise increase in the infarcted myocardium (68.51 ± 11.04 vs. 86.73 ± 13.32 vs. 109.53 ± 26.64 ml/100 ml/min, p = 0.001) and the penumbra (104.92 ± 29.29 vs. 120.32 ± 24.74 vs. 183.01 ± 57.98 ml/100 ml/min, p = 0.008), but not in the remote myocardium (150.05 ± 35.70 vs. 166.66 ± 38.17 vs. 195.36 ± 49.64 ml/100 ml/min, p = 0.120). The CTP-MBF correlated with max slope (r = 0.584, p < 0.001), max signal intensity (r = 0.357, p < 0.001), and time to max (r = − 0.378, p < 0.001) by CMR perfusion. Moreover, CTP-MBF defined the infarcted myocardium on triphenyl tetrazolium chloride staining (AUC: 0.810, p < 0.001) and correlated with microvascular density on CD31 staining (r = 0.561, p = 0.002). CTP-MBF could quantify the longitudinal changes of microvascular function in different regions of the post-MI myocardium, which demonstrates good agreement with contemporary CMR and histopathological findings. • The CT perfusion–based myocardial blood flow (CTP-MBF) could quantify the microvascular impairment in different myocardial regions after myocardial infarction (MI) and track its recovery over time. • The assessment of CTP-MBF is in good agreement with contemporary cardiac MRI and histopathological findings, which potentially facilitates a rapid approach for pathophysiological insights following MI.
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- 2020
11. Incremental prognostic value of myocardial strain over ventricular volume in patients with repaired tetralogy of Fallot
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Li Jiang, Ying-Kun Guo, Hua-Yan Xu, Xiao Zhu, Wei-Feng Yan, Yuan Li, and Zhi-Gang Yang
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Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
The relative incremental predictive value of myocardial deformation over ventricular volume for future adverse events in patients with repaired tetralogy of Fallot (rTOF) remains unknown. We aimed to determine the incremental prognostic value of myocardial deformation over ventricular volume to predict adverse events in patients with rToF.We retrospectively included patients with rTOF who completed cardiac magnetic resonance (CMR) and follow-up in our hospital from January 2014 to October 2020, and stratified according to the presence or absence of adverse events during follow-up. The strain parameters of the right ventricular (RV) and left ventricular (LV) were obtained from CMR-derived feature tracking. Multivariable Cox proportional hazard models and net reclassification improvement analysis were used to analyze the prognostic information of biventricular strain and volume parameters in rTOF patients.Among 98 patients with rTOF, 54 (55.1%) experienced primary and/or secondary events during a median follow-up period of 27.0 months. Univariable analysis indicated that RV volume and strain were significantly associated with both primary events and all adverse events (all p.01). Multivariable Cox regression and net reclassification improvement analyses achieved incremental global χRV and LV myocardial deformation provided incremental prognostic information and significant improvement for risk stratification over RV size and clinical variables and therefore can be combined to further enhance prognostication.• RV volume and strain were significantly associated with both primary events and all adverse events, whereas LV volume and strain were associated with primary events. • Ventricular myocardial deformation is a strong predictor of adverse outcomes of patients with repaired tetralogy of Fallot, providing increased prognostic information and significantly improved risk stratification over ventricular size.
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- 2022
12. Quantitative assessment of left ventricular myocardial involvement in patients with connective tissue disease: a 3.0T contrast-enhanced cardiovascular magnetic resonance study
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Jin Wang, Yue Gao, Zhi-Gang Yang, Ying-Kun Guo, Li Jiang, Rui Shi, Hua-Yan Xu, Shan Huang, and Yuan Li
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Abstract
The aim of this study was to evaluate left ventricular (LV) myocardial involvement in connective tissue disease (CTD) patients using multiparemetric imaging derived from cardiovascular magnetic resonance (CMR). CMR was performed on 146 CTD patients (comprising of 74 with idiopathic inflammatory myopathy (IIM) and 72 with non-IIM) and 72 healthy controls and included measures of LV global strains [including peak strain (PS), peak systolic (PSSR) and diastolic strain rate (PDSR)], myocardial perfusion [including upslope, max signal intensity (MaxSI), and time to maximum signal intensity (TTM)], and late gadolinium enhancement (LGE) parameters. Univariable and multivariable linear regression analyses were performed to determine the association between LV deformation and microvascular perfusion, as well as LGE. Our results indicated that CTD patients had decreased global longitudinal PS (GLPS), PSSR, PDSR, and myocardial perfusion (all p
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- 2021
13. Global, segmental and layer specific analysis of myocardial involvement in Duchenne muscular dystrophy by cardiovascular magnetic resonance native T1 mapping
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Hua-yan Xu, Xiao-tang Cai, Hang Fu, Bin Zhou, Rong Xu, Lin-jun Xie, Ying-kun Guo, Zhi-gang Yang, Hui Liu, Ke Xu, and Li Yu
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Male ,Duchenne muscular dystrophy ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Native T1 mapping ,Cardiomyopathy ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Basal (phylogenetics) ,Predictive Value of Tests ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Late gadolinium enhancement ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Angiology ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Myocardium ,Research ,Area under the curve ,Magnetic resonance imaging ,medicine.disease ,Muscular Dystrophy, Duchenne ,RC666-701 ,Cardiology ,Cardiovascular magnetic resonance ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Progressive cardiomyopathy accounts for almost all mortality among Duchenne muscular dystrophy (DMD) patients. Thus, our aim was to comprehensively characterize myocardial involvement by investigating the heterogeneity of native T1 mapping in DMD patients using global and regional (including segmental and layer-specific) analysis across a large cohort. Methods We prospectively enrolled 99 DMD patients (8.8 ± 2.5 years) and 25 matched male healthy controls (9.5 ± 2.5 years). All subjects underwent cardiovascular magnetic resonance (CMR) with cine, T1 mapping and late gadolinium enhancement (LGE) sequences. Native T1 values based on the global and regional myocardium were measured, and LGE was defined. Results LGE was present in 49 (49%) DMD patients. Global native T1 values were significantly longer in LGE-positive (LGE +) patients than in healthy controls, both in basal slices (1304 ± 55 vs. 1246 ± 27 ms, p Conclusions Myocardial regional native T1, particularly epicardial native T1, seems to have potential as a novel robust marker of very early cardiac involvement in DMD patients. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) ChiCTR1800018340, 09/12/2018, Retrospectively registered.
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- 2021
14. Dynamic forecasting and optimal scheduling of by-product gases in integrated iron and steel works
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Bo-yang Yu, Jia-lin Ma, Qi Zhang, Hui Li, Gang Wang, Shan Jiang, and Hua-yan Xu
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010302 applied physics ,Power station ,business.industry ,Total cost ,0211 other engineering and technologies ,Metals and Alloys ,Boiler (power generation) ,Environmental pollution ,02 engineering and technology ,01 natural sciences ,Steelmaking ,Mechanics of Materials ,Gas holder ,0103 physical sciences ,Least squares support vector machine ,Materials Chemistry ,Electricity ,business ,Process engineering ,021102 mining & metallurgy - Abstract
The by-product gases, which are generated in ironmaking, coking and steelmaking processes, can be used as fuel for the metallurgical processes and on-site power plants. However, if the supply and demand of by-product gases are imbalanced, gas flaring may occur, leading to energy wastage and environmental pollution. Therefore, optimal scheduling of by-product gases is important in iron and steel works. A BP_LSSVM model, which combines back-propagation (BP) neural network and least squares support vector machine (LSSVM), and an improved mixed integer linear programming model were proposed to forecast the surplus gases and allocate them optimally. To maximize energy utilization, the stability of gas holders and boilers was considered and a concise heuristic procedure was proposed to assign penalties for boilers and gas holders. Moreover, the optimal level of gas holder was studied to enhance the stability of the gas system. Compared to the manual operation, the optimal results showed that the electricity generated by the power plant increased by 2.93% in normal condition and by 22.2% in overhaul condition. The proposed model minimizes the total cost by optimizing the boiler load with less adjustment frequency and the stability of gas holders and can be used as a guidance in dynamic forecasting and optimal scheduling of by-product gases in integrated iron and steel works.
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- 2019
15. Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis
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Lin-jun Xie, Zuguang Yang, W.F. Yan, Lingyi Wen, X.D. Wang, Haiyan Fu, Rui-Hua Xu, Hua-yan Xu, Ying-kun Guo, and Ke Xu
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Correlation coefficient ,Doppler echocardiography ,symbols.namesake ,Thoracic Arteries ,Cardiac valve ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Magnetic resonance imaging ,General Medicine ,Heart Valves ,Magnetic Resonance Imaging ,Flow (mathematics) ,Great arteries ,Cardiovascular Diseases ,Echocardiography ,Meta-analysis ,symbols ,business ,Nuclear medicine ,Doppler effect ,Blood Flow Velocity - Abstract
AIM To objectively examine the agreement and correlation between four-dimensional (4D) flow magnetic resonance imaging (MRI) and traditional two-dimensional (2D) phase-contrast (PC) MRI with the reference standard of Doppler echocardiography for measuring peak blood velocity at the cardiac valve and great arteries, and to assess if 4D flow MRI offers an advantage over the traditional 2D method. MATERIALS AND METHODS The literature was searched systematically for studies that evaluate the degree of correlation and agreement between 4D flow MRI or 2D PC MRI and Doppler retrieved from PubMed, EMBASE, and the Cochrane Library. A meta-analysis was conducted to determine the peak velocity pooled bias with 95% limits of agreement (LoA) and correlation coefficient (r) for 4D flow MRI and 2D PC MRI compared with Doppler. RESULTS Ten studies that compared 4D flow MRI with Doppler and 12 studies that compared 2D PC MRI with Doppler were included. 4D flow MRI showed an underestimation with bias and 95% LoA of -0.09 (-0.41, 0.24) m/s (p=0.079) while 2D PC MRI showed a poorer agreement with a bias and 95% LoA of -0.25 (-0.53, 0.03), p=0.596. 4D flow MRI and 2D PC MRI showed a strong correlation with R=0.80 (95% CI 0.75, 0.84; p
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- 2021
16. Utility of single-shot compressed sensing cardiac magnetic resonance cine imaging for assessment of biventricular function in free-breathing and arrhythmic pediatric patients
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Rong Xu, Chuan Fu, Ying-kun Guo, Zhi-gang Yang, Qing Zou, Hua-yan Xu, Meng-Xi Yang, and Xiaoyue Zhou
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Magnetic Resonance Spectroscopy ,Image quality ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Pediatrics ,Breath Holding ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,Medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Child ,End-systolic volume ,Ejection fraction ,business.industry ,Reproducibility of Results ,Stroke volume ,Magnetic Resonance Imaging ,Compressed sensing ,cardiovascular system ,End-diastolic volume ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Cardiac magnetic resonance ,Free breathing ,circulatory and respiratory physiology - Abstract
This study aimed to explore the feasibility and accuracy of single-shot compressed-sensing (CS) cardiac magnetic resonance cine technology for the assessment of biventricular function and morphology in free-breathing (FB) pediatrics, especially those with arrhythmia.Seventy consecutive pediatric participants (6.27 ± 3.8 years, range:0.5-14 years) were enrolled between August 2019 and July 2020. Single-shot CS and conventional balanced steady-state free-precession (bSSFP) cine were obtained. The total scanning time, image quality and biventricular function parameters were compared for both sequences.Single-shot CS cine had shorter acquisition time compared with the conventional bSSFP cine (all P0.001). The single-shot CS cine also had fewer artifacts than conventional bSSFP cine (breath-hold (BH): 4.6 ± 0.6 vs. 4.3 ± 0.6; FB without ongoing arrhythmia: 4.5 ± 0.6 vs. 3.6 ± 0.9; FB with ongoing arrhythmia: 4.7 ± 0.5 vs. 2.6 ± 1.1; all P0.05). No statistical difference of left ventricular parameters and right ventricular end-systolic volume/ejection fraction were found between the single-shot CS and conventional bSSFP cine in both BH and FB without ongoing arrhythmia group. There was an excellent correlation (RThe single-shot CS cine can significantly reduce the image acquisition time, offering reliable quantification of biventricular function in free breathing condition for arrhythmic patients.
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- 2020
17. Performance of Two Risk-Stratification Models in Hospitalized Patients With Coronavirus Disease
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Ran Sun, Ming Yang, Rong Xu, Lingyi Wen, Hui Liu, Zhi-gang Yang, Hang Fu, Ying-kun Guo, Lin-jun Xie, Kun Zhang, Keke Hou, Hua-yan Xu, and Na Zhang
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0301 basic medicine ,medicine.medical_specialty ,Respiratory rate ,Disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,Epidemiology ,medicine ,MuLBSTA score ,030212 general & internal medicine ,Survival analysis ,Original Research ,lcsh:R5-920 ,risk-stratification ,business.industry ,Area under the curve ,General Medicine ,medicine.disease ,Intensive care unit ,CURB65 score ,030104 developmental biology ,Blood pressure ,coronavirus disease ,ICU ,Coinfection ,Medicine ,lcsh:Medicine (General) ,business - Abstract
Background: Despite an increase in the familiarity of the medical community with the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19), there is presently a lack of rapid and effective risk stratification indicators to predict the poor clinical outcomes of COVID-19 especially in severe patients. Methods: In this retrospective single-center study, we included 117 cases confirmed with COVID-19. The clinical, laboratory, and imaging features were collected and analyzed during admission. The Multi-lobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension and Age (MuLBSTA) Score and Confusion, Urea, Respiratory rate, Blood pressure, Age 65 (CURB65) score were used to assess the death and intensive care unit (ICU) risks in all patients. Results: Among of all 117 hospitalized patients, 21 (17.9%) patients were admitted to the ICU care, and 5 (4.3%) patients were died. The median hospital stay was 12 (10–15) days. There were 18 patients with MuLBSTA score ≥ 12 points and were all of severe type. In severe type, ICU care and death patients, the proportion with MuLBSTA ≥ 12 points were greater than that of CURB65 score ≥ 3 points (severe type patients, 50 vs. 27.8%; ICU care, 61.9 vs. 19.0%; death, 100 vs. 40%). For the MuLBSTA score, the ROC curve showed good efficiency of diagnosis death (area under the curve [AUC], 0.956; cutoff value, 12; specificity, 89.5%; sensitivity, 100%) and ICU care (AUC, 0.875; cutoff value, 11; specificity, 91.7%; sensitivity, 71.4%). The K–M survival analysis showed that patients with MuLBSTA score ≥ 12 had higher risk of ICU (log-rank, P = 0.001) and high risk of death (log-rank, P = 0.000). Conclusions: The MuLBSTA score is valuable for risk stratification and could effectively screen high-risk patients at admission. The higher score at admission have higher risk of ICU care and death in patients infected with COVID.
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- 2020
18. Characterization of infarcted myocardium by T1-mapping and its association with left ventricular remodeling
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Yong He, Meng-Xi Yang, Chunchao Xia, Wan-Lin Peng, Ying-kun Guo, Hua-yan Xu, Zhi-gang Yang, Hong Li, Zhen-Lin Li, Min Ma, and Qin Zhao
- Subjects
medicine.medical_specialty ,Myocardial Infarction ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Late gadolinium enhancement ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Myocardial infarction ,Ventricular remodeling ,Ventricular Remodeling ,business.industry ,Myocardium ,General Medicine ,medicine.disease ,Infarct size ,Cine imaging ,030220 oncology & carcinogenesis ,Global function ,Cardiology ,business ,Cardiac magnetic resonance ,human activities - Abstract
Purpose Acutely infarcted native T1 (native T1AI) and extracellular volume (ECVAI) could quantify myocardial injury after acute myocardial infarction (AMI). Therefore, we sought to further explore their association with left ventricular (LV) remodeling during follow-up. Methods 56 ST-segment-elevation MI patients were prospectively recruited and completed acute and 3-month cardiac magnetic resonance scans. T1 mapping, late gadolinium enhancement and cine imaging were performed to measure native T1AI, ECVAI, infarct size and LV global function, respectively. LV remodeling was evaluated as the change in LV end-diastolic volume index (△EDV) at follow-up scan compared with baseline. Results In acute scan, 37 patients (66.07 %) had microvascular obstruction (MVO). The native T1AI did not significantly differ between patients with or without MVO (1482.0 ± 80.6 ms vs. 1469.0 ± 71.6 ms, P = 0.541). However, ECVAI in patients without MVO was lower than that in patients with MVO (49.60 ± 8.57 % vs. 58.53 ± 8.62 %, P = 0.001). The native T1AI only correlated with △EDV in patients without MVO (rmvo- = 0.495, P = 0.031); while ECVAI was associated with △EDV in all patients (rmvo- = 0.665, P = 0.002; rmvo+ = 0.506, P = 0.001; rall patients = 0.570, P Conclusion As a promising parameter for early risk stratification after AMI, ECVAI is associated with LV remodeling during follow-up; while native T1AI may be feasible when MVO is absent.
- Published
- 2020
19. Left ventricular global function index by magnetic resonance imaging — a novel marker for differentiating cardiac amyloidosis from hypertrophic cardiomyopathy
- Author
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Kai-yue Diao, Ke Shi, Sen He, Zhi-gang Yang, Yue Gao, Yong He, Hua-yan Xu, Ying-kun Guo, Shan Huang, Meng-ting Shen, and Yi Zhang
- Subjects
Male ,medicine.medical_specialty ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Article ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,Muscle hypertrophy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,lcsh:Science ,Aged ,Multidisciplinary ,Ejection fraction ,Troponin T ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Hypertrophic cardiomyopathy ,Area under the curve ,Reproducibility of Results ,Magnetic resonance imaging ,Amyloidosis ,Odds ratio ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Cardiac hypertrophy ,ROC Curve ,Cardiac amyloidosis ,Heart Function Tests ,cardiovascular system ,Cardiology ,Female ,lcsh:Q ,business ,Biomarkers - Abstract
Differentiating cardiac amyloidosis (CA) from hypertrophic cardiomyopathy (HCM) remains a clinical challenge, particularly in those with preserved left ventricular ejection fraction (LVEF) and similar hypertrophy. This study aimed to use left ventricular global function index (LVGFI) and myocardial contraction fraction (MCF) to discriminate CA from HCM without using contrast agents on cardiovascular magnetic resonance imaging (CMR). In total, we included 68 CA patients, 90 HCM patients, and 35 healthy controls. We found that LVGFI had excellent diagnostic performance in differentiating CA from HCM (area under the curve (AUC) = 0.91, 95% CI [0.86–0.95]), even in the challenging conditions of similar hypertrophy (AUC = 0.92, 95% CI [0.87–0.97]) and preserved LVEF (AUC = 0.90, 95% CI [0.84–0.96]). LVGFI also had significant correlations with LGE extent, NT-proBNP and troponin T (all p p = 0.034). In conclusion, LVGFI is a novel and clinically useful parameters with excellent ability in determining myocardial function and differentiating cardiac amyloidosis from hypertrophic cardiomyopathy.
- Published
- 2020
20. The association of secondary hyperparathyroidism and myocardial damages in hemodialysis end-stage renal disease patients: assessed by cardiovascular magnetic resonance native T1 mapping
- Author
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Wan-Lin Peng, Rong Xu, Yi Zhang, Hua-yan Xu, Zhen-Lin Li, Zhi-gang Yang, Chunchao Xia, and Ying-kun Guo
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Time Factors ,Native T1 mapping ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,Basal (phylogenetics) ,0302 clinical medicine ,Risk Factors ,Prospective Studies ,Ejection fraction ,Radiological and Ultrasound Technology ,Middle Aged ,End stage renal disease ,Up-Regulation ,Treatment Outcome ,Parathyroid Hormone ,Cardiology ,Secondary hyperparathyroidism ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Heart Diseases ,Magnetic Resonance Imaging, Cine ,Risk Assessment ,03 medical and health sciences ,Predictive Value of Tests ,Renal Dialysis ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Risk factor ,Angiology ,Aged ,business.industry ,Myocardium ,Research ,Stroke Volume ,medicine.disease ,lcsh:RC666-701 ,Case-Control Studies ,Kidney Failure, Chronic ,Hyperparathyroidism, Secondary ,Cardiovascular magnetic resonance ,Complication ,business ,Biomarkers - Abstract
BackgroundSecondary hyperparathyroidism is a common complication of end-stage renal disease (ESRD), which may be associated with cardiovascular diseases. Thus, this study aimed to explore myocardial damage using non-contrast cardiovascular magnetic resonance (CMR) in ESRD patients undergoing hemodialysis and further investigate its relationship with parathyroid hormone (PTH) toxicity.MethodsSeventy-two adult ESRD patients receiving regular hemodialysis and 30 healthy subjects underwent CMR examination. Continuous CMR cine sections from the mitral valve level to the left ventricular (LV) apex in the short-axis plane, cine series of vertical two-chamber long-axis plane, and horizontal four-chamber plane were acquired. Native T1 mapping was obtained using modified Look-Locker inversion recovery (MOLLI) sequences. Native T1 values and myocardial strain were analyzed. Immunoreactive parathyroid hormone (iPTH) was obtained from all enrolled patients.ResultsForty (55.6%) hemodialysis ESRD patients were found to have increased iPTH levels. LV ejection fraction (LVEF) of both ESRD patients with targeted and increased iPTH levels was decreased compared with healthy subjects (55.9 ± 12.0% vs. 65.0 ± 4.5%; 51.7 ± 12.8 vs. 65.0 ± 4.5%, both P ConclusionsElevated iPTH level was associated with and was an independent risk factor for myocardial damage in ESRD patients undergoing maintenance hemodialysis.Trial registration:Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) ChiCTR-DND-17012976, 13/12/2017, retrospectively registered.
- Published
- 2020
21. Late gadolinium enhancement is a risk factor for major adverse cardiac events in unrecognised myocardial infarction without apparent symptoms: a meta-analysis
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Ying-kun Guo, Haiyan Fu, Lei Zhang, Hua-yan Xu, Z G Yang, Lin-jun Xie, Zuguang Yang, Jin Wang, Hao Li, and Meng-Xi Yang
- Subjects
medicine.medical_specialty ,Myocardial Infarction ,Contrast Media ,Subgroup analysis ,Gadolinium ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,Risk Factors ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Myocardial infarction ,Risk factor ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,General Medicine ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,Confidence interval ,030220 oncology & carcinogenesis ,Meta-analysis ,Asymptomatic Diseases ,Cardiology ,business - Abstract
AIM To assess the prognostic role of unrecognised myocardial infarction (UMI) detected at late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRII). MATERIALS AND METHODS Electronic databases including PubMed, EMBASE, Medline, and Cochrane were searched systematically for studies exploring the predictive value of UMI detected by LGE-CMRI for major adverse cardiac events (MACEs) and all-cause mortality in patients without apparent symptoms. Pooled hazard ratios (HRs) along with their 95% confidence intervals (CIs) were obtained from a random-effects model. Subgroup analyses were performed according to the different participants and outcomes. RESULTS Eight studies (2,009 participants) were identified comprising 442 patients with UMI detected at LGE-CMRI and 1,567 without UMI. The presence of UMI on LGE was associated with a significantly increased risk for MACEs (HRs: 3.44, 95% CI: 2.06 to 5.75; p
- Published
- 2020
22. Prognostic value of dual-source computed tomography (DSCT) angiography characteristics in anomalous coronary artery from the opposite sinus (ACAOS) patients: a large-scale retrospective study
- Author
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Hua-yan Xu, Kai-yue Diao, Ying-kun Guo, Min Ma, Qin Zhao, Zhi-gang Yang, Ke Shi, and Yue Gao
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,China ,medicine.medical_specialty ,Time Factors ,Computed Tomography Angiography ,Coronary Vessel Anomalies ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Severity of Illness Index ,Congenital abnormalities ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Diagnosis ,Prevalence ,medicine ,Humans ,Risk factor ,Aged ,Retrospective Studies ,Computed tomography angiography ,Prognostic factor ,medicine.diagnostic_test ,business.industry ,Incidence ,Coronary Sinus ,Coronary Stenosis ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Cardiac surgery ,Stenosis ,030228 respiratory system ,lcsh:RC666-701 ,Relative risk ,Angiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Research Article - Abstract
Background Most reported cases of right anomalous coronary artery from the opposite sinus (R-ACAOS) have benign clinical outcomes. However, patients with left ACAOS (L-ACAOS) and some of the patients with R-ACAOS are more at risk for arrhythmias and sudden cardiac death, which remains a major concern. Here we report the prevalence and anatomical features of ACAOS patients. Moreover, we explore the high-risk morphological signs and evaluate their mid-term prognostic value in R-ACAOS patients without surgical intervention. Methods Data from coronary computed tomography angiography (CTA) of 30,593 patients, pertaining to a single center over 5 consecutive years, were retrospectively analyzed. The image analysis included stenosis severity ranking and high-risk anatomy evaluation, based on the commercially available image post-processing software OsirX. Patients with R-ACAOS and without evidence of coronary atherosclerosis (CAD) were followed-up, with recording of the cardiovascular clinical events. Cox regression analysis was performed to identify the potential anatomical risk factors of cardiovascular clinical events for non-CAD R-ACAOS patients, using R project. Results The prevalence of ACAOS in the study population was 0.69% (211/30593). Significant differences were found between patients with mild ( 50%) stenosis, in terms of height-to-weight ratio (HW ratio), take-off angle, and proximal stenosis length. A total of 54 cardiovascular clinical events were observed among 108 non-CAD R-ACAOS patients and an average follow-up of 27.8 ± 18.7 months. Among those patients’ anatomical features, stenosis severity was the main risk factor for cardiovascular clinical events during the mid-term follow-up, with a risk ratio of 4.14 (95% CI: 1.78 to 9.63, P Conclusions Among patients referred to coronary CTA, the overall incidence of ACAOS was 0.69%. For patients with R-ACAOS, severe stenosis was the independent risk factor of adverse clinical events in the mid-term follow-up, and positive clinical intervention might be needed to help them avoid the malignant clinical events.
- Published
- 2020
23. RETRACTED ARTICLE: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging
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Zhen-Lin Li, Li Rao, Ying Peng, Hua-yan Xu, Rong Xu, Chunchao Xia, Li Yuming, Yong He, Yi Zhang, Hong-ling Gao, Ying-kun Guo, Wan-Lin Peng, and Zhi-gang Yang
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Cardiac magnetic resonance ,medicine.medical_treatment ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Risk Assessment ,030218 nuclear medicine & medical imaging ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Renal Dialysis ,Risk Factors ,Cardiac magnetic resonance imaging ,Myocardial fibrosis ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,Risk factor ,Aged ,Angiology ,Heart Failure ,Ventricular Remodeling ,medicine.diagnostic_test ,business.industry ,Myocardium ,Hazard ratio ,T1 mapping ,ECV ,Middle Aged ,Prognosis ,medicine.disease ,Fibrosis ,Confidence interval ,lcsh:RC666-701 ,Case-Control Studies ,Heart failure ,Cardiology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business - Abstract
BackgroundEnd-stage renal disease (ESRD) patients are at high cardiovascular risk, and myocardial fibrosis (MF) accounts for most of their cardiac events. The purpose of this study is to investigate the prognostic value and risk stratification of MF as measured by extracellular volume (ECV) on cardiac magnetic resonance (CMR) for heart failure (HF) in patients with hemodialysis-dependent ESRD.MethodsSixty-six hemodialysis ESRD patients and 25 matched healthy volunteers were prospectively enrolled and underwent CMR to quantify multiple parameters of MF by T1 mapping and late gadolinium enhancement (LGE). All ESRD patients were followed up for 11–30 months, and the end-point met the 2016 ESC guidelines for the definition of HF.ResultsOver a median follow-up of 18 months (range 11–30 months), there were 26 (39.39%) guideline-diagnosed HF patients in the entire cohort of ESRD subjects. The native T1 value was elongated, and ECV was enlarged in the HF cohort relative to the non-HF cohort and normal controls (native T1, 1360.10 ± 50.14 ms, 1319.39 ± 55.44 ms and 1276.35 ± 56.56 ms; ECV, 35.42 ± 4.42%, 31.85 ± 3.01% and 26.97 ± 1.87%; all pr = − 0.501,p = 0.009), global circumferential strain (GCS) (r = 0.553,p = 0.005) and global longitudinal strain (GLS) (r = 0.507,p = 0.008) in ESRD patients with HF. Cox proportional hazard regression models revealed that ECV (hazard ratio [HR] = 1.160, 95% confidence interval: 1.022 to 1.318,p = 0.022) was the only independent predictor of HF in ESRD patients. It also had a higher diagnostic accuracy for detecting MF (area under the curve [AUC] = 0.936; 95% confidence interval: 0.864 to 0.976) than native T1 and post T1 (allp ≤ 0.002). Kaplan-Meier analysis revealed that the high-ECV group had a shorter median overall survival time than the low-ECV group (18 months vs. 20 months, log-rankp = 0.046) and that ESRD patients with high ECV were more likely to have HF.ConclusionsMyocardial fibrosis quantification by ECV on CMR T1 mapping was shown to be an independent risk factor of heart failure, providing incremental prognostic value and risk stratification for cardiac events in ESRD patients.Trial registrationChinese Clinical Trial RegistryChiCTR-DND-17012976, 13/12/2017, Retrospectively registered.
- Published
- 2020
24. Left Ventricular Deformation in Patients with Connective Tissue Disease: Evaluated by 3.0T Cardiac Magnetic Resonance Tissue Tracking
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Ke Shi, Xi Liu, Yue Gao, Hua-yan Xu, Zhi-gang Yang, Hong Yu, Qin Zhao, Jin Wang, and Ying-kun Guo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tissue tracking ,medicine.drug_class ,Heart Ventricles ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Natriuretic peptide ,Humans ,Ventricular Function ,In patient ,lcsh:Science ,Connective tissue diseases ,Multidisciplinary ,Ejection fraction ,Ventricular Remodeling ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Connective tissue disease ,Cardiovascular diseases ,Cardiology ,lcsh:Q ,Female ,CTD ,business ,Cardiac magnetic resonance - Abstract
The aim of this study was to assess left ventricular (LV) myocardial strain in patients with connective tissue disease (CTD) and compare LV deformation between subgroups of idiopathic inflammatory myopathy (IIM) and non-IIM. Ninety-eight patients with CTD, comprising 56 with IIM and 42 with non-IIM, and 30 healthy subjects were enrolled and underwent 3.0T cardiac magnetic resonance imaging (MRI) scanning. The LV function and strain parameters were measured and assessed. Our result revealed that CTD patients had preserved LV ejection fraction (60.85%) and had significantly decreased global and regional peak strain (PS) in radial, circumferential, and longitudinal directions (all p
- Published
- 2019
25. Assessment of right ventricular dysfunction in end-stage renal disease patients on maintenance haemodialysis by cardiac magnetic resonance imaging
- Author
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Yingkun Guo, Huapeng Zhang, Li Yuming, Zhen-Lin Li, Zhang Jinge, Pu Jin, Wan-Lin Peng, Liu Keling, Chunchao Xia, Tianlei Cui, and Hua-yan Xu
- Subjects
Male ,medicine.medical_specialty ,Heart Ventricles ,Ventricular Dysfunction, Right ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Risk factor ,Prospective cohort study ,Dialysis ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,Magnetic resonance imaging ,General Medicine ,Stroke volume ,Middle Aged ,Magnetic Resonance Imaging ,Cardiology ,Kidney Failure, Chronic ,Female ,business - Abstract
To assess right ventricular (RV) dysfunction in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD) by cardiac magnetic resonance (CMR) imaging and determined the risk factors associated with RV dysfunction.Fifty ESRD patients on maintenance HD and 16 age- and gender-matched healthy individuals were prospectively enrolled and underwent CMR imaging. Left ventricular (LV) and RV function parameters, including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF), were measured and compared. Independent sample t-test and Mann-Whitney U-test were used to compare the differences between healthy individuals and ESRD patients. Pearson correlation and multiple linear regression analyses were used to assess risk factors associated with RV dysfunction.Significantly lower RVEF and LVEF were observed in ESRD patients than in the control group (all p 0.001). RVEDV, RVESV and RVSV in ESRD patients were also lower than those in the control group (all p 0.05). Meanwhile, higher LVESV, LV mass and interventricular septum thickness were found in ESRD patients than in the control group (all p 0.05). RVEF was positively correlated with LVEF (r = 0.37, p = 0.008) and negatively correlated with the duration of renal insufficiency (r = -0.53, p 0.001) and dialysis (r = -0.63, p 0.001). Moreover, multiple linear regression analyses revealed that the duration of dialysis and LVEF were independently associated with decreased RVEF (adjusted RIn ESRD patients on maintenance HD, RV function was impaired and associated with the deterioration of LV function. More importantly, the duration of dialysis was considered as a risk factor independently associated with RV dysfunction.
- Published
- 2018
26. Assessment of left ventricular myocardial deformation by cardiac MRI strain imaging reveals myocardial dysfunction in patients with primary cardiac tumors
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Zhi-gang Yang, Ying-kun Guo, Jing Chen, Hua-yan Xu, and Ke Shi
- Subjects
Male ,medicine.medical_specialty ,Diastole ,Magnetic Resonance Imaging, Cine ,Strain (injury) ,030204 cardiovascular system & hematology ,Heart Neoplasms ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Cardiac Tumors ,Retrospective Studies ,Tumor size ,business.industry ,Myocardium ,Ventricular wall ,Strain imaging ,Stroke Volume ,medicine.disease ,Normal group ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
To assess left ventricular myocardial deformation in patients with primary cardiac tumors.MRI was retrospectively performed in 61 patients, including 31 patients with primary cardiac tumors and 30 matched normal controls. Left ventricular strain and function parameters were then assessed by MRI-tissue tracking. Differences between the tumor group and controls, left and right heart tumor groups, left ventricular wall tumor and non-left ventricular wall tumor groups, and tumors with and without LV enlargement groups were assessed. Finally, the correlations among tumor diameter, myocardial strain, and LV function were analyzed.Left ventricular myocardial strain was milder for tumor group than for normal group. Peak circumferential strain (PCS) and its diastolic strain rate, longitudinal strains (PLS) and its diastolic strain rates, and peak radial systolic and diastolic velocities of the right heart tumor group were lower than those of the left heart tumor group (all p0.050), but the peak radial systolic strain rate of the former was higher than that of the latter (p=0.017). The corresponding strains were lower in the left ventricular wall tumor groups than in the non-left ventricular wall tumor group (p0.050). Peak radial systolic velocities were generally higher for tumors with LV enlargement than for tumors without LV enlargement (p0.050). Peak radial strain, PCS, and PLS showed important correlations with the left ventricular ejection fraction (all p0.050).MRI-tissue tracking is capable of quantitatively assessing left ventricular myocardial strain to reveal sub-clinical abnormalities of myocardial contractile function.
- Published
- 2018
27. Myocardial motion-corrected phase-sensitive inversion recovery late gadolinium enhancement in free breathing paediatric patients: a comparison with single-shot coherent gradient echo ('TrueFISP') phase-sensitive inversion recovery
- Author
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Haiming Fan, Hua-yan Xu, Lin-jun Xie, J.S. Mu, Rui-Hua Xu, Zhe Xu, Xue-sheng Li, Xiaoming Bi, Ying-kun Guo, and Xiaoyue Zhou
- Subjects
Male ,Adolescent ,Heart Diseases ,Contrast Media ,Gadolinium ,Inversion recovery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,Humans ,Medicine ,Late gadolinium enhancement ,Radiology, Nuclear Medicine and imaging ,Child ,Retrospective Studies ,Paediatric patients ,medicine.diagnostic_test ,business.industry ,Respiration ,Single shot ,Infant ,Heart ,Magnetic resonance imaging ,General Medicine ,Image Enhancement ,Magnetic Resonance Imaging ,Child, Preschool ,030220 oncology & carcinogenesis ,Myocardial motion ,Female ,business ,Nuclear medicine ,Free breathing ,Gradient echo - Abstract
To investigate the value of motion-corrected (MOCO) phase-sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) compared with single-shot balanced steady-state gradient echo ("TrueFISP", Siemens) PSIR in free breathing paediatric patients.In this retrospective study, 238 paediatric patients underwent clinical contrast-enhanced cardiovascular magnetic resonance imaging (CMRI). Both the single-shot TrueFISP PSIR and MOCO PSIR sequences were performed on each child. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Two radiologists rated the quality of the images on a scale of 1-5 (1 = poor, 5 = very good). Bland-Altman, linear regression, and intraclass correlation coefficient were used to compared the extent of LGE of the single-shot TrueFISP PSIR and MOCO PSIR. Imaging artefacts were described and compared.Children ranged in age from 60 days to 17 years with an average age of 8.1 ± 3.8 years. MOCO PSIR had higher SNR and CNR than the single-shot TrueFISP PSIR (p0.001). Mean quality ratings for short-axis imaging were 4 (interquartile range, 3-4) for single-shot TrueFISP PSIR and 4 (interquartile range, 4-5) for MOCO PSIR (p0.001). The scan time was faster for single-shot TrueFISP PSIR than for MOCO PSIR. The myocardial LGE results were similar with high agreement between the single-shot TrueFISP PSIR and MOCO PSIR (ICC = 0.955-0.986).The MOCO PSIR sequence is feasible in children. MOCO PSIR is robust at high heart rates and can be performed without breath-holding with higher image-quality ratings than the single-shot TrueFISP PSIR.
- Published
- 2021
28. Cardiovascular magnetic resonance abnormalities of high altitude heart disease in infancy
- Author
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Rong Xu, Lingyi Wen, Zhongqin Zhou, Hua-yan Xu, and Ying-kun Guo
- Subjects
medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Heart Diseases ,medicine.diagnostic_test ,Heart disease ,business.industry ,Altitude ,Cardiovascular Abnormalities ,MEDLINE ,Infant ,Magnetic resonance imaging ,General Medicine ,Altitude Sickness ,Effects of high altitude on humans ,medicine.disease ,Text mining ,Internal medicine ,Cardiology ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
29. Preoperative evaluation of anomalous pulmonary venous connection using dual-source computed tomography: Comparison with echocardiography
- Author
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Ying-kun Guo, Rui Li, Kai-yue Diao, Ke Shi, Li Jiang, Hua-yan Xu, Zhi-gang Yang, and Lin-jun Xie
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Computed tomography ,030204 cardiovascular system & hematology ,Preoperative care ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Scimitar syndrome ,Preoperative Care ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Surgical treatment ,Aged ,Retrospective Studies ,Anomalous pulmonary venous connection ,medicine.diagnostic_test ,business.industry ,Scimitar Syndrome ,Infant ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Echocardiography ,Child, Preschool ,Dual source computed tomography ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Radiology ,Tomography, X-Ray Computed ,business ,Preoperative imaging - Abstract
To evaluate the image features and diagnostic agreement for anomalous pulmonary venous connection (APVC) by dual-source computed tomography (DSCT) before surgery when compared with trans-thoracic echocardiography (TTE).A total of one hundred and twenty-three patients were enrolled in this study. The associated malformation was analyzed between 39 total anomalous pulmonary venous connections (TAPVC) and 84 partial anomalous pulmonary venous connections (PAPVC). For 75 patients who received surgical treatment, the diagnostic agreement between the surgical findings of DSCT and TTE was evaluated. The dimensions of the four chambers of the heart were also measured by DSCT and TTE.Atrial septal defect is the most common anomaly associated with APVC (86/123, 69.9%), which has a higher incidence in TAPVC compared to that in PAPVC (100% vs. 56.0%, p0.001). Of 75 operative patients, discrepancies in diagnostic sensitivity existed between DSCT and TTE for different drainage sites, supracardiac (94.4% vs. 82.2%, p=0.001), cardiac (98.7% vs. 91.1%, p=0.089), and infracardiac (100% vs. 57.1%, p=0.096), respectively, and for different venous origins, right superior pulmonary vein (98.4% vs. 87.1%, p=0.871), right inferior pulmonary vein (100% vs. 87.3%, p=0.006), left superior pulmonary vein (100% vs. 93.1%, p=0.246), left inferior pulmonary vein (100% vs. 95.7%, p=0.500), and atypical pulmonary vein (66.7% vs. 44.4%, p=0.011), respectively. Good agreement was obtained between DSCT and TTE for measurements of left atrium, left ventricle, right atrium, and right ventricle sizes (bias 0.3±5.05mm, -0.3±4.50mm, 5.8±14.15mm, and 1.1±5.95mm, respectively).DSCT can provide optimal and accurate anatomy details for patients with APVC, and serves as a promising accessary imaging modality after TTE to achieve a better and comprehensive preoperative imaging evaluation.
- Published
- 2017
30. Assessment of left ventricular deformation in patients with Ebstein’s anomaly by cardiac magnetic resonance tissue tracking
- Author
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Hua-yan Xu, Lin-jun Xie, Li Jiang, Xi Liu, Ying-kun Guo, Zhi-gang Yang, Ke Shi, Kai-yue Diao, and Qin Zhang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tissue tracking ,Heart Ventricles ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Ebstein's anomaly ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Observer Variation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Global strain ,Ebstein Anomaly ,medicine.anatomical_structure ,ROC Curve ,Ventricle ,cardiovascular system ,Cardiology ,Female ,business ,Cardiac magnetic resonance - Abstract
The aim of this study was to clarify the feasibility of myocardial strain using cardiovascular magnetic resonance (CMR) for the evaluation of left ventricular (LV) deformation in patients with Ebstein's anomaly (EA).We recruited 32 patients with EA and 30 controls for CMR examination and measured LV function, dimension and tissue tracking parameters (the global and regional radial, circumferential and longitudinal peak strain), together with the right ventricle (RV) dimension. LV strain parameters were compared among the controls, patients with preserved LV ejection fraction (LVEF; ≥55%), and patients with reduced LVEF (55%). Pearson's correlation was used to evaluate relationships between tissue tracking parameters with the RVEDD/LVEDD index and LVEF. An ROC analysis was also performed to determine whether the cut-off values for PS could be used to differentiate LV dysfunction between patients with EA and controls. The intraclass correlation coefficient (ICC) was used to assess the inter- and intra-observer variability.The global strain parameters all decreased significantly in the EA group compared with the control group (all P0.05). Furthermore, the global radial and circumferential peak strain (PS) were obviously even lower in the reduced LVEF group than the strain measured in preserved LVEF groups (28.64% vs. 37.39%, p0.05; and -8.20% vs. -17.89%; p0.05; respectively). The regional strain abnormalities in EA patients were mainly involved in basal and middle segments. The results also demonstrated a significant correlation between the ratio of the RV end-diastolic dimension to the LV end-diastolic dimension (RVEDD/LVEDD index) with the global circumferential PS (r=0.508) and the longitudinal PS (r=0.474), as well as a good correlation between radial PS and LVEF (r=0.465). The ICCs for intra- and inter-observer variability were 0.797-0.904 and 0.701-0.896.LV strain serves an earlier and more comprehensive measurement of LV dysfunction than LVEF in EA, which could potentially be included as a supplementary diagnostic procedure in the evaluation of EA.
- Published
- 2017
31. Cardiac magnetic resonance feature tracking for quantifying right ventricular deformation in type 2 diabetes mellitus patients
- Author
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Ke Shi, Zhi-gang Yang, Lin-jun Xie, Zhen-Lin Li, Yue Gao, Meng-ting Shen, Hua-yan Xu, Wan-Lin Peng, Li Jiang, Yan Ren, Ying-kun Guo, Jin Wang, Chunchao Xia, Hong Li, Ming-yan Deng, Xi Liu, and Bi-yue Hu
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Heart Ventricles ,Ventricular Dysfunction, Right ,Cardiology ,Magnetic Resonance Imaging, Cine ,lcsh:Medicine ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,lcsh:Science ,Prospective cohort study ,Aged ,Subclinical infection ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,Myocardium ,lcsh:R ,Type 2 Diabetes Mellitus ,Type 2 diabetes ,Magnetic resonance imaging ,Odds ratio ,Middle Aged ,030104 developmental biology ,medicine.anatomical_structure ,Diabetes Mellitus, Type 2 ,ROC Curve ,Ventricle ,Ventricular Function, Right ,Feature tracking ,Female ,lcsh:Q ,business ,Cardiac magnetic resonance ,030217 neurology & neurosurgery - Abstract
To determine the feasibility of deformation analysis in the right ventricle (RV) using cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) in type 2 diabetes mellitus (T2DM) patients. We enrolled 104 T2DM patients, including 14 with impaired right ventricular ejection fraction (RVEF) and 90 with preserved RVEF, and 26 healthy controls in this prospective study. CMR was used to determine RV feature-tracking parameters. RV strain parameters were compared among the controls, patients with preserved and reduced RVEF. Binary logistic regression was used to predict RV dysfunction. Receiver operating characteristic analysis was used to assess the diagnostic accuracy. The agreement was tested by Bland–Altman analysis. Compared with controls, longitudinal and circumferential global peak strain (PS) and PS at mid-ventricular, apical slices were significantly decreased in T2DM patients with or without reduced RVEF (p
- Published
- 2019
32. Morphologic and functional abnormalities in patients with Ebstein’s anomaly with cardiac magnetic resonance imaging: Correlation with tricuspid regurgitation
- Author
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Qin Zhang, Xi Liu, Rui Li, Ke Shi, Ying-kun Guo, Zhi-gang Yang, Lingyi Wen, Hua-yan Xu, and Jing Chen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Heart Ventricles ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,Ebstein's anomaly ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Ejection fraction ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Tricuspid Valve Insufficiency ,Cardiac surgery ,Ebstein Anomaly ,medicine.anatomical_structure ,ROC Curve ,Echocardiography ,Ventricle ,cardiovascular system ,Cardiology ,Female ,Tricuspid Valve Regurgitation ,business - Abstract
Purpose The aim of this study was to assess the correlations of functional and dimensional parameters with the severity of tricuspid regurgitation in patients with Ebstein’s anomaly (EA) by using cardiac magnetic resonance (CMR) imaging. Materials and methods Thirty-three patients with EA without previous cardiac surgery and 25 normal individuals were recruited and underwent both cardiac MR imaging and preoperative transthoracic echocardiography. The left ventricular (LV) functional parameters and dimensions of the right ventricle (RV) and LV were measured using 3.0-T cardiac MR imaging. Tricuspid regurgitation severity grading was estimated by echocardiography. The functional and dimensional parameters were compared between EA patients and controls using independent sample t-tests. Spearman’s rank correlation was used to determine the correlations between the functional and dimensional parameters and tricuspid regurgitation. Receiver operating characteristic (ROC) analysis was used to predict tricuspid regurgitation severity using individual functional and dimensional parameters. Results Statistical analysis revealed significant differences in the functional and dimensional parameters between EA patients and controls. Within the EA group, tricuspid valve regurgitation negatively correlated well with the left ventricular ejection fraction (LVEF) (r = −0.558, p = 0.001). The ratio of the right ventricular (functional right ventricle) end-diastolic dimension to the left ventricle end-diastolic dimension (RVEDD/LVEDD) in EA patients also correlated well with the severity of tricuspid valve regurgitation (r = 0.492, p = 0.004). Moreover, ROC analysis revealed that high sensitivity and specificity were obtained for predicting the severity of tricuspid valve regurgitation with LVEF (78.3%, 90.0%) and RVEDD/LVEDD (78.3%, 94.3%). Conclusion In EA patients, the left and right ventricular functional and dimensional parameters from MRI correlated well with tricuspid regurgitation, which helped predict the severity of EA.
- Published
- 2016
33. Dual-source computed tomography for evaluating pulmonary artery in pediatric patients with cyanotic congenital heart disease: Comparison with transthoracic echocardiography
- Author
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Xi Liu, Ke Shi, Si-xiu Zhao, Hua-yan Xu, Zhi-gang Yang, and Ying-kun Guo
- Subjects
Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Cyanotic congenital heart disease ,Pulmonary Artery ,030204 cardiovascular system & hematology ,Positive correlation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Ultrasonography ,business.industry ,Reproducibility of Results ,Mean age ,General Medicine ,Left pulmonary artery ,Surgical procedures ,Right pulmonary artery ,Child, Preschool ,Dual source computed tomography ,Pulmonary artery ,Cardiology ,Female ,Tomography, X-Ray Computed ,business - Abstract
To evaluate the quantitative accuracy of dual-source computed tomography (DSCT) on measurements of pulmonary artery in pediatric patients with cyanotic congenital heart diseases (CCHDs) when compared with transthoracic echocardiography (TTE).Thirty-five patients (mean age: 27.88 ± 28.27 months) with CCHDs underwent DSCT and TTE for evaluating the diameter of the main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA). Surgical measurements were obtained and served as the reference standard. The agreement was tested by linear regression analysis, Pearson's correlation coefficient, and Bland-Altman analysis. The intra- and extracardiac malformations were also observed.There was a markedly positive correlation between DSCT and surgical measurements of the MPA, RPA, and LPA (r=0.95-0.97; all p0.001), although the overestimation of the measurements of MPA, RPA, and LPA (bias 0.15 ± 0.95, 0.31 ± 0.63 and 0.35 ± 0.68 mm, respectively) was observed. However, there was a moderate correlation between TTE and surgical measurements of MPA, RPA, and LPA (r=0.61-0.84; all p0.001), and the underestimation of the measurements of MPA, RPA, and LPA (bias-1.20 ± 1.69, -1.80 ± 1.77, and -1.50 ± 2.30 mm, respectively) was observed. In addition, DSCT was more efficient in finding associated malformations than TTE (40/40 vs. 33/40).As a reliable, noninvasive and radiation-save imaging modality, DSCT can provide more accurate pulmonary artery measurements than TTE in cardiac surgical procedures.
- Published
- 2016
34. Histological Validation of Cardiovascular Magnetic Resonance T1 Mapping for Assessing the Evolution of Myocardial Injury in Myocardial Infarction: An Experimental Study
- Author
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Meng Xi Yang, Ran Sun, Hua-yan Xu, Tianyu Miao, Lu Zhang, Xiaoyue Zhou, Ying-kun Guo, Rong Xu, Jichun Zhao, Lin Chen, Zhi-gang Yang, and Chuan Fu
- Subjects
Male ,medicine.medical_specialty ,Histology ,Subacute phase ,Swine ,Myocardial Infarction ,Contrast Media ,Magnetic Resonance Imaging, Cine ,030218 nuclear medicine & medical imaging ,Masson's trichrome stain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Extracellular fluid ,Image Processing, Computer-Assisted ,Quantitative assessment ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,Cardiovascular Imaging ,medicine.diagnostic_test ,business.industry ,Myocardium ,Reproducibility of Results ,Magnetic resonance imaging ,T1 mapping ,medicine.disease ,Disease Models, Animal ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Acute Disease ,Chronic Disease ,Cardiology ,Original Article ,Cardiovascular magnetic resonance ,business ,Cardiac ,Artery - Abstract
Objective To determine whether T1 mapping could monitor the dynamic changes of injury in myocardial infarction (MI) and be histologically validated. Materials and Methods In 22 pigs, MI was induced by ligating the left anterior descending artery and they underwent serial cardiovascular magnetic resonance examinations with modified Look-Locker inversion T1 mapping and extracellular volume (ECV) computation in acute (within 24 hours, n = 22), subacute (7 days, n = 13), and chronic (3 months, n = 7) phases of MI. Masson's trichrome staining was performed for histological ECV calculation. Myocardial native T1 and ECV were obtained by region of interest measurement in infarcted, peri-infarct, and remote myocardium. Results Native T1 and ECV in peri-infarct myocardium differed from remote myocardium in acute (1181 ± 62 ms vs. 1113 ± 64 ms, p = 0.002; 24 ± 4% vs. 19 ± 4%, p = 0.031) and subacute phases (1264 ± 41 ms vs. 1171 ± 56 ms, p < 0.001; 27 ± 4% vs. 22 ± 2%, p = 0.009) but not in chronic phase (1157 ± 57 ms vs. 1120 ± 54 ms, p = 0.934; 23 ± 2% vs. 20 ± 1%, p = 0.109). From acute to chronic MI, infarcted native T1 peaked in subacute phase (1275 ± 63 ms vs. 1637 ± 123 ms vs. 1471 ± 98 ms, p < 0.001), while ECV progressively increased with time (35 ± 7% vs. 46 ± 6% vs. 52 ± 4%, p < 0.001). Native T1 correlated well with histological findings (R2 = 0.65 to 0.89, all p < 0.001) so did ECV (R2 = 0.73 to 0.94, all p < 0.001). Conclusion T1 mapping allows the quantitative assessment of injury in MI and the noninvasive monitoring of tissue injury evolution, which correlates well with histological findings.
- Published
- 2020
35. Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study
- Author
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Lin-jun Xie, Li Jiang, Zhi-gang Yang, Bi-yue Hu, Kai-yue Diao, Yan Ren, Hua-yan Xu, Meng-ting Shen, Ying-kun Guo, Xi Liu, Ke Shi, and Yue Gao
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Cardiac magnetic resonance ,Diabetic Cardiomyopathies ,Subclinical myocardial dysfunction ,Endocrinology, Diabetes and Metabolism ,Diastole ,Contrast Media ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,Myocardial perfusion ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Coronary Circulation ,Diabetes mellitus ,Internal medicine ,Type 2 diabetes mellitus ,medicine ,Humans ,Prospective Studies ,Original Investigation ,Angiology ,Subclinical infection ,medicine.diagnostic_test ,business.industry ,Microcirculation ,Myocardial Perfusion Imaging ,Type 2 Diabetes Mellitus ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Early Diagnosis ,Diabetes Mellitus, Type 2 ,lcsh:RC666-701 ,Case-Control Studies ,Heart failure ,Asymptomatic Diseases ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Perfusion - Abstract
Background Early detection of subclinical myocardial dysfunction in patients with diabetes mellitus (DM) is essential for recommending therapeutic interventions that can prevent or reverse heart failure, thereby improving the prognosis in such patients. This study aims to quantitatively evaluate left ventricular (LV) myocardial deformation and perfusion using cardiovascular magnetic resonance (CMR) imaging in patients with type 2 diabetes mellitus (T2DM), and to investigate the association between LV subclinical myocardial dysfunction and coronary microvascular perfusion. Methods We recruited 71 T2DM patients and 30 healthy individuals as controls who underwent CMR examination. The T2DM patients were subdivided into two groups, namely the newly diagnosed DM group (n = 31, patients with diabetes for ≤ 5 years) and longer-term DM group (n = 40, patients with diabetes > 5 years). LV deformation parameters, including global peak strain (PS), peak systolic strain rate, and peak diastolic strain rate (PSDR), and myocardial perfusion parameters such as upslope, time to maximum signal intensity (TTM), and max signal intensity (Max SI, were measured and compared among the three groups. Pearson’s correlation was used to evaluate the correlation between LV deformation and perfusion parameters. Results Pooled data from T2DM patients showed a decrease in global longitudinal, circumferential, and radial PDSR compared to healthy individuals, apart from lower upslope. In addition, increased TTM and reduced Max SI were found in the longer-term diabetics compared to the normal subjects (p
- Published
- 2018
36. Evaluation of myocardial fibrosis in diabetes with cardiac magnetic resonance T1-mapping: Correlation with the high-level hemoglobin A1c
- Author
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Meng-ting Shen, Zhi-gang Yang, Chunchao Xia, Ying-kun Guo, Lin-jun Xie, Yue Gao, Hua-yan Xu, Bi-yue Hu, Xiaoyue Zhou, Ming-yan Deng, Li Jiang, Xi Liu, Zhen-Lin Li, Yan Ren, Li-ling Deng, and Li Yuming
- Subjects
Male ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Level hemoglobin ,Magnetic Resonance Imaging, Cine ,030209 endocrinology & metabolism ,Correlation ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Predictive Value of Tests ,Internal medicine ,Diabetes mellitus ,Diabetic cardiomyopathy ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Glycated Hemoglobin ,business.industry ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Fibrosis ,Diabetes Mellitus, Type 2 ,ROC Curve ,Case-Control Studies ,Cardiology ,Myocardial fibrosis ,Female ,Hemoglobin ,business ,Cardiac magnetic resonance ,Cardiomyopathies - Abstract
The aim of the study was to assess the extracellular volume fraction (ECV) in type 2 diabetes mellitus (T2DM) patients with different level of hemoglobin A1c (HbA1c) by cardiac magnetic resonance (CMR), and the ability of HbA1c to predict myocardial fibrosis.In total, 80 T2DM patients and 20 age- and sex-matched controls were prospective enrolled and underwent CMR to obtain ECV value and LV function parameters. We divided all patients into a group of HbA1c 7.0% and a group of HbA1c ≥ 7.0%.In the higher HbA1c group the ECV value (all p 0.001) was higher than both lower HbA1c group (36.23% vs. 32.19%, p 0.001) and controls (36.23% vs. 29.73%, p 0.001). HbA1c was positively associated (β = 0.36, p = 0.004) with ECV, and it was also an independent predictor of myocardial fibrosis (OR = 2.00, P = 0.014). The ROC analysis showed that 7.1% was the optimal cutoff value of HbA1c that predicted the risk of myocardial fibrosis with high diagnostic accuracy (area under the curve = 0.78).T1 mapping provided myocardial fibrosis information in T2DM patients. HbA1c is positively correlated with myocardial fibrosis and can be an independently predictor of myocardial fibrosis, which may be helpful for the clinical decision-making of blood glucose control.
- Published
- 2018
37. Quantified evaluation of tracheal compression in pediatric complex congenital vascular ring by computed tomography
- Author
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Rong Xu, Qin Zhao, Hua-yan Xu, Kai-yue Diao, Zhi-gang Yang, Ke Shi, and Ying-kun Guo
- Subjects
Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Heart disease ,lcsh:Medicine ,Computed tomography ,030204 cardiovascular system & hematology ,Pediatrics ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,X ray computed ,Humans ,Medicine ,In patient ,TRACHEAL COMPRESSION ,lcsh:Science ,Retrospective Studies ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Infant ,Vascular ring ,Retrospective cohort study ,respiratory system ,medicine.disease ,Vascular Ring ,Trachea ,Diameter ratio ,Child, Preschool ,lcsh:Q ,Female ,Radiology ,Tomography, X-Ray Computed ,Tracheal Stenosis ,business - Abstract
Clinically, early diagnosis and treatment is important for survival of pediatric with vascular ring (VR) associated with congenital heart disease (CHD), and accurate evaluation of VR is a prerequisite for repair surgical. The study aimed to assess the quantitative characteristics of tracheal compression in pediatrics with VR and CHD using dual-source computed tomography (DSCT), and further provided effective information for surgical decisions. A total of 49 VR patients with CHD and 56 controls were enrolled. The tracheal quantitative measurements (short diameter, long diameter, tracheal area and tracheal length) were obtained, and the degree of tracheal compression was assessed. Our results indicated that VR associated with CHD may cause more serious and complex symptoms, and the greater tracheal compression were found on DSCT when more severe symptoms were present (r = 0.84). The degree of tracheal compression was significantly different within the VR group between those with and without surgery (P = 0.002). Finally, there were good agreement among (1-long diameter ratio), (1-short diameter ratio) and (1-area ratio) in patients and controls, respectively. This study indicated that DSCT enables provides accurate quantitative tracheal compression information for VR pediatrics associated with CHD, and evaluation of the degree of tracheal compression by 1-area ratio may contribute to the repair surgical of VR.
- Published
- 2018
38. Predictors of aortic dilation in patients with coarctation of the aorta: evaluation with dual-source computed tomography
- Author
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Kai-yue Diao, Ke Shi, Ying-kun Guo, Zhi-gang Yang, Xi Liu, Qin Zhao, and Hua-yan Xu
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Adolescent ,Computed Tomography Angiography ,Coarctation of the aorta ,Collateral Circulation ,030204 cardiovascular system & hematology ,Aortography ,Severity of Illness Index ,Aortic Coarctation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,medicine.artery ,Internal medicine ,Degree of coarctation ,Ascending aorta ,medicine ,Humans ,Child ,Aorta ,Angiology ,Retrospective Studies ,Body surface area ,business.industry ,Odds ratio ,medicine.disease ,Collateral circulation ,Prognosis ,Cardiac surgery ,Aortic Aneurysm ,lcsh:RC666-701 ,Regional Blood Flow ,Dual-source computed tomography ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Aortic dilation ,Dilatation, Pathologic ,Research Article - Abstract
Background Coarctation of aorta (CoA) may progressively develop aortic dilation at other site of the aorta and can lead to fatal aortic diseases. We aimed to evaluate the occurrence of aortic dilation and related predictors in patients with CoA using dual-source computed tomography (DSCT). Methods Fifty-three patients with CoA identified by DSCT were retrospectively reviewed. Aortic diameters were measured at six different levels and standardized as z-scores based on the square root of body surface area. Coarctation site–diaphragm ratio (CDR) was used to describe the degree of narrowing. A total of 26 patients were included in mild group (CDR > 50%) and 27 in severe group (CDR
- Published
- 2017
39. Dual-source Computed Tomography for Evaluating Pulmonary Artery and Aorta in Pediatric Patients with Single Ventricle
- Author
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Ying-kun Guo, Hua-yan Xu, Ke Shi, Kai-yue Diao, Meng-Xi Yang, Zhi-gang Yang, and Yi Zhang
- Subjects
Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Heart Ventricles ,medicine.medical_treatment ,lcsh:Medicine ,Pulmonary Artery ,030204 cardiovascular system & hematology ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Ductus arteriosus ,Ascending aorta ,Image Processing, Computer-Assisted ,medicine ,Humans ,lcsh:Science ,Child ,Aorta ,Computed tomography angiography ,Cardiac catheterization ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Infant ,medicine.anatomical_structure ,Echocardiography ,Great arteries ,Case-Control Studies ,Child, Preschool ,Pulmonary artery ,Cardiology ,lcsh:Q ,Female ,Tomography, X-Ray Computed ,business ,Artery - Abstract
To explore the accuracy of main pulmonary artery (MPA) and ascending aorta (AAO) image evaluation in pediatric patients with single ventricle (SV) by comparing dual-source computed tomography (DSCT) with echocardiography. Thirty-one children with SV were retrospectively enrolled. The stenosis, dilation, and location of MPA and AAO were independently evaluated by DSCT and echocardiography. The accompanying arterial malformations were also assessed by DSCT. For 17 patients undergoing cardiac catheterization, the DSCT-based diameters of MPA and AAO were correlated with their pressures as measured by catheterization. Referring to the surgical and catheterization findings, DSCT had better diagnostic performance in detecting the stenosis, dilation, and location of MPA and AAO with higher sensitivity than echocardiography (sensitivity, MPA: 88.0% vs. 80.0%, AAO: 100% vs. 66.7%, great arteries location: 95.7% vs. 95.2%). The correlations between diameters of MPA and AAO with their pressures were 0.399 (p = 0.04) and 0.611 (p = 0.01), respectively. In addition, DSCT detected 23 cases with patent ductus arteriosus, 26 systemic-to-pulmonary collaterals, 9 branch pulmonary distortions, and 4 coronary artery anomalies. DSCT is reliable for assessing the anatomic features of pulmonary artery and aorta in SV children, and provides comprehensive information for surgical strategy-making.
- Published
- 2017
40. Assessment of transposition of the great arteries associated with multiple malformations using dual-source computed tomography
- Author
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Ying-kun Guo, Lin-jun Xie, Zhi-gang Yang, Ke Shi, Li Jiang, Hua-yan Xu, Rui Li, and Kai-yue Diao
- Subjects
Myocardial bridge ,Heart Septal Defects, Ventricular ,Male ,Computed Tomography Angiography ,Cardiovascular Procedures ,Transposition of Great Vessels ,lcsh:Medicine ,Vascular Surgery ,030204 cardiovascular system & hematology ,Coronary Angiography ,Pathology and Laboratory Medicine ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Medicine and Health Sciences ,Morphogenesis ,Ventricular outflow tract ,Pulmonary Arteries ,lcsh:Science ,Child ,Aorta ,Coronary Arteries ,Computed tomography angiography ,Stenosis ,Multidisciplinary ,medicine.diagnostic_test ,Heart ,Arteries ,Congenital Heart Defects ,medicine.anatomical_structure ,Great vessels ,Great arteries ,Echocardiography ,Child, Preschool ,Female ,Radiology ,Anatomy ,Research Article ,Adult ,Heart Defects, Congenital ,medicine.medical_specialty ,Adolescent ,Cardiac Ventricles ,Heart Ventricles ,Myocardial Bridging ,Cardiology ,Surgical and Invasive Medical Procedures ,Ventricular Outflow Obstruction ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,medicine ,Congenital Disorders ,Humans ,Birth Defects ,business.industry ,lcsh:R ,Coronary Stenosis ,Infant ,Biology and Life Sciences ,Digital subtraction angiography ,medicine.disease ,Coronary arteries ,Cardiovascular Anatomy ,Ventricular Septal Defects ,Blood Vessels ,lcsh:Q ,business ,Developmental Biology - Abstract
Purpose To determine the value of dual-source computed tomography (DSCT) in depicting the morphological characteristics and diagnosing the associated malformations for patients with transposition of the great arteries (TGA) before surgery. Materials and methods Twenty-five patients with TGA who underwent DSCT and transthoracic echocardiography (TTE) examination were retrospectively reviewed. The morphological types of TGA, the spatial relationship between the pulmonary artery and the aorta, as well as coronary artery-associated abnormalities were assessed by DSCT. In contrast to TTE, the diagnostic accuracy of associated malformations on DSCT were analyzed and calculated with reference to surgical or digital subtraction angiography (DSA) findings. Effective doses (EDs) were also calculated. Results Among the 25 patients, 12 (48%) had ventricular septal defects and left ventricular outflow tract stenosis. Sixteen patients (16/25, 64%) had great arteries with an oblique spatial relationship on DSCT. In addition, we found seven patients (7/25, 28%) with coronary artery malformation, including five with an abnormal coronary origin and two with signs of a myocardial bridge. According to DSA or surgical findings, DSCT was superior to TTE in demonstrating extracardiac anomalies (sensitivity, anomalies of great vessels: 100% vs. 93.33%, other anomalies: 100% vs. 46.15%). The mean estimated ED for those aged
- Published
- 2017
41. Early marker of regional left ventricular deformation in patients with hypertrophic cardiomyopathy evaluated by MRI tissue tracking: The effects of myocardial hypertrophy and fibrosis
- Author
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Hua-Yan, Xu, Jing, Chen, Zhi-Gang, Yang, Rui, Li, Ke, Shi, Qin, Zhang, Xi, Liu, Lin-Jun, Xie, Li, Jiang, and Ying-Kun, Guo
- Subjects
Adult ,Male ,Observer Variation ,Heart Ventricles ,Myocardium ,Contrast Media ,Reproducibility of Results ,Heart ,Hypertrophy ,Middle Aged ,Fibrosis ,Magnetic Resonance Imaging ,Ventricular Dysfunction, Left ,Young Adult ,Echocardiography ,Humans ,Female ,Aged - Abstract
To evaluate the regional left ventricular (LV) myocardial strain of early stage hypertrophic cardiomyopathy (HCM) patients by magnetic resonance (MR) tissue tracking.In all, 114 adult HCM patients classified as NYHA I or II and 32 healthy volunteers were enrolled and underwent 3.0T MR examination. Vertical 2-chamber long axis, horizontal 4-chamber, and short axis cine sequence as well as late gadolinium enhancement images (LGE) were scanned. The cardiac function, regional LV tissue tracking variables, end-diastolic wall thickness (EDTH), and LGE extent were measured.In the HCM group, 38 were NYHA I and 76 were NYHA II. By regional analysis, peak strain (PS) and peak displacement (PD) with radial, circumferential direction of hypertrophic segments (n = 283) were significantly lower than nonhypertrophic segments (n = 1541) (all P 0.05). Radial PS was significantly correlated with LVEDTH (r = -0.467, P 0.0001). Radial PD was negatively associated with LVEDTH (r = -0.331, P 0.0001). The PS and PD of all directions were decreased in segments with LGE (n = 723) compared with those without LGE (n = 1101) (all P 0.05). In addition, radial PS and PD were negatively associated with LGE extent (radial PS, r = -0.441; radial PD, r = -0.274; both P 0.0001). All strain parameters showed excellent inter- and intraobserver agreements.Decreased regional LV myocardial strain hypertrophic and fibrotic segments of early-stage HCM patients can be measured by MR tissue tracking based on routine cine images. Moreover, myocardial strain may decrease with the increasing of myocardial hypertrophy as well as fibrosis.2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1368-1376.
- Published
- 2016
42. Myocardial Iron Deficiency in Hemodialysis-Dependent End-Stage Renal Disease Patients Undergoing Oral Iron Therapy
- Author
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Zhi-gang Yang, Chunchao Xia, Ke Shi, Li Zhenlin, Hua-yan Xu, Yi Zhang, Qing-yong Chen, Wan-Lin Peng, Rui Li, and Ying-kun Guo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Anemia ,Iron ,medicine.medical_treatment ,Administration, Oral ,Myocardial iron ,Disease ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Gastroenterology ,End stage renal disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Young adult ,Aged ,Aged, 80 and over ,Anemia, Iron-Deficiency ,business.industry ,Myocardium ,Iron deficiency ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Kidney Failure, Chronic ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Iron deficiency is the most common complication and the main cause of anemia in patients with hemodialysis-dependent end-stage renal disease (ESRD). There are possible relations among iron deficiency, cardiac failure, renal failure, and anemia, termed as the cardio-renal-anemia iron deficiency
- Published
- 2017
43. Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis
- Author
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Li Jiang, Kai-yue Diao, Hua-yan Xu, Lingyi Wen, Qin Zhang, Lin-jun Xie, Xi Liu, Zhi-gang Yang, Ying-kun Guo, and Ke Shi
- Subjects
medicine.medical_specialty ,Myocardial biopsy ,Heart Diseases ,Biopsy ,030204 cardiovascular system & hematology ,Cochrane Library ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Myocardial fibrosis ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Angiology ,Medicine(all) ,Cardiovascular magnetic resonance, T1 mapping ,Chi-Square Distribution ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Myocardium ,Research ,Reproducibility of Results ,Magnetic resonance imaging ,Fibrosis ,Magnetic Resonance Imaging ,Meta-analysis ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Biopsy findings - Abstract
Background Myocardial fibrosis is being increasingly recognised as a common final pathway of a wide range of diseases. Thus, the development of an accurate and convenient method to evaluate myocardial fibrosis is of major importance. Although T1 mapping is a potential alternative for myocardial biopsy, validation studies are limited to small numbers and vary regarding technical facets, and include only a restricted number of disease. A systematic review and meta-analysis was conducted to objectively and comprehensively evaluate the performance of T1 mapping on the quantification of myocardial fibrosis using cardiovascular magnetic resonance (CMR). Methods PubMed, EMBASE and the Cochrane Library databases were searched for studies applying T1 mapping to measure myocardial fibrosis and that validated the results via histological analysis. A pooled correlation coefficient between the CMR and histology measurements was used to evaluate the performance of the T1 mapping. Results A total of 15 studies, including 308 patients who had CMR and myocardial biopsy were included and the pooled correlation coefficient between ECV measured by T1 mapping and biopsy for the selected studies was 0.884 (95% CI: 0.854, 0.914) and was not notably heterogeneous chi-squared = 7.44; P = 0.489 for the Q test and I^2 = 0.00%). Conclusions The quantitative measurement of myocardial fibrosis via T1 mapping is associated with a favourable overall correlation with the myocardial biopsy measurements. Further studies are required to determine the calibration of the T1 mapping results for the biopsy findings of different cardiomyopathies.
- Published
- 2016
44. Assessing Mitral Regurgitation in Patients with Dilated Cardiomyopathy Using 3.0T Cardiac Magnetic Resonance Imaging: Correlation with Morphological and Functional Abnormalities
- Author
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Lingyi Wen, Ying-kun Guo, Hua-yan Xu, Zhi-gang Yang, and Jia-yu Sun
- Subjects
medicine.medical_specialty ,Mitral regurgitation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Cardiomyopathy ,Dilated cardiomyopathy ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Ventricle ,Cardiac magnetic resonance imaging ,Internal medicine ,Mitral valve ,cardiovascular system ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Mitral Valve Annulus ,cardiovascular diseases ,business - Abstract
Background: Mitral regurgitation frequently accompanies dilated cardiomyopathy (DCM), which is associated with poor progno- sis. Objectives: To evaluate morphological and functional abnormalities in DCM patients and correlate these features with the severity of coexistent mitral regurgitation using 3.0 T magnetic resonance imaging (MRI). Patients and Methods: Forty-one patients with DCM and 26 healthy control subjects underwent MRI and echocardiography exami- nations. The maximum and minimum mitral annulus areas (MAA), diameters of left ventricle and atrium, end-diastolic and systolic volumes, and ejection fraction were assessed with MRI and were indexed to body surface area. Mitral regurgitation severity grading was estimated by echocardiography. Results: Of the 41 patients with DCM, echocardiography examination revealed 11 patients (27%) without mitral regurgitation and 12 (29%) with mild, 11 (27%) with moderate, and seven (17%) with severe mitral regurgitation. All of the morphological and functional parameters of left ventricle, atrium and mitral valve in DCM patients were greater than those in healthy subjects (all P < 0.05), except for ejection fraction. The indexed end-systolic diameters of left ventricle (LVESD) and atrium (LAESD) and indexed minimum MAA might have the capability to distinguish no/mild mitral regurgitation patients from moderate/severe patients (areas under the receiver operating characteristic curve (AUC) = 0.876, 0.816, and 0.773, respectively; all P < 0.05). Using a combination of indexed LAESD, LVESD and minimum MAA, the specificity increased to 91.3%. Conclusion: Mitral regurgitation in DCM patients is associated with morphological and functional abnormalities of left heart and mitral valve annulus. The indexed LVESD, LAESD, and minimum MAA values can assist in predicting the severity of mitral regurgita- tion with a high sensitivity and specificity.
- Published
- 2016
45. [Chemical Exchange Saturation Transfer Imaging of Creatine Metabolites: a 3.0 T MRI Pilot]
- Author
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Ying-kun, Guo, Zhen-lin, Li, Yu, Rong, Chun-chao, Xia, Li-zhi, Zhang, Wan-ling, Peng, Xi, Liu, Hua-yan, Xu, Ti-jiang, Zhang, Pan-li, Zuo, and Benjamin, Schmitt
- Subjects
Phantoms, Imaging ,Creatine ,Magnetic Resonance Imaging - Abstract
To determine the feasibility of using chemical exchange saturation transfer (CEST) imaging to measure creatine (Cr) metabolites with 3.0 T MR.Phantoms containing different concentrations of Cr under various pH conditions were studied with CEST sequence on 3.0 T MR imaging. CEST effect and Z spectra were analyzed.Cr exhibited significant CEST effect (± 1.8 ppm, F = 99.08, P0.001) on 3.0 T MR imaging, and positive correlation was found between the signal intensity and concentration of Cr (r = 0.963, P0.001). The CEST effect showed pH dependency of Cr (r = 0.41, P = 0.035).Creatine CEST imaging can be performed on 3.0 T MR imaging. Creatine concentrations and pH influence CEST effect.
- Published
- 2016
46. Regional myocardial microvascular dysfunction in cardiac amyloid light-chain amyloidosis: assessment with 3T cardiovascular magnetic resonance
- Author
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Lin-yi Wen, Zhi-gang Yang, Xi Liu, Qin Zhang, Rui Li, Hua-yan Xu, and Ying-kun Guo
- Subjects
Male ,Biopsy ,Perfusion scanning ,030204 cardiovascular system & hematology ,Coronary microvascular function ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Medicine(all) ,Ejection fraction ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Left ventricular function ,Myocardial Perfusion Imaging ,Amyloid light-chain cardiac amyloidosis ,Amyloidosis ,Stroke volume ,Middle Aged ,Perfusion imaging ,Coronary Vessels ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Area Under Curve ,Cardiology ,Female ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,Perfusion ,Adult ,medicine.medical_specialty ,Systole ,03 medical and health sciences ,Myocardial perfusion imaging ,Coronary circulation ,Predictive Value of Tests ,Coronary Circulation ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,business.industry ,Research ,Microcirculation ,Stroke Volume ,ROC Curve ,Cardiac amyloidosis ,Case-Control Studies ,Microvessels ,Feasibility Studies ,Cardiovascular magnetic resonance ,Immunoglobulin Light Chains ,business - Abstract
Background Coronary microvascular dysfunction is highly prevalent in patients with amyloid light-chain (AL) cardiac amyloidosis (AL-CA). The aim of this study was to clarify the feasibility of first-pass perfusion imaging using 3 T cardiovascular magnetic resonance (CMR) for evaluating the difference in left ventricular (LV) regional myocardial microvascular function among normal subjects and in patients with AL-CA. The amyloidosis patients were classified into those with impaired systolic function [LV ejection fraction (LVEF)
- Published
- 2016
47. Leukemias involving abdominal and pelvic lymph nodes: evaluation with contrast-enhanced MDCT
- Author
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Ge Zhang, Jiao Bai, Hua-yan Xu, Qi-hua Long, Zhi-gang Yang, and Yuan Li
- Subjects
Adult ,Radiography, Abdominal ,medicine.medical_specialty ,Adolescent ,Urology ,Iohexol ,Contrast Media ,Pelvis ,Diagnosis, Differential ,Young Adult ,hemic and lymphatic diseases ,Internal medicine ,Abdomen ,Multidetector Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Sex Distribution ,Lymph node ,Lymphatic Diseases ,Aged ,Retrospective Studies ,Leukemia ,Radiological and Ultrasound Technology ,business.industry ,Gastroenterology ,General Medicine ,Hepatology ,Pelvic cavity ,Middle Aged ,medicine.disease ,Pelvic lymph nodes ,Radiographic Image Enhancement ,medicine.anatomical_structure ,Female ,Lymph ,Radiology ,Lymph Nodes ,Differential diagnosis ,business - Abstract
To clarify features of lymph nodes associated with leukemia purposing to offer help for imaging diagnosis and differential diagnosis of leukemia.We retrospectively analyzed 47 patients with clinically proven leukemia involving the abdominal and pelvic lymph nodes. Of these 47 patients, 10 had acute myeloid leukemia, 9 had acute lymphocytic leukemia, and 28 had chronic lymphocytic leukemia. MDCT was used to determine lymph node features such as morphology, growth patterns, size, enhancement patterns, anatomical distribution, and manifestations in extramedullary organs.Incidence of leukemia was higher in men than in women. Enlarged lymph nodes were more frequently conglomerated in chronic lymphocytic leukemia (96.4%) than in acute myeloid leukemia (50%) and acute lymphocytic leukemia (55.6%; P 0.05 for both). Lymph nodes associated with chronic lymphocytic leukemia were larger than those associated with acute myeloid and lymphocytic leukemias (P 0.05 for both). The enlarged lymph nodes appeared homogeneous (80.9%) and homogeneous mixed with peripheral (19.1%). No statistically significant differences were observed between the three types of leukemias with respect to enhancement patterns (all P 0.05). The lymph nodes commonly associated with these three leukemias were located in the lesser omentum, upper and lower para-aortic regions, and groin region.Our study showed that contrast-enhanced MDCT could accurately determine the enhancement patterns and anatomical distribution of lymph nodes associated with leukemia. Therefore, it is helpful for imaging diagnosis and differential diagnosis of leukemia.
- Published
- 2014
48. The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance
- Author
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Hua-yan Xu, Ying-kun Guo, Shuai Zhang, Jia-yu Sun, Ge Zhang, Zhi-gang Yang, and Lingyi Wen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ventricular outflow tract obstruction ,Perfusion scanning ,Coronary Artery Disease ,Sensitivity and Specificity ,Ventricular Outflow Obstruction ,Internal medicine ,Peak intensity ,medicine ,Ventricular outflow tract ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,business.industry ,Myocardium ,Hypertrophic cardiomyopathy ,Reproducibility of Results ,General Medicine ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,First pass perfusion ,Microvessels ,cardiovascular system ,Cardiology ,Female ,medicine.symptom ,Cardiac magnetic resonance ,business ,Perfusion ,Magnetic Resonance Angiography - Abstract
To assess regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction using 3.0-T cardiac magnetic resonance (CMR) first-pass perfusion imaging.Forty-two HCM patients, including 25 HCM patients with left ventricular outflow tract obstruction (HOCM), 17 HCM patients without left ventricular outflow tract obstruction (NOHCM), and 14 healthy subjects underwent CMR. The left ventricular (LV) function, left ventricular end-diastolic wall thickness (EDTH), and diameter of left ventricular outflow tract (LVOT) were measured and calculated. Based on the signal-time curve of the first-pass myocardium perfusion imaging, perfusion parameters including upslope, time to peak, and peak intensity, were assessed and compared by using one-way analysis of variance and independent t tests.On the first-pass perfusion imaging, lower upslope and peak intensity and longer time to peak were found in HCM patients compared with normal subjects (all p0.05). In contrast to the NOHCM group, the average time to peak of the HOCM group was increased (13.30 ± 4.82 s vs 16.28 ± 4.90 s, p0.05), but first-pass perfusion upslope was reduced (4.96 ± 2.55 vs 2.58 ± 0.77, p0.05). According to the bull's-eye model, the HOCM group's average thickness of basal segments was thicker than the NOHCM group, especially the anteroseptal, inferolateral, and anterior wall values, with a corresponding lower first-pass perfusion upslope than the NOHCM group (all p0.05). A significant correlation was observed between first-pass perfusion upslope and LV EDTH (r=-0.551, p0.001) and LVOT diameter (r=0.472, p0.001).The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction can be detected with first-pass perfusion CMR imaging.
- Published
- 2013
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