150 results on '"Qin, Hua"'
Search Results
2. A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse
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Zhi-Jing Sun, Xiu-Qi Wang, Jing-He Lang, Tao Xu, Yong-Xian Lu, Ke-Qin Hua, Jin-Song Han, Huai-Fang Li, Xiao-Wen Tong, Ping Wang, Jian-Liu Wang, Xin Yang, Xiang-Hua Huang, Pei-Shu Liu, Yan-Feng Song, Hang-Mei Jin, Jing-Yan Xie, Lu-Wen Wang, Qing-Kai Wu, Jian Gong, Yan Wang, Li-Qun Wang, Zhao-Ai Li, Hui-Cheng Xu, Zhi-Jun Xia, Li-Na Gu, Qing Liu, Lan Zhu, and Pei-Fang Wei
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medicine.medical_specialty ,Synthetic mesh ,China ,lcsh:Medicine ,Transvaginal placement of surgical mesh ,Pelvic Organ Prolapse ,Urogynecology ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Medicine ,Humans ,Laparoscopic sacrocolpopexy ,Trial registration ,Pelvic organ ,Pelvic floor ,business.industry ,lcsh:R ,General Medicine ,Original Articles ,Pelvic Floor ,Surgical procedures ,Surgical Mesh ,Surgery ,medicine.anatomical_structure ,Surgical mesh ,Treatment Outcome ,030220 oncology & carcinogenesis ,Vagina ,Female ,business ,030217 neurology & neurosurgery - Abstract
Background:. It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011. Methods:. A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided). Results:. The number of different procedures during October 1, 2011−September 30, 2018 was more than twice that during October 1, 2004−September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004–September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011–September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P
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- 2021
3. Current Status of Red and Near-infrared Emission Halide Scintillation Crystals
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Shuang-liang Cheng, Jie-nan Yang, Dong-dong Liu, Yun-tao Wu, Qin-hua Wei, Lai-shun Qin, and Xue-min Wen
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Radiation ,Materials science ,business.industry ,Near-infrared spectroscopy ,Scintillation crystals ,Optoelectronics ,Halide ,Current (fluid) ,Condensed Matter Physics ,business ,Electronic, Optical and Magnetic Materials - Published
- 2021
4. Effect of ambrisentan on echocardiographic and Doppler measures from patients in China with pulmonary arterial hypertension
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Yong Wang, Xiaofeng Zeng, Gang-Cheng Zhang, Zhi-Cheng Jing, Yong Huo, Qin-Hua Zhao, Jinming Liu, Fu-Hua Peng, Qiu-Shang Ji, Jian-Hui Li, Zai-Xin Yu, and Lu Zi
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Adult ,Male ,China ,medicine.medical_specialty ,Ambrisentan ,Ventricular Dysfunction, Right ,030204 cardiovascular system & hematology ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,skin and connective tissue diseases ,Retrospective Studies ,Pulmonary Arterial Hypertension ,Phenylpropionates ,business.industry ,General Medicine ,Middle Aged ,humanities ,Pyridazines ,body regions ,medicine.anatomical_structure ,Echocardiography ,Ventricle ,Ventricular Function, Right ,symbols ,Cardiology ,Female ,sense organs ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,medicine.drug - Abstract
We retrospectively evaluated the echocardiographic data of ambrisentan-treated patients with pulmonary arterial hypertension (PAH) (NCT01808313).Change from baseline in right ventricle (RV) systolic function, right heart structure, and pulmonary artery systolic pressure (PASP) prognosis to Weeks 12 and 24 was evaluated by echocardiography.In the overall population, the mean tissue Doppler-derived tricuspid lateral annular systolic velocity (S') increased by 0.6 cm/s at both Weeks 12 (p 0.001) and 24 (p = 0.004) and tricuspid annular plane systolic excursion increased by 0.13 cm at Week 12 and 0.15 cm at Week 24 (both p 0.001). A marked decrease in transverse and longitudinal RV and RA diameter at Weeks 12 and 24 was observed. A significant decrease in diastolic eccentricity index at both Weeks 12 (-0.1; p = 0.02) and 24 (-0.1; p = 0.001). The decrease in PASP from baseline was significant at both Weeks 12 (-9.5 mmHg; p0.001) and 24 (-7.6 mmHg; p0.001), while a decrease in the estimated right atrium pressure was found to be significant at Week 24 (-0.8mmHg; p = 0.01).Significant improvements in a number of RV echocardiographic parameters were observed at Weeks 12 and 24 after ambrisentan treatment in patients with PAH.
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- 2020
5. Sex differences of hemodynamics during acute vasoreactivity testing to predict the outcomes of chronic thromboembolic pulmonary hypertension
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Yan-Zhe Yu, Rong Jiang, Ping Yuan, Chuan‐Yu Wang, Ci-Jun Luo, Weiping Xie, Yi-Lan Yang, Qin-Hua Zhao, Lan Wang, Jian Guo, Yuan Li, Jing He, Wen-Hui Wu, Hong-Ling Qiu, Jinling Li, Jinming Liu, and Su-Gang Gong
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Right heart catheterization ,Cardiac Catheterization ,China ,medicine.medical_specialty ,Hypertension, Pulmonary ,Vasodilator Agents ,Hemodynamics ,Independent predictor ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Administration, Inhalation ,Female patient ,medicine ,Humans ,Immunology and Allergy ,In patient ,Iloprost ,Pulmonary Wedge Pressure ,030212 general & internal medicine ,Lung ,Genetics (clinical) ,Aged ,Sex Characteristics ,Receiver operating characteristic ,business.industry ,Middle Aged ,Prognosis ,Progression-Free Survival ,ROC Curve ,030228 respiratory system ,Male patient ,Chronic Disease ,Cardiology ,Regression Analysis ,Female ,Chronic thromboembolic pulmonary hypertension ,Pulmonary Embolism ,business - Abstract
BACKGROUND Acute vasoreactivity testing (AVT) which reflects the compliance of the pulmonary vascular bed has been proven to be of prognostic value. The purpose of the present study is to explore the sex differences of hemodynamics during the AVT and their impact on event-free survival in patients with chronic thromboembolic pulmonary hypertension (CTEPH). METHODS Eighty-six patients underwent a right heart catheterization and AVT at Shanghai Pulmonary Hospital from February 2009 to February 2018. Univariate and multiple stepwise regression analysis were performed to determine the predictors of independent event-free survival, and receiver operating characteristic curve was plotted to determine the cut-off value of independent parameters in CTEPH. RESULTS There were no significant differences in both demographics and hemodynamics between male and female patients with CTEPH. Except ΔPVR/PVR showed a significantly higher difference in female than male patients (P = 0.034). Male patients had higher mRAP of pre- and post-AVT than female patients in the event-free subgroup, while, female patients showed higher PVR of pre-AVT than male patients in the event subgroup (P
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- 2020
6. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecologic surgeries: A systematic review
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Ke-qin Hua and Chun-bo Li
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Natural Orifice Endoscopic Surgery ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,03 medical and health sciences ,Gynecologic Surgical Procedures ,0302 clinical medicine ,Salpingectomy ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Hysterectomy ,business.industry ,General surgery ,Treatment options ,lcsh:RD1-811 ,Natural orifice transluminal endoscopic surgery ,Surgical procedures ,Safety profile ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Surgery ,Lymphadenectomy ,Ovarian cystectomy ,business - Abstract
Summary: Natural orifice transluminal endoscopic surgery (NOTES) is a significant innovation in the field of minimally invasive surgery. Transvaginal NOTES has gained the most popularity than other transluminal natural orifices such as mouth, rectum, urinary tract or vagina. Since vNOTES is introduced, many surgeons have developed the technique in various gynecologic surgeries. The aim is to collect the growing evidences of vNOTES in gynecological surgeries and highlight vNOTES with an acceptable safety profile. In the present literature review, the search was carried out using the PubMed database with the following keywords: “natural orifice transluminal endoscopic surgery”, “NOTES”, “natural orifice” and “gynecologic surgery”. The current status of vNOTES in gynecologic surgeries was investigated. A total of 33 studies with 628 cases were included in the review. Our outcomes showed that vNOTES had been performed successfully in a series of surgical procedures including salpingectomy, ovarian cystectomy, myomectomy, hysterectomy, lymphadenectomy and sacrocolpopexy. Advances in technology have improved the feasibility of vNOTES as a treatment option for gynecologic surgeries. When the technical limitations are overcome, wide application of vNOTES is expected to increase. Further prospective and comparative studies are needed to clarify the application of the techniques in gynecologic surgeries. Keywords: Minimally invasive surgery, Natural orifice transluminal surgery, Transvaginal route, Gynecologic surgery
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- 2020
7. Feasibility of serum-free culture in isolating endometriotic stem cells
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Xin Tian, Hongyan Cui, Ke-Qin Hua, Qiong Zhang, and Songping Liu
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Andrology ,Reproductive Medicine ,Serum free ,business.industry ,Obstetrics and Gynecology ,Medicine ,Stem cell ,business - Published
- 2019
8. PeakPETCO2 combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
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Jing He, Rui Zhang, Rong Jiang, Wen-Hui Wu, Jinming Liu, Lan Wang, Hong-Ling Qiu, Su-Gang Gong, Jian Guo, Ci-Jun Luo, Qin-Hua Zhao, Ping Yuan, and Changwei Wu
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,Vasodilation ,acute vasodilator test ,FEV1/FVC ratio ,pulmonary function test ,Internal medicine ,medicine ,Cardiology ,right heart catheterization ,Original Research Article ,business ,cardiopulmonary exercise test - Abstract
Cardiopulmonary exercise testing and pulmonary function test are important methods for detecting human cardio-pulmonary function. Whether they could screen vasoresponsiveness in idiopathic pulmonary artery hypertension (IPAH) patients remains undefined. One hundred thirty-two IPAH patients with complete data were retrospectively enrolled. Patients were classified as vasodilator-responsive (VR) group and vasodilator-nonresponsive (VNR) group on the basis of the acute vasodilator test. Pulmonary function test and cardiopulmonary exercise testing were assessed subsequently and all patients were confirmed by right heart catheterization. We analyzed cardiopulmonary exercise testing and pulmonary function test data and derived a prediction rule to screen vasodilator-responsive patients in IPAH. Nineteen of VR-IPAH and 113 of VNR-IPAH patients were retrospectively enrolled. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects (lower RAP, m PAP, PAWP, and PVR). And VR-IPAH patients had higher anaerobic threshold (AT), peak partial pressure of end-tidal carbon dioxide (PETCO2), oxygen uptake efficiency (OUEP), and FEV1/FVC (P all
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- 2021
9. Liver dysfunction in idiopathic pulmonary arterial hypertension: prevalence, characteristics and prognostic significance, a retrospective cohort study in China
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Jing He, Jinming Liu, Qin-Hua Zhao, Rui Zhang, Wen-Hui Wu, Ping Yuan, Rong Jiang, Hong-Ling Qiu, Jinling Li, Lan Wang, Ci-Jun Luo, Su-Gang Gong, and Changwei Wu
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Adult ,medicine.medical_specialty ,China ,Adolescent ,Bilirubin ,thoracic medicine ,Cardiovascular Medicine ,Gastroenterology ,risk management ,chemistry.chemical_compound ,Young Adult ,Internal medicine ,adult cardiology ,medicine ,Prevalence ,Humans ,Familial Primary Pulmonary Hypertension ,Longitudinal Studies ,Survival analysis ,Aged ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Liver Diseases ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prognosis ,chemistry ,ROC Curve ,cardiology ,Medicine ,Abnormal Liver Function Test ,Liver function ,business ,TBIL - Abstract
ObjectivesThe aim was to elucidate the relationship between liver function and idiopathic pulmonary arterial hypertension (IPAH).Design and settingRetrospective, longitudinal study in urban tertiary care centre in Shanghai, China.Participants407 IPAH consecutive incident patients age 18–65 years were retrospectively enrolled from January 2008 to December 2018.Outcome measurementsThe primary endpoint was all-cause mortality. The cut-off value was determined by receiver operating characteristic curve (ROC), which was validated by Cox proportional hazard model was internally validated by bootstrap analysis and used for survival analysis. The Cox model was (internally) validated and cross-validated areas under the curve (AUC) should be reported.ResultsThe prevalence of abnormal liver function tests (LFTs) at baseline was 77.6%. Hyperbilirubinaemia is the most common abnormal biochemical liver test: abnormal total bilirubin (TBIL in 51.6% patients). During the follow-up, 160 patients died. Patients with mixed liver dysfunction have worse prognosis than those with normal LFTs or isolated abnormal bilirubin metabolism. Comparing with patients with hepatocellular injury, the survival of patients with abnormal bilirubin metabolism is lower. Multivariable Cox models revealed a positive association between TBIL, γ-glutamyltransferase (GGT) and mortality showing that each Ig increment in TBIL and GGT was associated with a higher all-cause mortality (TBIL: HR 4. 29 (95% CI 1. 21 to 15. 27), p=0. 02; GGT: HR 2. 76 (95% CI 1. 18 to 6. 45), p=0. 02). A novel formula named Liver Function Predict Index (LFPI) was constructed (LFPI=−0.002*6MWD+1.014*lg GGT+1.458*lg TBIL) to predict prognosis. ROC curve analysis did further identify 2.729 as the best cut-off value for LFPI (AUC 0.75, pConclusionsLiver dysfunction is frequent in IPAH, and characterised by a predominantly cholestatic enzyme profile. LFTs abnormalities are associated with worse survival and LFPI was a new and simple predictor for prognosis of IPAH.
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- 2021
10. Comparative Effectiveness of Exercise Training for Patients With Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Endarterectomy: A Systematic Review and Meta-Analysis
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Lan Wang, Jinming Liu, Rui Zhang, Ping Yuan, Hong-Ling Qiu, Ci-Jun Luo, Rong Jiang, Qin-Hua Zhao, Ya-Lin Zhao, Su-Gang Gong, and Jing He
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medicine.medical_specialty ,pulmonary endarterectomy ,Oxygen pulse ,Exercise intolerance ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,pulmonary hypertension ,medicine ,Diseases of the circulatory (Cardiovascular) system ,cardiorespiratory fitness ,business.industry ,VO2 max ,Cardiorespiratory fitness ,medicine.disease ,exercise intolerance ,Pulmonary hypertension ,030228 respiratory system ,RC666-701 ,Cardiology ,Systematic Review ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise ,exercise training - Abstract
Background: Patients with chronic thromboembolic pulmonary hypertension (CTEPH) still experience reduced exercise capacity despite pulmonary endarterectomy (PEA). Exercise training improves the exercise capacity and quality of life (QoL) in patients with PH, but data on the effects of exercise training on these patients are scarce. The aim of this meta-analysis and systematic review was to evaluate the effectiveness and safety of exercise training in CTEPH after PEA.Methods: We searched the relevant literature published before January 2020 for the systematic review and meta-analysis using the PubMed, EMBASE, and Cochrane Library databases. The primary outcome was a change in the 6-min walking distance (6 MWD). We also assessed the effect of exercise on the peak oxygen uptake (VO2) or peak VO2/kg, oxygen uptake anaerobic threshold, workload, oxygen pulse, hemodynamics, arterial blood gases, oxygen saturation, N-terminal pro-brain-type natriuretic peptide (NT-proBNP), quality of life (QoL) and pulmonary function tests.Results: We included 4 studies with 208 exercise-training participants. In the pooled analysis, short-term exercise training can improve the 6 MWD of 58.89 m (95% CI: 46.26–71.52 m, P < 0.0001). There was a significant increase in the peak VO2/kg or peak VO2 after exercise training (3.15 ml/min/kg, 95% CI: 0.82–5.48, P = 0.008; 292.69 ml/min, 95% CI: 24.62–560.75, P = 0.032, respectively). After exercise training, the maximal workload and O2 pulse significantly improved. Three months of exercise training increased the right ventricular ejection fraction by 3.53% (95% CI: 6.31–11.94, P < 0.00001, I2 = 0) independently of PEA surgery. In addition, NT-proBNP plasma levels significantly improved with exercise training after PEA [weighted mean difference (WMD): −524.79 ng/L, 95% CI: 705.16 to −344.42, P < 0.0001, I2 = 0]. The partial pressure of oxygen and pH improved progressively over 12 weeks of exercise training (WMD: 4 mmHg, 95% CI: 1.01–8.33, P = 0.01; WMD: 0.03, 95% CI: 0.02–0.04, P < 0.0001, respectively). Subscales of the QoL measured by the SF-36 questionnaire had also improved. In addition, exercise training was well-tolerated with a low dropout rate, and no major adverse events occurred during exercise training.Conclusion: Exercise training may be associated with a significant improvement in the exercise capacity and QoL among CTEPH patients after PEA and was proven to be safe. However, more large-scale multicentre studies are needed to confirm the effectiveness and safety of exercise training in CTEPH patients after PEA.PROSPERO registration number:CRD42021235275.
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- 2021
11. Survival in severe pulmonary hypertension due to chronic lung disease: influence of in-hospital platelet distribution width
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Jinming Liu, Lan Wang, Hong-Ling Qiu, Bigyan Pudasaini, Su-Gang Gong, Ci-Jun Luo, Rong Jiang, Rui Zhang, Li Shen, Jing He, Ya-Lin Zhao, Ping Yuan, and Qin-Hua Zhao
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,RC705-779 ,business.industry ,Platelet Distribution Width ,Idiopathic Pulmonary Arterial Hypertension ,medicine.disease ,Pulmonary hypertension ,all-cause death ,Diseases of the respiratory system ,Lung disease ,Internal medicine ,RC666-701 ,pulmonary hypertension ,chronic lung diseases ,medicine ,Cardiology ,platelet distribution width ,Diseases of the circulatory (Cardiovascular) system ,Original Research Article ,prognosis ,business ,All cause mortality - Abstract
BACKGROUND: Platelet distribution width (PDW) has been recognized as risk predictors of idiopathic pulmonary arterial hypertension. This study aims to investigate whether in-hospital PDW would be useful to predict all-cause death in patients with severe pulmonary hypertension due to chronic lung diseases (CLD-PH).METHODS: Early in-hospital PDW was measured in 67 severe CLD-PH patients who were confirmed by right heart catheterization and followed up. Event-free survival was estimated using the Kaplan–Meier method and analyzed with the log-rank test. Cox proportional hazards models were performed to determine the association between the PDW level and all-cause death.RESULTS: Pulmonary function test and echocardiography parameters were different among patients divided by 17% (the upper reference range of the PDW). There were no significant differences in both clinical variables and RHC parameters among patients with PDW ≥ or < 17%. During median of 2.4 (2.5, 3.7) years of follow-up, 44 patients died. A significant association was noted between in-hospital PDW level and the adjusted risk of all-cause mortality (hazard ratio [HR], 1.245; 95% confidence interval [CI], 1.099-1.409). Compared with those with PDW < 17%, the HR for all-cause death increased to 5.067 (95% CI: 2.420-10.609, P < 0.001) among patients with PDW ≥ 17 %. Higher levels of PDW were also associated with increased risk of all-cause death.CONCLUSIONS: In-hospital PDW was independently associated with all-cause death in patients with severe CLD-PH. This potentially could be used to estimate the severity of severe CLD-PH.
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- 2021
12. Adult-onset hypoxaemia, diffuse lung lesions, and pulmonary hypertension in cobalamin C defect: a case report
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Qin-Hua Zhao, Li-Jun Fu, Wen-Hui Wu, and Lan Wang
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medicine.medical_specialty ,Homocysteine ,Ambrisentan ,Methylmalonic acid ,Cobalamin ,Gastroenterology ,Pulmonary hypertension ,Hypoxemia ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Diffuse lung lesions ,030225 pediatrics ,Internal medicine ,Case report ,medicine ,AcademicSubjects/MED00200 ,Lung ,business.industry ,medicine.disease ,Cobalamin C defect ,medicine.anatomical_structure ,chemistry ,Vomiting ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background Cobalamin C (cbl-C) defect is an inherited autosomal recessive disorder that commonly affects the central nervous system of infants. Severe pulmonary hypertension (PH) and diffuse lung lesions are unusual clinical manifestations, especially among adults. Case summary A 25-year-old man with hypoxaemia, diffuse lung lesions, and PH, suddenly developed nausea, vomiting, headache, and worsening of dyspnoea. Metabolic screening showed elevated serum levels of methylmalonic acid and homocysteine, and genetic testing revealed MMACHC gene mutations. He was eventually diagnosed with severe PH secondary to cbl-C defect and was successfully managed with vitamin B12, betaine, L-carnitine, folate, as well as ambrisentan and sildenafil. Discussion cbl-C is a rare cause of PH and can present with severe PH and diffuse lung lesions in adults. Given that the condition is treatable, a careful metabolic screening should be considered when a diagnosis of PH is made.
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- 2021
13. Echocardiographic Prognosis Relevance of Attenuated Right Heart Remodeling in Idiopathic Pulmonary Arterial Hypertension
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Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Chao Li, Ge-Fei Chen, Ci-Jun Luo, Hong-Ling Qiu, Jin-Ming Liu, Lan Wang, and Rui Zhang
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medicine.medical_specialty ,Prognostic factor ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,right heart remodeling ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,pulmonary arterial hypertension ,medicine ,Diseases of the circulatory (Cardiovascular) system ,echocardiography ,In patient ,Original Research ,End point ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,biomarkers ,medicine.anatomical_structure ,030228 respiratory system ,RC666-701 ,Right heart ,Rv function ,Cardiology ,Right atrium ,prognosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Right ventricular (RV) function is a great determination of the fate in patients with pulmonary arterial hypertension (PAH). Monitoring RV structure back to normal or improvement should be useful for evaluation of RV function. The aims of this study were to assess the prognostic relevance of changed right heart (RH) dimensions by echocardiography and attenuated RH remodeling (ARHR) in idiopathic PAH (IPAH).Methods: We retrospectively analyzed 232 consecutive adult IPAH patients at baseline assessment and included RH catheterization and echocardiography. ARHR at the mean 20 ± 12 months' follow-up was defined by a decreased right atrium area, RV mid-diameter, and left ventricular end-diastolic eccentricity index. The follow-up end point was all-cause mortality.Results: At mean 20 ± 12 months' follow-up, 33 of 232 patients (14.2%) presented with ARHR. The remaining 199 surviving patients were monitored for another 25 ± 20 months. At the end of follow-up, the survival rates at 1, 3, and 5 years were 89, 89, and 68% in patients with ARHR, respectively, and 84, 65 and 41% in patients without ARHR (log-rank p = 0.01). ARHR was an independent prognostic factor for mortality. Besides, ARHR was available to further stratify patients' risk assessment through the French PAH non-invasive-risk criteria.Conclusions: Echocardiographic ARHR is an independent determinant of prognosis in IPAH at long-term follow-up. ARHR might be a useful tool to indicate the RV morphologic and functional improvement associated with better prognostic likelihood.
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- 2021
14. Value of heart rate recovery in female patients with pulmonary arterial hypertension due to systemic lupus erythematosus
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Su-Gang Gong, Rong Jiang, Caicun Zhou, Ping Yuan, Jinming Liu, Qin-Hua Zhao, Jian Guo, Wenlan Yang, Lan Wang, Bigyan Pudasaini, and Guoling Yang
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Adult ,Pulmonary and Respiratory Medicine ,Cardiac Catheterization ,medicine.medical_specialty ,Hemodynamics ,Walk Test ,Pulmonary function testing ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Heart Rate ,DLCO ,Diffusing capacity ,Internal medicine ,Natriuretic Peptide, Brain ,Heart rate ,Female patient ,Humans ,Lupus Erythematosus, Systemic ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Genetics (clinical) ,Associated Pulmonary Arterial Hypertension ,Retrospective Studies ,Pulmonary Arterial Hypertension ,business.industry ,Incidence (epidemiology) ,Middle Aged ,Peptide Fragments ,Respiratory Function Tests ,030228 respiratory system ,Exercise Test ,Cardiology ,Female ,business - Abstract
OBJECTIVE This study intended to explore the relation between heart rate recovery at 1 minutes (HRR1) during the recovery phase of cardiopulmonary exercise test (CPET) and exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension (SLE-PAH) patients. METHODS Twenty-one female SLE-PAH patients underwent right heart catheterization (RHC), pulmonary function test (PFT) and CPET. Forty-two healthy subjects matched with SLE-PAH patients in age, sex and BMI were recruited as a control group. The correlations between HRR1 with clinical and CPET parameters were performed. RESULTS Peak HR, ΔHR, HRR1, Peak HR-warm HR1min , Peak HR-warm HR2min and CR were significantly lower in SLE-PAH than in controls (P
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- 2019
15. The predictive value of minute ventilation versus carbon dioxide production in pulmonary hypertension associated with left heart disease
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Jinming Liu, Su-Gang Gong, Jie Tang, Xiu-jun Zhong, Qin-Hua Zhao, Lan Wang, Ping Yuan, and Rong Jiang
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medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Hemodynamics ,General Medicine ,Carbon dioxide production ,030204 cardiovascular system & hematology ,Logistic regression ,medicine.disease ,Pulmonary hypertension ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Internal medicine ,Hyperventilation ,Cardiology ,medicine ,Vascular resistance ,Original Article ,medicine.symptom ,business ,human activities ,Respiratory minute volume - Abstract
BACKGROUND: The aim of the present study was to investigate the role of key cardiopulmonary exercise testing (CPET) parameters in the identification of pre-capillary components in patients with pulmonary hypertension associated with left heart disease (PH-LHD), and to evaluate their correlations with hemodynamic parameters. METHODS: Ninety patients with PH-LHD underwent right-heart catheterization, echocardiography, and CPET. The differences in related indexes between a combined post- and pre-capillary PH (Cpc-PH) group (n=47) and an isolated post-capillary PH (Ipc-PH) group (n=43) were compared. Correlation analysis was performed. Logistic regression and receiver operator characteristic (ROC) analyses were performed to assess the ability of CPET variables to distinguish patients with Cpc-PH from those with Ipc-PH. RESULTS: The hemodynamics, hyperventilation and right ventricular function of Cpc-pH group were worse than those of Ipc-pH group. The parameters related to minute ventilation versus carbon dioxide production (VE/VCO(2)) played a significant role in the differentiation of Cpc-PH and Ipc-PH, and had a moderate positive correlation with pulmonary vascular resistance (PVR). Univariate and multivariate logistic analyses showed that lowest percentage of VE/VCO(2) in predicted value (VE/VCO(2)%pred) was the single best predictor of Cpc-PH, and the area under ROC curve also confirmed that lowest VE/VCO(2)%pred (≥137%) could serve as a novel diagnostic marker for Cpc-PH. On the basis of this lowest VE/VCO(2)%pred threshold, patients were divided into two groups. Most hemodynamic parameters were worse in patients with a lowest VE/VCO(2)%pred ≥137%. CONCLUSIONS: VE/VCO(2)-related parameters are powerful prognosticators for the presence of pre-capillary components in patients with PH-LHD, especially lowest VE/VCO(2)%pred.
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- 2021
16. Acute vasoreactivity testing predicts outcome of idiopathic pulmonary arterial hypertension patients with a negative acute response
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Hong-Ling Qiu, Jinling Li, Xiangrui Meng, Wen-Hui Wu, Jinming Liu, Yuanyuan Sun, Qin-Hua Zhao, Lingzi Shi, Ping Yuan, Rong Jiang, Ci-Jun Luo, Jing He, Yuan Li, Lan Wang, and Su-Gang Gong
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medicine.medical_specialty ,Inhalation ,business.industry ,Proportional hazards model ,Idiopathic Pulmonary Arterial Hypertension ,Hemodynamics ,General Medicine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,medicine.artery ,Internal medicine ,Pulmonary artery ,Cardiology ,medicine ,Original Article ,business ,Iloprost ,medicine.drug ,Oxygen saturation (medicine) ,Artery - Abstract
BACKGROUND: Acute vasoreactivity testing (AVT) during right heart catheterization (RHC) is performed in certain subsets of patients with pulmonary arterial hypertension (PAH) in order to identify those who benefit from calcium channel blockers. The present study aimed to investigate the prognostic value of pre-AVT, post-AVT, and changes in AVT (ΔAVT) parameters for idiopathic PAH (IPAH) patients with a negative acute response, and to identify sex differences that could be of prognostic value. METHODS: A total of 487 incident IPAH patients (171 males and 316 females) with a negative acute response to AVT were recruited from Shanghai Pulmonary Hospital between 2009 and 2018. Outcomes were predicted using the Kaplan-Meier curve and univariate/multivariate Cox regression analyses. All patients were followed up till January 2020, with outcome specified as all-cause mortality. RESULTS: Inhalation of iloprost aerosol improved the hemodynamic parameters for all patients. Post-PVR was decreased, and post-cardiac output (post-CO) and post-cardiac index (post-CI) were increased compared with pre-AVT parameters among males. Increased post- artery oxygen saturation (post-SaO(2)) and decreased post-mean right atrium pressure (post-mRAP) were also observed in females. For all patients, pre-CO ≥3.25 L/min, post-mPAP
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- 2021
17. Validity of 2015 ESC Risk Assessment in Idiopathic Pulmonary Arterial Hypertension in China
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Rong Jiang, Wen-Hui Wu, Chao Li, Su-Gang Gong, Rui Zhang, Qin-Hua Zhao, Lan Wang, Hong-Ling Qiu, and Ci-Jun Luo
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medicine.medical_specialty ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,Cardiac index ,Guideline ,medicine.disease ,Brain natriuretic peptide ,Pericardial effusion ,Pulmonary hypertension ,Blood pressure ,Internal medicine ,medicine ,Cardiology ,Risk assessment ,business - Abstract
Background: The 2015 European pulmonary hypertension guidelines recommend a risk stratification strategy for pulmonary arterial hypertension (PAH). We aimed to investigate the validation and potential prognostic information in our patients.Methods: The risk assessment variables proposed by the PH guidelines was performed, using World Health Organization function class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right arterial pressure, cardiac index, mixed venous saturation, right atrium area, pericardial effusion, peak oxygen consumption and ventilatory equivalents for carbon dioxide. An abbreviated version also was applied.Results: The 392 patients were enrolled between 2009 and 2018. After a median interval of 13 months, re-evaluation assessments were available for 386 subjects. The PH guidelines risk tool may effectively discriminate three risk group and mortality (p< 0.001) both at baseline and re-evaluation. Meanwhile, its simplified risk version was valid for baseline and accurately predicted the risk of death in all risk group (p< 0.001). At the time of re-evaluation, the percentage of low risk group has an increase, but a greater proportion achieved high risk group and a lesser proportion maintained in intermediate risk group.Conclusions: The 2015 European PH guidelines and its simplified version risk stratification assessment present effective discrimination of different risk groups and accurate mortality estimates in patients with IPAH. Changes of risk proportion at re-evaluation implicated that natural treatment decisions may not be consistently with goal-oriented treatment strategy.
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- 2020
18. Alteration of Extracellular Superoxide Dismutase in Idiopathic Pulmonary Arterial Hypertension
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Xin Jiang, Yang-Yang He, Xi-Qi Xu, Su-Gang Gong, Qin-Hua Zhao, Zhi-Cheng Jing, Lan Wang, Yuan Li, Rui Zhang, and Rong Jiang
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0301 basic medicine ,extracellular SOD ,medicine.medical_specialty ,Hemodynamics ,030204 cardiovascular system & hematology ,Superoxide dismutase ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,idiopathic pulmonary arterial hypertension ,medicine ,Extracellular ,Prospective cohort study ,Original Research ,chemistry.chemical_classification ,lcsh:R5-920 ,Reactive oxygen species ,biology ,business.industry ,biomarkers ,General Medicine ,superoxide dismutases ,BMPR2 ,030104 developmental biology ,Endocrinology ,medicine.anatomical_structure ,chemistry ,biology.protein ,Vascular resistance ,Medicine ,prognosis ,lcsh:Medicine (General) ,business - Abstract
Background: Superoxide dismutases (SODs) are an important family of antioxidant enzymes that modulate reactive oxygen species levels. It is largely unknown which SOD isoform(s) change in vivo in idiopathic pulmonary arterial hypertension (IPAH) patients. Methods: A total of 133 consecutive adult IPAH patients who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling were enrolled in this prospective study. The plasma activities of three subtypes of SOD [copper–zinc (Cu/Zn-SOD), manganese (Mn-SOD), and extracellular SOD (Ec-SOD)] were examined. Results: The activities of SODs were significantly lower in IPAH patients than in healthy subjects. However, only Ec-SOD activity in BMPR2 mutation patients was significantly decreased compared to those in patients without a mutation. The reduced Ec-SOD activity was markedly associated with mean pulmonary arterial pressure, pulmonary vascular resistance (PVR), and 6-min walking distance (6MWD). The reduction of Mn-SOD activity was only associated with 6MWD. There was no association between Cu/Zn-SOD and hemodynamics. Patients with a lower Ec-SOD level had a worse survival compared to those with a higher baseline. The reduced Ec-SOD activity and the raised PVR increased the mortality risk. Conclusions: Ec-SOD was correlated with BMPR2 mutation, hemodynamic dysfunction, and poor outcomes. Circulating Ec-SOD could be a potentially vital antioxidant enzyme in the pathogenesis of IPAH.
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- 2020
19. Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
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Gang-Hua Lu, Su-Gang Gong, Chao Li, Qin-Hua Zhao, Rong Jiang, Ci-Jun Luo, Lan Wang, and Rui Zhang
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0301 basic medicine ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,medicine.drug_class ,Hemodynamics ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Gastroenterology ,digestive system ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic peptide ,medicine ,idiopathic pulmonary arterial hypertension ,Gamma-glutamyltransferase ,Original Research ,biology ,business.industry ,Incidence (epidemiology) ,Idiopathic Pulmonary Arterial Hypertension ,biomarkers ,digestive system diseases ,BMPR2 ,030104 developmental biology ,lcsh:RC666-701 ,gender difference ,biology.protein ,prognosis ,Cardiology and Cardiovascular Medicine ,business ,gamma-glutamyltransferase - Abstract
Background: The elevated gamma-glutamyltransferase (GGT) activity is regarded as an indicator of cardiovascular disease, with males having higher values than females. The greater incidence of idiopathic pulmonary arterial hypertension (IPAH) is observed in women, whereas prognosis is poor in men. The present study aims to investigate the potential association of GGT on male patients.Methods: Serum GGT levels were measured in 338 consecutive adult IPAH patients, who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling, and matched with healthy subjects by sex and age. The followed interval was 48 ± 34 months.Results: Increased serum GGT levels were more common in patients with IPAH than controls (p < 0.001). GGT values were significantly higher in male patients than those of females (p < 0.001). Compared with female patients with BMPR2 mutation, GGT level in male patients with BMPR2 mutation was further increased (p = 0.002). Higher GGT levels were associated with worse hemodynamics and Nterminal pro B-type natriuretic peptide in all patients. However, males with a GGT concentration ≥ 53 U/L had a worse survival than those of females. Contrarily, if GGT concentration
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- 2020
20. Soluble ST2 and mixed venous oxygen saturation for prediction of mortality in patients with pulmonary hypertension
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Su-Gang Gong, Hong-Ling Qiu, Qin-Hua Zhao, Jing He, Jinling Li, Xiangrui Meng, Yuan Li, Ping Yuan, Wen-Hui Wu, Jinming Liu, Rong Jiang, Lan Wang, Ci-Jun Luo, Yuanyuan Sun, and Lingzi Shi
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Pulmonary and Respiratory Medicine ,Right heart catheterization ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hemodynamics ,Retrospective cohort study ,medicine.disease ,Gastroenterology ,Predictive value ,Pulmonary hypertension ,Clinical biomarker ,Internal medicine ,medicine ,In patient ,Original Article ,business - Abstract
BACKGROUND: Although soluble suppression of tumorigenicity-2 (sST2) has been identified as a clinical biomarker for pulmonary hypertension (PH) by previous studies, the implication of sST2 combined with hemodynamic parameters in PH has not been well studied. This study aimed to evaluate the relationship between sST2 and hemodynamic parameters and to evaluate the predictive value of sST2 for mortality in patients with PH. METHODS: One hundred eighty-four incident patients with PH and 14 healthy controls were retrospectively enrolled by Shanghai Pulmonary Hospital for this retrospective study. After all patients underwent right heart catheterization, blood samples were collected and serum sST2 concentration was assessed by the Presage™ ST2 assay. Kaplan-Meier curve and Cox regression analyses were used to predict survival and the association between survival and different factors such as sST2, SvO(2). RESULTS: During a follow-up of 44.9 (IQR 28.5–64.4) months, 65 patients died. The median concentration of sST2 in PH patients was 33.1 ng/mL, which is higher than that in control group (23.1 ng/mL, P=0.005). Furthermore, for PH group, the level of sST2 was higher in non-survivors than that in survivors. Cox regression analyses demonstrated that sST2 and SvO(2) were independent risk factors for survival. In Kaplan-Meier curve analyses, elevated sST2 level and reduced SvO(2) predicted a poor outcome for patients with PH. CONCLUSIONS: Higher sST2 was independently associated with increased mortality, as well as lower SvO(2) in patients with PH. Especially, the combination of higher sST2 and lower SvO(2) had the strongest predictive value of mortality in patients with PH.
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- 2020
21. Increased Levels of Runt-Related Transcription Factor 2 Are Associated With Poor Survival of Patients With Idiopathic Pulmonary Arterial Hypertension
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Yuanyuan Sun, Zuogang Wang, Qian Liu, Xun-Tao Yuan, Ping Yuan, Qin-Hua Zhao, Lan Wang, and Su-Gang Gong
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medicine.medical_specialty ,Health (social science) ,RUNX2 ,sex difference ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Gastroenterology ,survival ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Internal medicine ,Female patient ,medicine ,idiopathic pulmonary arterial hypertension ,Clinical severity ,Transcription factor ,Proportional hazards model ,business.industry ,musculoskeletal, neural, and ocular physiology ,Runt ,lcsh:R ,Public Health, Environmental and Occupational Health ,Idiopathic Pulmonary Arterial Hypertension ,Plasma levels ,030228 respiratory system ,embryonic structures ,Original Article ,business - Abstract
Runt-related transcription factor 2 (RUNX2) plays a pivotal role in the pathogenesis of pulmonary arterial hypertension (PAH); yet, whether circulating levels of RUNX2 can predict survival of patients with idiopathic PAH (IPAH) is still unclear. The present study aimed to investigate the correlation between circulating levels of RUNX2 and survival of patients with IPAH. Blood samples were collected from 46 incident patients with IPAH and 30 healthy controls in Shanghai Pulmonary Hospital. Levels of RUNX2 were measured using ELISA. Linear regression and cox proportional hazards analysis were performed to assess the prognostic value of RUNX2 levels in predicting survival using the Kaplan–Meier method. Nonsurvivors had significantly shorter 6MWD, higher levels of NT-proBNP, increased mRAP, mPAP, mPAWP, PVR, and decreased CO as well as CI, compared with survivors ( p < .05). Plasma levels of RUNX2 were significantly higher in nonsurvival and survival patients with IPAH compared with controls ( p ≤ .001), and higher in nonsurvivors than in survivors ( p = .001). RUNX2 levels served as an independent predictor of survival in these patients ( p < .001). RUNX2 levels ≥41.5 ng/ml had a sensitivity of 80.0% and a specificity of 74.2% by ROC analysis. Patients with a RUNX2 level
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- 2020
22. Variable predictors of acute pulmonary embolism recurrence with duration of follow-up
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Lan Wang, Yan-Zhe Yu, Yuan Li, Yi-Lan Yang, Bigyan Pudasaini, Jing He, Su-Gang Gong, Ping Yuan, Wen-Hui Wu, Jinming Liu, Ci-Jun Luo, Chang Chen, Hong-Ling Qiu, Jinling Li, Rong Jiang, Qin-Hua Zhao, Jian Guo, and Chuan-Yu Wang
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,Lower risk ,Pulmonary embolism ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,medicine ,Original Article ,030212 general & internal medicine ,Stage (cooking) ,business ,Survival analysis - Abstract
Background Acute pulmonary embolism (PE) is a critical disease and often leads to a high mortality and morbidity. Several studies have identified predictors of PE recurrence, but whether these predictors have prognostic value and how they vary during varied follow-up periods remain unclear. Methods We retrospectively assessed the occurrence of recurrent PE and the survival time of patients with a diagnosis of acute PE at Shanghai Pulmonary Hospital from May 2007 to May 2018. Potential predictors of recurrent PE were evaluated at different points (1, 3, 6, 12, 24, 60 and 120-month) during a long-term follow-up for each patient. Patients were stratified into two groups by gender to analyze the impact of sex in period-guided prognostic prediction. Receiver operating characteristic curve analysis, survival analysis and multivariate Cox proportional hazards analysis were implemented as statistical analysis methods. Results In total, 597 acute PE patients were included, of whom 62 reported a PE recurrence. Male patients tend to have a lower risk of PE recurrence than female patients during 3- to 60-month follow-up period but have a higher risk of PE recurrence than female patients during 120-month follow-up period. The independent predictors of recurrence-free survival varied among different follow-up periods: In all patients, diabetes was an independent predictor only within 30 days follow-up period and female was considered as an independent predictor during 3- to 120-month follow-up period. Among male patients, hyperlipidemia and Log D-dimer (cut-off value =3.436) was observed as a predictor of recurrent PE within 6-month and over 12-month follow-up respectively. However, there is no unified independent prognostic indicator for female patients identified. Conclusions In the early stage of follow-up, male PE patients have better prognosis, but with the extension of follow-up, female PE patients have better prognosis. The independent predictors of recurrence-free survival vary in different follow-up periods in PE patients when stratified based on gender and associated medical conditions.
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- 2020
23. Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients
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Qin-Hua Liu, Dunhuang Zeng, Yong Bin Wang, Xu Kan, and Kai-xiong Liu
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0301 basic medicine ,Male ,medicine.medical_specialty ,Article Subject ,Immunoglobulin E ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Asthma control ,parasitic diseases ,medicine ,Humans ,Family history ,Age of Onset ,Late-onset asthma ,Lung ,Asthma ,Aged ,COPD ,General Immunology and Microbiology ,biology ,business.industry ,Incidence (epidemiology) ,General Medicine ,social sciences ,medicine.disease ,humanities ,Respiratory Function Tests ,respiratory tract diseases ,030104 developmental biology ,030228 respiratory system ,Exhaled nitric oxide ,biology.protein ,Medicine ,Female ,business ,Research Article - Abstract
please go to the Account Update page (http://mts.hindawi.com/update/) in our Manuscript Tracking System and after you have logged in click on the ORCID link at the top of the page. This link will take you to the ORCID website where you will be able to create an account for yourself. Once you have done so, your new ORCID will be saved in our Manuscript Tracking System automatically."?>Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.
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- 2020
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24. Microsomal prostaglandin E2 synthase-1 and its inhibitors: Molecular mechanisms and therapeutic significance
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Huang Yuming, Qin-Hua Sun, Jin-Fang Luo, Yan-Yu Zhang, Hua Zhou, Fei-Chi Wu, Yun-Da Yao, Zhongqiu Liu, and Jian-Xin Liu
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musculoskeletal diseases ,Pharmacology ,ATP synthase ,biology ,business.industry ,Phospholipid ,Inflammation ,Metabolism ,In vitro ,chemistry.chemical_compound ,Drug development ,chemistry ,Microsome ,biology.protein ,medicine ,lipids (amino acids, peptides, and proteins) ,Prostaglandin E2 ,medicine.symptom ,business ,medicine.drug - Abstract
Inflammation is closely linked to the abnormal phospholipid metabolism chain of cyclooxygenase-2/microsomal prostaglandin E2 synthase-1/prostaglandin E2 (COX-2/mPGES-1/PGE2). In clinical practice, non-steroidal anti-inflammatory drugs (NSAIDs) as upstream COX-2 enzyme activity inhibitors are widely used to block COX-2 cascade to relieve inflammatory response. However, NSAIDs could also cause cardiovascular and gastrointestinal side effects due to its inhibition on other prostaglandins generation. To avoid this, targeting downstream mPGES-1 instead of upstream COX is preferable to selectively block overexpressed PGE2 in inflammatory diseases. Some mPGES-1 inhibitor candidates including synthetic compounds, natural products and existing anti-inflammatory drugs have been proved to be effective in in vitro experiments. After 20 years of in-depth research on mPGES-1 and its inhibitors, ISC 27864 have completed phase II clinical trial. In this review, we intend to summarize mPGES-1 inhibitors focused on their inhibitory specificity with perspectives for future drug development.
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- 2022
25. The role of oral oil administration in displaying the chylous tubes and preventing chylous leakage in laparoscopic para-aortic lymphadenectomy
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Jingxin Ding, Xiao-Qing Li, Guannan Zhou, Ke-Qin Hua, Weijuan Xin, and Xuyin Zhang
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Chylous leakage ,medicine.medical_specialty ,medicine.medical_treatment ,Administration, Oral ,Application time ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Para aortic lymphadenectomy ,Chylous Ascites ,Retrospective Studies ,Ovarian Neoplasms ,030219 obstetrics & reproductive medicine ,business.industry ,General Medicine ,Perioperative ,Middle Aged ,Endometrial Neoplasms ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Renal vessels ,Drainage ,Lymph Node Excision ,Female ,Laparoscopy ,Lymphadenectomy ,Lymph Nodes ,business ,Hospital stay ,Sesame Oil - Abstract
Background and objectives This study is aimed to investigate the possibility of preoperative oral oil administration in displaying the chylous tubes and preventing chylous leakage in laparoscopic para-aortic lymphadenectomy. Materials and methods In this retrospective nonrandomized study, of the 30 patients with gynecological malignancies who had indications for laparoscopic para-aortic lymphadenectomy up to renal vessels, 15 were administered preoperative oral oil (oil a administration) (control group) at our hospital between September 2017 and June 2018. The chylous tube displaying rates, incidences of chylous leakage, and other perioperative data of the two groups were compared. Results Successful display of chylous tubes was observed in 93.3% (14/15) patients in the oil administration group. The chylous leakage was zero in the oil administration group, and 33.3% (5/15) in the control group. The postoperative drainage duration (4.1 ± 1.0 days vs 7.6 ± 1.4 days, P = 0.000), somatostatin application time (0 day vs 5.9 ± 0.8 days), and postoperative hospital stay (6.0 ± 2.3 days vs 9.1 ± 2.1 days, P = 0.001) were significantly shorter in the oil administration group. The total cost is lower in the oil administration group (4972.52 ± 80.54 dollars vs 6260.80 ± 484.47 dollars, P = 0.000). Conclusions Preoperative oil administration is a feasible and effective method to display the chylous tubes and to prevent the chylous leakage in para-aortic lymphadenectomy.
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- 2018
26. Circulating exosomal microRNAs as novel potential detection biomarkers in pancreatic cancer
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Hongmei Wang, Qin‑Hua Chen, Xian‑De Liu, Li Chao Yao, Wei Wang, Zhi‑Gang Tang, Lin Ye, Lun Wu, Wen‑Bo Zhou, Jiao Zhou, Xiao‑Chun Chen, and Ying Wei
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0301 basic medicine ,Cancer Research ,Oncogene ,microRNA ,circulating biomarker ,business.industry ,pancreatic cancer ,Cancer ,Articles ,medicine.disease ,Exosome ,Molecular medicine ,Metastasis ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Real-time polymerase chain reaction ,Oncology ,Tumor progression ,030220 oncology & carcinogenesis ,Pancreatic cancer ,medicine ,Cancer research ,exosome ,business - Abstract
Circulating exosomal microRNAs (ex-miRNAs) are reflective of the characteristics of the tumor and are valuable biomarkers in different types of tumor. In addition, miRNAs serve important roles in tumor progression and metastasis. The present study aimed to investigate the circulating ex-miRNA-21 and miRNA-210 as novel biomarkers for patients with pancreatic cancer (PC). For this purpose, serum ex-miRNAs were extracted from the serum of patients with PC (n=30) and chronic pancreatitis (CP) (n=10) using an RNA isolation kit. For exosome identification in serum, transmission electron micrographs were used to determine crystalline structure, western blotting was used to identify exosomal markers, and NanoSight was used for nanoparticle characterization. The relative expression levels of ex-miRNAs were quantified using quantitative PCR and compared between patients with PC and CP. The expression levels of both ex-miRNA-21 and miRNA-210 were significantly higher in patients with PC compared with patients with CP (both P0.05). ex-miRNA-21 and miRNA-210 were associated with tumor stage, as well as other factors. The diagnostic potential of ex-miRNA-21 and miRNA-210 levels was 83 and 85%, respectively. In addition, when ex-miRNA and serum carbohydrate antigen 19-9 expression levels were combined, the accuracy increased to 90%. The present study identified that serum ex-miRNAs, miRNA-21 and miRNA-210 may be of value as potential biomarkers and therapeutic targets for the diagnosis and treatment of PC.
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- 2019
27. Comparative efficacy and safety of low-intensity warfarin therapy in preventing unprovoked recurrent venous thromboembolism: A systematic review and meta-analysis
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Rong Jiang, Jian Guo, Bigyan Pudasain, Qin-Hua Zhao, Ping Yuan, Rui Zhang, Jinming Liu, Lan Wang, Yu Shi, and Changtai Zhu
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Warfarin therapy ,Administration, Oral ,030204 cardiovascular system & hematology ,Placebo ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Recurrence ,law ,Internal medicine ,Antithrombotic ,medicine ,Humans ,Immunology and Allergy ,cardiovascular diseases ,030212 general & internal medicine ,Genetics (clinical) ,Randomized Controlled Trials as Topic ,business.industry ,Warfarin ,Anticoagulants ,Venous Thromboembolism ,Treatment Outcome ,Relative risk ,Meta-analysis ,Female ,business ,Venous thromboembolism ,medicine.drug - Abstract
BACKGROUND Although there exists potential risk of bleeding, extended 'lifelong' conventional-intensity [international normalized ratio (INR): 2.0-3.0] warfarin anticoagulation is recommended for unprovoked venous thromboembolism (VTE) patients because of risk of recurrent VTE. Whether long-term low-intensity (INR: 1.5-2.0) warfarin therapy reduced the risk of major bleeding without substantially lowered antithrombotic efficacy is not well understood. The aim of this study was to perform a systematic review and meta-analysis to evaluate the risk-benefits of low-intensity warfarin therapy. METHODS We conducted a comprehensive search of electronic databases and included randomized control trials (RCTs) that reported efficacy (recurrent VTE) and safety (bleeding episodes) of low-intensity warfarin therapy compared with conventional-intensity warfarin or placebo from inception through Jun 2016. RESULTS Four RCTs reporting high GRADE quality evidence were included. Although the relative risk of recurrent VTE with low-intensity therapy was significantly increased [2.96 (95% CI: 1.40 to 6.24), P
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- 2018
28. Expression of nerve growth factor carried by pseudotyped lentivirus improves neuron survival and cognitive functional recovery of post-ischemia in rats
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Yan-Fei Han, Yong Lin, Wen-Hua Sun, Yao-hua Pan, Bing Zhao, Jieqing Wan, Yi-ling Fan, Shenghao Ding, Jia-Yu Cao, Xiao-Ping Tong, and Qin-Hua Guo
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Male ,0301 basic medicine ,Microinjections ,Genetic enhancement ,Green Fluorescent Proteins ,Ischemia ,Morris water navigation task ,Apoptosis ,Striatum ,Pharmacology ,Statistics, Nonparametric ,Rats, Sprague-Dawley ,03 medical and health sciences ,GAP-43 Protein ,0302 clinical medicine ,Transduction, Genetic ,Physiology (medical) ,Nerve Growth Factor ,In Situ Nick-End Labeling ,medicine ,Animals ,Pharmacology (medical) ,Maze Learning ,Neurons ,TUNEL assay ,business.industry ,Penumbra ,Lentivirus ,Neurogenesis ,Infarction, Middle Cerebral Artery ,Recovery of Function ,Original Articles ,medicine.disease ,Rats ,Disease Models, Animal ,Psychiatry and Mental health ,030104 developmental biology ,Nerve growth factor ,Gene Expression Regulation ,nervous system ,Phosphopyruvate Hydratase ,Cognition Disorders ,business ,030217 neurology & neurosurgery - Abstract
Aims Nerve growth factor (NGF) has been reported to prevent neuronal damage and contributes to the functional recovery in animal brain injury models and human ischemic disease as well. We aimed to investigate a potential therapeutic effect of NGF gene treatment in ischemic stroke and to estimate the functional recovery both at the cellular and cognitive levels in an ischemia rat model. Methods After microinjection of pseudolentivirus-delivered β-NGF into an established ischemic stroke model in rats (tMCAO), we estimated neuronal cell apoptosis with TUNEL labeling and neurogenesis by cell proliferation marker Ki67 staining in both ischemic core and penumbra of striatum. Furthermore, we used behavioral functional tests, Morris water maze performance, to evaluate cognitive functional recovery in vivo and propose a potential underlying mechanism. Results We found that pseudolentivirus-mediated delivery of β-NGF gene into the brain induced high expression in striatum of the infarct core area after ischemia in rats. The β-NGF overexpression in the striatal infarction core after ischemia not only improved neuronal survival by reducing cell apoptosis and increasing cell proliferation, but also rescued cognitive functional impairment through upregulation of GAP-43 protein expression in tMCAO rat model of ischemia. Conclusion This study demonstrates a potential β-NGF gene therapy by utilization of pseudolentivirus in ischemia and indicates future applications of NGF gene treatment in ischemic patients.
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- 2018
29. Ovarian endometriosis: risk factor analysis and prediction of malignant transformation
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Ke-Qin Hua and YanNa Zhou
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Gynecology ,Original Paper ,prediction of malignant transformation ,medicine.medical_specialty ,Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Endometriosis ,endometriosis associated ovarian carcinoma ,Obstetrics and Gynecology ,Myoma ,ovarian endometriosis ,Lower risk ,medicine.disease ,Menopause ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Ovarian carcinoma ,medicine ,Ovarian Endometriosis ,Risk factor ,business - Abstract
Introduction For the prediction of endometriosis associated ovarian carcinoma (EAOC), the risk factors for malignant ovarian endometriosis (MOE) were explored. Material and methods A group of 104 EAOC patients was compared with a group of 104 ovarian endometrial cyst patients. Using single and multivariate risk analysis of EAOC by calculating the area under the curve (AUC) of receiver-operator characteristics (ROC) curves, risks of MOE transformation were calculated for various burdens of risk factors. Results The age range of 85 EAOC patients (81.73% of EAOC patients) was from 40 to 60 years old, as menopause occurs most frequently in this age range. From single factor ROC curve analysis, if disease duration/age/menopause/times of pregnancy/multiple foci of endometriosis index AUC were above 0.70, this suggested that the above indicators were predictive of MOE. Times of pregnancy/tumour size/myoma of uterus/multiple foci of endometriosis were taken as the independent risk factors of MOE. Using logistic regression, the AUC of 0.89 (95% confidence interval [CI]: 0.84-0.94) was statistically significant (p < 0.001), illustrating the predictive power of this model. Conclusions Times of pregnancy/BMI/irregular vaginal bleeding/thyroid disease/myoma of uterus/tumour serious fixation index indicate higher risk of MOE; age/tumour size/menopause/disease duration/ dysmenorrhea/multiple foci of endometriosis suggest lower risk of MOE. Therefore, in patients with endometriosis, malignant transformation could be predicted early.
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- 2018
30. Sex-specific cardiopulmonary exercise testing indices to estimate the severity of inoperable chronic thromboembolic pulmonary hypertension
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Wen-Hui Wu, Lan Wang, Qin-Hua Zhao, Tian-Xiang Chen, Su-Gang Gong, Bigyan Pudasaini, Jin-Ming Liu, Ping Yuan, Jian Guo, and Rong Jiang
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Male ,medicine.medical_specialty ,Time Factors ,sex difference ,Hypertension, Pulmonary ,severity ,Hemodynamics ,Kaplan-Meier Estimate ,International Journal of Chronic Obstructive Pulmonary Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Disease-Free Survival ,chronic thromboembolic pulmonary hypertension ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,cardiopulmonary exercise testing ,medicine ,Humans ,Lung ,Original Research ,Aged ,Proportional Hazards Models ,COPD ,Exercise Tolerance ,Pulmonary Gas Exchange ,business.industry ,Proportional hazards model ,Confounding ,General Medicine ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,medicine.anatomical_structure ,030228 respiratory system ,Case-Control Studies ,Exercise Test ,Cardiology ,Vascular resistance ,Female ,Pulmonary Embolism ,business ,Body mass index ,Respiratory minute volume - Abstract
Tian-Xiang Chen,1 Bigyan Pudasaini,1 Jian Guo,2 Su-Gang Gong,1 Rong Jiang,1 Lan Wang,1 Qin-Hua Zhao,1 Wen-Hui Wu,1 Ping Yuan,1 Jin-Ming Liu1 1Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China; 2Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China Background: Sex differences in chronic thromboembolic pulmonary hypertension (CTEPH) have been revealed in few studies. Although right heart catheterization (RHC) is the gold standard for clinical diagnosis and assessment of prognosis in pulmonary hypertension (PH), cardiopulmonary exercise testing (CPET) has been a more widely used assessment of functional capacity, disease severity, prognosis, and treatment response in PH. We hypothesized that the “sex-specific” CPET indices could estimate the severity of inoperable CTEPH.Methods: Data were retrieved for 33 male (age, mean ± standard deviation [SD] =62.5±13.4 years) and 40 female (age, mean ± SD =56.3±11.8 years) patients with stable CTEPH who underwent both RHC and CPET at Shanghai Pulmonary Hospital from February 2010 to February 2016. Univariate and forward/backward multiple stepwise regression analysis was performed to assess the predictive value of CPET indices to hemodynamic parameters. Event-free survival was estimated using the Kaplan–Meier method and analyzed with the log-rank test. Cox proportional hazards models were performed to determine the independent event-free survival predictors.Results: Numerous CPET parameters were different between male and female patients with CTEPH and the control group. There were no significant differences in both clinical variables and RHC parameters between male and female patients with CTEPH. O2 pulse, workload, minute ventilation (VE), and end-tidal partial pressure of O2 (PETO2) at anaerobic threshold, as well as peak O2 pulse, workload, VE, and nadir VE/CO2 were significantly higher in male patients than in female patients (P
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- 2018
31. Abnormal spontaneous brain activity in patients with non-arteritic anterior ischemic optic neuropathy detected using functional magnetic resonance imaging
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Peng-De Guo, Peng-Bo Zhao, Han Lv, Feng-Yuan Man, Yan Su, Jing Zhao, Ming Liu, Yun-Xiang Chen, Yan Wang, Hai-Qin Hua, Ling-Ling Cai, Jian Zhou, and Qiang Shi
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Adult ,Male ,medicine.medical_specialty ,Brain activity and meditation ,lcsh:Medicine ,Optic neuropathy ,Text mining ,Ophthalmology ,Jian Zhou ,Correspondence ,Humans ,Medicine ,Optic Neuropathy, Ischemic ,In patient ,Aged ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Brain ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Arteritic anterior ischemic optic neuropathy ,Female ,business ,Functional magnetic resonance imaging - Published
- 2019
32. Hemodynamic and gas exchange effects of inhaled iloprost in patients with COPD and pulmonary hypertension
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Rong Jiang, Yuan-Zhe Jin, Lan Wang, Wen-Hui Wu, Qin-Hua Zhao, Zhi-Cheng Jing, Jing He, Jin-Ming Liu, and Su-Gang Gong
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Male ,Pulmonary Circulation ,Time Factors ,Vasodilator Agents ,Hemodynamics ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Hypoxemia ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Risk Factors ,Hypoxic pulmonary vasoconstriction ,pulmonary hypertension ,Prospective Studies ,Lung ,Original Research ,COPD ,General Medicine ,Middle Aged ,medicine.anatomical_structure ,Treatment Outcome ,Cardiology ,Arterial blood ,Female ,medicine.symptom ,medicine.drug ,medicine.medical_specialty ,China ,Hypertension, Pulmonary ,International Journal of Chronic Obstructive Pulmonary Disease ,Pulmonary Artery ,03 medical and health sciences ,Internal medicine ,Administration, Inhalation ,medicine ,Humans ,Arterial Pressure ,Iloprost ,Antihypertensive Agents ,Aged ,business.industry ,Pulmonary Gas Exchange ,medicine.disease ,Pulmonary hypertension ,COPD pulmonary gas exchange ,Oxygen ,030228 respiratory system ,Vasoconstriction ,Vascular resistance ,business ,Biomarkers - Abstract
Lan Wang,1,* Yuan-Zhe Jin,2,* Qin-Hua Zhao,1 Rong Jiang,1 Wen-hui Wu,1 Su-Gang Gong,1 Jing He,1 Jin-Ming Liu,1 Zhi-Cheng Jing1,3 1Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; 2Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Liaoning, China; 3Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China *These authors contributed equally to this work Abstract: Studies have shown that vasodilators such as iloprost can be useful for treating pulmonary hypertension (PH). However, in patients with COPD, vasodilators may inhibit hypoxic pulmonary vasoconstriction and impair gas exchange. The efficacy and safety of iloprost inhalation was assessed in 67 patients with PH associated with COPD (COPD-PH), diagnosed by right heart catheterization. Of these, 37 patients had severe PH (mean pulmonary arterial pressure [mPAP] >35 mmHg or mPAP 25–35 mmHg with low cardiac index [
- Published
- 2017
33. The effect of docosahexaenoic acid on predicting the survival of patients with idiopathic pulmonary arterial hypertension
- Author
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Xiuying Sun, Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Jinling Li, Lan Wang, Ping Yuan, Wen-Hui Wu, Yuanyuan Sun, Yuqing Miao, and Huai Xu
- Subjects
medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Area under the curve ,Hemodynamics ,General Medicine ,medicine.disease ,Pulmonary hypertension ,Gastroenterology ,medicine.anatomical_structure ,Internal medicine ,Vascular resistance ,Medicine ,Biomarker (medicine) ,Original Article ,lipids (amino acids, peptides, and proteins) ,business ,TBIL - Abstract
Background Abnormal lipid metabolism has been reported in patients with idiopathic pulmonary arterial hypertension (IPAH); however, the prognostic value of plasma free fatty acids (FFAs) for these patients is unclear. The present study aimed to determine whether FFA can play a role in predicting the survival of patients with IPAH. Methods A total of 69 blood samples from patients with IPAH were subjected to liquid chromatography-mass spectrometry (LC-MS). According to the classification criteria for pulmonary hypertension in the European Society of Cardiology (ESC) guidelines, patients were divided into low-risk, intermediate-risk, and high-risk groups. The FFA expression levels of patients in the three groups were compared, and the indicators with significant differences were selected. Cox regression analysis was performed to examine the associations between survival and different factors. Receiver operator characteristic (ROC) curves were used to assess the predictive effect of plasma lipids in assessing patients' risk of morbidity, including area under the curve (AUC), sensitivity, specificity and the best cutoff value. Kaplan-Meier curves were used to predict survival. Results A total of 24 FFA molecules were detected in the patients with IPAH. Among them, FFA (20:4), FFA (20:5), FFA (22:5), FFA (22:6), FFA (24:0) and FFA (30:4) showed significant differences between the low-risk and the intermediate-risk or high-risk patients with IPAH. These six FFAs were significantly correlated with hemodynamic parameters. FFA (22:6), named docosahexaenoic acid (DHA), displayed significant negative correlations with World Health Organization functional classification (WHO FC), mean right atrial pressure (mRAP), and pulmonary vascular resistance (PVR), and significant positive correlations with 6-minute walking distance (6MWD) and cardiac index (CI). Cox regression analyses demonstrated that total bilirubin (TBIL) and DHA were independent risk factors for survival of IPAH. Receiver operating characteristic curve analysis revealed that DHA had a cut-off value of 77.55, which had a sensitivity of 96.7% and a specificity of 62.5% for predicting survival. Kaplan-Meier curve analysis showed that a lower level of DHA predicted a poor outcome in patients with IPAH. Conclusions Our study suggested that FFA levels were correlated with disease severity. Lower levels of DHA predict poor survival in patients with IPAH.
- Published
- 2021
34. A novel scoring index by Doppler echocardiography for predicting severe pulmonary hypertension due to chronic lung diseases: a cross-sectional diagnostic accuracy study
- Author
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Rui Zhang, Zhi-Cheng Jing, Rong Jiang, Jin-Ming Liu, Ping Yuan, Bigyan Pudasaini, Lan Wang, Wen-Hui Wu, Qin-Hua Zhao, and Cheng Wu
- Subjects
Right heart catheterization ,Lung Diseases ,Male ,Cardiac Catheterization ,Hemodynamics ,030204 cardiovascular system & hematology ,Doppler echocardiography ,Logistic regression ,hemodynamics ,Severity of Illness Index ,0302 clinical medicine ,Risk Factors ,pulmonary hypertension ,Odds Ratio ,echocardiography ,Prospective Studies ,Original Research ,COPD ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,Echocardiography, Doppler ,medicine.anatomical_structure ,Area Under Curve ,Cardiology ,Female ,medicine.medical_specialty ,Heart Ventricles ,Hypertension, Pulmonary ,International Journal of Chronic Obstructive Pulmonary Disease ,Pulmonary Artery ,chronic lung disease ,Risk Assessment ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,medicine.artery ,medicine ,Humans ,right heart catheterization ,Aged ,Retrospective Studies ,Lung ,business.industry ,Reproducibility of Results ,medicine.disease ,Pulmonary hypertension ,Cross-Sectional Studies ,Logistic Models ,030228 respiratory system ,ROC Curve ,Pulmonary artery ,Chronic Disease ,Multivariate Analysis ,Ventricular Function, Right ,business - Abstract
Rong Jiang,1 Cheng Wu,2 Bigyan Pudasaini,1 Lan Wang,1 Qin-Hua Zhao,1 Rui Zhang,1 Wen-Hui Wu,1 Ping Yuan,1 Zhi-Cheng Jing,1 Jin-Ming Liu1 1Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 2Department of Health Statistics, Second Military Medical University, Shanghai, People’s Republic of China Background: Severe pulmonary hypertension (PH) resulting from a chronic lung disease (CLD) (severe CLD-PH) requires more aggressive treatment due to its increased mortality compared with mild PH. Therefore, we developed a Doppler echocardiography scoring index (ESI) to predict severe CLD-PH.Methods: A derivation cohort of 107 patients with CLD who underwent echocardiography was classified into two groups, the normal/mild PH group and the severe PH group, based on the right heart catheterization. Meanwhile, we designed the ESI by multivariate logistic regression to validate the predicted outcomes. The ESI was calculated using the following formula: ESI=ESIRVEDTD + ESIPASP + ESIPAd - ESITAPSE. Additionally, the ESI was weighted by +2points for right ventricular end-diastolic transverse dimension ≥3.8 cm or pulmonary artery diameter≥2.7 cm, +3 points for systolic pulmonary artery pressure (PASP) ≥61 mmHg, and-3points for tricuspid annular plane systolic excursion ≥1.65 cm.Results: In the derivation cohort, PASP ≥61 mmHg estimated by echocardiography exhibited 80.4% sensitivity and 84.3% specificity with area under receiver-operating characteristic curve of 0.823 (95% CI: 0.797–0.942, P
- Published
- 2017
35. Sex-specific cardiopulmonary exercise testing parameters as predictors in patients with idiopathic pulmonary arterial hypertension
- Author
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Jinming Liu, Bigyan Pudasaini, Ping Yuan, Hui-Juan Ni, Rong Jiang, Qin-Hua Zhao, Hui Liu, Lan Wang, Tian-Xiang Chen, and Su-Gang Gong
- Subjects
Adult ,Male ,Cardiac output ,medicine.medical_specialty ,Physiology ,Population ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,FEV1/FVC ratio ,Oxygen Consumption ,Sex Factors ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,Familial Primary Pulmonary Hypertension ,Cardiac Output ,education ,Aged ,education.field_of_study ,Exercise Tolerance ,business.industry ,Proportional hazards model ,VO2 max ,Middle Aged ,Prognosis ,medicine.anatomical_structure ,030228 respiratory system ,Exercise Test ,Vascular resistance ,Cardiology ,Female ,Vascular Resistance ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise ,Respiratory minute volume - Abstract
Cardiopulmonary exercise testing (CPET) has been used for prognosis in idiopathic pulmonary arterial hypertension (IPAH). We explored whether sex differences had an impact on prognostic assessments of CPET in IPAH. Data were retrieved from 21 male and 36 female incident IPAH patients who underwent both right heart catheterization and CPET from 2010 to 2016 at Shanghai Pulmonary Hospital. Cox proportional hazards analysis was used to assess the prognostic value of CPET. The mean duration of follow-up was 22±15 months. Nine men and 15 women had an event. The differences in clinical parameters in the whole population were not the same as the inter-subgroup differences. Event-free women had significantly higher cardiac output, lower pulmonary vascular resistance and percentage of predicted FVC compared with event men (all P
- Published
- 2017
36. Pulmonary Arterial Hypertension and Fulminant Myocarditis as Initial Manifestation of Systemic Lupus Erythematosus
- Author
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Jing He, Rong Jiang, Su-Gang Gong, Qin-Hua Zhao, Rikesh Sapkota, Jinming Liu, and Lan Wang
- Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Systemic lupus erythematosus ,Myocarditis ,business.industry ,Cardiogenic shock ,Fulminant ,medicine.disease ,Ventricular tachycardia ,Connective tissue disease ,systemic lupus erythematosus ,Methylprednisolone ,lcsh:RC666-701 ,immune system diseases ,pulmonary arterial hypertension ,Internal medicine ,medicine ,Cardiology ,skin and connective tissue diseases ,Complication ,business ,medicine.drug - Abstract
Severe pulmonary arterial hypertension (PAH) is rarely observed as initial manifestation of systemic lupus erythematosus (SLE). Lupus myocarditis may rarely be initial presentation as a fatal complication of SLE, which mainly involved with the left ventricle. Here, we present a case of an incident PAH woman who had a delivery history 4 months previously. During hospitalization, she suffered from extensive myocardial damage, refractory ventricular tachycardia, and cardiogenic shock. Ultimately, she was diagnosed with SLE, fulminant lupus myocarditis, and PAH associated with connective tissue disease. After a large dose of methylprednisolone and PAH target therapy treatment, she recovered successfully and got a good result. To the best of our knowledge, this is the first case report of PAH and fulminant lupus myocarditis as initial manifestation of SLE in a previously healthy postpartum woman.
- Published
- 2017
37. Direct bilirubin: A new risk factor of adverse outcome in idiopathic pulmonary arterial hypertension
- Author
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Yan Wu, Fu-Hua Peng, Xin Jiang, Lan Wang, Kai Sun, Xi-Qi Xu, Qian-Qian Liu, Zhi-Cheng Jing, Qin-Hua Zhao, and Zi-Chao Lv
- Subjects
medicine.medical_specialty ,business.industry ,Proportional hazards model ,030204 cardiovascular system & hematology ,medicine.disease ,Pulmonary hypertension ,Gastroenterology ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Heart failure ,Predictive value of tests ,Severity of illness ,Medicine ,030212 general & internal medicine ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Survival rate ,Survival analysis - Abstract
Background Previous studies have shown that elevated total bilirubin was associated with advanced heart failure, yet no study has ascertained the predictive value of direct serum bilirubin (DBIL) in idiopathic pulmonary arterial hypertension (IPAH). This study aimed to investigate the predictive value of both baseline and follow-up DBIL in patients with IPAH. Methods Serum DBIL was measured in 404 IPAH patients at enrollment. Almost 92% patients received specific drugs after diagnosis confirmed. Serum DBIL was repeated in 237 patients after a mean of 8.3months treatment. Survival rate among normal DBIL group and abnormal DBIL group was compared using the Kaplan–Meier method. The prognostic value of baseline variables was tested by Cox regression models. Results During median follow-up period of 40months, 153 patients died. Baseline DBIL levels were significantly higher in non-survivors compared with survivors ( p p =0.002 and p Conclusions Serum DBIL could predict severity and outcomes of IPAH: in particular, no obvious decrease in DBIL during PAH-specific drug therapy is strongly associated with worse prognosis in IPAH.
- Published
- 2017
38. Clinical and hemodynamic characteristics of pulmonary hypertension associated with interstitial lung disease in China
- Author
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Lan Wang, Bigyan Pudasaini, Ping Yuan, Jin-Ming Liu, Su-Gang Gong, Rong Jiang, Jing He, and Qin-Hua Zhao
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Cardiac function curve ,Cardiac Catheterization ,China ,medicine.medical_specialty ,Cardiac output ,Tomography Scanners, X-Ray Computed ,Hypertension, Pulmonary ,Hemodynamics ,Walk Test ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Cardiac Output ,Lung ,Genetics (clinical) ,Aged ,Retrospective Studies ,business.industry ,Interstitial lung disease ,Middle Aged ,respiratory system ,Prognosis ,medicine.disease ,Pulmonary hypertension ,Respiratory Function Tests ,Surgery ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Cohort ,Vascular resistance ,Cardiology ,Female ,Vascular Resistance ,Lung Diseases, Interstitial ,Complication ,business - Abstract
Background: Pulmonary hypertension (PH) is an important complication of interstitial lung disease (ILD). The aim of the present study was to investigate characteristics and prognosis of ILD associated PH in a predominantly Chinese patient cohort. Methods: Consecutive patients with ILD associated PH, confirmed by right heart catheterization at shanghai pulmonary hospital were included in the study. Characteristics at baseline and during follow-up, as well as survival, were analyzed. Results: This observational study was conducted in 26 patients with a mean age of 60.0 ± 12.2 years old. The six-minutes walking distance was 335.0 ± 190.9 meters. Mean pulmonary arterial pressure (PAP) was 42.9 ± 10.9 mm Hg, cardiac output was 4.4 ± 1.0 L/min, and pulmonary vascular resistance (PVR) was 8.6 ± 4.1 Wood Units. Mean PAP was ≥35 mmHg in 69.2% of cases. There were no difference in lung function parameters between ILD with PH and ILD without PH. The overall survival rate was 92% at 1 year, 82% at 3 years, and 62% at 5 years. PVR was the only variable significantly associated with death. Conclusions: Severe hemodynamic impairment along with PH can occur in patients with ILD. These patients have more severely impaired exercise capacity and cardiac function than ILD patients without PH. PVR was the only prognostic factor identified in this group of patients. This article is protected by copyright. All rights reserved.
- Published
- 2017
39. Terahertz-wave devices based on plasmons in two-dimensional electron gas
- Author
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李 想 Li Xiang, 黄永丹 Huang Yong-dan, 张志鹏 Zhang Zhi-peng, 余 耀 Yu Yao, 秦 华 Qin Hua, 孙云飞 Sun Yun-fei, and 孙建东 Sun Jian-dong
- Subjects
Materials science ,business.industry ,Terahertz radiation ,Surface plasmon ,02 engineering and technology ,021001 nanoscience & nanotechnology ,01 natural sciences ,Atomic and Molecular Physics, and Optics ,0103 physical sciences ,Optoelectronics ,010306 general physics ,0210 nano-technology ,business ,Plasmon - Published
- 2017
40. Cardiopulmonary exercise testing improves diagnostic specificity in patients with echocardiography-suspected pulmonary hypertension
- Author
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Su-Gang Gong, Ping Yuan, Rong Jiang, Jin-Ming Liu, Jian Guo, Hui Liu, Zhi-Cheng Jing, Qin-Hua Zhao, Bigyan Pudasaini, Cheng Wu, Lan Wang, and Qiang Xiao
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Area under the curve ,VO2 max ,Cardiopulmonary exercise testing ,General Medicine ,030204 cardiovascular system & hematology ,Doppler echocardiography ,medicine.disease ,Logistic regression ,Pulmonary hypertension ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Respiratory minute volume - Abstract
Background Doppler echocardiography is usually the first diagnostic investigation for patients suspected with pulmonary hypertension (PH), but it is often inaccurate when used alone, especially in mild PH. Hypothesis Cardiopulmonary exercise testing (CPET) may serve as a complementary tool to improve diagnostic accuracy in echocardiography-suspected “PH possible” patients. Methods Eighty-eight consecutive patients with suspected PH (referred to as “PH possible” hereafter) based on echocardiography were included in the study. CPET was assessed subsequently and PH was confirmed by right-heart catheterization in all subjects. We analyzed CPET data from patients and derived a CPET prediction rule to hemodynamically differentiate PH. Results Eighty-eight patients (27 patients with confirmed PH, and PH ruled out in 61 patients) were included in the study. Compared with non-PH patients, the PH subjects had lower peak oxygen uptake (VO2 ), aerobic capacity (AT), peak partial pressure of end-tidal CO2 (PETCO2 ), oxygen uptake efficiency plateau (OUEP), and oxygen uptake efficiency slope (OUES), along with higher minute ventilation (VE)/carbon dioxide output (VCO2 ) slope and lowest VE/VCO2 (P < 0.001). VE/VCO2 slope and AT were independent predictors of PH derived from multivariate logistic regression adjusted for age and body mass index. A score combining VE/VCO2 slope and AT reached a high area under the curve value of 0.98. A score ≥0.5 had 95% specificity and 92.6% sensitivity for diagnosis of PH. Conclusions A score combining VE/VCO2 slope and AT provides high specificity in screening out PH from a pool of echocardiography-suspected PH patients.
- Published
- 2016
41. Significance of End-Tidal PCO2 and Its Relation to Functional Capacity in IPAH and CTEPH Patients
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Jian Guo, Jianping Liu, Su-Gang Gong, Xiaofang Shi, Qin-Hua Zhao, and Lei Wang
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,End tidal pco2 - Published
- 2019
42. Differences in Ventilation Inefficiency and Exercise Limitation in Patients with Chronic Thromboembolic Pulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
- Author
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Qiang Xiao, Su-Gang Gong, Jianping Liu, Qin-Hua Zhao, Jian Guo, and Lei Wang
- Subjects
medicine.medical_specialty ,Exercise limitation ,business.industry ,Internal medicine ,Breathing ,medicine ,Idiopathic Pulmonary Arterial Hypertension ,Cardiology ,In patient ,Chronic thromboembolic pulmonary hypertension ,Inefficiency ,business - Published
- 2019
43. Cardiopulmonary Exercise Test in Pulmonary Embolism
- Author
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L. Wang, Qin-Hua Zhao, P. Yuan, Jian Guo, Jianping Liu, and Su-Gang Gong
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiopulmonary exercise test ,Cardiology ,medicine ,medicine.disease ,business ,Pulmonary embolism - Published
- 2019
44. Difference in Exercise Capacity and Ventilatory Efficiency Between Chronic Obstructive Pulmonary Disease Associated Pulmonary Hypertension and Idiopathic Pulmonary Hypertension
- Author
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Jianping Liu, Hong Liu, Lei Wang, Su-Gang Gong, Qin-Hua Zhao, and Jian Guo
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Idiopathic Pulmonary Hypertension ,medicine ,Cardiology ,Pulmonary disease ,Exercise capacity ,business ,medicine.disease ,Pulmonary hypertension - Published
- 2019
45. Improvement of Exercise Capacity and Ventilatory Efficiency in Patients with Pulmonary Embolism After Anticoagulant Therapy
- Author
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Qin-Hua Zhao, Dandan Huang, Jianping Liu, Jian Guo, Su-Gang Gong, Wenlan Yang, and L. Wang
- Subjects
medicine.medical_specialty ,Anticoagulant therapy ,business.industry ,Internal medicine ,Cardiology ,Medicine ,In patient ,Exercise capacity ,business ,medicine.disease ,Pulmonary embolism - Published
- 2019
46. Characteristics of cardiopulmonary exercise testing of patients with borderline mean pulmonary artery pressure
- Author
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Bigyan Pudasaini, Su-Gang Gong, Wen-Hui Wu, Qin-Hua Zhao, Jin-Ming Liu, Cheng Wu, Lan Wang, Hui Liu, Hong-Ling Qiu, Zhi-Cheng Jing, Ping Yuan, Rui Zhang, Jing He, Rong Jiang, Jian Guo, Ci-Jun Luo, and Jian-Lin Xu
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,China ,Hypertension, Pulmonary ,Oxygen pulse ,Hemodynamics ,Exercise intolerance ,Pulmonary Artery ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Genetics (clinical) ,Aged ,business.industry ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Respiratory Function Tests ,Logistic Models ,030228 respiratory system ,Echocardiography ,Case-Control Studies ,Pulmonary artery ,Cardiology ,Breathing ,Exercise Test ,Female ,medicine.symptom ,business ,Anaerobic exercise - Abstract
Background Pulmonary hypertension patients with mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg had impaired cardiopulmonary exercise testing (CPET). Borderline mean pulmonary pressures (boPAP; 21-24 mm Hg) represent early pulmonary vasculopathy. The CPET characteristics of boPAP are a matter of discussion. We aimed to determine the CPET profile of such borderline hemodynamics. Methods A matched case-control study was conducted on consecutive boPAP patients at the Shanghai Pulmonary Hospital between Jan 2012 and Jan 2017. Hemodynamics, echocardiography, the pulmonary function test (PFT) and CPET parameters were compared between boPAP patients and normal mPAP patients which were matched 1:1 by sex and age. Conditional logistic regression analysis was performed to determine the efficacy of CPET in detecting boPAP. Results A total of 48 patients underwent RHC and CPET (24 Normal, 24 boPAP). There were no differences in the demographics, echocardiography and PFT. BoPAP patients had significantly decreased VO2 at the anaerobic threshold and peak VO2 /kg (858.4 ± 246.5 mL/min vs 727.9 ± 228.0 mL/min, P = 0.037; 21.1 ± 6.4 mL/min/kg vs. 15.5 ± 5.6 mL/min/kg, P = 0.001, respectively). Significant differences were not observed in ventilation efficiency. A trend of impaired oxygen pulse and submaximal exercise tolerance were observed in boPAP patients. Conditional logistical regression analysis revealed the risk of boPAP increased by 2.493 (95% confident interval: 1.388 to 4.476, P = 0.002) with every 5 mL/min/kg decrease in peak VO2 /kg. Conclusions Patients with boPAP have a greater prevalence of exercise intolerance, a trend of impaired oxygen pulse and submaximal exercise tolerance.
- Published
- 2018
47. Plasma exosomal miR-596: a novel biomarker predicts survival in patients with idiopathic pulmonary artery hypertension
- Author
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Ping Yuan, Xun-Tao Yuan, Yang Huang, Su-Gang Gong, Jie Zhang, Qin-Hua Zhao, Liang Tang, Yuanyuan Sun, Rong Jiang, Jinling Li, Zuogang Wang, Ci-Jun Luo, Lan Wang, Xiao-jun Yang, and Wen-Hui Wu
- Subjects
0301 basic medicine ,Medicine (General) ,medicine.medical_specialty ,Pulmonary Artery ,030204 cardiovascular system & hematology ,miR-596 ,survival ,Biochemistry ,Gastroenterology ,exosomal ,Pre-Clinical Research Report ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Internal medicine ,medicine.artery ,microRNA ,Humans ,Medicine ,Familial Primary Pulmonary Hypertension ,In patient ,Idiopathic pulmonary arterial hypertension ,business.industry ,Biochemistry (medical) ,Idiopathic Pulmonary Arterial Hypertension ,Cell Biology ,General Medicine ,Prognosis ,MicroRNAs ,030104 developmental biology ,Hypertension ,Pulmonary artery ,Biomarker (medicine) ,business ,Biomarkers - Abstract
ObjectiveTo determine if plasma exosomal microRNAs (miRNAs) can predict survival in patients with idiopathic pulmonary arterial hypertension (IPAH).MethodsThe study enrolled patients with IPAH that underwent right heart catheterization. Plasma was collected and exosomal miRNAs were extracted. Exosomes were evaluated using transmission electron microscopy, Western blot analysis and particle size distribution analysis. MiRNAs were evaluated using a miRNA microarray and validated using real-time polymerase chain reaction.ResultsThis study included 12 patients with IPAH in the study group and 48 patients with IPAH in the validation group. The mean ± SD follow-up duration was 60.3 ± 35.4 months in the overall cohort. The levels of miR-596 were higher in the nonsurvivors compared with the survivors. The levels of miR-596 significantly correlated with survival time, mean right atrial pressure, pulmonary vascular resistance (PVR) and cardiac index. High levels of miR-596 and PVR were significantly associated with poor overall survival. Multivariate analysis demonstrated that exosomal miR-596 (hazard ratio [HR] = 2.119; 95% confidence interval [CI] 1.402, 3.203) and PVR (HR = 1.146; 95% CI 1.010, 1.300) were independent predictors of survival.ConclusionsHigh levels of plasma exosomal miR-596 were significantly associated with disease severity and poor prognosis of patients with IPAH.
- Published
- 2021
48. Incidence and predictors of venous thromboembolism after surgery for gynecologic cancer
- Author
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Xiao-Juan Wang and Ke-Qin Hua
- Subjects
medicine.medical_specialty ,Oncology ,business.industry ,Incidence (epidemiology) ,Gynecologic cancer ,medicine ,Obstetrics and Gynecology ,business ,Venous thromboembolism ,Surgery - Published
- 2021
49. Nonpalpable breast masses
- Author
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Qin-Hua Huang, Chu-Miao Zhang, Qi Zhang, Hai-Yan Chen, Hongmei Wen, and Tao Xu
- Subjects
Adult ,China ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Observational Study ,Breast Neoplasms ,Breast Diseases ,Young Adult ,03 medical and health sciences ,breast cancer ,0302 clinical medicine ,Breast cancer ,Risk Factors ,Carcinoma ,medicine ,Humans ,030212 general & internal medicine ,Family history ,Early Detection of Cancer ,Aged ,business.industry ,Incidence (epidemiology) ,Carcinoma, Ductal, Breast ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Radiation therapy ,cancer screening ,030220 oncology & carcinogenesis ,Female ,Ultrasonography, Mammary ,Radiology ,nonpalpable breast mass ,business ,Body mass index ,Carcinoma in Situ ,cancer morbidity ,Mastectomy ,Follow-Up Studies ,Research Article ,early diagnosis - Abstract
Women with nonpalpable breast masses are at a high risk of developing breast cancer (BC) due to misdiagnosis during the follow-up period. A total of 40,334 women were divided into palpable and nonpalpable breast mass groups. We assessed the risk factors for cancer development in patients with nonpalpable breast masses during a 1-year follow-up period. Of the 1335 patients in the nonpalpable breast mass group, we found 50 patients of BC, of which 35 patients accepted surgery and were confirmed with biopsy at the beginning of the study. The remaining 15 (1.1%) were diagnosed with BC during follow-up, and included 10 in situ and 5 invasive carcinomas. Four of the 10 patients in the in situ subgroup, and 2 out of the 5 in the invasive subgroup were overweight (Body mass index > 24 kg/m2). Nine in situ BC patients had breast-conserving surgery, 1 had a mastectomy. No patient in the in situ group received chemotherapy or radiotherapy. All 5 patients with invasive disease received 6 cycles of chemotherapy. Only 3 (20%) of the 15 patients with BC had a positive family history. We found 131 BC cases, including BC detected during screening (81) and follow-up (50). The incidence of BC was 240.2 per 100,000 inhabitants. Patients with nonpalpable breast masses require regular follow-up as they have a high risk of cancer occurrence. Regular follow-up can lead to early diagnosis and effective treatment of these early-stage BC patients.
- Published
- 2020
50. Clinical characteristics of pulmonary hypertension in bronchiectasis
- Author
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Su-Gang Gong, Qin-Hua Zhao, Lan Wang, Jin-Ming Liu, Zhi-Cheng Jing, Ping Yuan, Bigyan Pudasaini, Jingyun Shi, Sen Jiang, Rong Jiang, and Jing He
- Subjects
Adult ,Male ,China ,medicine.medical_specialty ,Cardiac output ,Adolescent ,Hypertension, Pulmonary ,Hemodynamics ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Survival rate ,Aged ,Retrospective Studies ,Bronchiectasis ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Surgery ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Vascular resistance ,Cardiology ,Regression Analysis ,Female ,business ,Complication - Abstract
Pulmonary hypertension (PH), as a complication of bronchiectasis, is associated with increased mortality. However, hemodynamic characteristics and the efficacy of pulmonary arterial hypertension (PAH) therapies in patients with bronchiectasis and PH remain unknown. Patients with bilateral bronchiectasis and concurrent PH were included in the study. Patient characteristics at baseline and during follow-up, as well as survival, were analyzed. This observational study was conducted in 36 patients with a mean age of 51.5 years (range, 17‒74 years). The 6 min walking distance was 300.8 ± 3.3 m. The mean pulmonary arterial pressure (PAP) was 41.5 ± 1.7 mmHg, cardiac output was 5.2 ± 1.4 L/min, and pulmonary vascular resistance was 561.5 ± 281.5 dyn∙s∙cm(-5). The mean PAP was > 35 mmHg in 75% of the cases. Mean PAP was inversely correlated with arterial oxygen saturation values (r =-0.45, P = 0.02). In 24 patients who received oral PAH therapy, systolic PAP was reduced from 82.4 ± 27.0 mmHg to 65.5 ± 20.9 mmHg (P = 0.025) on echocardiography after a median of 6 months of follow-up. The overall probability of survival was 97.1% at 1 year, 83.4% at 3 years, and 64.5% at 5 years. Given the results, we conclude that PH with severe hemodynamic impairment can occur in patients with bilateral bronchiectasis, and PAH therapy might improve hemodynamics in such patients. Prospective clinical trials focusing on this patient population are warranted.
- Published
- 2016
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