In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contr...In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contributions of cardiac equivalent source models and volume conductor models to the MCG are deeply and comprehensively investigated. The single dipole source model, the multiple dipoles source model and the equivalent double layer （EDL） source model are analysed and compared with the cardiac equivalent source models. Meanwhile, the effect of the volume conductor model on the MCG combined with these cardiac equivalent sources is investigated. The simulation results demonstrate that the cardiac electrophysiological information will be partly missed when only the single dipole source is taken, while the EDL source is a good option for MCG simulation and the effect of the volume conductor is smallest for the EDL source. Therefore, the EDL source is suitable for the study of MCG forward and inverse problems, and more attention should be paid to it in future MCG studies.展开更多
Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intr...Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis.展开更多
Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (G...Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (GC) could reduce myocardial ischemia-reperfusion (IR) injury in rat heart. Methods: Twelve rats were randomized to IR group and GC group, then the hearts were isolated and perfused with Langendorff apparatus. Before cardioplegia, the perfusion was stopped abruptly in IR group while slowly with 5-minute in GC group. The hearts were subjected to 30-minute ischemia and 60-minute reperfusion. The left ventricular develop pressure (LVDP) and systolic pressure (LVSP), the maximal rate of the increase and decrease of left ventricular pressure (+dp/dt<sub>max</sub>, ﹣dp/dt<sub>max</sub>) were measured by polygraph system at different time points. The recovery of the variables was expressed as the ratio of these values at individual time point after reperfusion to the baseline respectively. Results: The recovery of LVDP after reperfusion was better than that in IR group (P = 0.034). No significant difference in the recovery of LVSP, +dp/dtmax and ﹣dp/dt<sub>max</sub> between groups was observed. Conclusions: Gradual clamping could improve the recovery of LVDP after IR, suggesting that gradual clamping could reduce myocardial IR injury.展开更多
This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a ...This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a current dipole and volume currents. Then by using the simulated magnetic fields based on torso-heart model as input, the cardiac current sources--an array of current dipoles by optimal constrained linear inverse method are constructed. Next, the current dipole array reconstruction considering boundaries is compared with that in an unbounded homogeneous medium. Furthermore, the influence of random noise on reconstruction is also considered and the reconstructing effect is judged by several reconstructing parameters.展开更多
Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardi...Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardiovascular disease is atherosclerosis and,as to coronary heart disease,coronary atherosclerosis and resulting lumen stenosis,even total occlusions.In translational research,several animals,such as mice,rabbits and pigs,have been used as disease models of human atherosclerosis and related cardiovascular disorders.However,coronary lesions are either naturally rare or hard to be fast induced in these models,hence,coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions,thus unrepresentative of human coronary heart disease progression and pathology.In this review,we describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.展开更多
To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 spe...To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 specimens with severe congenital heart disease（case group） from induced abortions were enrolled in this study from March 2013 to June 2015 in our hospital. Cast models were prepared by injecting casting material into vascular lumen to demonstrate real geometries of fetal cardiovascular system. Casting effectiveness was analyzed in terms of local anatomic structures and different anatomical levels（including overall level, atrioventricular and great vascular system, left-sided and right-sided heart）, as well as different trimesters of pregnancy. In our study, all specimens were successfully casted. Casting effectiveness analysis of local anatomic structures showed a mean score from 1.90±1.45 to 3.60±0.52, without significant differences between case and control groups in most local anatomic structures except left ventricle, which had a higher score in control group（P=0.027）. Inter-group comparison of casting effectiveness in different anatomical levels showed no significant differences between the two groups. Intra-group comparison also revealed undifferentiated casting effectiveness between atrioventricular and great vascular system, or left-sided and right-sided heart in corresponding group. Third-trimester group had a significantly higher perfusion score in great vascular system than second-trimester group（P=0.046）, while the other anatomical levels displayed no such difference. Vascular corrosion technique can be successfully used in fabrication of fetal cardiovascular cast model. It is also a reliable method to demonstrate three-dimensional anatomy of severe congenital heart disease and normal heart in fetus.展开更多
The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of wea...The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.展开更多
Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on b...Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on basis of the principle of wavelet analysis considering the time-frequency characteristics of the heart murmur. This method uses Mel frequency cepstral coefficient (MFCC) to extract representative features and develops hidden Markov model (HMM) for signal classification. The result shows that this method?is able to recognize the murmur efficiently and superior to BP?neural network (94.2% vs 82.8%). And the findings suggest that the method may have the potential to be used to assist doctors for a more objective diagnosis.展开更多
Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical d...Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical discordance, increasing the risk of atrial fibrillation(AF) and myocardial ischemia. IAB was generally believed to be caused by impaired conduction along the Bachmann bundle(BB). However, there are three other conduction pathways, including the fibers posteriorly in the vicinity of the right pulmonary veins(VRPV), transseptal fibers in the fossa ovalis(FO), and muscular bundles on the inferior atrial surface near the coronary sinus(CS). We hypothesized that the importance of BB on IAB might have been overestimated. To test this hypothesis, various combinations of conduction pathway blocks were simulated based on a realistic human atrial model to investigate their effects on the index of clinical diagnosis standard of IAB using a simulated 12-lead electrocardiogram(ECG). Firstly, the results showed that the BB block alone could not generate typical P wave morphology of IAB, and that the combination of BB and VRPV pathway block played important roles in the occurrence of IAB. Secondly, although single FO and CS pathways play subordinate roles in inter atrial conduction, their combination with BB and VRPV block could also produce severe IAB. In summary, this simulation study has demonstrated that the combinations of different inter atrial conduction pathways, rather than BB alone, resulted in ECG morphology of IAB. Attention needs to be paid to this in future pathophysiological and clinical studies of IAB.展开更多
背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风...背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风险预测模型,为相关风险预测模型的构建、选择与推广提供参考。方法检索中国知网、维普网、万方数据库知识服务平台、中国生物医学文献服务系统、PubMed、Cochrane Library、Web of Science、Embase数据库与我国冠心病患者并发心力衰竭风险预测模型相关的研究,检索时限为建库至2024年10月。由2名研究者独立筛选文献并提取信息,使用预测模型偏倚风险评价工具(PROBAST)评估纳入研究的偏倚风险及适用性。结果共纳入27篇文献,报告了64个风险预测模型的开发情况,模型的受试者工作特征(ROC)曲线下面积(AUC)为0.511~0.989,其中63个模型AUC>0.7,提示模型整体预测性能较好;偏倚风险评估工具评估结果显示,纳入的27篇文献均为高偏倚风险,适用性偏低。年龄、左心室射血分数、糖尿病病史、高血压病史、N末端B型钠尿肽前体、Gensini评分是模型中纳入的重要预测因子。结论当前我国冠心病患者并发心力衰竭风险预测模型的稳定性和外推性有待行前瞻性、大样本研究验证,后续建模应当严格遵循PROBAST指南设计实施研究,以开发可推广性强的高质量预测模型。展开更多
目的探讨基于Cox健康行为互动(interaction model of client health behavior,IMCHB)模式在心力衰竭(heart failure,HF)患者中的应用效果。方法选择广东省茂名市人民医院2023年10月—2024年7月收治的86例HF患者为研究对象,按照组间基本...目的探讨基于Cox健康行为互动(interaction model of client health behavior,IMCHB)模式在心力衰竭(heart failure,HF)患者中的应用效果。方法选择广东省茂名市人民医院2023年10月—2024年7月收治的86例HF患者为研究对象,按照组间基本特征具有可比性的原则分为观察组与对照组,各43例。对照组接受常规护理干预,观察组在对照组基础上接受基于IMCHB的护理干预,两组均干预至患者转出心脏重症监护室。比较干预前后两组患者自护能力、心理状态、服药依从性及干预期间不良事件发生情况。结果干预后,观察组患者心力衰竭自我护理指数(SCHFI)中自我护理维持、自我护理管理、自我护理信心评分高于对照组,差异均有统计学意义(P<0.05);观察组患者医院焦虑抑郁量表(HADS)中焦虑及抑郁评分均低于对照组,差异均有统计学意义(P<0.05)。观察组患者Morisky服药依从性量表(MMAS-8)评分高于对照组,差异有统计学意义(P<0.05)。两组患者干预期间不良事件总发生率比较,差异无统计学意义(P>0.05)。结论基于IMCHB的护理干预可提高HF患者自护能力,改善其心理状态,提高其服药依从性。展开更多
基金supported by the State Key Development Program for Basic Research of China (Grant Nos. 2007CB512100 and2006CB601007)the National Natural Science Foundation of China (Grant No. 10674006)+2 种基金the National High Technology Research and Development Program of China (Grant No. 2007AA03Z238)China Postdoctoral Science Foundation (Grant No. 20090461376)the Fundamental Research Funds for the Central Universities (Grant No. KYJD09001)
文摘In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contributions of cardiac equivalent source models and volume conductor models to the MCG are deeply and comprehensively investigated. The single dipole source model, the multiple dipoles source model and the equivalent double layer （EDL） source model are analysed and compared with the cardiac equivalent source models. Meanwhile, the effect of the volume conductor model on the MCG combined with these cardiac equivalent sources is investigated. The simulation results demonstrate that the cardiac electrophysiological information will be partly missed when only the single dipole source is taken, while the EDL source is a good option for MCG simulation and the effect of the volume conductor is smallest for the EDL source. Therefore, the EDL source is suitable for the study of MCG forward and inverse problems, and more attention should be paid to it in future MCG studies.
基金Project supported by the National Natural Science Foundation of China(Nos.61527811 and 61701435)
文摘Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis.
文摘Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (GC) could reduce myocardial ischemia-reperfusion (IR) injury in rat heart. Methods: Twelve rats were randomized to IR group and GC group, then the hearts were isolated and perfused with Langendorff apparatus. Before cardioplegia, the perfusion was stopped abruptly in IR group while slowly with 5-minute in GC group. The hearts were subjected to 30-minute ischemia and 60-minute reperfusion. The left ventricular develop pressure (LVDP) and systolic pressure (LVSP), the maximal rate of the increase and decrease of left ventricular pressure (+dp/dt<sub>max</sub>, ﹣dp/dt<sub>max</sub>) were measured by polygraph system at different time points. The recovery of the variables was expressed as the ratio of these values at individual time point after reperfusion to the baseline respectively. Results: The recovery of LVDP after reperfusion was better than that in IR group (P = 0.034). No significant difference in the recovery of LVSP, +dp/dtmax and ﹣dp/dt<sub>max</sub> between groups was observed. Conclusions: Gradual clamping could improve the recovery of LVDP after IR, suggesting that gradual clamping could reduce myocardial IR injury.
基金Project supported by the State Key Development Program for Basic Research of China(Grant No.2006CB601007)the National Natural Science Foundation of China(Grant No.10674006)the National High Technology Research and Development Program of China(Grant No.2007AA03Z238)
文摘This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a current dipole and volume currents. Then by using the simulated magnetic fields based on torso-heart model as input, the cardiac current sources--an array of current dipoles by optimal constrained linear inverse method are constructed. Next, the current dipole array reconstruction considering boundaries is compared with that in an unbounded homogeneous medium. Furthermore, the influence of random noise on reconstruction is also considered and the reconstructing effect is judged by several reconstructing parameters.
文摘Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardiovascular disease is atherosclerosis and,as to coronary heart disease,coronary atherosclerosis and resulting lumen stenosis,even total occlusions.In translational research,several animals,such as mice,rabbits and pigs,have been used as disease models of human atherosclerosis and related cardiovascular disorders.However,coronary lesions are either naturally rare or hard to be fast induced in these models,hence,coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions,thus unrepresentative of human coronary heart disease progression and pathology.In this review,we describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.
基金supported by grants from the National Natural Science Foundation of China(No.81530056 and No.81501494)Hubei Province Health and Family Planning Scientific Research Project(No.WJ2015MB016)Hubei Provincial Key Laboratory of Molecular Imaging Foundation,China(No.02.03.2014-29)
文摘To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 specimens with severe congenital heart disease（case group） from induced abortions were enrolled in this study from March 2013 to June 2015 in our hospital. Cast models were prepared by injecting casting material into vascular lumen to demonstrate real geometries of fetal cardiovascular system. Casting effectiveness was analyzed in terms of local anatomic structures and different anatomical levels（including overall level, atrioventricular and great vascular system, left-sided and right-sided heart）, as well as different trimesters of pregnancy. In our study, all specimens were successfully casted. Casting effectiveness analysis of local anatomic structures showed a mean score from 1.90±1.45 to 3.60±0.52, without significant differences between case and control groups in most local anatomic structures except left ventricle, which had a higher score in control group（P=0.027）. Inter-group comparison of casting effectiveness in different anatomical levels showed no significant differences between the two groups. Intra-group comparison also revealed undifferentiated casting effectiveness between atrioventricular and great vascular system, or left-sided and right-sided heart in corresponding group. Third-trimester group had a significantly higher perfusion score in great vascular system than second-trimester group（P=0.046）, while the other anatomical levels displayed no such difference. Vascular corrosion technique can be successfully used in fabrication of fetal cardiovascular cast model. It is also a reliable method to demonstrate three-dimensional anatomy of severe congenital heart disease and normal heart in fetus.
文摘The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.
文摘Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on basis of the principle of wavelet analysis considering the time-frequency characteristics of the heart murmur. This method uses Mel frequency cepstral coefficient (MFCC) to extract representative features and develops hidden Markov model (HMM) for signal classification. The result shows that this method?is able to recognize the murmur efficiently and superior to BP?neural network (94.2% vs 82.8%). And the findings suggest that the method may have the potential to be used to assist doctors for a more objective diagnosis.
基金Project supported by the National R&D Program for Major Research Instruments of China(No.61527811)the National Natural Science Foundation of China(No.61701435)the Zhejiang Provincial Natural Science Foundation of China(No.LY17H180003)
文摘Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical discordance, increasing the risk of atrial fibrillation(AF) and myocardial ischemia. IAB was generally believed to be caused by impaired conduction along the Bachmann bundle(BB). However, there are three other conduction pathways, including the fibers posteriorly in the vicinity of the right pulmonary veins(VRPV), transseptal fibers in the fossa ovalis(FO), and muscular bundles on the inferior atrial surface near the coronary sinus(CS). We hypothesized that the importance of BB on IAB might have been overestimated. To test this hypothesis, various combinations of conduction pathway blocks were simulated based on a realistic human atrial model to investigate their effects on the index of clinical diagnosis standard of IAB using a simulated 12-lead electrocardiogram(ECG). Firstly, the results showed that the BB block alone could not generate typical P wave morphology of IAB, and that the combination of BB and VRPV pathway block played important roles in the occurrence of IAB. Secondly, although single FO and CS pathways play subordinate roles in inter atrial conduction, their combination with BB and VRPV block could also produce severe IAB. In summary, this simulation study has demonstrated that the combinations of different inter atrial conduction pathways, rather than BB alone, resulted in ECG morphology of IAB. Attention needs to be paid to this in future pathophysiological and clinical studies of IAB.
文摘背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风险预测模型,为相关风险预测模型的构建、选择与推广提供参考。方法检索中国知网、维普网、万方数据库知识服务平台、中国生物医学文献服务系统、PubMed、Cochrane Library、Web of Science、Embase数据库与我国冠心病患者并发心力衰竭风险预测模型相关的研究,检索时限为建库至2024年10月。由2名研究者独立筛选文献并提取信息,使用预测模型偏倚风险评价工具(PROBAST)评估纳入研究的偏倚风险及适用性。结果共纳入27篇文献,报告了64个风险预测模型的开发情况,模型的受试者工作特征(ROC)曲线下面积(AUC)为0.511~0.989,其中63个模型AUC>0.7,提示模型整体预测性能较好;偏倚风险评估工具评估结果显示,纳入的27篇文献均为高偏倚风险,适用性偏低。年龄、左心室射血分数、糖尿病病史、高血压病史、N末端B型钠尿肽前体、Gensini评分是模型中纳入的重要预测因子。结论当前我国冠心病患者并发心力衰竭风险预测模型的稳定性和外推性有待行前瞻性、大样本研究验证,后续建模应当严格遵循PROBAST指南设计实施研究,以开发可推广性强的高质量预测模型。
文摘目的探讨基于Cox健康行为互动(interaction model of client health behavior,IMCHB)模式在心力衰竭(heart failure,HF)患者中的应用效果。方法选择广东省茂名市人民医院2023年10月—2024年7月收治的86例HF患者为研究对象,按照组间基本特征具有可比性的原则分为观察组与对照组,各43例。对照组接受常规护理干预,观察组在对照组基础上接受基于IMCHB的护理干预,两组均干预至患者转出心脏重症监护室。比较干预前后两组患者自护能力、心理状态、服药依从性及干预期间不良事件发生情况。结果干预后,观察组患者心力衰竭自我护理指数(SCHFI)中自我护理维持、自我护理管理、自我护理信心评分高于对照组,差异均有统计学意义(P<0.05);观察组患者医院焦虑抑郁量表(HADS)中焦虑及抑郁评分均低于对照组,差异均有统计学意义(P<0.05)。观察组患者Morisky服药依从性量表(MMAS-8)评分高于对照组,差异有统计学意义(P<0.05)。两组患者干预期间不良事件总发生率比较,差异无统计学意义(P>0.05)。结论基于IMCHB的护理干预可提高HF患者自护能力,改善其心理状态,提高其服药依从性。
