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Objective: To identify risk factors of saphenous vein graft (SVG) failure and to investigate the utility of anatomical SYNTAX score (SS) and SYNTAX score II (SS-II) in predicting SVG failure. Methods: A total of 598 patients who underwent angiography for clinical reasons after coronary artery bypass grafting (CABG) were included. Baseline data and factors related to SVG failure were analyzed at the patient and graft levels. Patients were divided in tertiles by anatomical SS and in three groups by SS-II revascularization recommendation, and SVG patency was analyzed across these groups. Results: Patency rates were similar in all SS-stratified and SS-II recommendation groups within 1, 5, and 10 years after CABG. At the patient level, fasting blood glucose (FBG) level

Objective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the relationship between them and collaterals in patients with CTO.Materials and Methods: We enrolled 194 patients with one CTO artery as detected by coronary angiography. Patients were scheduled for CMR within 1 week after coronary angiography.Results: A total of 128 CTO territories (66%) showed scar based on late gadolinium enhancement (LGE) imaging. There were 1,112 segments in CTO territory, while only 198 segments (18%) subtended by the CTO artery showed transmural scar (i.e., >50% extent on LGE). Patients with viable myocardium had higher LV ejection fraction (LVEF) (56.7 ± 13.5% vs. 48.3 ± 15.4%, p < 0.001) than those with transmural scar. Angiographically, well-developed collaterals were found in 164 patients (85%). There was no significant correlation between collaterals and the presence of myocardial scar (p = 0.680) or between collaterals and LVEF (p = 0.191). Nevertheless, more segments with transmural scar were observed in patients with poorly-developed collaterals than in those with well-developed collaterals (25 vs. 17%, p = 0.010).Conclusion: Myocardial infarction detected by CMR is widespread among patients with CTO, yet only a bit of transmural myocardial scar was observed within CTO territory. Limited number of segments with transmural scar is associated with preserved LV function. Well-developed collaterals are not related to the prevalence of myocardial scar or systolic functioning, but could be related to reduce number of non-viable segments subtended by the CTO artery.

Background We investigated whether glycated haemoglobin A1c (HbA1c) could independently predict the decline in the myocardial perfusion reserve index (MPRI) in patients with coronary microvascular disease (CMD) by stress perfusion cardiac magnetic resonance (CMR).Methods From November 2019, 174 patients with ischemic symptoms but without obstructive coronary disease were screened. The MPRI was recorded in 88 patients who underwent stress perfusion CMR detection. Eighty patients with an MPRI of < 2.5 were included in the study. The patients were divided into two groups based on whether their MPRI was greater or less than 1.47. The effects of each index on the MPRI were analysed using bivariate correlation analysis, and the risk factors for CMD were explored using logistic regression analysis.ResultsA total of 80 patients with an MPRI of 1.69±0.79 were included (mean age 54.07 ± 11.06 years; 66.3% male). CMD patients with an MPRI of ≤1.47 were higher than those in the group with an MPRI of >1.47 in age (57.61±9.65 years vs. 51.74±11.41 years), presence of diabetes mellitus (45.5% vs. 21.3%), fasting blood glucose levels [6.33(5.16, 8.01) vs. 5.30(5.15, 6.56)], and HbA1c levels [6.30(5.70, 7.70) vs. 5.80(5.60, 6.50)], (P < 0.05). The MPRI was negatively correlated with HbA1c (r=-0.378, P=0.004). Logistic regression analysis showed that HbA1c (OR=2.336, 95% CI: 1.119-4.876, P=0.024) was an independent risk factor for decreased MPRI in all patients with CMD, especially in patients without diabetes (OR=19.953, 95% CI: 1.743-93.449, P=0.029), but not in patients with diabetes (OR=0.984, 95% CI: 0.265-3.658, P=0.981).ConclusionsHbA1c is an independent predictor of MPRI decline in CMD patients, notably in CMD patients without diabetes, but not for those with diabetes.Trial RegistrationThis clinical trial has been registered in the Chinese clinical Trial Registry with an identifier: ChiCTR1900025810.

BACKGROUND: The present study aimed to investigate the benefits of percutaneous coronary intervention (PCI) in patients with chronic total occlusions (CTOs) by using cardiac magnetic resonance imaging (CMR) feature tracking. METHODS: Fifty-five CTOs with successful CTO-PCI underwent CMR at baseline and 12 months. Feature tracking was applied to measure left ventricle strain index in CTOs with decreased and preserved left ventricular ejection fraction (LVEF). CTOs were also divided into two groups according to the infarct size of 10% or combined with multi-vessel disease. We also measured these parameters in 40 healthy subjects. RESULTS: Three quarters of CTOs showed preserved ejection fraction and no enlargement of left ventricle at baseline, but the global strains were lower than the controls (all P

Background:Coronary artery disease (CAD) is the leading cause of death in advanced kidney disease. However, its best treatment has not been determined.Methods:We searched PubMed and Cochrane databases and scanned references to related articles. Studies comparing the different treatments for patients with CAD and advanced CKD (estimated glomerular filtration rate 2or dialysis) were selected. The primary result was all-cause death, classified according to the follow-up time: short-term (1 year).Results:A total of 32 studies were selected to enroll 84,498 patients with advanced kidney disease. Compared with medical therapy (MT) alone, percutaneous coronary intervention (PCI) was associated with low risk of short-, medium-term and long-term all-cause death (more than 3 years). For AMI patients, compared with MT, PCI was not associated with low risk of short- and medium-term all-cause death. For non-AMI patients, compared with MT, PCI was associated with low risk of long-term mortality (more than 3 years). Compared with MT, coronary artery bypass surgery (CABG) had no significant advantages in each follow-up period of all-cause death. Compared with PCI, CABG was associated with a high risk of short-term death, but low risk of long-term death: 1–3 years; more than 3 years. CABG could also reduce the risk of long-term risk of cardiac death, major adverse cardiovascular events (MACEs), myocardial infarction (MI), and repeat revascularization.Conclusions:In patients with advanced kidney disease and CAD, PCI reduced the risk of short-, medium- and long- term (more than 3 years) all-cause death compared with MT. Compared with PCI, CABG was associated with a high risk of short-term death and a low risk of long-term death and adverse events.

Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P < 0.001) and a moderately strong agreement (Kappa = 0.62, P < 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF r = 0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF

Aims We assessed the viable myocardium status and investigated the relationship between collaterals with the ischemia burden and myocardial viability utilizing cardiac magnetic resonance imaging (CMR) and adenosine stress single-photon emission computed tomography (SPECT). Methods and results 150 consecutive patients with at least one native CTO artery, as confirmed by coronary arteriography or coronary CT angiography, were prospectively recruited. SPECT examination was accepted by only 50 patients while declined by the other 100 patients for reasons such as financial problems. Of all segments in the 173 CTO artery territories, only 10.4% exhibited transmural myocardial infarction and 60.2% showed no late gadolinium enhancement. Among 50 patients who completed SPECT examination, 36 patients showed inducible perfusion defect in CTO territory, and the proportion of the ischemic area of 42% patients was over 10%. Conclusion Most patients with CTO had different degrees of myocardial infarction detected by CMR, but only a minority of them showed transmural infarction and cardiac function in patients with transmural infarction declined compared to those without transmural infarction. Approximately half of CTO patients exhibited inducible ischemia in CTO territory. Based on this, a large proportion of patients potentially benefit from CTO-PCI. Figure 1. Relationship between WMSI, LVE Funding Acknowledgement Type of funding source: Other. Main funding source(s): Beijing Municipal Education Commission Science and Technology Plan for 2020, Capital Health Development Research Project (no. 2018-2-2063)

Objective This study aims to investigate the impact of cardiovascular medications on the coronary flow reserve (CFR) in patients without obstructive coronary artery disease (CAD). Methods We searched PubMed, EMBASE, and Cochrane databases from inception to 15 November 2019. Studies were included if they reported CFR from baseline to follow-up after oral drug therapy of patients without obstructive CAD. Data were pooled using random-effects modeling. The primary outcome was change in CFR from baseline to follow-up after oral drug therapy. Results A total of 46 studies including 845 subjects were included in this study. Relative to baseline, the CFR was improved by angiotensin converting enzyme (ACEIs), aldosterone receptor antagonists (ARBs) (SMD: 1.12; 95%CI: 0.77 to 1.47), and statins treatments (SMD: 0.61; 95%CI: 0.36 to 0.85). 6-12 months of calcium channel blockers (CCBs) treatments improved CFR (SMD: 1.04; 95%CI: 0.51 to 1.58). Beta-blocker (SMD: 0.24; 95%CI: -0.39 to 0.88) and ranolazine treatment (SMD: 0.31; 95%CI: -0.39 to 1.01) was not associated with improved CFR. Conclusions Therapy with ACEIs, ARBs, and statins was associated with improved CFR in patients with confirmed or suspicious CMD. CCBs also improved CFR among patients followed for 6 to 12 months. Beta-blocker and ranolazine had no impact on CFR. Keywords: Oral drug, coronary microvascular, microvascular function, coronary flow reserve

User preferences are influenced by the purchased products, and ratings of products are also related to theirs public praises. Dynamic latent representations can be learned from these sequence information. Researches show that learning such dynamic features is helpful to build model-based collaborative filtering. However, static features also play an irreplaceable role in recommendations by reason of inherent characteristics of users/items. Ratings of users on products directly represent user preferences and qualities of products. A neural network model for learning both static and dynamic features is proposed in this paper. Autoencoder is adopted as a static model focusing on explicit feedback i.e. ratings, and gated recurrent unit is adopted as a dynamic model focusing on implicit feedback i.e. sequences. Features learned from static and dynamic models are combined to make predictions. Experiments on two real-word datasets i.e. Baby of Amazon dataset and MovieLens 10M show improvement of our proposed model over the state-of-the-art methods.

Introduction: Coronary microvascular dysfunction (CMVD), highly prevalent among patients with a mental disorder (anxiety or depression), is closely related to adverse cardiac events, including hospitalization, sudden cardiac death, and myocardial infarction. Shexiang Tongxin Dropping Pills (STDP), a traditional Chinese medicine, exerts endothelial protective function by anti-inflammation, anti-oxidative stress, and promoting blood circulation. STDP protects against CMVD in previous fundamental studies. The present trial is aiming at evaluating the effect of STDP on CMVD among depressed or anxious patients with non-obstructive coronary artery disease (NOCAD). Methods and analysis: Seventy-two depressed or anxious patients diagnosed with NOCAD combined with CMVD utilizing coronary artery angiography and stress cardiac magnetic resonance (CMR) will be recruited in the present study. These patients will be randomized into two groups, namely, Nicorandil group (Nicorandil combined with routine medicine), and STDP groups (STDP combined with routine medicine). The change of CMVD status by assessing absolute myocardial blood flow and myocardial reperfusion using stress CMR 3-month after discharge is defined as the primary endpoint. Major adverse cardiac events (MACEs), quality of life (QOL), and metal disorder improvement are defined as the secondary endpoints. Seattle angina questionnaire (SAQ) which is used to assess angina pectoris and QOL will be recorded at 1-, 3-, 6-, 9-, 12-month of follow-up. Seven-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item depression module from the Patient Health Questionnaire (PHQ9) which utilized to evaluate anxiety and depression, respectively, will be recorded at 1-, 3-, 6-, 9-, 12-month of follow-up. This study will first evaluate the efficacy of STDP on CMVD among patients with a mental disorder and NOCAD, and discuss the potential mechanisms, providing therapeutic evidence for the STDP for these patients.

Aims The purpose of the present trial is to determine whether opening co-existing chronic total occlusions (CTOs) using percutaneous coronary interventions (PCIs) improves cardiac function in patients with multi-vessel disease (MVD). Patients with MVD are defined as having at least one additional major vessel exhibiting no less than 75% stenosis combined with the presence of a CTO artery. Methods and results Patients will be prospectively recruited who meet the following criteria:Patients presenting with no necrosis of myocardial tissue in the territory of the CTO will be excluded. Recruited patients will be randomized into 2 groups: those undergoing PCI of only the non-CTO artery (non-CTO PCI group), and those undergoing PCI of the non-CTO artery concurrently with the CTO artery (CTO-PCI group). The primary outcome will be the change in cardiac function evaluated via CMR at a 12-month of follow-up appointment, which will be compared to a baseline measurement. Secondary outcomes include occurrence of major cardiac events, CMR-assessed myocardial viability in the CTO-supplied territory, and quality of life assessed by Seattle angina questionnaire, Patient Health Questionnaire 9 and Generalized Anxiety Disorder Scale-7 after 12-month follow-up. Conclusion The SOS-moral trial will provide data necessary to determine whether to open concurrent CTOs among MVD patients with CMR-detected necrotic myocardial tissue.

Drinking water distribution system models have been increasingly utilized in the development and implementation of contaminant warning systems. This study proposes a Bayesian approach for probabilistic contamination source identification using a beta-binomial conjugate pair framework to identify contaminant source locations and times and compares the performance of this algorithm to previous work based on a Bayes’ rule approach. The proposed algorithm is capable of directly assigning a probability to a potential source location and updating the probability through the use of a backtracking algorithm and Bayesian statistics. The evaluation of the performance associated with the two algorithms was conducted by a simple comparison, as well as a simulation study in terms of a conservative chemical intrusion event through both a small skeletonized network and a large all-pipe distribution system network. Results from the simple comparison showed that the beta-binomial approach was more responsive to ch...

A method of manufacturing three-dimension microneedle electrode arrays is presented in this paper using the micromolding technology with liquid metal at room temperature, based on the physical property of the Bi-In-Sn liquid metal alloy, being its melting point especially low. Observed under scanning electron microscopy, the needle body of the electrode chip manufactured using this method has a good consistency. Skin penetration test in-vitro indicates that the microneedle electrode can pierce the stratum corneum and cross the high-impedance layer to acquire electrical signals. Electrical impedance and polarization voltage experimental results show that the electrode chips have great electric characteristics and meet the practical application demands.