Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited p...Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited patients with CAD undergoing optical coherence tomography(OCT)-directed PCI between January 2019 and June 2021 for our single-center,hospital-based,retrospective cohort investigation.We assessed the link between post-PCI OFR and major adverse cardiovascular events(MACE)via multivariate Cox regression analy-sis.Results:Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91,and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI.On the basis of survival curves,patients with OFR≤0.91(P<0.001)and thin-cap fibroatheroma(TCFA)(P=0.007)exhibited higher MACE incidence,and myocardial infarction(MI)incidence was considerably greater among patients with OFR≤0.91(P<0.001),compared with OFR>0.91.Multivariate Cox regression analysis suggested that OFR≤0.91(hazard ratio[HR]:3.60;95%confidence interval[CI]:1.24–10.44;P=0.019),and TCFA(HR:3.63;95%CI:1.42–9.20;P=0.007)were independent risk factors for MACE,and OFR≤0.91 was independently associated with MI(HR:14.64;95%CI:3.27–65.54;P<0.001).Conclusion:OFR after PCI is an independent MACE bio-indicator among patients with CAD.Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.展开更多
Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclu...Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]展开更多
基金supported by the Outstanding Young Talent Program of Guangdong Provincial People’s Hospital(grant number KJ012019084)the High-level Hospital Construction Project(grant number DFJH2020021).
文摘Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited patients with CAD undergoing optical coherence tomography(OCT)-directed PCI between January 2019 and June 2021 for our single-center,hospital-based,retrospective cohort investigation.We assessed the link between post-PCI OFR and major adverse cardiovascular events(MACE)via multivariate Cox regression analy-sis.Results:Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91,and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI.On the basis of survival curves,patients with OFR≤0.91(P<0.001)and thin-cap fibroatheroma(TCFA)(P=0.007)exhibited higher MACE incidence,and myocardial infarction(MI)incidence was considerably greater among patients with OFR≤0.91(P<0.001),compared with OFR>0.91.Multivariate Cox regression analysis suggested that OFR≤0.91(hazard ratio[HR]:3.60;95%confidence interval[CI]:1.24–10.44;P=0.019),and TCFA(HR:3.63;95%CI:1.42–9.20;P=0.007)were independent risk factors for MACE,and OFR≤0.91 was independently associated with MI(HR:14.64;95%CI:3.27–65.54;P<0.001).Conclusion:OFR after PCI is an independent MACE bio-indicator among patients with CAD.Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.
基金funded by the key Program of Union of National Natural Science Foundation of China-Guangdong Province(No.U1401255)the Natural Science Foundation of Guangdong Province(No.2018A030313785)+2 种基金the National key Research and Development Program(No.2018YFC1002600)the Science and Technology Planning Project of Guangdong Province(No.2019B020230003/No.2018B090944002/No.2017A070701013/No.2017B090904034/No.2017B030314109)Guangdong Medical Science and Technology Research Fund(No.A2018038)
文摘Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]
