100 results on '"Hua-yan Xu"'
Search Results
2. The impact of diabetes mellitus on cardiac function assessed by magnetic resonance imaging in patients with hypertrophic cardiomyopathy
- Author
-
Shi-Qin Yu, Ke Shi, Yuan Li, Jin Wang, Yue Gao, Rui Shi, Wei-Feng Yan, Hua-Yan Xu, Ying-Kun Guo, and Zhi-Gang Yang
- Subjects
Diabetes mellitus ,Hypertrophic cardiomyopathy ,Cardiac magnetic resonance ,Strain ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The adverse prognostic impact of diabetes on hypertrophic cardiomyopathy (HCM) is poorly understood. We sought to explore the underlying mechanisms in terms of structural and functional remodelling in HCM patients with coexisting diabetes (HCM-DM). Methods A total of 45 HCM-DM patients were retrospectively included. Isolated HCM controls (HCM patients without diabetes) were matched to HCM-DM patients in terms of maximal wall thickness, age, and gender distribution. Left ventricular (LV) and atrial (LA) performance were evaluated using cardiac magnetic resonance feature tracking strain analyses. The associations between diabetes and LV/LA impairment were investigated by univariable and multivariable linear regression. Results Compared with the isolated HCM controls, the HCM-DM patients had smaller end-diastolic volume and stroke volume, lower ejection fraction, larger mass/volume ratio and impaired strains in all three directions (all P
- Published
- 2024
- Full Text
- View/download PDF
3. Sex differences in clinical profile, left ventricular remodeling and cardiovascular outcomes among diabetic patients with heart failure and reduced ejection fraction: a cardiac-MRI-based study
- Author
-
Ke Shi, Ge Zhang, Hang Fu, Xue-Ming Li, Li Jiang, Yue Gao, Wen-Lei Qian, Li-Ting Shen, Hua-Yan Xu, Yuan Li, Ying-Kun Guo, and Zhi-Gang Yang
- Subjects
Heart failure with reduced ejection fraction ,Diabetes mellitus ,Sex ,Cardiac magnetic resonance imaging ,Outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Heart failure with reduced ejection fraction (HFrEF) is associated with a high rate of mortality and morbidity. Evidence has shown that sex differences may be an important contributor to phenotypic heterogeneity in patients with HFrEF. Although diabetes mellitus (DM) frequently coexists with HFrEF and results in a worse prognosis, there remains a need to identify sex-related differences in the characteristics and outcomes of this population. In this study, we aimed to investigate the between-sex differences in clinical profile, left ventricular (LV) remodeling, and cardiovascular risk factors and outcomes in patients with HFrEF concomitant with DM. Methods A total of 273 patients with HFrEF concomitant with DM who underwent cardiac MRI were included in this study. Clinical characteristics, LV remodeling as assessed by cardiac MRI, and cardiovascular risk factors and outcomes were compared between sexes. Results Women were older, leaner and prone to have anemia and hypoproteinemia but less likely to have ischemic etiology. Cardiac MRI revealed that despite similar LVEFs between the sexes, there was more LV concentric remodeling, less impaired global systolic peak strain in longitudinal and circumferential components and a decreased likelihood of late gadolinium enhancement presence in women than in men. During a median follow-up time of 34.6 months, women exhibited better overall survival than men did (log-rank P = 0.042). Multivariable Cox proportional hazards analysis indicated different risk factors for predicting outcomes between sexes, with hypertension [hazard ratio (HR) = 2.05, 95% confidence interval (CI) 1.05 to 4.85, P = 0.041] and hypoproteinemia (HR = 2.27, 95% CI 1.06 to 4.37, P = 0.039) serving as independent determinants of outcomes in women, whereas ischemic etiology (HR = 1.96, 95% CI 1.11 to 3.48, P = 0.021) and atrial fibrillation (HR = 1.86, 95% CI 1.02 to 3.41, P = 0.044) served as independent determinants of outcomes in men. Conclusions Among patients with HFrEF concomitant with DM, women displayed different LV remodeling and risk factors and had better survival than men did. Sex-based phenotypic heterogeneity in patients with HFrEF in the context of DM should be addressed in clinical practice.
- Published
- 2024
- Full Text
- View/download PDF
4. Glycemic control and clinical outcomes in diabetic patients with heart failure and reduced ejection fraction: insight from ventricular remodeling using cardiac MRI
- Author
-
Ke Shi, Ge Zhang, Hang Fu, Xue-Ming Li, Yue Gao, Rui Shi, Hua-Yan Xu, Yuan Li, Ying-Kun Guo, and Zhi-Gang Yang
- Subjects
Glycosylated hemoglobin ,Type 2 diabetes mellitus ,Heart failure with reduced ejection fraction ,Myocardial contractile dysfunction ,Outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Glycemic control, as measured by glycosylated hemoglobin (HbA1c), is an important biomarker to evaluate diabetes severity and is believed to be associated with heart failure development. Type 2 diabetes mellitus (T2DM) and heart failure with reduced ejection fraction (HFrEF) commonly coexist, and the combination of these two diseases indicates a considerably poorer outcome than either disease alone. Therefore, glycemic control should be carefully managed. The present study aimed to explore the association between glycemic control and clinical outcomes, and to determine the optimal glycemic target in this specific population. Methods A total of 262 patients who underwent cardiac MRI were included and were split by HbA1c levels [HbA1c 7.5% (poor control)]. The biventricular volume and function, as well as left ventricular (LV) systolic strains in patients in different HbA1c categories, were measured and compared. The primary and secondary outcomes were recorded. The association of different HbA1c levels with adverse outcomes was assessed. Results Despite similar biventricular ejection fractions, both patients with intensive and poor glycemic control exhibited prominent deterioration of LV systolic strain in the longitudinal component (P = 0.004). After a median follow-up of 35.0 months, 55 patients (21.0%) experienced at least one confirmed endpoint event. Cox multivariable analysis indicated that both patients in the lowest and highest HbA1c categories exhibited a more than 2-fold increase in the risk for primary outcomes [HbA1c 7.5%: HR = 2.24, 95% CI = 1.01–4.99; P = 0.038] and secondary outcomes (HbA1c 7.5%: HR = 2.65, 95% CI = 1.08–6.50; P = 0.038) compared with those in the middle HbA1c category. Conclusions We showed a U-shaped association of glycemic control with clinical outcomes in patients with T2DM and HFrEF, with the lowest risk of adverse outcomes among patients with modest glycemic control. HbA1c between 6.5% and 7.5% may be served as the optimal hypoglycemic target in this specific population.
- Published
- 2024
- Full Text
- View/download PDF
5. Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study
- Author
-
Li Jiang, Wei‑Feng Yan, Lu Zhang, Hua‑Yan Xu, Ying‑Kun Guo, Zhen-Lin Li, Ke-Ling Liu, Ling-Ming Zeng, Yuan Li, and Zhi-Gang Yang
- Subjects
Microvascular dysfunction ,Diabetes ,Quantitative myocardial perfusion ,Myocardial microvascular reserve function. ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Microvascular pathology is one of the main characteristics of diabetic cardiomyopathy; however, the early longitudinal course of diabetic microvascular dysfunction remains uncertain. This study aimed to investigate the early dynamic changes in left ventricular (LV) microvascular function in diabetic pig model using the cardiac magnetic resonance (CMR)-derived quantitative perfusion technique. Methods Twelve pigs with streptozotocin-induced diabetes mellitus (DM) were included in this study, and longitudinal CMR scanning was performed before and 2, 6, 10, and 16 months after diabetic modeling. CMR-derived semiquantitative parameters (upslope, maximal signal intensity, perfusion index, and myocardial perfusion reserve index [MPRI]) and fully quantitative perfusion parameters (myocardial blood flow [MBF] and myocardial perfusion reserve [MPR]) were analyzed to evaluate longitudinal changes in LV myocardial microvascular function. Pearson correlation was used to analyze the relationship between LV structure and function and myocardial perfusion function. Results With the progression of DM duration, the upslope at rest showed a gradually increasing trend (P = 0.029); however, the upslope at stress and MBF did not change significantly (P > 0.05). Regarding perfusion reserve function, both MPRI and MPR showed a decreasing trend with the progression of disease duration (MPRI, P = 0.001; MPR, P = 0.042), with high consistency (r = 0.551, P
- Published
- 2024
- Full Text
- View/download PDF
6. Reduced thoracic skeletal muscle size is associated with adverse outcomes in diabetes patients with heart failure and reduced ejection fraction: quantitative analysis of sarcopenia by using cardiac MRI
- Author
-
Ke Shi, Ge Zhang, Hang Fu, Xue-Ming Li, Shi-Qin Yu, Rui Shi, Wei-Feng Yan, Wen-Lei Qian, Hua-Yan Xu, Yuan Li, Ying-Kun Guo, and Zhi-Gang Yang
- Subjects
Diabetes mellitus ,Heart failure with reduced ejection fraction ,Sarcopenia ,Cardiac MRI ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Sarcopenia is frequently found in patients with heart failure with reduced ejection fraction (HFrEF) and is associated with reduced exercise capacity, poor quality of life and adverse outcomes. Recent evidence suggests that axial thoracic skeletal muscle size could be used as a surrogate to assess sarcopenia in HFrEF. Since diabetes mellitus (DM) is one of the most common comorbidities with HFrEF, we aimed to explore the potential association of axial thoracic skeletal muscle size with left ventricular (LV) remodeling and determine its prognostic significance in this condition. Methods A total of 243 diabetes patients with HFrEF were included in this study. Bilateral axial thoracic skeletal muscle size was obtained using cardiac MRI. Patients were stratified by the tertiles of axial thoracic skeletal muscle index (SMI). LV structural and functional indices, as well as amino-terminal pro-B-type natriuretic peptide (NT-proBNP), were measured. The determinants of elevated NT-proBNP were assessed using linear regression analysis. The associations between thoracic SMI and clinical outcomes were assessed using a multivariable Cox proportional hazards model. Results Patients in the lowest tertile of thoracic SMI displayed a deterioration in LV systolic strain in three components, together with an increase in LV mass and a heavier burden of myocardial fibrosis (all P
- Published
- 2024
- Full Text
- View/download PDF
7. Derivation and validation of diagnostic models for myocardial fibrosis in duchenne muscular dystrophy: assessed by multi-parameter cardiovascular magnetic resonance
- Author
-
Zi-qi Zhou, Hua-yan Xu, Hang Fu, Ke Xu, Rong Xu, Xiao-tang Cai, and Ying-kun Guo
- Subjects
Duchenne muscular dystrophy ,Cardiovascular magnetic resonance ,Late gadolinium enhancement ,Native T1 ,Longitudinal strain ,Medicine - Abstract
Abstract Background Gadolinium-enhanced cardiovascular magnetic resonance (CMR) is the most widely used approach for diagnosing myocardial fibrosis with late gadolinium enhancement (LGE) in cardiomyopathy associated with Duchenne muscular dystrophy. Given the limitations and safety of gadolinium use, we wanted to develop and evaluate multi-parametric pre-contrast CMR models for the diagnosis of LGE and investigate whether they could be utilised as surrogates for LGE in DMD patients. Methods A total of 136 DMD patients were prospectively recruited and separated into LGE − and LGE + groups. In the first subset of patients (derivation cohort), regression models for the diagnosis of LGE were built by logistic regression using pre-contrast sequence parameters. In a validation cohort of other patients, the models’ performances were evaluated. Results EF, native T1 and longitudinal strain alone, as well as their combinations form seven models. The model that included EF, native T1 and longitudinal strain had the best diagnostic value, but there was no significant difference in diagnostic accuracy among the other models except EF. In the validation cohort, the diagnosis outcomes of models were moderate consistent with the existence of LGE. The longitudinal strain outperformed the other models in terms of diagnostic value (sensitivity: 83.33%, specificity: 54.55%). Conclusions Pre-contrast sequences have a moderate predictive value for LGE. Thus, pre-contrast parameters may be considered only in a specific subset of DMD patients who cannot cooperate for long-time examinations and have contradiction of contrast agent to help predict the presence of LGE. Trial registration number (TRN) ChiCTR1800018340 Date of registration 20180107
- Published
- 2023
- Full Text
- View/download PDF
8. Effects of diabetes mellitus on left ventricular function and deformation in patients with restrictive cardiomyopathies: a 3.0T CMR feature tracking study
- Author
-
Yue Gao, Yi-Ning Jiang, Rui Shi, Ying-Kun Guo, Hua-Yan Xu, Chen-Yan Min, Zhi-Gang Yang, and Yuan Li
- Subjects
Diabetes mellitus ,Restrictive cardiomyopathy ,Global peak strain ,Cardiac magnetic resonance ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Diabetes mellitus (DM) is the most common metabolic disease worldwide and a major risk factor for adverse cardiovascular events, while the additive effects of DM on left ventricular (LV) deformation in the restrictive cardiomyopathy (RCM) cohort remain unclear. Accordingly, we aimed to investigate the additive effects of DM on LV deformation in patients with RCM. Materials and methods One hundred thirty-six RCM patients without DM [RCM(DM−)], 46 with DM [RCM (DM+)], and 66 age- and sex-matched control subjects who underwent cardiac magnetic resonance (CMR) scanning were included. LV function, late gadolinium enhancement (LGE) type, and LV global peak strains (including radial, circumferential, and longitudinal directions) were measured. The determinant of reduced LV global myocardial strain for all RCM patients was assessed using multivariable linear regression analyses. The receiver operating characteristic curve (ROC) was performed to illustrate the relationship between DM and decreased LV deformation. Results Compared with the control group, RCM (DM−) and RCM(DM+) patients presented increased LV end-diastolic index and end-systolic volume index and decreased LV ejection fraction. LV GPS in all three directions and longitudinal PDSR progressively declined from the control group to the RCM(DM−) group to the RCM(DM+) group (all p
- Published
- 2023
- Full Text
- View/download PDF
9. Association of insulin use with LV remodeling and clinical outcomes in diabetic patients with heart failure and reduced ejection fraction: assessed by cardiac MRI
- Author
-
Ke Shi, Ge Zhang, Hang Fu, Shan Huang, Hua-Yan Xu, Yue Gao, Rui Shi, Wei-Feng Yan, Wen-Lei Qian, Yuan Li, Ying-Kun Guo, and Zhi-Gang Yang
- Subjects
Heart failure with reduced ejection fraction ,Insulin ,Left ventricular remodeling ,Contractile dysfunction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Insulin is commonly used in type 2 diabetes mellitus (T2DM) to achieve glycemic control. However, recent evidence showed that insulin use is associated with poor outcomes in the context of heart failure (HF). Since heart failure with reduced ejection fraction (HFrEF) accounts for approximately 50% of cases in the general HF population, we aimed to evaluate the effect of insulin treatment on left ventricular (LV) remodeling and contractility abnormalities in a HFrEF cohort and assess whether insulin was a predictor of adverse outcomes in this entity. Methods A total of 377 HFrEF patients who underwent cardiac MRI were included and divided according to diabetes status and the need for insulin treatment. LV structural and functional indices, as well as systolic strains, were measured. The determinants of impaired myocardial strains were assessed using linear regression analysis. The associated endpoints were determined using a multivariable Cox proportional hazards model. Results T2DM patients on insulin displayed a higher indexed LV end-diastolic volume and LV mass than those with T2DM not on insulin or those without T2DM, despite similar LV ejection fractions, accompanied by a higher three-dimensional spherical index (P
- Published
- 2023
- Full Text
- View/download PDF
10. The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking
- Author
-
Rui Shi, Zhi-Gang Yang, Ying-Kun Guo, Wen-Lei Qian, Yue Gao, Xue-Ming Li, Li Jiang, Hua-Yan Xu, and Yuan Li
- Subjects
Diabetes mellitus ,Right ventricular dysfunction ,Ventricular interdependence ,CMR feature-tracking ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background To investigate the difference of right ventricular (RV) structural and functional alteration in patients with diabetes mellitus (DM) with preserved left ventricular ejection fraction (LVEF), and the ventricular interdependence in these patients, using cardiac MR (CMR) feature tracking. Methods From December 2016 to February 2022, 148 clinically diagnosed patients with DM who underwent cardiac MR (CMR) in our hospital were consecutively recruited. Fifty-four healthy individuals were included as normal controls. Biventricular strains, including left/right ventricular global longitudinal strain (LV-/RVGLS), left/right ventricular global circumferential strain (LV-/RVGCS), left/right ventricular global radial strain (LV-/RVGRS) were evaluated, and compared between patients with DM and healthy controls. Multiple linear regression and mediation analyses were used to evaluate DM's direct and indirect effects on RV strains. Results No differences were found in age (56.98 ± 10.98 vs. 57.37 ± 8.41, p = 0.985), sex (53.4% vs. 48.1%, p = 0.715), and body surface area (BSA) (1.70 ± 0.21 vs. 1.69 ± 0.17, p = 0.472) between DM and normal controls. Patients with DM had decreased RVGLS (− 21.86 ± 4.14 vs. − 24.49 ± 4.47, p = 0.001), RVGCS (− 13.16 ± 3.86 vs. − 14.92 ± 3.08, p = 0.011), and no decrease was found in RVGRS (22.62 ± 8.11 vs. 23.15 ± 9.05, p = 0.743) in patients with DM compared with normal controls. The difference in RVGLS between normal controls and patients with DM was totally mediated by LVGLS (indirect effecting: 0.655, bootstrapped 95%CI 0.138–0.265). The difference in RVGCS between normal controls and DM was partly mediated by the LVGLS (indirect effecting: 0.336, bootstrapped 95%CI 0.002–0.820) and LVGCS (indirect effecting: 0.368, bootstrapped 95%CI 0.028–0.855). Conclusions In the patients with DM and preserved LVEF, the difference in RVGLS between DM and normal controls was totally mediated by LVGLS. Although there were partly mediating effects of LVGLS and LVGCS, the decrease in RVGCS might be directly affected by the DM.
- Published
- 2023
- Full Text
- View/download PDF
11. Association of diabetes mellitus and glycemic control with left ventricular function and deformation in patients after acute myocardial infarction: a 3 T cardiac magnetic resonance study
- Author
-
Yue Gao, Rui Shi, Yuan Li, Ying-kun Guo, Hua-Yan Xu, Ke Shi, and Zhi-gang Yang
- Subjects
Diabetes mellitus ,Myocardial infarction ,Global peak strain ,Cardiovascular magnetic resonance ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Diabetes mellitus (DM) is considered a major risk factor for myocardial infarction (MI), and MI patients with DM have a poor prognosis. Accordingly, we aimed to investigate the additive effects of DM on LV deformation in patients after acute MI. Materials and methods One hundred thirteen MI patients without DM [MI (DM−)], 95 with DM [MI (DM+)] and 71 control subjects who underwent CMRscanning were included. LV function, infarct size and LV global peak strains in the radial, circumferential and longitudinal directions were measured. MI (DM+) patients were divided into two subgroups based on the HbA1c level (
- Published
- 2023
- Full Text
- View/download PDF
12. Chemotherapy effect on myocardial fibrosis markers in patients with gynecologic cancer and low cardiovascular risk
- Author
-
Lu Ye, Dan-qing Wang, Meng-xi Yang, Qing-li Li, Hong Luo, Xiao-juan Lin, Ke-min Li, Liang Song, Yu Ma, Hui-qiong Huang, Lan Zhong, Lu Yang, Jian-jun Zhang, Feng-ming Gong, Hua-yan Xu, Lin-jun Xie, Ru-tie Yin, and Ying-kun Guo
- Subjects
cardiotoxicity ,T1 mapping ,myocardial fibrosis ,cardiac magnetic resonance ,neoplasms ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundPatients with gynecologic cancers experience side effects of chemotherapy cardiotoxicity. We aimed to quantify cardiac magnetic resonance (CMR) markers of myocardial fibrosis in patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy.MethodsThis study is part of a registered clinical research. CMR T1 mapping was performed in patients with gynecologic cancer and low cardiovascular risk undergoing chemotherapy. The results were compared with those of age-matched healthy control subjects.Results68 patients (median age = 50 years) and 30 control subjects were included. The median number of chemotherapy cycles of patients was 9.0 (interquartile range [IQR] 3.3–17.0). Extracellular volume fraction (ECV) (27.2% ± 2.7% vs. 24.5% ± 1.7%, P < 0.001) and global longitudinal strain (−16.2% ± 2.8% vs. −17.4% ± 2.0%, P = 0.040) were higher in patients compared with controls. Patients with higher chemotherapy cycles (>6 cycles) (n=41) had significantly lower intracellular mass indexed (ICMi) compared with both patients with lower chemotherapy cycles (≤6 cycles) (n=27) (median 27.44 g/m2 [IQR 24.03–31.15 g/m2] vs. median 34.30 g/m2 [IQR 29.93–39.79 g/m2]; P = 0.002) and the control group (median 27.44 g/m2 [IQR 24.03–31.15 g/m2] vs. median 32.79 g/m2 [IQR 27.74–35.76 g/m2]; P = 0.002). Patients with two or more chemotherapy regimens had significantly lower ICMi compared with both patients with one chemotherapy regimen (27.45 ± 5.16 g/m2 vs. 33.32 ± 6.42 g/m2; P < 0.001) and the control group (27.45 ± 5.16 g/m2 vs. 33.02 ± 5.52 g/m2; P < 0.001). The number of chemotherapy cycles was associated with an increase in the ECV (Standard regression coefficient [β] = 0.383, P = 0.014) and a decrease in the ICMi (β = -0.349, P = 0.009).ConclusionPatients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy have diffuse extracellular volume expansion, which is obvious with the increase of chemotherapy cycles. Myocyte loss may be part of the mechanism in patients with a higher chemotherapy load.Clinical trial registrationhttp://www.chictr.org.cn, identifier ChiCTR-DDD-17013450.
- Published
- 2023
- Full Text
- View/download PDF
13. Early longitudinal changes in left ventricular function and morphology in diabetic pigs: evaluation by 3.0T magnetic resonance imaging
- Author
-
Wei-Feng Yan, Hua-Yan Xu, Li Jiang, Lu Zhang, Ying-Kun Guo, Yuan Li, Li-Ting Shen, Chen-Yan Min, and Zhi-Gang Yang
- Subjects
Diabetic cardiomyopathy ,Cardiac magnetic resonance ,Time‒volume curve ,Feature tracking technique ,Diabetic pig ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Previous researches on large animal models of diabetic cardiomyopathy were insufficient. The aim of this study was to evaluate early changes in left ventricular (LV) function and morphology in diabetic pigs using a cardiac magnetic resonance (CMR) time-volume curve and feature tracking technique. Methods Streptozotocin (STZ) was used to induce diabetic in sixteen pigs. 3.0T MRI scanned the pig’s heart before and 2, 6, 10 and 16 months after modelling. CMR biomarkers, including time-volume curve and myocardial strain, were compared to analyse the longitudinal changes in LV function and morphology. Pearson correlation was used to evaluate the relationship between LV strain and remodelling. Cardiac specimens were obtained at 6, 10, and 16 months after modelling to observe the myocardial ultrastructural and microstructure at different courses of diabetes. Results Twelve pigs developed diabetes. The 80% diastolic volume recovery rate (DVR) at 6 months after modelling was significantly higher than that before modelling (0.78 ± 0.08vs. 0.67 ± 0.15). The LV global longitudinal peak strain (GLPS) (− 10.21 ± 3.15 vs. − 9.74 ± 2.78 vs. − 9.38 ± 3.71 vs. − 8.71 ± 2.68 vs. − 6.59 ± 2.90%) altered gradually from the baseline data to 2, 6, 10 and 16 months after modelling. After 16 months of modelling, the LV remodelling index (LVRI) of pigs increased compared with that before modelling (2.19 ± 0.97 vs. 1.36 ± 0.45 g/ml). The LVRI and myocardial peak strain were correlated in diabetic pigs (r= − 0.40 to − 0.54), with GLPS being the most significant. Electron microscopy and Masson staining showed that myocardial damage and fibrosis gradually increased with the progression of the disease. Conclusion Intravenous injection of STZ can induce a porcine diabetic cardiomyopathy model, mainly characterized by decreased LV diastolic function and strain changes accompanied by myocardial remodelling. The changes in CMR biomarkers could reflect the early myocardial injury of diabetic cardiomyopathy.
- Published
- 2023
- Full Text
- View/download PDF
14. Global, segmental and layer specific analysis of myocardial involvement in Duchenne muscular dystrophy by cardiovascular magnetic resonance native T1 mapping
- Author
-
Ke Xu, Hua-yan Xu, Rong Xu, Lin-jun Xie, Zhi-gang Yang, Li Yu, Bin Zhou, Hang Fu, Hui Liu, Xiao-tang Cai, and Ying-kun Guo
- Subjects
Duchenne muscular dystrophy ,Cardiovascular magnetic resonance ,Native T1 mapping ,Cardiomyopathy ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Progressive cardiomyopathy accounts for almost all mortality among Duchenne muscular dystrophy (DMD) patients. Thus, our aim was to comprehensively characterize myocardial involvement by investigating the heterogeneity of native T1 mapping in DMD patients using global and regional (including segmental and layer-specific) analysis across a large cohort. Methods We prospectively enrolled 99 DMD patients (8.8 ± 2.5 years) and 25 matched male healthy controls (9.5 ± 2.5 years). All subjects underwent cardiovascular magnetic resonance (CMR) with cine, T1 mapping and late gadolinium enhancement (LGE) sequences. Native T1 values based on the global and regional myocardium were measured, and LGE was defined. Results LGE was present in 49 (49%) DMD patients. Global native T1 values were significantly longer in LGE-positive (LGE +) patients than in healthy controls, both in basal slices (1304 ± 55 vs. 1246 ± 27 ms, p
- Published
- 2021
- Full Text
- View/download PDF
15. Impact of myocardial scars on left ventricular deformation in type 2 diabetes mellitus after myocardial infarction by contrast-enhanced cardiac magnetic resonance
- Author
-
Yue Gao, Hua-yan Xu, Ying-kun Guo, Xiao-ling Wen, Rui Shi, Yuan Li, and Zhi-gang Yang
- Subjects
Diabetic cardiomyopathy ,Myocardial infarction ,Myocardial scar ,Cardiac magnetic resonance ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluate myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of myocardial scar on left ventricular (LV) deformation. Methods Overall, 202 T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI−)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR), were compared among these groups. Correlation and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation. Results Decreases were observed in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Reduced LV deformation (p
- Published
- 2021
- Full Text
- View/download PDF
16. The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction
- Author
-
Qing Zou, Rong Xu, Xiao Li, Hua-yan Xu, Zhi-gang Yang, Yi-ning Wang, Hai-ming Fan, and Ying-kun Guo
- Subjects
Medicine ,Science - Abstract
Abstract This study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P
- Published
- 2021
- Full Text
- View/download PDF
17. RETRACTED ARTICLE: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging
- Author
-
Hua-yan Xu, Zhi-gang Yang, Yi Zhang, Wan-lin Peng, Chun-chao Xia, Zhen-lin Li, Yong He, Rong Xu, Li Rao, Ying Peng, Yu-ming Li, Hong-ling Gao, and Ying-kun Guo
- Subjects
End stage renal disease ,Myocardial fibrosis ,Cardiac magnetic resonance ,T1 mapping ,ECV ,Heart failure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background End-stage renal disease (ESRD) patients are at high cardiovascular risk, and myocardial fibrosis (MF) accounts for most of their cardiac events. The purpose of this study is to investigate the prognostic value and risk stratification of MF as measured by extracellular volume (ECV) on cardiac magnetic resonance (CMR) for heart failure (HF) in patients with hemodialysis-dependent ESRD. Methods Sixty-six hemodialysis ESRD patients and 25 matched healthy volunteers were prospectively enrolled and underwent CMR to quantify multiple parameters of MF by T1 mapping and late gadolinium enhancement (LGE). All ESRD patients were followed up for 11–30 months, and the end-point met the 2016 ESC guidelines for the definition of HF. Results Over a median follow-up of 18 months (range 11–30 months), there were 26 (39.39%) guideline-diagnosed HF patients in the entire cohort of ESRD subjects. The native T1 value was elongated, and ECV was enlarged in the HF cohort relative to the non-HF cohort and normal controls (native T1, 1360.10 ± 50.14 ms, 1319.39 ± 55.44 ms and 1276.35 ± 56.56 ms; ECV, 35.42 ± 4.42%, 31.85 ± 3.01% and 26.97 ± 1.87%; all p
- Published
- 2020
- Full Text
- View/download PDF
18. Prognostic value of dual-source computed tomography (DSCT) angiography characteristics in anomalous coronary artery from the opposite sinus (ACAOS) patients: a large-scale retrospective study
- Author
-
Kai-yue Diao, Qin Zhao, Yue Gao, Ke Shi, Min Ma, Hua-yan Xu, Ying-kun Guo, and Zhi-gang Yang
- Subjects
Coronary vessel anomalies ,Computed tomography angiography ,Congenital abnormalities ,Diagnosis ,Prognostic factor ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Most reported cases of right anomalous coronary artery from the opposite sinus (R-ACAOS) have benign clinical outcomes. However, patients with left ACAOS (L-ACAOS) and some of the patients with R-ACAOS are more at risk for arrhythmias and sudden cardiac death, which remains a major concern. Here we report the prevalence and anatomical features of ACAOS patients. Moreover, we explore the high-risk morphological signs and evaluate their mid-term prognostic value in R-ACAOS patients without surgical intervention. Methods Data from coronary computed tomography angiography (CTA) of 30,593 patients, pertaining to a single center over 5 consecutive years, were retrospectively analyzed. The image analysis included stenosis severity ranking and high-risk anatomy evaluation, based on the commercially available image post-processing software OsirX. Patients with R-ACAOS and without evidence of coronary atherosclerosis (CAD) were followed-up, with recording of the cardiovascular clinical events. Cox regression analysis was performed to identify the potential anatomical risk factors of cardiovascular clinical events for non-CAD R-ACAOS patients, using R project. Results The prevalence of ACAOS in the study population was 0.69% (211/30593). Significant differences were found between patients with mild ( 50%) stenosis, in terms of height-to-weight ratio (HW ratio), take-off angle, and proximal stenosis length. A total of 54 cardiovascular clinical events were observed among 108 non-CAD R-ACAOS patients and an average follow-up of 27.8 ± 18.7 months. Among those patients’ anatomical features, stenosis severity was the main risk factor for cardiovascular clinical events during the mid-term follow-up, with a risk ratio of 4.14 (95% CI: 1.78 to 9.63, P
- Published
- 2020
- Full Text
- View/download PDF
19. Association of myocardial fibrosis detected by late gadolinium-enhanced MRI with clinical outcomes in patients with diabetes: a systematic review and meta-analysis
- Author
-
Hang Fu, Hui Liu, Hong Li, Lu Zhang, Rong Xu, Zhi-gang Yang, Jia-rong Wang, Hua-yan Xu, Ling-jun Xie, Meng-xi Yang, Ling-yi Wen, and Ying-kun Guo
- Subjects
Medicine - Published
- 2022
- Full Text
- View/download PDF
20. Distinguishing Cardiac Amyloidosis and Hypertrophic Cardiomyopathy by Thickness and Myocardial Deformation of the Right Ventricle
- Author
-
Hui Liu, Peng Bai, Hua-Yan Xu, Zhen-Lin Li, Chun-Chao Xia, Xiao-Yue Zhou, Liang-Geng Gong, and Ying-Kun Guo
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives. To compare right ventricular thickness (RVT) and deformation of cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) patients. Methods. Sixty CA (mean age 58 ± 10 years; 33 males (55%)) and sixty HCM patients (mean age 55 ± 14 years; 27 males (45%)) were retrospectively enrolled. RVT, global radical peak strain (GRPS), global longitudinal peak strain (GLPS), and global circumferential peak stain (GCPS) were analyzed. To determine the cutoff values of the RVT and RV strain parameters for distinguishing CA from HCM, the areas under the receiver operating characteristic curve (AUCs) were analyzed. Results. RVT of CA patients was significantly thicker than that of HCM patients (7.8 ± 2.1 vs 5.9 ± 1.3, p
- Published
- 2022
- Full Text
- View/download PDF
21. Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study
- Author
-
Xi Liu, Zhi-gang Yang, Yue Gao, Lin-jun Xie, Li Jiang, Bi-yue Hu, Kai-yue Diao, Ke Shi, Hua-yan Xu, Meng-ting Shen, Yan Ren, and Ying-kun Guo
- Subjects
Type 2 diabetes mellitus ,Cardiac magnetic resonance ,Subclinical myocardial dysfunction ,Myocardial perfusion ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Early detection of subclinical myocardial dysfunction in patients with diabetes mellitus (DM) is essential for recommending therapeutic interventions that can prevent or reverse heart failure, thereby improving the prognosis in such patients. This study aims to quantitatively evaluate left ventricular (LV) myocardial deformation and perfusion using cardiovascular magnetic resonance (CMR) imaging in patients with type 2 diabetes mellitus (T2DM), and to investigate the association between LV subclinical myocardial dysfunction and coronary microvascular perfusion. Methods We recruited 71 T2DM patients and 30 healthy individuals as controls who underwent CMR examination. The T2DM patients were subdivided into two groups, namely the newly diagnosed DM group (n = 31, patients with diabetes for ≤ 5 years) and longer-term DM group (n = 40, patients with diabetes > 5 years). LV deformation parameters, including global peak strain (PS), peak systolic strain rate, and peak diastolic strain rate (PSDR), and myocardial perfusion parameters such as upslope, time to maximum signal intensity (TTM), and max signal intensity (Max SI, were measured and compared among the three groups. Pearson’s correlation was used to evaluate the correlation between LV deformation and perfusion parameters. Results Pooled data from T2DM patients showed a decrease in global longitudinal, circumferential, and radial PDSR compared to healthy individuals, apart from lower upslope. In addition, increased TTM and reduced Max SI were found in the longer-term diabetics compared to the normal subjects (p
- Published
- 2018
- Full Text
- View/download PDF
22. Predictors of aortic dilation in patients with coarctation of the aorta: evaluation with dual-source computed tomography
- Author
-
Qin Zhao, Ke Shi, Zhi-gang Yang, Kai-yue Diao, Hua-yan Xu, Xi Liu, and Ying-kun Guo
- Subjects
Coarctation of the aorta ,Aortic dilation ,Aorta ,Dual-source computed tomography ,Degree of coarctation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Coarctation of aorta (CoA) may progressively develop aortic dilation at other site of the aorta and can lead to fatal aortic diseases. We aimed to evaluate the occurrence of aortic dilation and related predictors in patients with CoA using dual-source computed tomography (DSCT). Methods Fifty-three patients with CoA identified by DSCT were retrospectively reviewed. Aortic diameters were measured at six different levels and standardized as z-scores based on the square root of body surface area. Coarctation site–diaphragm ratio (CDR) was used to describe the degree of narrowing. A total of 26 patients were included in mild group (CDR > 50%) and 27 in severe group (CDR
- Published
- 2018
- Full Text
- View/download PDF
23. Computed tomography for evaluating right ventricle and pulmonary artery in pediatric tetralogy of Fallot: correlation with post-operative pulmonary regurgitation
- Author
-
Yue Gao, Zhi-gang Yang, Ke Shi, Kai-yue Diao, Hua-yan Xu, and Ying-kun Guo
- Subjects
Medicine ,Science - Abstract
Abstract Pulmonary regurgitation (PR) is the most common complication after tetralogy of Fallot (TOF) surgical repair, and long-term PR might result in cardiovascular events. The aim of this study was to assess the influence of pre-operative right ventricle (RV) and pulmonary artery (PA) parameters assessed by dual-source computed tomography on post-operative PR. A total of 41 TOF patients who underwent trans-valve surgical repair were retrospectively recruited. The RV and PA parameters evaluated by pre-operative DSCT were compared between the PR and non-PR groups. Our result revealed that the PA parameters (McGoon ratio, Nakata index, and LPA diameter) and RV parameters (RV length diameter and RV short diameter) all showed significant differences between the two groups (all p
- Published
- 2018
- Full Text
- View/download PDF
24. Assessment of tetralogy of Fallot–associated congenital extracardiac vascular anomalies in pediatric patients using low-dose dual-source computed tomography
- Author
-
Bi-yue Hu, Ke Shi, Yu-Ping Deng, Kai-Yue Diao, Hua-Yan Xu, Rui Li, Zhi-Gang Yang, and Ying-Kun Guo
- Subjects
Tetralogy of Fallot ,Dual-source computed tomography ,Pediatrics ,Radiation dosing ,Extracardiac vascular anomalies ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background To investigate the diagnostic value of dual-source computed tomography (DSCT) in the evaluation of tetralogy of Fallot (TOF)-associated extracardiac vascular abnormalities in pediatric patients compared with transthoracic echocardiography (TTE). Methods One hundred and twenty-three pediatric patients diagnosed with TOF were included in this retrospective study. All patients underwent DSCT and TTE preoperatively. All associated extracardiac vascular abnormalities and their percentages were recorded. The diagnostic performances of DSCT and TTE were compared based on the surgical results. The image quality of DSCT was rated, and the effective radiation dose (ED) was calculated. Results A total of 159 associated extracardiac vascular deformities were confirmed by surgery. Patent ductus arteriosus (36, 22.64%), right-sided aortic arch (29, 18.24%), and pulmonary valve stenosis (23, 14.47%) were the most common associated extracardiac vascular abnormalities. DSCT was superior to TTE in demonstrating associated extracardiac anomalies (diagnostic accuracy: 99.13% vs. 97.39%; sensitivity: 92.45% vs. 77.07%; specificity: 99.81% vs. 99.42%). The agreement on grading the image quality of DSCT was excellent (κ = 0.80), and the mean score of the image quality was 3.39 ± 0.50. The mean ED of DSCT was 0.86 ± 0.47 mSv. Conclusions Compared to TTE, low-dose DSCT has high diagnostic accuracy in the depiction of associated extracardiac vascular anomalies in pediatric patients with TOF, and could provide more morphological details for surgeons.
- Published
- 2017
- Full Text
- View/download PDF
25. Myocardial Deformation in Cardiac Amyloid Light-chain Amyloidosis: Assessed with 3T Cardiovascular Magnetic Resonance Feature Tracking
- Author
-
Rui Li, Zhi-gang Yang, Hua-yan Xu, Ke Shi, Xi Liu, Kai-yue Diao, and Ying-kun Guo
- Subjects
Medicine ,Science - Abstract
Abstract Clinically, assessment of myocardial function is essential in patients with amyloid light-chain cardiac amyloidosis (AL-CA) to predict outcome and determine therapeutic approach. The aim of this study was to investigate the feasibility of cardiovascular magnetic resonance (CMR)-derived feature tracking algorithm for assessing left ventricular (LV) myocardial deformation in AL-CA, and to determine if these abnormal myocardial deformation parameters are correlated to impaired LV myocardial microvascular dysfunction. A total of 42 AL-CA patients, including 26 with preserved systolic function and 16 with impaired LVEF, and 35 healthy controls were enrolled and underwent CMR examination. Our result indicated that AL-CA patients had significantly reduced global peak strain (PS) (longitudinal, circumferential, and radial) (all P
- Published
- 2017
- Full Text
- View/download PDF
26. Volume-time curve of cardiac magnetic resonance assessed left ventricular dysfunction in coronary artery disease patients with type 2 diabetes mellitus
- Author
-
Hua-yan Xu, Zhi-gang Yang, Ying-kun Guo, Ke Shi, Xi Liu, Qin Zhang, Li Jiang, and Lin-jun Xie
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Type 2 diabetes mellitus (DM2) may induce epicardial coronary artery diseases and left ventricular myocardial damaging as well. Left ventricular dysfunction was found in DM2. In this research, we compared the left ventricular dysfunction of coronary artery disease (CAD) patients with and without type 2 diabetes mellitus as well as normal controls using the volume-time curve of cardiac magnetic resonance (CMR). Methods Sixty-one CAD patients (28 with DM2 and 33 without DM2) and 18 normal individuals were enrolled in this study. Left ventricular function parameters, including the end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV) and ejection fraction (EF), and morphologic dimension parameters (end diastolic and systolic diameter (EDD and ESD), were measured and compared. Volume-time curve parameters, including the peak ejection rate (PER), peak ejection time (PET), peak filling rate (PFR), peak filling time from ES (PFT), peak ejection rate normalized to EDV (PER/EDV), and peak filling rate normalized to EDV (PFR/EDV), were derived automatically and compared. Results LVEF in the diabetic CAD group was markedly reduced when compared to the normal and CAD without DM2 groups (all p 166.0 msec). Higher sensitivity (87.5%) and specificity (100.0%) were obtained for PFR/EDV (criterion ≤3.7EDV/s). Conclusions Parameters that are derived from the volume-time curve on CMR, including PET, PFT and PFR/EDV, allow clinicians to predict left ventricular dysfunction in diabetic CAD subjects with a high degree of sensitivity and specificity.
- Published
- 2017
- Full Text
- View/download PDF
27. Retraction Note: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging
- Author
-
Hua-yan Xu, Zhi-gang Yang, Yi Zhang, Wan-lin Peng, Chun-chao Xia, Zhen-lin Li, Yong He, Rong Xu, Li Rao, Ying Peng, Yu-ming Li, Hong-ling Gao, and Ying-kun Guo
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
An amendment to this paper has been published and can be accessed via the original article.
- Published
- 2020
- Full Text
- View/download PDF
28. Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography
- Author
-
Ge Zhang, Zhi-gang Yang, Jin Yao, Wen Deng, Shuai Zhang, Hua-yan Xu, and Qi-hua Long
- Subjects
Tuberculosis ,Leukemia ,MDCT ,Lymph node ,Abdomen ,Pelvic cavity ,Medicine (General) ,R5-920 - Abstract
PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p
- Published
- 2015
- Full Text
- View/download PDF
29. Assessment of transposition of the great arteries associated with multiple malformations using dual-source computed tomography.
- Author
-
Lin-Jun Xie, Li Jiang, Zhi-Gang Yang, Ke Shi, Hua-Yan Xu, Rui Li, Kai-Yue Diao, and Ying-Kun Guo
- Subjects
Medicine ,Science - Abstract
To determine the value of dual-source computed tomography (DSCT) in depicting the morphological characteristics and diagnosing the associated malformations for patients with transposition of the great arteries (TGA) before surgery.Twenty-five patients with TGA who underwent DSCT and transthoracic echocardiography (TTE) examination were retrospectively reviewed. The morphological types of TGA, the spatial relationship between the pulmonary artery and the aorta, as well as coronary artery-associated abnormalities were assessed by DSCT. In contrast to TTE, the diagnostic accuracy of associated malformations on DSCT were analyzed and calculated with reference to surgical or digital subtraction angiography (DSA) findings. Effective doses (EDs) were also calculated.Among the 25 patients, 12 (48%) had ventricular septal defects and left ventricular outflow tract stenosis. Sixteen patients (16/25, 64%) had great arteries with an oblique spatial relationship on DSCT. In addition, we found seven patients (7/25, 28%) with coronary artery malformation, including five with an abnormal coronary origin and two with signs of a myocardial bridge. According to DSA or surgical findings, DSCT was superior to TTE in demonstrating extracardiac anomalies (sensitivity, anomalies of great vessels: 100% vs. 93.33%, other anomalies: 100% vs. 46.15%). The mean estimated ED for those aged
- Published
- 2017
- Full Text
- View/download PDF
30. Assessment of Double Outlet Right Ventricle Associated with Multiple Malformations in Pediatric Patients Using Retrospective ECG-Gated Dual-Source Computed Tomography.
- Author
-
Ke Shi, Zhi-gang Yang, Jing Chen, Ge Zhang, Hua-yan Xu, and Ying-kun Guo
- Subjects
Medicine ,Science - Abstract
To evaluate the feasibility and diagnostic accuracy of retrospective electrocardiographically (ECG)-gated dual-source computed tomography (DSCT) for the assessment of double outlet right ventricle (DORV) and associated multiple malformations in pediatric patients.Forty-seven patients
- Published
- 2015
- Full Text
- View/download PDF
31. Assessing right ventricular function in patients with hypertrophic cardiomyopathy with cardiac MRI: correlation with the New York Heart Function Assessment (NYHA) classification.
- Author
-
Shuai Zhang, Zhi-Gang Yang, Jia-Yu Sun, Ling-Yi Wen, Hua-Yan Xu, Ge Zhang, and Ying-Kun Guo
- Subjects
Medicine ,Science - Abstract
PURPOSE: To determine whether 3.0-T magnetic resonance imaging (MRI) could assess right ventricular (RV) function in patients with hypertrophic cardiomyopathy (HCM), and if this assessment is correlated with the New York Heart Function Assessment (NYHA) classification. MATERIALS AND METHODS: Forty-six patients with HCM and 23 normal individuals were recruited. Left and right ventricular function parameters including end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV) and ejection fraction (EF) and dimensions were measured and compared using 3.0-T MRI. RV function parameters between HCM patients and controls were compared using independent sample t tests. A one way ANOVA test with Bonferroni correction was used to determine significant differences among different NYHA groups. Receiver operating characteristic analyses calculated the sensitivity and specificity of RV dysfunction on MRI for the prediction of HCM severity. RESULTS: Statistical analysis revealed significant differences of left ventricular (LV) and RV volumetric values and masses between the HCM patients and controls (all p0.05). However, significant differences between the Class IV and I-III groups (all P
- Published
- 2014
- Full Text
- View/download PDF
32. The relationship between abnormal myocardial alterations and glycemic control validated by cardiac magnetic resonance in a pig model of diabetes mellitus
- Author
-
Lu Zhang, Ying-kun Guo, Zhi-gang Yang, Li Jiang, Wei-feng Yan, and Hua-yan Xu
- Abstract
Aims To investigate the relationship between hemoglobin (HbAlc) and abnormal myocardial alterations as determined by cardiac magnetic resonance (CMR) T1 mapping and feature tracking in a pig model of diabetes mellitus (DM). Methods Eight DM models were successfully established and were divided into two groups based on their HbAlc median value (high HbAlc ≥ 6.07%, n = 5; low HbAlc 2 = 0.470 to 0.849, all p
- Published
- 2023
33. Clinical utilisation of multimodal quantitative magnetic resonance imaging in investigating muscular damage in Duchenne muscular dystrophy: a study on the association between gluteal muscle groups and motor function
- Author
-
Yu Song, Hua-yan Xu, Ke Xu, Ying-kun Guo, Lin-jun Xie, Fei Peng, Rong Xu, Hang Fu, Wei-feng Yuan, Zi-qi Zhou, Bo-chao Cheng, Chuan Fu, Hui Zhou, Xiao-tang Cai, and Xue-sheng Li
- Subjects
Pediatrics, Perinatology and Child Health ,Radiology, Nuclear Medicine and imaging - Abstract
Background Duchenne muscular dystrophy (DMD) is a neuromuscular disease characterised by progressive muscular weakness and atrophy. Currently, studies on DMD muscle function mostly focus on individual muscles; little is known regarding the effect of gluteal muscle group damage on motor function. Objective To explore potential imaging biomarkers of hip and pelvic muscle groups for measuring muscular fat replacement and inflammatory oedema in DMD with multimodal quantitative magnetic resonance imaging (MRI). Materials and methods One hundred fifty-nine DMD boys and 32 healthy male controls were prospectively included. All subjects underwent MRI examination of the hip and pelvic muscles with T1 mapping, T2 mapping and Dixon sequences. Quantitatively measured parameters included longitudinal relaxation time (T1), transverse relaxation time (T2) and fat fraction. Investigations were all based on hip and pelvic muscle groups covering flexors, extensors, adductors and abductors. The North Star Ambulatory Assessment and stair climbing tests were used to measure motor function in DMD. Results T1 of the extensors (r = 0.720, P r = 0.558, P r = 0.697, P r = -0.711, P r = -0.753, P b = 0.013, t = 2.052, P = 0.042), T2 of the adductors (b = -0.234, t = -2.554, P = 0.012) and fat fraction of the extensors (b = -0.637, t = − 4.096, P Conclusion Magnetic resonance biomarkers of hip and pelvic muscle groups (particularly T1 values of the abductor muscles) have the potential to be used as independent risk factors for motor dysfunction in DMD.
- Published
- 2023
34. Inflammation in Remote Myocardium and Left Ventricular Remodeling After Acute Myocardial Infarction: A Pilot Study Using <scp>T2</scp> Mapping
- Author
-
Ke Shi, Chuan Fu, Hong Li, Xue-Sheng Li, Hua-yan Xu, Meng-Xi Yang, Xiaoyue Zhou, Lu Zhang, Ying-kun Guo, Yong He, Z G Yang, Jun-Long Wang, Min Ma, Zhi-gang Yang, and Bin Zhou
- Subjects
medicine.medical_specialty ,Swine ,T2 mapping ,Myocardial Infarction ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Pilot Projects ,Inflammation ,Animal model ,Internal medicine ,medicine ,Animals ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Prospective Studies ,Myocardial infarction ,Ventricular remodeling ,Ventricular Remodeling ,business.industry ,Myocardium ,medicine.disease ,Pathophysiology ,Cardiology ,Analysis of variance ,medicine.symptom ,business - Abstract
BACKGROUND The pathophysiological changes in the remote myocardium after acute myocardial infarction (MI) remains less understood. PURPOSE To assess the inflammation in the remote myocardium post-MI and its association with left ventricular (LV) remodeling using T2 mapping. STUDY TYPE Prospective. ANIMAL MODEL AND SUBJECTS Twelve pigs at 3-day post-MI, 6 pigs at 3-month post-MI, 6 healthy pigs; 54 patients at 3-day and 3-month post-MI, 31 healthy volunteers; FIELD STRENGTH/SEQUENCE: A 3 T MRI/ steady-state free-precession sequence for T2 mapping (animals: 0, 30, and 55 msec; human: 0, 25, and 55 msec), phase-sensitive inversion recovery gradient echo for late gadolinium enhancement (LGE), balanced steady free-precession sequence for cine. ASSESSMENT Infarcted myocardium was defined on LGE, remote T2 was measured on T2 maps. LV remodeling was evaluated as LV end-diastolic volume change index between two scans using cine. CD68 staining was conducted to detect monocyte/macrophage. STATISTICAL TESTS Student-t test and one-way ANOVA were used to compare remote T2 with normal controls. The association of remote T2 with LV remodeling was assessed using linear regression. P values of
- Published
- 2021
35. Risk stratification of cardiac sequelae detected using cardiac magnetic resonance in late convalescence at the six-month follow-up of recovered COVID-19 patients
- Author
-
Keke Hou, Rong Xu, Hua-yan Xu, Ying-kun Guo, Yongli Zheng, Nan Jiang, Hang Fu, Zhongqin Zhou, Tao Li, Lin-jun Xie, Jun Lin, Xiaoyu Niu, Tao Zeng, Bennan Zhao, Na Zhang, and Bin Kang
- Subjects
Microbiology (medical) ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Convalescence ,media_common.quotation_subject ,Follow up studies ,COVID-19 ,Risk Assessment ,Infectious Diseases ,Internal medicine ,Risk stratification ,medicine ,Humans ,Cardiac magnetic resonance ,business ,Risk assessment ,Letter to the Editor ,Follow-Up Studies ,Month follow up ,media_common - Published
- 2021
36. Effect of Obesity on Left Ventricular Remodeling and Clinical Outcome in Chinese Patients With Hypertrophic Cardiomyopathy: Assessed by Cardiac MRI
- Author
-
Ke Shi, Shan Huang, Xiang Li, Hua‐Yan Xu, Meng‐Xi Yang, Yuan Li, Ying‐Kun Guo, and Zhi‐Gang Yang
- Subjects
Radiology, Nuclear Medicine and imaging - Abstract
Obesity is highly prevalent in patients with hypertrophic cardiomyopathy (HCM) and believed to influence its phenotype.To explore the effects of obesity on left ventricular (LV) remodeling and long-term clinical course in Chinese patients with HCM.Longitudinal.A total of 247 patients with HCM classified according to body mass index (BMI) (normal weight: BMI = 18.0-22.9 kg/m3.0 T/Balanced steady-state free precession sequence and phase-sensitive inversion recovery late gadolinium enhancement (LGE) sequence.LV function and geometry were measured. LV peak strain analysis was performed. The presence and percentage of LGE in the LV were recorded. The endpoints including heart failure, sudden cardiac death, and overall composite outcome were assessed during a median follow-up of 4.1 years (interquartile range, 3.0-6.2 years).One-way analysis of variance, Kruskal-Wallis test, or chi-square test; Pearson correlation coefficient (r); multivariable linear regression analysis; Kaplan-Meier survival analysis; and Cox proportional hazards model analysis were conducted. A two-tailed P-value0.05 was considered statistically significant.Obese patients exhibited a significant progressive increase in LV mass compared with normal-weight patients. The magnitude of all LV strain indices gradually and significantly decreased as BMI increased, whereas LV ejection fraction was not significantly different among BMI groups (P = 0.364). Multivariable linear regression analysis showed that obesity had a significant association with impaired strain indices as well as with indexed LV mass. Multivariable Cox model analysis retained obesity as an independent marker for future endpoints, and conveyed a3-fold increase in risk compared with patients with normal weight (hazard ratio, 3.04; 95% confidence interval, 1.07-6.57).Obesity is an important environmental modifier that is associated with adverse LV remodeling and is independently associated with future clinical outcomes in Chinese patients with HCM.3 TECHNICAL EFFICACY: Stage 2.
- Published
- 2022
37. The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction
- Author
-
Hua-yan Xu, Haiming Fan, Yi-ning Wang, Zhi-gang Yang, Rong Xu, Ying-kun Guo, Qing Zou, and Xiao Li
- Subjects
Adult ,Cardiomyopathy, Dilated ,Male ,Cardiac function curve ,medicine.medical_specialty ,Science ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Magnetic resonance imaging ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Stage (cooking) ,End-systolic volume ,Retrospective Studies ,Mitral regurgitation ,Isolated Noncompaction of the Ventricular Myocardium ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,Myocardium ,Mitral Valve Insufficiency ,Heart ,Middle Aged ,medicine.disease ,Cardiovascular diseases ,Case-Control Studies ,Heart failure ,Cardiology ,cardiovascular system ,End-diastolic volume ,Left ventricular noncompaction ,Medicine ,Female ,business - Abstract
This study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P
- Published
- 2021
38. Prognostic value of multiple cardiac magnetic resonance imaging parameters in patients with idiopathic dilated cardiomyopathy
- Author
-
Rong Xu, Lingyi Wen, Ran Sun, Kun Zhang, Hui Liu, Hua-yan Xu, Lu Zhang, Lin-jun Xie, Hang Fu, Zhi-gang Yang, and Ying-kun Guo
- Subjects
Cardiomyopathy, Dilated ,Cardiac function curve ,medicine.medical_specialty ,medicine.medical_treatment ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Cardiac magnetic resonance imaging ,Internal medicine ,Idiopathic dilated cardiomyopathy ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,End-systolic volume ,Retrospective Studies ,Heart transplantation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Heart failure ,cardiovascular system ,Cardiology ,End-diastolic volume ,Cardiology and Cardiovascular Medicine ,business - Abstract
Our study aimed to comprehensively explore efficient prognostic indicators in idiopathic dilated cardiomyopathy (IDCM) patients with reduced left ventricular ejection fraction (LVEF40%).Prognostic value of cardiac magnetic resonance(CMR) parameters for IDCM have been inconsistent.126 IDCM patients with reduced LVEF (40%) were retrospectively enrolled. Cardiac function parameters, myocardial strain indices and myocardial fibrosis were evaluated. Laboratory data also were analyzed. The endpoint was a combination of major adverse cardiac events (MACEs), including cardiac death, heart transplantation, and rehospitalization. Prognostic value was evaluated by the Kaplan-Meier method and Cox regression.During a median follow-up of 31 months, 44 patients experienced MACEs, including 9 deaths, 1 heart transplantation, and 34 rehospitalizations due to heart failure. Univariate and multivariate Cox analyses showed that cardiac function and myocardial strain indexes were not associated with the prognosis of IDCM (all p0.05). NT-proBNP (HR 1.5, 95%CI: 1.053 to 2.137), Late‑gadolinium enhancement(LGE) mass (HR 1.022, 95%CI: 1.005 to 1.038), and LGE mass/left ventricle mass were significant predictors (HR 1.027, 95%CI: 1.007 to 1.046) for MACEs, all p 0.05. Besides, poorest prognosis was observed in IDCM patients with positive LGE combined with NT-proBNP (log-rank = 27.261, p ≤ 0.001).NT-proBNP and extent of LGE were reliable predictors in IDCM patients with reduced LVEF. Additionally, presence of LGE combined with NT-proBNP showed the strongest prognostic value in IDCM with reduced LVEF. Myocardial strain parameters seemed to have no prognostic value in IDCM patients with reduced LVEF.
- Published
- 2021
39. Myocardial perfusion assessment in the infarct core and penumbra zones in an in-vivo porcine model of the acute, sub-acute, and chronic infarction
- Author
-
Hui Liu, Lin Chen, Liu Keling, Hua-yan Xu, Hang Fu, Hong Li, Rong Xu, Chuan Fu, Meng-Xi Yang, Xiaoyue Zhou, Xue-Sheng Li, Ying-kun Guo, Zhi-gang Yang, and Lu Zhang
- Subjects
medicine.medical_specialty ,Swine ,Myocardial Infarction ,Infarction ,Perfusion scanning ,030218 nuclear medicine & medical imaging ,Microcirculation ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Coronary Circulation ,Internal medicine ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,business.industry ,Penumbra ,Myocardial Perfusion Imaging ,Microvascular Density ,General Medicine ,Blood flow ,medicine.disease ,Perfusion ,030220 oncology & carcinogenesis ,cardiovascular system ,Cardiology ,Radiology ,Tomography, X-Ray Computed ,business ,circulatory and respiratory physiology - Abstract
To assess the longitudinal changes of microvascular function in different myocardial regions after myocardial infarction (MI) using myocardial blood flow derived by dynamic CT perfusion (CTP-MBF), and compare CTP-MBF with the results of cardiac magnetic resonance (CMR) and histopathology. The CTP scanning was performed in a MI porcine model 1 day (n = 15), 7 days (n = 10), and 3 months (n = 5) following induction surgery. CTP-MBF was measured in the infarcted myocardium, penumbra, and remote myocardium, respectively. CMR perfusion and histopathology were performed for validation. From baseline to follow-up scans, CTP-MBF presented a stepwise increase in the infarcted myocardium (68.51 ± 11.04 vs. 86.73 ± 13.32 vs. 109.53 ± 26.64 ml/100 ml/min, p = 0.001) and the penumbra (104.92 ± 29.29 vs. 120.32 ± 24.74 vs. 183.01 ± 57.98 ml/100 ml/min, p = 0.008), but not in the remote myocardium (150.05 ± 35.70 vs. 166.66 ± 38.17 vs. 195.36 ± 49.64 ml/100 ml/min, p = 0.120). The CTP-MBF correlated with max slope (r = 0.584, p < 0.001), max signal intensity (r = 0.357, p < 0.001), and time to max (r = − 0.378, p < 0.001) by CMR perfusion. Moreover, CTP-MBF defined the infarcted myocardium on triphenyl tetrazolium chloride staining (AUC: 0.810, p < 0.001) and correlated with microvascular density on CD31 staining (r = 0.561, p = 0.002). CTP-MBF could quantify the longitudinal changes of microvascular function in different regions of the post-MI myocardium, which demonstrates good agreement with contemporary CMR and histopathological findings. • The CT perfusion–based myocardial blood flow (CTP-MBF) could quantify the microvascular impairment in different myocardial regions after myocardial infarction (MI) and track its recovery over time. • The assessment of CTP-MBF is in good agreement with contemporary cardiac MRI and histopathological findings, which potentially facilitates a rapid approach for pathophysiological insights following MI.
- Published
- 2020
40. Incremental prognostic value of myocardial strain over ventricular volume in patients with repaired tetralogy of Fallot
- Author
-
Li Jiang, Ying-Kun Guo, Hua-Yan Xu, Xiao Zhu, Wei-Feng Yan, Yuan Li, and Zhi-Gang Yang
- Subjects
Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
The relative incremental predictive value of myocardial deformation over ventricular volume for future adverse events in patients with repaired tetralogy of Fallot (rTOF) remains unknown. We aimed to determine the incremental prognostic value of myocardial deformation over ventricular volume to predict adverse events in patients with rToF.We retrospectively included patients with rTOF who completed cardiac magnetic resonance (CMR) and follow-up in our hospital from January 2014 to October 2020, and stratified according to the presence or absence of adverse events during follow-up. The strain parameters of the right ventricular (RV) and left ventricular (LV) were obtained from CMR-derived feature tracking. Multivariable Cox proportional hazard models and net reclassification improvement analysis were used to analyze the prognostic information of biventricular strain and volume parameters in rTOF patients.Among 98 patients with rTOF, 54 (55.1%) experienced primary and/or secondary events during a median follow-up period of 27.0 months. Univariable analysis indicated that RV volume and strain were significantly associated with both primary events and all adverse events (all p.01). Multivariable Cox regression and net reclassification improvement analyses achieved incremental global χRV and LV myocardial deformation provided incremental prognostic information and significant improvement for risk stratification over RV size and clinical variables and therefore can be combined to further enhance prognostication.• RV volume and strain were significantly associated with both primary events and all adverse events, whereas LV volume and strain were associated with primary events. • Ventricular myocardial deformation is a strong predictor of adverse outcomes of patients with repaired tetralogy of Fallot, providing increased prognostic information and significantly improved risk stratification over ventricular size.
- Published
- 2022
41. Association of myocardial fibrosis detected by late gadolinium-enhanced MRI with clinical outcomes in patients with diabetes: a systematic review and meta-analysis
- Author
-
Zhi Yang, Rong Xu, Jia-rong Wang, Hua-yan Xu, Hang Fu, Ling-jun Xie, Meng-xi Yang, Lu Zhang, Ling-yi Wen, Hui Liu, Hong Li, Zhi-gang Yang, and Ying-kun Guo
- Subjects
Myocardium ,Radiology and Imaging ,Contrast Media ,Magnetic Resonance Imaging, Cine ,diabetes & endocrinology ,Gadolinium ,General Medicine ,Prognosis ,Fibrosis ,Magnetic Resonance Imaging ,Diabetes Mellitus, Type 2 ,Predictive Value of Tests ,Humans ,Medicine ,radiology & imaging ,cardiovascular diseases ,Prospective Studies ,cardiovascular imaging ,Language - Abstract
ObjectiveThis meta-analysis assessed the associations of myocardial fibrosis detected by late gadolinium-enhanced (LGE)-MRI with the risk of major adverse cardiac and cerebrovascular events (MACCEs) and major adverse cardiac events (MACEs) in patients with diabetes.DesignSystematic review and meta-analysis reported in accordance with the guidelines of the Meta-analysis of Observational Studies in Epidemiology statement.Data sourcesWe searched the Medline, Embase and Cochrane by Ovid databases for studies published up to 27 August 2021.Eligibility criteriaProspective or respective cohort studies were included if they reported the HR and 95% CIs for MACCEs/MACEs in patients with either type 1 or 2 diabetes and LGE-MRI-detected myocardial fibrosis compared with patients without LGE-MRI-detected myocardial fibrosis and if the articles were published in the English language.Data extraction and synthesisTwo review authors independently extracted data and assessed the quality of the included studies. Pooled HRs and 95% CIs were analysed using a random effects model. Heterogeneity was assessed using forest plots and I2 statistics.ResultsEight studies with 1121 patients with type 1 or type 2 diabetes were included in this meta-analysis, and the follow-up ranged from 17 to 70 months. The presence of myocardial fibrosis detected by LGE-MRI was associated with an increased risk for MACCEs (HR: 2.58; 95% CI 1.42 to 4.71; p=0.002) and MACEs (HR: 5.28; 95% CI 3.20 to 8.70; pConclusionsThis study demonstrated that ischaemic myocardial fibrosis detected by LGE-MRI was associated with an increased risk of MACCEs/MACEs in patients with diabetes and may be an imaging biomarker for risk stratification. Whether LGE-MRI provides incremental prognostic information with respect to MACCEs/MACEs over risk stratification by conventional cardiovascular risk factors requires further study.
- Published
- 2022
42. Quantitative assessment of left ventricular myocardial involvement in patients with connective tissue disease: a 3.0T contrast-enhanced cardiovascular magnetic resonance study
- Author
-
Jin Wang, Yue Gao, Zhi-Gang Yang, Ying-Kun Guo, Li Jiang, Rui Shi, Hua-Yan Xu, Shan Huang, and Yuan Li
- Subjects
Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Abstract
The aim of this study was to evaluate left ventricular (LV) myocardial involvement in connective tissue disease (CTD) patients using multiparemetric imaging derived from cardiovascular magnetic resonance (CMR). CMR was performed on 146 CTD patients (comprising of 74 with idiopathic inflammatory myopathy (IIM) and 72 with non-IIM) and 72 healthy controls and included measures of LV global strains [including peak strain (PS), peak systolic (PSSR) and diastolic strain rate (PDSR)], myocardial perfusion [including upslope, max signal intensity (MaxSI), and time to maximum signal intensity (TTM)], and late gadolinium enhancement (LGE) parameters. Univariable and multivariable linear regression analyses were performed to determine the association between LV deformation and microvascular perfusion, as well as LGE. Our results indicated that CTD patients had decreased global longitudinal PS (GLPS), PSSR, PDSR, and myocardial perfusion (all p
- Published
- 2021
43. Global, segmental and layer specific analysis of myocardial involvement in Duchenne muscular dystrophy by cardiovascular magnetic resonance native T1 mapping
- Author
-
Hua-yan Xu, Xiao-tang Cai, Hang Fu, Bin Zhou, Rong Xu, Lin-jun Xie, Ying-kun Guo, Zhi-gang Yang, Hui Liu, Ke Xu, and Li Yu
- Subjects
Male ,Duchenne muscular dystrophy ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Native T1 mapping ,Cardiomyopathy ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Basal (phylogenetics) ,Predictive Value of Tests ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Late gadolinium enhancement ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Angiology ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Myocardium ,Research ,Area under the curve ,Magnetic resonance imaging ,medicine.disease ,Muscular Dystrophy, Duchenne ,RC666-701 ,Cardiology ,Cardiovascular magnetic resonance ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Progressive cardiomyopathy accounts for almost all mortality among Duchenne muscular dystrophy (DMD) patients. Thus, our aim was to comprehensively characterize myocardial involvement by investigating the heterogeneity of native T1 mapping in DMD patients using global and regional (including segmental and layer-specific) analysis across a large cohort. Methods We prospectively enrolled 99 DMD patients (8.8 ± 2.5 years) and 25 matched male healthy controls (9.5 ± 2.5 years). All subjects underwent cardiovascular magnetic resonance (CMR) with cine, T1 mapping and late gadolinium enhancement (LGE) sequences. Native T1 values based on the global and regional myocardium were measured, and LGE was defined. Results LGE was present in 49 (49%) DMD patients. Global native T1 values were significantly longer in LGE-positive (LGE +) patients than in healthy controls, both in basal slices (1304 ± 55 vs. 1246 ± 27 ms, p Conclusions Myocardial regional native T1, particularly epicardial native T1, seems to have potential as a novel robust marker of very early cardiac involvement in DMD patients. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) ChiCTR1800018340, 09/12/2018, Retrospectively registered.
- Published
- 2021
44. Impact of myocardial scars on left ventricular deformation in type 2 diabetes mellitus after myocardial infarction by contrast-enhanced cardiac magnetic resonance
- Author
-
Hua-yan Xu, Xiao-ling Wen, Ying-kun Guo, Yuan Li, Yue Gao, Zhi-gang Yang, and Rui Shi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cardiac magnetic resonance ,Diabetic Cardiomyopathies ,Endocrinology, Diabetes and Metabolism ,Diastole ,Myocardial Infarction ,Infarction ,Scars ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Diabetic cardiomyopathy ,Risk Assessment ,Ventricular Function, Left ,Coronary artery disease ,Meglumine ,Predictive Value of Tests ,Internal medicine ,Myocardial scarring ,medicine ,Organometallic Compounds ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Myocardial infarction ,Angiology ,Original Investigation ,Aged ,Retrospective Studies ,business.industry ,Myocardium ,Middle Aged ,medicine.disease ,Prognosis ,Myocardial scar ,Diabetes Mellitus, Type 2 ,Heart Disease Risk Factors ,RC666-701 ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluate myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of myocardial scar on left ventricular (LV) deformation. Methods Overall, 202 T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI−)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR), were compared among these groups. Correlation and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation. Results Decreases were observed in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Reduced LV deformation (p p p p 2 = 0.37) and circumferential PS (β = 0.339 and β = 0.530, respectively, all p 2 = 0.41), LV anterior wall infarction was independently associated with LV global longitudinal PS (β = 0.398, p = 0.006). Conclusions The myocardial scarring size in T2DM patients after MI is negatively correlated with LV global PS and PSSR, particularly in the circumferential direction. Additionally, different MI regions have different effects on the reduction of LV deformation, and relevant clinical evaluations should be strengthened.
- Published
- 2021
45. Dynamic forecasting and optimal scheduling of by-product gases in integrated iron and steel works
- Author
-
Bo-yang Yu, Jia-lin Ma, Qi Zhang, Hui Li, Gang Wang, Shan Jiang, and Hua-yan Xu
- Subjects
010302 applied physics ,Power station ,business.industry ,Total cost ,0211 other engineering and technologies ,Metals and Alloys ,Boiler (power generation) ,Environmental pollution ,02 engineering and technology ,01 natural sciences ,Steelmaking ,Mechanics of Materials ,Gas holder ,0103 physical sciences ,Least squares support vector machine ,Materials Chemistry ,Electricity ,business ,Process engineering ,021102 mining & metallurgy - Abstract
The by-product gases, which are generated in ironmaking, coking and steelmaking processes, can be used as fuel for the metallurgical processes and on-site power plants. However, if the supply and demand of by-product gases are imbalanced, gas flaring may occur, leading to energy wastage and environmental pollution. Therefore, optimal scheduling of by-product gases is important in iron and steel works. A BP_LSSVM model, which combines back-propagation (BP) neural network and least squares support vector machine (LSSVM), and an improved mixed integer linear programming model were proposed to forecast the surplus gases and allocate them optimally. To maximize energy utilization, the stability of gas holders and boilers was considered and a concise heuristic procedure was proposed to assign penalties for boilers and gas holders. Moreover, the optimal level of gas holder was studied to enhance the stability of the gas system. Compared to the manual operation, the optimal results showed that the electricity generated by the power plant increased by 2.93% in normal condition and by 22.2% in overhaul condition. The proposed model minimizes the total cost by optimizing the boiler load with less adjustment frequency and the stability of gas holders and can be used as a guidance in dynamic forecasting and optimal scheduling of by-product gases in integrated iron and steel works.
- Published
- 2019
46. Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis
- Author
-
Lin-jun Xie, Zuguang Yang, W.F. Yan, Lingyi Wen, X.D. Wang, Haiyan Fu, Rui-Hua Xu, Hua-yan Xu, Ying-kun Guo, and Ke Xu
- Subjects
Correlation coefficient ,Doppler echocardiography ,symbols.namesake ,Thoracic Arteries ,Cardiac valve ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Magnetic resonance imaging ,General Medicine ,Heart Valves ,Magnetic Resonance Imaging ,Flow (mathematics) ,Great arteries ,Cardiovascular Diseases ,Echocardiography ,Meta-analysis ,symbols ,business ,Nuclear medicine ,Doppler effect ,Blood Flow Velocity - Abstract
AIM To objectively examine the agreement and correlation between four-dimensional (4D) flow magnetic resonance imaging (MRI) and traditional two-dimensional (2D) phase-contrast (PC) MRI with the reference standard of Doppler echocardiography for measuring peak blood velocity at the cardiac valve and great arteries, and to assess if 4D flow MRI offers an advantage over the traditional 2D method. MATERIALS AND METHODS The literature was searched systematically for studies that evaluate the degree of correlation and agreement between 4D flow MRI or 2D PC MRI and Doppler retrieved from PubMed, EMBASE, and the Cochrane Library. A meta-analysis was conducted to determine the peak velocity pooled bias with 95% limits of agreement (LoA) and correlation coefficient (r) for 4D flow MRI and 2D PC MRI compared with Doppler. RESULTS Ten studies that compared 4D flow MRI with Doppler and 12 studies that compared 2D PC MRI with Doppler were included. 4D flow MRI showed an underestimation with bias and 95% LoA of -0.09 (-0.41, 0.24) m/s (p=0.079) while 2D PC MRI showed a poorer agreement with a bias and 95% LoA of -0.25 (-0.53, 0.03), p=0.596. 4D flow MRI and 2D PC MRI showed a strong correlation with R=0.80 (95% CI 0.75, 0.84; p
- Published
- 2021
47. Chest CT features and progression of patients with coronavirus disease 2019
- Author
-
Hang Fu, Ying-kun Guo, Hui Liu, Hua-yan Xu, Rong Xu, Zhongqin Zhou, Ming Yang, Keke Hou, Lin-jun Xie, and Zhen-Lin Li
- Subjects
Adult ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,macromolecular substances ,030204 cardiovascular system & hematology ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Betacoronavirus ,Young Adult ,0302 clinical medicine ,Internal medicine ,Pandemic ,Severity of illness ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Young adult ,Lung ,Pandemics ,Aged ,Retrospective Studies ,biology ,Full Paper ,business.industry ,SARS-CoV-2 ,Public health ,COVID-19 ,Reproducibility of Results ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,biology.organism_classification ,Pneumonia ,Disease Progression ,Female ,business ,Coronavirus Infections ,Tomography, X-Ray Computed - Abstract
Objectives: Coronavirus disease 2019 (COVID-19) is a major public health emergency. It poses a grave threat to human life and health. The purpose of the study is to investigate the chest CT findings and progression of the disease observed in COVID-19 patients. Methods: Forty-nine confirmed cases of adult COVID-19 patients with common type, severe and critically severe type were included in this retrospective single-center study. The thin-section chest CT features and progress of the disease were evaluated. The clinical and chest imaging findings of COVID-19 patients with different severity types were compared. The CT severity score and MuLBSTA score (a prediction of mortality risk) were calculated in those patients. Results: Among the 49 patients, 35 patients (71%) were common type and 14 patients (28%) were severe and critically severe type. Nearly all patients (98%) had pure ground-glass opacities (GGO) in CT imaging. Of the severe and critically severe type patients, 86% exhibited GGO with consolidation, in comparison with 54% of the patients with common type. Fibrosis presented in 79% of the severe and critically severe type patients and 43% of the common type patients. The severe and critically severe type patients were significantly more prone to experience five-lobe involvement compared to the common type patients (p = 0.002). The severe and critically severe type patients also had higher CT severity and MuLBSTA scores than the common type patients (5.43 ± 2.38 vs 3.37 ± 2.40, p < 0.001;and 10.21 ± 3.83 vs 4.63 ± 3.43, p < 0.001, respectively). MuLBSTA score was positively correlated with admittance to the intensive care unit (p = 0.005, r = 0.351). Nineteen patients underwent three times CT scan. The interval between first and second CT scan was 4[4,8] days, second and third was 3[2,4] days. There were greater improvements in the third CT follow-up findings compared to the second (p = 0.002). Conclusions: The severe and critically severe type patients often experienced more severe lung lesions, including GGO with consolidation. The CT severity score and MuLBSTA score may be helpful for the assessment of COVID-19 severity and progression. Advances in knowledge: Chest CT has the value of evaluated radiographical features of COVID-19 and allow for dynamic observation of the disease progression. Considering coagulation disorder of COVID-19, MuLBSTA score may need to be updated to increase new understanding of COVID-19.
- Published
- 2020
48. Utility of single-shot compressed sensing cardiac magnetic resonance cine imaging for assessment of biventricular function in free-breathing and arrhythmic pediatric patients
- Author
-
Rong Xu, Chuan Fu, Ying-kun Guo, Zhi-gang Yang, Qing Zou, Hua-yan Xu, Meng-Xi Yang, and Xiaoyue Zhou
- Subjects
Magnetic Resonance Spectroscopy ,Image quality ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Pediatrics ,Breath Holding ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,Medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Child ,End-systolic volume ,Ejection fraction ,business.industry ,Reproducibility of Results ,Stroke volume ,Magnetic Resonance Imaging ,Compressed sensing ,cardiovascular system ,End-diastolic volume ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Cardiac magnetic resonance ,Free breathing ,circulatory and respiratory physiology - Abstract
This study aimed to explore the feasibility and accuracy of single-shot compressed-sensing (CS) cardiac magnetic resonance cine technology for the assessment of biventricular function and morphology in free-breathing (FB) pediatrics, especially those with arrhythmia.Seventy consecutive pediatric participants (6.27 ± 3.8 years, range:0.5-14 years) were enrolled between August 2019 and July 2020. Single-shot CS and conventional balanced steady-state free-precession (bSSFP) cine were obtained. The total scanning time, image quality and biventricular function parameters were compared for both sequences.Single-shot CS cine had shorter acquisition time compared with the conventional bSSFP cine (all P0.001). The single-shot CS cine also had fewer artifacts than conventional bSSFP cine (breath-hold (BH): 4.6 ± 0.6 vs. 4.3 ± 0.6; FB without ongoing arrhythmia: 4.5 ± 0.6 vs. 3.6 ± 0.9; FB with ongoing arrhythmia: 4.7 ± 0.5 vs. 2.6 ± 1.1; all P0.05). No statistical difference of left ventricular parameters and right ventricular end-systolic volume/ejection fraction were found between the single-shot CS and conventional bSSFP cine in both BH and FB without ongoing arrhythmia group. There was an excellent correlation (RThe single-shot CS cine can significantly reduce the image acquisition time, offering reliable quantification of biventricular function in free breathing condition for arrhythmic patients.
- Published
- 2020
49. Clinical Characteristics and Risk Factors of Cardiac Involvement in COVID‐19
- Author
-
Ying-kun Guo, Keke Hou, Hang Fu, Hua-yan Xu, Rong Xu, Lingyi Wen, Lin-jun Xie, Na Zhang, Zhen-Lin Li, Zhi-gang Yang, Ming Yang, Joseph B. Selvanayagam, and Hui Liu
- Subjects
Male ,Comorbidity ,030204 cardiovascular system & hematology ,Severity of Illness Index ,0302 clinical medicine ,Risk Factors ,030212 general & internal medicine ,Original Research ,Aged, 80 and over ,medicine.diagnostic_test ,Age Factors ,Middle Aged ,Prognosis ,Up-Regulation ,C-Reactive Protein ,risk factor ,Host-Pathogen Interactions ,Female ,Cardiology and Cardiovascular Medicine ,Coronavirus Infections ,Adult ,medicine.medical_specialty ,China ,acute cardiac injury ,Heart Diseases ,Cardiac marker ,Pneumonia, Viral ,Risk Assessment ,03 medical and health sciences ,Betacoronavirus ,Young Adult ,COVID‐19 ,Predictive Value of Tests ,Diabetes mellitus ,Internal medicine ,Severity of illness ,medicine ,cardiac involvement ,Humans ,Risk factor ,Pandemics ,Aged ,Retrospective Studies ,Heart Failure ,Inflammation ,business.industry ,SARS-CoV-2 ,Inflammatory Heart Disease ,COVID-19 ,Retrospective cohort study ,medicine.disease ,business ,Electrocardiography ,Biomarkers ,Kidney disease - Abstract
Background Increasing studies demonstrated that the cardiac involvements are related to coronavirus disease 2019 (COVID‐19). Thus, we investigated the clinical characteristics of patients with COVID‐19 and further determined the risk factors for cardiac involvement in them. Methods and Results We analyzed data from 102 consecutive laboratory‐confirmed and hospitalized patients with COVID‐19 (52 women aged 19–87 years). Epidemiologic and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury, with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvement was found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormalities (n=23), echocardiography abnormalities (n=59), elevated myocardial enzymes (n=55), and acute cardiac injury (n=9). Eight patients with acute cardiac injury were aged >60 years; seven of them had ≥2 underlying comorbidities (hypertension, diabetes mellitus, cardiovascular diseases, chronic obstructive pulmonary disease, and chronic kidney disease). Novel coronavirus pneumonia was much more severe in the patients with acute cardiac injury than in patients with nondefinite acute cardiac injury ( P Conclusions Cardiac involvements are common in patients with COVID‐19. Elevated CRP levels, old age, underlying comorbidities, and novel coronavirus pneumonia severity are the main risk factors for cardiac involvement in patients with COVID‐19. More attention should be given to cardiovascular protection during COVID‐19 treatment for mortality reduction. Registration URL: https://www.chictr.org ; Unique identifier: ChiCTR2000029955.
- Published
- 2020
50. Performance of Two Risk-Stratification Models in Hospitalized Patients With Coronavirus Disease
- Author
-
Ran Sun, Ming Yang, Rong Xu, Lingyi Wen, Hui Liu, Zhi-gang Yang, Hang Fu, Ying-kun Guo, Lin-jun Xie, Kun Zhang, Keke Hou, Hua-yan Xu, and Na Zhang
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Respiratory rate ,Disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,Epidemiology ,medicine ,MuLBSTA score ,030212 general & internal medicine ,Survival analysis ,Original Research ,lcsh:R5-920 ,risk-stratification ,business.industry ,Area under the curve ,General Medicine ,medicine.disease ,Intensive care unit ,CURB65 score ,030104 developmental biology ,Blood pressure ,coronavirus disease ,ICU ,Coinfection ,Medicine ,lcsh:Medicine (General) ,business - Abstract
Background: Despite an increase in the familiarity of the medical community with the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19), there is presently a lack of rapid and effective risk stratification indicators to predict the poor clinical outcomes of COVID-19 especially in severe patients. Methods: In this retrospective single-center study, we included 117 cases confirmed with COVID-19. The clinical, laboratory, and imaging features were collected and analyzed during admission. The Multi-lobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension and Age (MuLBSTA) Score and Confusion, Urea, Respiratory rate, Blood pressure, Age 65 (CURB65) score were used to assess the death and intensive care unit (ICU) risks in all patients. Results: Among of all 117 hospitalized patients, 21 (17.9%) patients were admitted to the ICU care, and 5 (4.3%) patients were died. The median hospital stay was 12 (10–15) days. There were 18 patients with MuLBSTA score ≥ 12 points and were all of severe type. In severe type, ICU care and death patients, the proportion with MuLBSTA ≥ 12 points were greater than that of CURB65 score ≥ 3 points (severe type patients, 50 vs. 27.8%; ICU care, 61.9 vs. 19.0%; death, 100 vs. 40%). For the MuLBSTA score, the ROC curve showed good efficiency of diagnosis death (area under the curve [AUC], 0.956; cutoff value, 12; specificity, 89.5%; sensitivity, 100%) and ICU care (AUC, 0.875; cutoff value, 11; specificity, 91.7%; sensitivity, 71.4%). The K–M survival analysis showed that patients with MuLBSTA score ≥ 12 had higher risk of ICU (log-rank, P = 0.001) and high risk of death (log-rank, P = 0.000). Conclusions: The MuLBSTA score is valuable for risk stratification and could effectively screen high-risk patients at admission. The higher score at admission have higher risk of ICU care and death in patients infected with COVID.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.