65 results on '"SU Gang"'
Search Results
2. Sex differences of hemodynamics during acute vasoreactivity testing to predict the outcomes of chronic thromboembolic pulmonary hypertension
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Yan-Zhe Yu, Rong Jiang, Ping Yuan, Chuan‐Yu Wang, Ci-Jun Luo, Weiping Xie, Yi-Lan Yang, Qin-Hua Zhao, Lan Wang, Jian Guo, Yuan Li, Jing He, Wen-Hui Wu, Hong-Ling Qiu, Jinling Li, Jinming Liu, and Su-Gang Gong more...
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Right heart catheterization ,Cardiac Catheterization ,China ,medicine.medical_specialty ,Hypertension, Pulmonary ,Vasodilator Agents ,Hemodynamics ,Independent predictor ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Administration, Inhalation ,Female patient ,medicine ,Humans ,Immunology and Allergy ,In patient ,Iloprost ,Pulmonary Wedge Pressure ,030212 general & internal medicine ,Lung ,Genetics (clinical) ,Aged ,Sex Characteristics ,Receiver operating characteristic ,business.industry ,Middle Aged ,Prognosis ,Progression-Free Survival ,ROC Curve ,030228 respiratory system ,Male patient ,Chronic Disease ,Cardiology ,Regression Analysis ,Female ,Chronic thromboembolic pulmonary hypertension ,Pulmonary Embolism ,business - Abstract
BACKGROUND Acute vasoreactivity testing (AVT) which reflects the compliance of the pulmonary vascular bed has been proven to be of prognostic value. The purpose of the present study is to explore the sex differences of hemodynamics during the AVT and their impact on event-free survival in patients with chronic thromboembolic pulmonary hypertension (CTEPH). METHODS Eighty-six patients underwent a right heart catheterization and AVT at Shanghai Pulmonary Hospital from February 2009 to February 2018. Univariate and multiple stepwise regression analysis were performed to determine the predictors of independent event-free survival, and receiver operating characteristic curve was plotted to determine the cut-off value of independent parameters in CTEPH. RESULTS There were no significant differences in both demographics and hemodynamics between male and female patients with CTEPH. Except ΔPVR/PVR showed a significantly higher difference in female than male patients (P = 0.034). Male patients had higher mRAP of pre- and post-AVT than female patients in the event-free subgroup, while, female patients showed higher PVR of pre-AVT than male patients in the event subgroup (P more...
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- 2020
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3. PeakPETCO2 combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
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Jing He, Rui Zhang, Rong Jiang, Wen-Hui Wu, Jinming Liu, Lan Wang, Hong-Ling Qiu, Su-Gang Gong, Jian Guo, Ci-Jun Luo, Qin-Hua Zhao, Ping Yuan, and Changwei Wu
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,Vasodilation ,acute vasodilator test ,FEV1/FVC ratio ,pulmonary function test ,Internal medicine ,medicine ,Cardiology ,right heart catheterization ,Original Research Article ,business ,cardiopulmonary exercise test - Abstract
Cardiopulmonary exercise testing and pulmonary function test are important methods for detecting human cardio-pulmonary function. Whether they could screen vasoresponsiveness in idiopathic pulmonary artery hypertension (IPAH) patients remains undefined. One hundred thirty-two IPAH patients with complete data were retrospectively enrolled. Patients were classified as vasodilator-responsive (VR) group and vasodilator-nonresponsive (VNR) group on the basis of the acute vasodilator test. Pulmonary function test and cardiopulmonary exercise testing were assessed subsequently and all patients were confirmed by right heart catheterization. We analyzed cardiopulmonary exercise testing and pulmonary function test data and derived a prediction rule to screen vasodilator-responsive patients in IPAH. Nineteen of VR-IPAH and 113 of VNR-IPAH patients were retrospectively enrolled. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects (lower RAP, m PAP, PAWP, and PVR). And VR-IPAH patients had higher anaerobic threshold (AT), peak partial pressure of end-tidal carbon dioxide (PETCO2), oxygen uptake efficiency (OUEP), and FEV1/FVC (P all more...
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- 2021
4. Liver dysfunction in idiopathic pulmonary arterial hypertension: prevalence, characteristics and prognostic significance, a retrospective cohort study in China
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Jing He, Jinming Liu, Qin-Hua Zhao, Rui Zhang, Wen-Hui Wu, Ping Yuan, Rong Jiang, Hong-Ling Qiu, Jinling Li, Lan Wang, Ci-Jun Luo, Su-Gang Gong, and Changwei Wu
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Adult ,medicine.medical_specialty ,China ,Adolescent ,Bilirubin ,thoracic medicine ,Cardiovascular Medicine ,Gastroenterology ,risk management ,chemistry.chemical_compound ,Young Adult ,Internal medicine ,adult cardiology ,medicine ,Prevalence ,Humans ,Familial Primary Pulmonary Hypertension ,Longitudinal Studies ,Survival analysis ,Aged ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Liver Diseases ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prognosis ,chemistry ,ROC Curve ,cardiology ,Medicine ,Abnormal Liver Function Test ,Liver function ,business ,TBIL - Abstract
ObjectivesThe aim was to elucidate the relationship between liver function and idiopathic pulmonary arterial hypertension (IPAH).Design and settingRetrospective, longitudinal study in urban tertiary care centre in Shanghai, China.Participants407 IPAH consecutive incident patients age 18–65 years were retrospectively enrolled from January 2008 to December 2018.Outcome measurementsThe primary endpoint was all-cause mortality. The cut-off value was determined by receiver operating characteristic curve (ROC), which was validated by Cox proportional hazard model was internally validated by bootstrap analysis and used for survival analysis. The Cox model was (internally) validated and cross-validated areas under the curve (AUC) should be reported.ResultsThe prevalence of abnormal liver function tests (LFTs) at baseline was 77.6%. Hyperbilirubinaemia is the most common abnormal biochemical liver test: abnormal total bilirubin (TBIL in 51.6% patients). During the follow-up, 160 patients died. Patients with mixed liver dysfunction have worse prognosis than those with normal LFTs or isolated abnormal bilirubin metabolism. Comparing with patients with hepatocellular injury, the survival of patients with abnormal bilirubin metabolism is lower. Multivariable Cox models revealed a positive association between TBIL, γ-glutamyltransferase (GGT) and mortality showing that each Ig increment in TBIL and GGT was associated with a higher all-cause mortality (TBIL: HR 4. 29 (95% CI 1. 21 to 15. 27), p=0. 02; GGT: HR 2. 76 (95% CI 1. 18 to 6. 45), p=0. 02). A novel formula named Liver Function Predict Index (LFPI) was constructed (LFPI=−0.002*6MWD+1.014*lg GGT+1.458*lg TBIL) to predict prognosis. ROC curve analysis did further identify 2.729 as the best cut-off value for LFPI (AUC 0.75, pConclusionsLiver dysfunction is frequent in IPAH, and characterised by a predominantly cholestatic enzyme profile. LFTs abnormalities are associated with worse survival and LFPI was a new and simple predictor for prognosis of IPAH. more...
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- 2021
5. Value of heart rate recovery in female patients with pulmonary arterial hypertension due to systemic lupus erythematosus
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Su-Gang Gong, Rong Jiang, Caicun Zhou, Ping Yuan, Jinming Liu, Qin-Hua Zhao, Jian Guo, Wenlan Yang, Lan Wang, Bigyan Pudasaini, and Guoling Yang
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Adult ,Pulmonary and Respiratory Medicine ,Cardiac Catheterization ,medicine.medical_specialty ,Hemodynamics ,Walk Test ,Pulmonary function testing ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Heart Rate ,DLCO ,Diffusing capacity ,Internal medicine ,Natriuretic Peptide, Brain ,Heart rate ,Female patient ,Humans ,Lupus Erythematosus, Systemic ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Genetics (clinical) ,Associated Pulmonary Arterial Hypertension ,Retrospective Studies ,Pulmonary Arterial Hypertension ,business.industry ,Incidence (epidemiology) ,Middle Aged ,Peptide Fragments ,Respiratory Function Tests ,030228 respiratory system ,Exercise Test ,Cardiology ,Female ,business - Abstract
OBJECTIVE This study intended to explore the relation between heart rate recovery at 1 minutes (HRR1) during the recovery phase of cardiopulmonary exercise test (CPET) and exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension (SLE-PAH) patients. METHODS Twenty-one female SLE-PAH patients underwent right heart catheterization (RHC), pulmonary function test (PFT) and CPET. Forty-two healthy subjects matched with SLE-PAH patients in age, sex and BMI were recruited as a control group. The correlations between HRR1 with clinical and CPET parameters were performed. RESULTS Peak HR, ΔHR, HRR1, Peak HR-warm HR1min , Peak HR-warm HR2min and CR were significantly lower in SLE-PAH than in controls (P more...
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- 2019
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6. Epidemiology of Takayasu arteritis in Shanghai: A hospital-based study and systematic review
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Xin Wu, Xiao-Yan Zhang, Yu Xue, Guang-Hui Yang, Su-Gang Gong, Ai Peng, Jiayi Wang, Jing Ding, Qiang-Hua Wei, Ling Qin, Zhu-Jing Zhu, Jun-Ying, Fu-Tao Zhao, Xiang-Fei Wang, Ying Sun, Jian-Long Guan, Liang-Jing Lv, Hua Liu, Xiao-Xiang Chen, Dan Luo, Ben Li, Ruina Kong, Ting Li, Zhihui Dong, Meng-Meng Yin, Run Feng, Xiao-Ning Sun, Jian-Ping Tang, Jie Chen, Sheng-Ming Dai, Dongyi He, Honglei Liu, Lindi Jiang, Jie Han, Jiang Lin, Dongbao Zhao, Huji Xu, Chunyuan Xiao, Xiao Su, Chengde Yang, Xiaomin Dai, Luan Xue, Shuang Ye, Hui-Ping Huang, Jian-Chun Mao, Jian-Zhou Zou, Lili Ma, and Zhen-Hang Zhu more...
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Adult ,Male ,medicine.medical_specialty ,China ,Time Factors ,Adolescent ,Population ,Takayasu arteritis ,Prevalence ,Hospital based study ,Young Adult ,Age Distribution ,Rheumatology ,Epidemiology ,Medicine ,Humans ,Sex Distribution ,education ,Disease burden ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Middle Aged ,Takayasu Arteritis ,Hospitals ,Race Factors ,Systematic review ,Female ,business ,Demography - Abstract
Background Takayasu arteritis (TAK) is a rare large vessel vasculitis, and epidemiological data on TAK are lacking in China. Thus, we designed this study to estimate the TAK prevalence and incidence in residential Shanghai, China. Methods Data on diagnosed TAK cases aged over 16 years were retrieved from 22 tertiary hospitals in Shanghai through hospital electronic medical record systems between January 1, 2015 and December 31, 2017 to estimate the prevalence and incidence. A systematic literature review based on searches in PubMed, Ovid-Medline, Excerpta Medica Database (EMBASE), Web of Science, and China National Knowledge Infrastructure (CNKI) was performed to summarize TAK distribution across the world. Results In total 102 TAK patients, with 64% female, were identified. The point prevalence (2015-2017) was 7.01 (95% CI 5.65-8.37) cases per million, and the mean annual incidence was 2.33 (1.97-3.21) cases per million. The average age of TAK patients was 44 ± 16 years, with the highest prevalence (11.59 [9.23-19.50] cases per million) and incidence (3.55 [0.72 3.74] cases per million) in the 16 to 34 years population. Seventeen reports were included in the system review, showing that the epidemiology of TAK varied greatly across the world. The incidence and prevalence were both relatively higher in Asian countries, with the prevalence ranging 3.3-40 cases per million and annual incidence ranging 0.34-2.4 cases per million. Conclusions The prevalence and incidence of TAK in Shanghai was at moderate to high levels among the previous reports. The disease burden varied globally among racial populations. more...
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- 2021
7. Comparative Effectiveness of Exercise Training for Patients With Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Endarterectomy: A Systematic Review and Meta-Analysis
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Lan Wang, Jinming Liu, Rui Zhang, Ping Yuan, Hong-Ling Qiu, Ci-Jun Luo, Rong Jiang, Qin-Hua Zhao, Ya-Lin Zhao, Su-Gang Gong, and Jing He
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medicine.medical_specialty ,pulmonary endarterectomy ,Oxygen pulse ,Exercise intolerance ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,pulmonary hypertension ,medicine ,Diseases of the circulatory (Cardiovascular) system ,cardiorespiratory fitness ,business.industry ,VO2 max ,Cardiorespiratory fitness ,medicine.disease ,exercise intolerance ,Pulmonary hypertension ,030228 respiratory system ,RC666-701 ,Cardiology ,Systematic Review ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise ,exercise training - Abstract
Background: Patients with chronic thromboembolic pulmonary hypertension (CTEPH) still experience reduced exercise capacity despite pulmonary endarterectomy (PEA). Exercise training improves the exercise capacity and quality of life (QoL) in patients with PH, but data on the effects of exercise training on these patients are scarce. The aim of this meta-analysis and systematic review was to evaluate the effectiveness and safety of exercise training in CTEPH after PEA.Methods: We searched the relevant literature published before January 2020 for the systematic review and meta-analysis using the PubMed, EMBASE, and Cochrane Library databases. The primary outcome was a change in the 6-min walking distance (6 MWD). We also assessed the effect of exercise on the peak oxygen uptake (VO2) or peak VO2/kg, oxygen uptake anaerobic threshold, workload, oxygen pulse, hemodynamics, arterial blood gases, oxygen saturation, N-terminal pro-brain-type natriuretic peptide (NT-proBNP), quality of life (QoL) and pulmonary function tests.Results: We included 4 studies with 208 exercise-training participants. In the pooled analysis, short-term exercise training can improve the 6 MWD of 58.89 m (95% CI: 46.26–71.52 m, P < 0.0001). There was a significant increase in the peak VO2/kg or peak VO2 after exercise training (3.15 ml/min/kg, 95% CI: 0.82–5.48, P = 0.008; 292.69 ml/min, 95% CI: 24.62–560.75, P = 0.032, respectively). After exercise training, the maximal workload and O2 pulse significantly improved. Three months of exercise training increased the right ventricular ejection fraction by 3.53% (95% CI: 6.31–11.94, P < 0.00001, I2 = 0) independently of PEA surgery. In addition, NT-proBNP plasma levels significantly improved with exercise training after PEA [weighted mean difference (WMD): −524.79 ng/L, 95% CI: 705.16 to −344.42, P < 0.0001, I2 = 0]. The partial pressure of oxygen and pH improved progressively over 12 weeks of exercise training (WMD: 4 mmHg, 95% CI: 1.01–8.33, P = 0.01; WMD: 0.03, 95% CI: 0.02–0.04, P < 0.0001, respectively). Subscales of the QoL measured by the SF-36 questionnaire had also improved. In addition, exercise training was well-tolerated with a low dropout rate, and no major adverse events occurred during exercise training.Conclusion: Exercise training may be associated with a significant improvement in the exercise capacity and QoL among CTEPH patients after PEA and was proven to be safe. However, more large-scale multicentre studies are needed to confirm the effectiveness and safety of exercise training in CTEPH patients after PEA.PROSPERO registration number:CRD42021235275. more...
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- 2021
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8. Survival in severe pulmonary hypertension due to chronic lung disease: influence of in-hospital platelet distribution width
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Jinming Liu, Lan Wang, Hong-Ling Qiu, Bigyan Pudasaini, Su-Gang Gong, Ci-Jun Luo, Rong Jiang, Rui Zhang, Li Shen, Jing He, Ya-Lin Zhao, Ping Yuan, and Qin-Hua Zhao
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,RC705-779 ,business.industry ,Platelet Distribution Width ,Idiopathic Pulmonary Arterial Hypertension ,medicine.disease ,Pulmonary hypertension ,all-cause death ,Diseases of the respiratory system ,Lung disease ,Internal medicine ,RC666-701 ,pulmonary hypertension ,chronic lung diseases ,medicine ,Cardiology ,platelet distribution width ,Diseases of the circulatory (Cardiovascular) system ,Original Research Article ,prognosis ,business ,All cause mortality - Abstract
BACKGROUND: Platelet distribution width (PDW) has been recognized as risk predictors of idiopathic pulmonary arterial hypertension. This study aims to investigate whether in-hospital PDW would be useful to predict all-cause death in patients with severe pulmonary hypertension due to chronic lung diseases (CLD-PH).METHODS: Early in-hospital PDW was measured in 67 severe CLD-PH patients who were confirmed by right heart catheterization and followed up. Event-free survival was estimated using the Kaplan–Meier method and analyzed with the log-rank test. Cox proportional hazards models were performed to determine the association between the PDW level and all-cause death.RESULTS: Pulmonary function test and echocardiography parameters were different among patients divided by 17% (the upper reference range of the PDW). There were no significant differences in both clinical variables and RHC parameters among patients with PDW ≥ or < 17%. During median of 2.4 (2.5, 3.7) years of follow-up, 44 patients died. A significant association was noted between in-hospital PDW level and the adjusted risk of all-cause mortality (hazard ratio [HR], 1.245; 95% confidence interval [CI], 1.099-1.409). Compared with those with PDW < 17%, the HR for all-cause death increased to 5.067 (95% CI: 2.420-10.609, P < 0.001) among patients with PDW ≥ 17 %. Higher levels of PDW were also associated with increased risk of all-cause death.CONCLUSIONS: In-hospital PDW was independently associated with all-cause death in patients with severe CLD-PH. This potentially could be used to estimate the severity of severe CLD-PH. more...
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- 2021
9. Echocardiographic Prognosis Relevance of Attenuated Right Heart Remodeling in Idiopathic Pulmonary Arterial Hypertension
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Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Chao Li, Ge-Fei Chen, Ci-Jun Luo, Hong-Ling Qiu, Jin-Ming Liu, Lan Wang, and Rui Zhang
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medicine.medical_specialty ,Prognostic factor ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,right heart remodeling ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,pulmonary arterial hypertension ,medicine ,Diseases of the circulatory (Cardiovascular) system ,echocardiography ,In patient ,Original Research ,End point ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,biomarkers ,medicine.anatomical_structure ,030228 respiratory system ,RC666-701 ,Right heart ,Rv function ,Cardiology ,Right atrium ,prognosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Right ventricular (RV) function is a great determination of the fate in patients with pulmonary arterial hypertension (PAH). Monitoring RV structure back to normal or improvement should be useful for evaluation of RV function. The aims of this study were to assess the prognostic relevance of changed right heart (RH) dimensions by echocardiography and attenuated RH remodeling (ARHR) in idiopathic PAH (IPAH).Methods: We retrospectively analyzed 232 consecutive adult IPAH patients at baseline assessment and included RH catheterization and echocardiography. ARHR at the mean 20 ± 12 months' follow-up was defined by a decreased right atrium area, RV mid-diameter, and left ventricular end-diastolic eccentricity index. The follow-up end point was all-cause mortality.Results: At mean 20 ± 12 months' follow-up, 33 of 232 patients (14.2%) presented with ARHR. The remaining 199 surviving patients were monitored for another 25 ± 20 months. At the end of follow-up, the survival rates at 1, 3, and 5 years were 89, 89, and 68% in patients with ARHR, respectively, and 84, 65 and 41% in patients without ARHR (log-rank p = 0.01). ARHR was an independent prognostic factor for mortality. Besides, ARHR was available to further stratify patients' risk assessment through the French PAH non-invasive-risk criteria.Conclusions: Echocardiographic ARHR is an independent determinant of prognosis in IPAH at long-term follow-up. ARHR might be a useful tool to indicate the RV morphologic and functional improvement associated with better prognostic likelihood. more...
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- 2021
10. The predictive value of minute ventilation versus carbon dioxide production in pulmonary hypertension associated with left heart disease
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Jinming Liu, Su-Gang Gong, Jie Tang, Xiu-jun Zhong, Qin-Hua Zhao, Lan Wang, Ping Yuan, and Rong Jiang
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medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Hemodynamics ,General Medicine ,Carbon dioxide production ,030204 cardiovascular system & hematology ,Logistic regression ,medicine.disease ,Pulmonary hypertension ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Internal medicine ,Hyperventilation ,Cardiology ,medicine ,Vascular resistance ,Original Article ,medicine.symptom ,business ,human activities ,Respiratory minute volume - Abstract
BACKGROUND: The aim of the present study was to investigate the role of key cardiopulmonary exercise testing (CPET) parameters in the identification of pre-capillary components in patients with pulmonary hypertension associated with left heart disease (PH-LHD), and to evaluate their correlations with hemodynamic parameters. METHODS: Ninety patients with PH-LHD underwent right-heart catheterization, echocardiography, and CPET. The differences in related indexes between a combined post- and pre-capillary PH (Cpc-PH) group (n=47) and an isolated post-capillary PH (Ipc-PH) group (n=43) were compared. Correlation analysis was performed. Logistic regression and receiver operator characteristic (ROC) analyses were performed to assess the ability of CPET variables to distinguish patients with Cpc-PH from those with Ipc-PH. RESULTS: The hemodynamics, hyperventilation and right ventricular function of Cpc-pH group were worse than those of Ipc-pH group. The parameters related to minute ventilation versus carbon dioxide production (VE/VCO(2)) played a significant role in the differentiation of Cpc-PH and Ipc-PH, and had a moderate positive correlation with pulmonary vascular resistance (PVR). Univariate and multivariate logistic analyses showed that lowest percentage of VE/VCO(2) in predicted value (VE/VCO(2)%pred) was the single best predictor of Cpc-PH, and the area under ROC curve also confirmed that lowest VE/VCO(2)%pred (≥137%) could serve as a novel diagnostic marker for Cpc-PH. On the basis of this lowest VE/VCO(2)%pred threshold, patients were divided into two groups. Most hemodynamic parameters were worse in patients with a lowest VE/VCO(2)%pred ≥137%. CONCLUSIONS: VE/VCO(2)-related parameters are powerful prognosticators for the presence of pre-capillary components in patients with PH-LHD, especially lowest VE/VCO(2)%pred. more...
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- 2021
11. Acute vasoreactivity testing predicts outcome of idiopathic pulmonary arterial hypertension patients with a negative acute response
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Hong-Ling Qiu, Jinling Li, Xiangrui Meng, Wen-Hui Wu, Jinming Liu, Yuanyuan Sun, Qin-Hua Zhao, Lingzi Shi, Ping Yuan, Rong Jiang, Ci-Jun Luo, Jing He, Yuan Li, Lan Wang, and Su-Gang Gong
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medicine.medical_specialty ,Inhalation ,business.industry ,Proportional hazards model ,Idiopathic Pulmonary Arterial Hypertension ,Hemodynamics ,General Medicine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,medicine.artery ,Internal medicine ,Pulmonary artery ,Cardiology ,medicine ,Original Article ,business ,Iloprost ,medicine.drug ,Oxygen saturation (medicine) ,Artery - Abstract
BACKGROUND: Acute vasoreactivity testing (AVT) during right heart catheterization (RHC) is performed in certain subsets of patients with pulmonary arterial hypertension (PAH) in order to identify those who benefit from calcium channel blockers. The present study aimed to investigate the prognostic value of pre-AVT, post-AVT, and changes in AVT (ΔAVT) parameters for idiopathic PAH (IPAH) patients with a negative acute response, and to identify sex differences that could be of prognostic value. METHODS: A total of 487 incident IPAH patients (171 males and 316 females) with a negative acute response to AVT were recruited from Shanghai Pulmonary Hospital between 2009 and 2018. Outcomes were predicted using the Kaplan-Meier curve and univariate/multivariate Cox regression analyses. All patients were followed up till January 2020, with outcome specified as all-cause mortality. RESULTS: Inhalation of iloprost aerosol improved the hemodynamic parameters for all patients. Post-PVR was decreased, and post-cardiac output (post-CO) and post-cardiac index (post-CI) were increased compared with pre-AVT parameters among males. Increased post- artery oxygen saturation (post-SaO(2)) and decreased post-mean right atrium pressure (post-mRAP) were also observed in females. For all patients, pre-CO ≥3.25 L/min, post-mPAP more...
- Published
- 2021
12. Validity of 2015 ESC Risk Assessment in Idiopathic Pulmonary Arterial Hypertension in China
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Rong Jiang, Wen-Hui Wu, Chao Li, Su-Gang Gong, Rui Zhang, Qin-Hua Zhao, Lan Wang, Hong-Ling Qiu, and Ci-Jun Luo
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medicine.medical_specialty ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,Cardiac index ,Guideline ,medicine.disease ,Brain natriuretic peptide ,Pericardial effusion ,Pulmonary hypertension ,Blood pressure ,Internal medicine ,medicine ,Cardiology ,Risk assessment ,business - Abstract
Background: The 2015 European pulmonary hypertension guidelines recommend a risk stratification strategy for pulmonary arterial hypertension (PAH). We aimed to investigate the validation and potential prognostic information in our patients.Methods: The risk assessment variables proposed by the PH guidelines was performed, using World Health Organization function class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right arterial pressure, cardiac index, mixed venous saturation, right atrium area, pericardial effusion, peak oxygen consumption and ventilatory equivalents for carbon dioxide. An abbreviated version also was applied.Results: The 392 patients were enrolled between 2009 and 2018. After a median interval of 13 months, re-evaluation assessments were available for 386 subjects. The PH guidelines risk tool may effectively discriminate three risk group and mortality (p< 0.001) both at baseline and re-evaluation. Meanwhile, its simplified risk version was valid for baseline and accurately predicted the risk of death in all risk group (p< 0.001). At the time of re-evaluation, the percentage of low risk group has an increase, but a greater proportion achieved high risk group and a lesser proportion maintained in intermediate risk group.Conclusions: The 2015 European PH guidelines and its simplified version risk stratification assessment present effective discrimination of different risk groups and accurate mortality estimates in patients with IPAH. Changes of risk proportion at re-evaluation implicated that natural treatment decisions may not be consistently with goal-oriented treatment strategy. more...
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- 2020
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13. Alteration of Extracellular Superoxide Dismutase in Idiopathic Pulmonary Arterial Hypertension
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Xin Jiang, Yang-Yang He, Xi-Qi Xu, Su-Gang Gong, Qin-Hua Zhao, Zhi-Cheng Jing, Lan Wang, Yuan Li, Rui Zhang, and Rong Jiang
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0301 basic medicine ,extracellular SOD ,medicine.medical_specialty ,Hemodynamics ,030204 cardiovascular system & hematology ,Superoxide dismutase ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,idiopathic pulmonary arterial hypertension ,medicine ,Extracellular ,Prospective cohort study ,Original Research ,chemistry.chemical_classification ,lcsh:R5-920 ,Reactive oxygen species ,biology ,business.industry ,biomarkers ,General Medicine ,superoxide dismutases ,BMPR2 ,030104 developmental biology ,Endocrinology ,medicine.anatomical_structure ,chemistry ,biology.protein ,Vascular resistance ,Medicine ,prognosis ,lcsh:Medicine (General) ,business - Abstract
Background: Superoxide dismutases (SODs) are an important family of antioxidant enzymes that modulate reactive oxygen species levels. It is largely unknown which SOD isoform(s) change in vivo in idiopathic pulmonary arterial hypertension (IPAH) patients. Methods: A total of 133 consecutive adult IPAH patients who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling were enrolled in this prospective study. The plasma activities of three subtypes of SOD [copper–zinc (Cu/Zn-SOD), manganese (Mn-SOD), and extracellular SOD (Ec-SOD)] were examined. Results: The activities of SODs were significantly lower in IPAH patients than in healthy subjects. However, only Ec-SOD activity in BMPR2 mutation patients was significantly decreased compared to those in patients without a mutation. The reduced Ec-SOD activity was markedly associated with mean pulmonary arterial pressure, pulmonary vascular resistance (PVR), and 6-min walking distance (6MWD). The reduction of Mn-SOD activity was only associated with 6MWD. There was no association between Cu/Zn-SOD and hemodynamics. Patients with a lower Ec-SOD level had a worse survival compared to those with a higher baseline. The reduced Ec-SOD activity and the raised PVR increased the mortality risk. Conclusions: Ec-SOD was correlated with BMPR2 mutation, hemodynamic dysfunction, and poor outcomes. Circulating Ec-SOD could be a potentially vital antioxidant enzyme in the pathogenesis of IPAH. more...
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- 2020
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14. Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
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Gang-Hua Lu, Su-Gang Gong, Chao Li, Qin-Hua Zhao, Rong Jiang, Ci-Jun Luo, Lan Wang, and Rui Zhang
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0301 basic medicine ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,medicine.drug_class ,Hemodynamics ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Gastroenterology ,digestive system ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic peptide ,medicine ,idiopathic pulmonary arterial hypertension ,Gamma-glutamyltransferase ,Original Research ,biology ,business.industry ,Incidence (epidemiology) ,Idiopathic Pulmonary Arterial Hypertension ,biomarkers ,digestive system diseases ,BMPR2 ,030104 developmental biology ,lcsh:RC666-701 ,gender difference ,biology.protein ,prognosis ,Cardiology and Cardiovascular Medicine ,business ,gamma-glutamyltransferase - Abstract
Background: The elevated gamma-glutamyltransferase (GGT) activity is regarded as an indicator of cardiovascular disease, with males having higher values than females. The greater incidence of idiopathic pulmonary arterial hypertension (IPAH) is observed in women, whereas prognosis is poor in men. The present study aims to investigate the potential association of GGT on male patients.Methods: Serum GGT levels were measured in 338 consecutive adult IPAH patients, who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling, and matched with healthy subjects by sex and age. The followed interval was 48 ± 34 months.Results: Increased serum GGT levels were more common in patients with IPAH than controls (p < 0.001). GGT values were significantly higher in male patients than those of females (p < 0.001). Compared with female patients with BMPR2 mutation, GGT level in male patients with BMPR2 mutation was further increased (p = 0.002). Higher GGT levels were associated with worse hemodynamics and Nterminal pro B-type natriuretic peptide in all patients. However, males with a GGT concentration ≥ 53 U/L had a worse survival than those of females. Contrarily, if GGT concentration more...
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- 2020
15. Soluble ST2 and mixed venous oxygen saturation for prediction of mortality in patients with pulmonary hypertension
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Su-Gang Gong, Hong-Ling Qiu, Qin-Hua Zhao, Jing He, Jinling Li, Xiangrui Meng, Yuan Li, Ping Yuan, Wen-Hui Wu, Jinming Liu, Rong Jiang, Lan Wang, Ci-Jun Luo, Yuanyuan Sun, and Lingzi Shi
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Pulmonary and Respiratory Medicine ,Right heart catheterization ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hemodynamics ,Retrospective cohort study ,medicine.disease ,Gastroenterology ,Predictive value ,Pulmonary hypertension ,Clinical biomarker ,Internal medicine ,medicine ,In patient ,Original Article ,business - Abstract
BACKGROUND: Although soluble suppression of tumorigenicity-2 (sST2) has been identified as a clinical biomarker for pulmonary hypertension (PH) by previous studies, the implication of sST2 combined with hemodynamic parameters in PH has not been well studied. This study aimed to evaluate the relationship between sST2 and hemodynamic parameters and to evaluate the predictive value of sST2 for mortality in patients with PH. METHODS: One hundred eighty-four incident patients with PH and 14 healthy controls were retrospectively enrolled by Shanghai Pulmonary Hospital for this retrospective study. After all patients underwent right heart catheterization, blood samples were collected and serum sST2 concentration was assessed by the Presage™ ST2 assay. Kaplan-Meier curve and Cox regression analyses were used to predict survival and the association between survival and different factors such as sST2, SvO(2). RESULTS: During a follow-up of 44.9 (IQR 28.5–64.4) months, 65 patients died. The median concentration of sST2 in PH patients was 33.1 ng/mL, which is higher than that in control group (23.1 ng/mL, P=0.005). Furthermore, for PH group, the level of sST2 was higher in non-survivors than that in survivors. Cox regression analyses demonstrated that sST2 and SvO(2) were independent risk factors for survival. In Kaplan-Meier curve analyses, elevated sST2 level and reduced SvO(2) predicted a poor outcome for patients with PH. CONCLUSIONS: Higher sST2 was independently associated with increased mortality, as well as lower SvO(2) in patients with PH. Especially, the combination of higher sST2 and lower SvO(2) had the strongest predictive value of mortality in patients with PH. more...
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- 2020
16. Increased Levels of Runt-Related Transcription Factor 2 Are Associated With Poor Survival of Patients With Idiopathic Pulmonary Arterial Hypertension
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Yuanyuan Sun, Zuogang Wang, Qian Liu, Xun-Tao Yuan, Ping Yuan, Qin-Hua Zhao, Lan Wang, and Su-Gang Gong
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medicine.medical_specialty ,Health (social science) ,RUNX2 ,sex difference ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Gastroenterology ,survival ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Internal medicine ,Female patient ,medicine ,idiopathic pulmonary arterial hypertension ,Clinical severity ,Transcription factor ,Proportional hazards model ,business.industry ,musculoskeletal, neural, and ocular physiology ,Runt ,lcsh:R ,Public Health, Environmental and Occupational Health ,Idiopathic Pulmonary Arterial Hypertension ,Plasma levels ,030228 respiratory system ,embryonic structures ,Original Article ,business - Abstract
Runt-related transcription factor 2 (RUNX2) plays a pivotal role in the pathogenesis of pulmonary arterial hypertension (PAH); yet, whether circulating levels of RUNX2 can predict survival of patients with idiopathic PAH (IPAH) is still unclear. The present study aimed to investigate the correlation between circulating levels of RUNX2 and survival of patients with IPAH. Blood samples were collected from 46 incident patients with IPAH and 30 healthy controls in Shanghai Pulmonary Hospital. Levels of RUNX2 were measured using ELISA. Linear regression and cox proportional hazards analysis were performed to assess the prognostic value of RUNX2 levels in predicting survival using the Kaplan–Meier method. Nonsurvivors had significantly shorter 6MWD, higher levels of NT-proBNP, increased mRAP, mPAP, mPAWP, PVR, and decreased CO as well as CI, compared with survivors ( p < .05). Plasma levels of RUNX2 were significantly higher in nonsurvival and survival patients with IPAH compared with controls ( p ≤ .001), and higher in nonsurvivors than in survivors ( p = .001). RUNX2 levels served as an independent predictor of survival in these patients ( p < .001). RUNX2 levels ≥41.5 ng/ml had a sensitivity of 80.0% and a specificity of 74.2% by ROC analysis. Patients with a RUNX2 level more...
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- 2020
17. Gender-Related Serum Gamma-Glutamyltransferase in Idiopathic Pulmonary Arterial Hypertension: A Potential Factor Associated with High Mortality in Male Patients
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Rui Zhang, Chunbo Li, Lei Wang, Su-Gang Gong, and G. Lu
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medicine.medical_specialty ,biology ,business.industry ,Male patient ,Internal medicine ,High mortality ,Idiopathic Pulmonary Arterial Hypertension ,biology.protein ,Medicine ,Gamma-glutamyltransferase ,business ,Gender related ,Gastroenterology - Published
- 2020
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18. Variable predictors of acute pulmonary embolism recurrence with duration of follow-up
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Lan Wang, Yan-Zhe Yu, Yuan Li, Yi-Lan Yang, Bigyan Pudasaini, Jing He, Su-Gang Gong, Ping Yuan, Wen-Hui Wu, Jinming Liu, Ci-Jun Luo, Chang Chen, Hong-Ling Qiu, Jinling Li, Rong Jiang, Qin-Hua Zhao, Jian Guo, and Chuan-Yu Wang more...
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,Lower risk ,Pulmonary embolism ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,medicine ,Original Article ,030212 general & internal medicine ,Stage (cooking) ,business ,Survival analysis - Abstract
Background Acute pulmonary embolism (PE) is a critical disease and often leads to a high mortality and morbidity. Several studies have identified predictors of PE recurrence, but whether these predictors have prognostic value and how they vary during varied follow-up periods remain unclear. Methods We retrospectively assessed the occurrence of recurrent PE and the survival time of patients with a diagnosis of acute PE at Shanghai Pulmonary Hospital from May 2007 to May 2018. Potential predictors of recurrent PE were evaluated at different points (1, 3, 6, 12, 24, 60 and 120-month) during a long-term follow-up for each patient. Patients were stratified into two groups by gender to analyze the impact of sex in period-guided prognostic prediction. Receiver operating characteristic curve analysis, survival analysis and multivariate Cox proportional hazards analysis were implemented as statistical analysis methods. Results In total, 597 acute PE patients were included, of whom 62 reported a PE recurrence. Male patients tend to have a lower risk of PE recurrence than female patients during 3- to 60-month follow-up period but have a higher risk of PE recurrence than female patients during 120-month follow-up period. The independent predictors of recurrence-free survival varied among different follow-up periods: In all patients, diabetes was an independent predictor only within 30 days follow-up period and female was considered as an independent predictor during 3- to 120-month follow-up period. Among male patients, hyperlipidemia and Log D-dimer (cut-off value =3.436) was observed as a predictor of recurrent PE within 6-month and over 12-month follow-up respectively. However, there is no unified independent prognostic indicator for female patients identified. Conclusions In the early stage of follow-up, male PE patients have better prognosis, but with the extension of follow-up, female PE patients have better prognosis. The independent predictors of recurrence-free survival vary in different follow-up periods in PE patients when stratified based on gender and associated medical conditions. more...
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- 2020
19. Flexural behavior of steel deep beams prestressed with externally unbonded straight multi-tendons
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Huiyong Ban, Bin Wang, Yuanqing Wang, Jia Song, Su Gang, and Yangzhi Ren
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Timoshenko beam theory ,Statically indeterminate ,Materials science ,business.industry ,Quantitative Biology::Tissues and Organs ,Mechanical Engineering ,020101 civil engineering ,02 engineering and technology ,Building and Construction ,Structural engineering ,Finite element method ,0201 civil engineering ,020303 mechanical engineering & transports ,0203 mechanical engineering ,Flexural strength ,Deep beam ,Image warping ,business ,Beam (structure) ,Civil and Structural Engineering - Abstract
External prestressing is one of the most powerful techniques to retrofit and strengthen the existing beams and columns. In this paper, the flexural behavior of deep beam prestressed with multi-tendons is investigated under concentrated forces for both post- and pre- tensioning processes. Solutions for displacements and stresses are achieved based on Timoshenko beam theory. Besides, a statically indeterminate system was established, and a compatibility condition between the beam and tendons was founded to solve the increase in tendon force in loading period in pre-tensioning. Verifications were performed in tables by applying Finite element analysis. Finally, parameter studies were carried out to examine the effects of tendon force and eccentricity on the flexure of beams. Numerical results were summarized into a series of curves indicating the distribution of warping stresses on flanges and the increases in sub-tendon forces. more...
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- 2018
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20. The modified layer-by-layer weakening solar radiation models based on relative humidity and air quality index
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Xi Yue, Su Gang, Shuangyang Zhang, Yao Wanxiang, Li Ziwei, and Mengru Hu
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Haze ,business.industry ,Mechanical Engineering ,Air pollution ,Building and Construction ,Radiation ,medicine.disease_cause ,Solar energy ,Atmospheric sciences ,Pollution ,R-value (insulation) ,Industrial and Manufacturing Engineering ,General Energy ,Physics::Space Physics ,medicine ,Environmental science ,Relative humidity ,Satellite ,Astrophysics::Earth and Planetary Astrophysics ,Electrical and Electronic Engineering ,business ,Air quality index ,Civil and Structural Engineering - Abstract
Air pollution has a significant weakening effect on solar radiation. Therefore, it is important for the development and utilization of solar energy to establish a solar radiation model under the influence of fog and haze. Based on the analysis of existing layer-by-layer weakening solar radiation models, the discontinuous meteorological data provided by MODIS satellite are replaced by continuous measured data from meteorological stations. The beam solar radiation model and diffuse solar radiation model are modified by using relative humidity ( φ ) and air quality index (AQI). The results show that the correction effects of these modified models are better. The R value of beam solar radiation models have increased by 5.74%, the R value of diffuse solar radiation models have increased by 41.27%, and other statistical parameters (RSE, RMSE and NSE) have also been improved to a certain extent. The calculated value of the modified models is closer to the measured data. In addition, the order of correction parameters also has an effect on the results. The research shows that the best correction effect is to use relative humidity first and then AQI. According to this method, the layer-by-layer weakening solar radiation models can be more accurate and reliable. more...
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- 2022
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21. Sex-specific cardiopulmonary exercise testing indices to estimate the severity of inoperable chronic thromboembolic pulmonary hypertension
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Wen-Hui Wu, Lan Wang, Qin-Hua Zhao, Tian-Xiang Chen, Su-Gang Gong, Bigyan Pudasaini, Jin-Ming Liu, Ping Yuan, Jian Guo, and Rong Jiang
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Male ,medicine.medical_specialty ,Time Factors ,sex difference ,Hypertension, Pulmonary ,severity ,Hemodynamics ,Kaplan-Meier Estimate ,International Journal of Chronic Obstructive Pulmonary Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Disease-Free Survival ,chronic thromboembolic pulmonary hypertension ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,cardiopulmonary exercise testing ,medicine ,Humans ,Lung ,Original Research ,Aged ,Proportional Hazards Models ,COPD ,Exercise Tolerance ,Pulmonary Gas Exchange ,business.industry ,Proportional hazards model ,Confounding ,General Medicine ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,medicine.anatomical_structure ,030228 respiratory system ,Case-Control Studies ,Exercise Test ,Cardiology ,Vascular resistance ,Female ,Pulmonary Embolism ,business ,Body mass index ,Respiratory minute volume - Abstract
Tian-Xiang Chen,1 Bigyan Pudasaini,1 Jian Guo,2 Su-Gang Gong,1 Rong Jiang,1 Lan Wang,1 Qin-Hua Zhao,1 Wen-Hui Wu,1 Ping Yuan,1 Jin-Ming Liu1 1Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China; 2Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China Background: Sex differences in chronic thromboembolic pulmonary hypertension (CTEPH) have been revealed in few studies. Although right heart catheterization (RHC) is the gold standard for clinical diagnosis and assessment of prognosis in pulmonary hypertension (PH), cardiopulmonary exercise testing (CPET) has been a more widely used assessment of functional capacity, disease severity, prognosis, and treatment response in PH. We hypothesized that the “sex-specific” CPET indices could estimate the severity of inoperable CTEPH.Methods: Data were retrieved for 33 male (age, mean ± standard deviation [SD] =62.5±13.4 years) and 40 female (age, mean ± SD =56.3±11.8 years) patients with stable CTEPH who underwent both RHC and CPET at Shanghai Pulmonary Hospital from February 2010 to February 2016. Univariate and forward/backward multiple stepwise regression analysis was performed to assess the predictive value of CPET indices to hemodynamic parameters. Event-free survival was estimated using the Kaplan–Meier method and analyzed with the log-rank test. Cox proportional hazards models were performed to determine the independent event-free survival predictors.Results: Numerous CPET parameters were different between male and female patients with CTEPH and the control group. There were no significant differences in both clinical variables and RHC parameters between male and female patients with CTEPH. O2 pulse, workload, minute ventilation (VE), and end-tidal partial pressure of O2 (PETO2) at anaerobic threshold, as well as peak O2 pulse, workload, VE, and nadir VE/CO2 were significantly higher in male patients than in female patients (P more...
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- 2018
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22. Hemodynamic and gas exchange effects of inhaled iloprost in patients with COPD and pulmonary hypertension
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Rong Jiang, Yuan-Zhe Jin, Lan Wang, Wen-Hui Wu, Qin-Hua Zhao, Zhi-Cheng Jing, Jing He, Jin-Ming Liu, and Su-Gang Gong
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Male ,Pulmonary Circulation ,Time Factors ,Vasodilator Agents ,Hemodynamics ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Hypoxemia ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Risk Factors ,Hypoxic pulmonary vasoconstriction ,pulmonary hypertension ,Prospective Studies ,Lung ,Original Research ,COPD ,General Medicine ,Middle Aged ,medicine.anatomical_structure ,Treatment Outcome ,Cardiology ,Arterial blood ,Female ,medicine.symptom ,medicine.drug ,medicine.medical_specialty ,China ,Hypertension, Pulmonary ,International Journal of Chronic Obstructive Pulmonary Disease ,Pulmonary Artery ,03 medical and health sciences ,Internal medicine ,Administration, Inhalation ,medicine ,Humans ,Arterial Pressure ,Iloprost ,Antihypertensive Agents ,Aged ,business.industry ,Pulmonary Gas Exchange ,medicine.disease ,Pulmonary hypertension ,COPD pulmonary gas exchange ,Oxygen ,030228 respiratory system ,Vasoconstriction ,Vascular resistance ,business ,Biomarkers - Abstract
Lan Wang,1,* Yuan-Zhe Jin,2,* Qin-Hua Zhao,1 Rong Jiang,1 Wen-hui Wu,1 Su-Gang Gong,1 Jing He,1 Jin-Ming Liu,1 Zhi-Cheng Jing1,3 1Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; 2Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Liaoning, China; 3Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China *These authors contributed equally to this work Abstract: Studies have shown that vasodilators such as iloprost can be useful for treating pulmonary hypertension (PH). However, in patients with COPD, vasodilators may inhibit hypoxic pulmonary vasoconstriction and impair gas exchange. The efficacy and safety of iloprost inhalation was assessed in 67 patients with PH associated with COPD (COPD-PH), diagnosed by right heart catheterization. Of these, 37 patients had severe PH (mean pulmonary arterial pressure [mPAP] >35 mmHg or mPAP 25–35 mmHg with low cardiac index [ more...
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- 2017
23. Sex-specific cardiopulmonary exercise testing parameters as predictors in patients with idiopathic pulmonary arterial hypertension
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Jinming Liu, Bigyan Pudasaini, Ping Yuan, Hui-Juan Ni, Rong Jiang, Qin-Hua Zhao, Hui Liu, Lan Wang, Tian-Xiang Chen, and Su-Gang Gong
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Adult ,Male ,Cardiac output ,medicine.medical_specialty ,Physiology ,Population ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,FEV1/FVC ratio ,Oxygen Consumption ,Sex Factors ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,Familial Primary Pulmonary Hypertension ,Cardiac Output ,education ,Aged ,education.field_of_study ,Exercise Tolerance ,business.industry ,Proportional hazards model ,VO2 max ,Middle Aged ,Prognosis ,medicine.anatomical_structure ,030228 respiratory system ,Exercise Test ,Vascular resistance ,Cardiology ,Female ,Vascular Resistance ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise ,Respiratory minute volume - Abstract
Cardiopulmonary exercise testing (CPET) has been used for prognosis in idiopathic pulmonary arterial hypertension (IPAH). We explored whether sex differences had an impact on prognostic assessments of CPET in IPAH. Data were retrieved from 21 male and 36 female incident IPAH patients who underwent both right heart catheterization and CPET from 2010 to 2016 at Shanghai Pulmonary Hospital. Cox proportional hazards analysis was used to assess the prognostic value of CPET. The mean duration of follow-up was 22±15 months. Nine men and 15 women had an event. The differences in clinical parameters in the whole population were not the same as the inter-subgroup differences. Event-free women had significantly higher cardiac output, lower pulmonary vascular resistance and percentage of predicted FVC compared with event men (all P more...
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- 2017
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24. Pulmonary Arterial Hypertension and Fulminant Myocarditis as Initial Manifestation of Systemic Lupus Erythematosus
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Jing He, Rong Jiang, Su-Gang Gong, Qin-Hua Zhao, Rikesh Sapkota, Jinming Liu, and Lan Wang
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lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Systemic lupus erythematosus ,Myocarditis ,business.industry ,Cardiogenic shock ,Fulminant ,medicine.disease ,Ventricular tachycardia ,Connective tissue disease ,systemic lupus erythematosus ,Methylprednisolone ,lcsh:RC666-701 ,immune system diseases ,pulmonary arterial hypertension ,Internal medicine ,medicine ,Cardiology ,skin and connective tissue diseases ,Complication ,business ,medicine.drug - Abstract
Severe pulmonary arterial hypertension (PAH) is rarely observed as initial manifestation of systemic lupus erythematosus (SLE). Lupus myocarditis may rarely be initial presentation as a fatal complication of SLE, which mainly involved with the left ventricle. Here, we present a case of an incident PAH woman who had a delivery history 4 months previously. During hospitalization, she suffered from extensive myocardial damage, refractory ventricular tachycardia, and cardiogenic shock. Ultimately, she was diagnosed with SLE, fulminant lupus myocarditis, and PAH associated with connective tissue disease. After a large dose of methylprednisolone and PAH target therapy treatment, she recovered successfully and got a good result. To the best of our knowledge, this is the first case report of PAH and fulminant lupus myocarditis as initial manifestation of SLE in a previously healthy postpartum woman. more...
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- 2017
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25. Cardiopulmonary Exercise Test in Pulmonary Embolism
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L. Wang, Qin-Hua Zhao, P. Yuan, Jian Guo, Jianping Liu, and Su-Gang Gong
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medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiopulmonary exercise test ,Cardiology ,medicine ,medicine.disease ,business ,Pulmonary embolism - Published
- 2019
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26. Significance of End-Tidal PCO2 and Its Relation to Functional Capacity in IPAH and CTEPH Patients
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Jian Guo, Jianping Liu, Su-Gang Gong, Xiaofang Shi, Qin-Hua Zhao, and Lei Wang
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,End tidal pco2 - Published
- 2019
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27. Differences in Ventilation Inefficiency and Exercise Limitation in Patients with Chronic Thromboembolic Pulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
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Qiang Xiao, Su-Gang Gong, Jianping Liu, Qin-Hua Zhao, Jian Guo, and Lei Wang
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medicine.medical_specialty ,Exercise limitation ,business.industry ,Internal medicine ,Breathing ,medicine ,Idiopathic Pulmonary Arterial Hypertension ,Cardiology ,In patient ,Chronic thromboembolic pulmonary hypertension ,Inefficiency ,business - Published
- 2019
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28. Difference in Exercise Capacity and Ventilatory Efficiency Between Chronic Obstructive Pulmonary Disease Associated Pulmonary Hypertension and Idiopathic Pulmonary Hypertension
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Jianping Liu, Hong Liu, Lei Wang, Su-Gang Gong, Qin-Hua Zhao, and Jian Guo
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medicine.medical_specialty ,business.industry ,Internal medicine ,Idiopathic Pulmonary Hypertension ,medicine ,Cardiology ,Pulmonary disease ,Exercise capacity ,business ,medicine.disease ,Pulmonary hypertension - Published
- 2019
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29. Improvement of Exercise Capacity and Ventilatory Efficiency in Patients with Pulmonary Embolism After Anticoagulant Therapy
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Qin-Hua Zhao, Dandan Huang, Jianping Liu, Jian Guo, Su-Gang Gong, Wenlan Yang, and L. Wang
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medicine.medical_specialty ,Anticoagulant therapy ,business.industry ,Internal medicine ,Cardiology ,Medicine ,In patient ,Exercise capacity ,business ,medicine.disease ,Pulmonary embolism - Published
- 2019
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30. The effect of docosahexaenoic acid on predicting the survival of patients with idiopathic pulmonary arterial hypertension
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Xiuying Sun, Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Jinling Li, Lan Wang, Ping Yuan, Wen-Hui Wu, Yuanyuan Sun, Yuqing Miao, and Huai Xu
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medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Proportional hazards model ,Area under the curve ,Hemodynamics ,General Medicine ,medicine.disease ,Pulmonary hypertension ,Gastroenterology ,medicine.anatomical_structure ,Internal medicine ,Vascular resistance ,Medicine ,Biomarker (medicine) ,Original Article ,lipids (amino acids, peptides, and proteins) ,business ,TBIL - Abstract
Background Abnormal lipid metabolism has been reported in patients with idiopathic pulmonary arterial hypertension (IPAH); however, the prognostic value of plasma free fatty acids (FFAs) for these patients is unclear. The present study aimed to determine whether FFA can play a role in predicting the survival of patients with IPAH. Methods A total of 69 blood samples from patients with IPAH were subjected to liquid chromatography-mass spectrometry (LC-MS). According to the classification criteria for pulmonary hypertension in the European Society of Cardiology (ESC) guidelines, patients were divided into low-risk, intermediate-risk, and high-risk groups. The FFA expression levels of patients in the three groups were compared, and the indicators with significant differences were selected. Cox regression analysis was performed to examine the associations between survival and different factors. Receiver operator characteristic (ROC) curves were used to assess the predictive effect of plasma lipids in assessing patients' risk of morbidity, including area under the curve (AUC), sensitivity, specificity and the best cutoff value. Kaplan-Meier curves were used to predict survival. Results A total of 24 FFA molecules were detected in the patients with IPAH. Among them, FFA (20:4), FFA (20:5), FFA (22:5), FFA (22:6), FFA (24:0) and FFA (30:4) showed significant differences between the low-risk and the intermediate-risk or high-risk patients with IPAH. These six FFAs were significantly correlated with hemodynamic parameters. FFA (22:6), named docosahexaenoic acid (DHA), displayed significant negative correlations with World Health Organization functional classification (WHO FC), mean right atrial pressure (mRAP), and pulmonary vascular resistance (PVR), and significant positive correlations with 6-minute walking distance (6MWD) and cardiac index (CI). Cox regression analyses demonstrated that total bilirubin (TBIL) and DHA were independent risk factors for survival of IPAH. Receiver operating characteristic curve analysis revealed that DHA had a cut-off value of 77.55, which had a sensitivity of 96.7% and a specificity of 62.5% for predicting survival. Kaplan-Meier curve analysis showed that a lower level of DHA predicted a poor outcome in patients with IPAH. Conclusions Our study suggested that FFA levels were correlated with disease severity. Lower levels of DHA predict poor survival in patients with IPAH. more...
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- 2021
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31. Plasma exosomal miR-596: a novel biomarker predicts survival in patients with idiopathic pulmonary artery hypertension
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Ping Yuan, Xun-Tao Yuan, Yang Huang, Su-Gang Gong, Jie Zhang, Qin-Hua Zhao, Liang Tang, Yuanyuan Sun, Rong Jiang, Jinling Li, Zuogang Wang, Ci-Jun Luo, Lan Wang, Xiao-jun Yang, and Wen-Hui Wu
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0301 basic medicine ,Medicine (General) ,medicine.medical_specialty ,Pulmonary Artery ,030204 cardiovascular system & hematology ,miR-596 ,survival ,Biochemistry ,Gastroenterology ,exosomal ,Pre-Clinical Research Report ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Internal medicine ,medicine.artery ,microRNA ,Humans ,Medicine ,Familial Primary Pulmonary Hypertension ,In patient ,Idiopathic pulmonary arterial hypertension ,business.industry ,Biochemistry (medical) ,Idiopathic Pulmonary Arterial Hypertension ,Cell Biology ,General Medicine ,Prognosis ,MicroRNAs ,030104 developmental biology ,Hypertension ,Pulmonary artery ,Biomarker (medicine) ,business ,Biomarkers - Abstract
ObjectiveTo determine if plasma exosomal microRNAs (miRNAs) can predict survival in patients with idiopathic pulmonary arterial hypertension (IPAH).MethodsThe study enrolled patients with IPAH that underwent right heart catheterization. Plasma was collected and exosomal miRNAs were extracted. Exosomes were evaluated using transmission electron microscopy, Western blot analysis and particle size distribution analysis. MiRNAs were evaluated using a miRNA microarray and validated using real-time polymerase chain reaction.ResultsThis study included 12 patients with IPAH in the study group and 48 patients with IPAH in the validation group. The mean ± SD follow-up duration was 60.3 ± 35.4 months in the overall cohort. The levels of miR-596 were higher in the nonsurvivors compared with the survivors. The levels of miR-596 significantly correlated with survival time, mean right atrial pressure, pulmonary vascular resistance (PVR) and cardiac index. High levels of miR-596 and PVR were significantly associated with poor overall survival. Multivariate analysis demonstrated that exosomal miR-596 (hazard ratio [HR] = 2.119; 95% confidence interval [CI] 1.402, 3.203) and PVR (HR = 1.146; 95% CI 1.010, 1.300) were independent predictors of survival.ConclusionsHigh levels of plasma exosomal miR-596 were significantly associated with disease severity and poor prognosis of patients with IPAH. more...
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- 2021
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32. Clinical and hemodynamic characteristics of pulmonary hypertension associated with interstitial lung disease in China
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Lan Wang, Bigyan Pudasaini, Ping Yuan, Jin-Ming Liu, Su-Gang Gong, Rong Jiang, Jing He, and Qin-Hua Zhao
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Male ,Pulmonary and Respiratory Medicine ,Cardiac function curve ,Cardiac Catheterization ,China ,medicine.medical_specialty ,Cardiac output ,Tomography Scanners, X-Ray Computed ,Hypertension, Pulmonary ,Hemodynamics ,Walk Test ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Cardiac Output ,Lung ,Genetics (clinical) ,Aged ,Retrospective Studies ,business.industry ,Interstitial lung disease ,Middle Aged ,respiratory system ,Prognosis ,medicine.disease ,Pulmonary hypertension ,Respiratory Function Tests ,Surgery ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Cohort ,Vascular resistance ,Cardiology ,Female ,Vascular Resistance ,Lung Diseases, Interstitial ,Complication ,business - Abstract
Background: Pulmonary hypertension (PH) is an important complication of interstitial lung disease (ILD). The aim of the present study was to investigate characteristics and prognosis of ILD associated PH in a predominantly Chinese patient cohort. Methods: Consecutive patients with ILD associated PH, confirmed by right heart catheterization at shanghai pulmonary hospital were included in the study. Characteristics at baseline and during follow-up, as well as survival, were analyzed. Results: This observational study was conducted in 26 patients with a mean age of 60.0 ± 12.2 years old. The six-minutes walking distance was 335.0 ± 190.9 meters. Mean pulmonary arterial pressure (PAP) was 42.9 ± 10.9 mm Hg, cardiac output was 4.4 ± 1.0 L/min, and pulmonary vascular resistance (PVR) was 8.6 ± 4.1 Wood Units. Mean PAP was ≥35 mmHg in 69.2% of cases. There were no difference in lung function parameters between ILD with PH and ILD without PH. The overall survival rate was 92% at 1 year, 82% at 3 years, and 62% at 5 years. PVR was the only variable significantly associated with death. Conclusions: Severe hemodynamic impairment along with PH can occur in patients with ILD. These patients have more severely impaired exercise capacity and cardiac function than ILD patients without PH. PVR was the only prognostic factor identified in this group of patients. This article is protected by copyright. All rights reserved. more...
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- 2017
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33. A Clinical Experience of Bilateral Facial Palsy accompanied by Contralateral Otitis Media under Treatment for Bell's palsy
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Su-Yeun Park, Hae-Hwa Kim, Jong-Han Kim, Min-Young Jung, Bung-Su Gang, Jung-Hwa Choi, and Gyung-Mim Lim
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Bilateral facial palsy ,medicine.medical_specialty ,Facial diplegia ,Otitis ,business.industry ,Bell's palsy ,medicine ,Audiology ,medicine.symptom ,medicine.disease ,business - Published
- 2016
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34. Cardiopulmonary exercise testing improves diagnostic specificity in patients with echocardiography-suspected pulmonary hypertension
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Su-Gang Gong, Ping Yuan, Rong Jiang, Jin-Ming Liu, Jian Guo, Hui Liu, Zhi-Cheng Jing, Qin-Hua Zhao, Bigyan Pudasaini, Cheng Wu, Lan Wang, and Qiang Xiao
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Area under the curve ,VO2 max ,Cardiopulmonary exercise testing ,General Medicine ,030204 cardiovascular system & hematology ,Doppler echocardiography ,medicine.disease ,Logistic regression ,Pulmonary hypertension ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Respiratory minute volume - Abstract
Background Doppler echocardiography is usually the first diagnostic investigation for patients suspected with pulmonary hypertension (PH), but it is often inaccurate when used alone, especially in mild PH. Hypothesis Cardiopulmonary exercise testing (CPET) may serve as a complementary tool to improve diagnostic accuracy in echocardiography-suspected “PH possible” patients. Methods Eighty-eight consecutive patients with suspected PH (referred to as “PH possible” hereafter) based on echocardiography were included in the study. CPET was assessed subsequently and PH was confirmed by right-heart catheterization in all subjects. We analyzed CPET data from patients and derived a CPET prediction rule to hemodynamically differentiate PH. Results Eighty-eight patients (27 patients with confirmed PH, and PH ruled out in 61 patients) were included in the study. Compared with non-PH patients, the PH subjects had lower peak oxygen uptake (VO2 ), aerobic capacity (AT), peak partial pressure of end-tidal CO2 (PETCO2 ), oxygen uptake efficiency plateau (OUEP), and oxygen uptake efficiency slope (OUES), along with higher minute ventilation (VE)/carbon dioxide output (VCO2 ) slope and lowest VE/VCO2 (P < 0.001). VE/VCO2 slope and AT were independent predictors of PH derived from multivariate logistic regression adjusted for age and body mass index. A score combining VE/VCO2 slope and AT reached a high area under the curve value of 0.98. A score ≥0.5 had 95% specificity and 92.6% sensitivity for diagnosis of PH. Conclusions A score combining VE/VCO2 slope and AT provides high specificity in screening out PH from a pool of echocardiography-suspected PH patients. more...
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- 2016
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35. Clinical characteristics of pulmonary hypertension in bronchiectasis
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Su-Gang Gong, Qin-Hua Zhao, Lan Wang, Jin-Ming Liu, Zhi-Cheng Jing, Ping Yuan, Bigyan Pudasaini, Jingyun Shi, Sen Jiang, Rong Jiang, and Jing He
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Adult ,Male ,China ,medicine.medical_specialty ,Cardiac output ,Adolescent ,Hypertension, Pulmonary ,Hemodynamics ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Survival rate ,Aged ,Retrospective Studies ,Bronchiectasis ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Surgery ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Vascular resistance ,Cardiology ,Regression Analysis ,Female ,business ,Complication - Abstract
Pulmonary hypertension (PH), as a complication of bronchiectasis, is associated with increased mortality. However, hemodynamic characteristics and the efficacy of pulmonary arterial hypertension (PAH) therapies in patients with bronchiectasis and PH remain unknown. Patients with bilateral bronchiectasis and concurrent PH were included in the study. Patient characteristics at baseline and during follow-up, as well as survival, were analyzed. This observational study was conducted in 36 patients with a mean age of 51.5 years (range, 17‒74 years). The 6 min walking distance was 300.8 ± 3.3 m. The mean pulmonary arterial pressure (PAP) was 41.5 ± 1.7 mmHg, cardiac output was 5.2 ± 1.4 L/min, and pulmonary vascular resistance was 561.5 ± 281.5 dyn∙s∙cm(-5). The mean PAP was > 35 mmHg in 75% of the cases. Mean PAP was inversely correlated with arterial oxygen saturation values (r =-0.45, P = 0.02). In 24 patients who received oral PAH therapy, systolic PAP was reduced from 82.4 ± 27.0 mmHg to 65.5 ± 20.9 mmHg (P = 0.025) on echocardiography after a median of 6 months of follow-up. The overall probability of survival was 97.1% at 1 year, 83.4% at 3 years, and 64.5% at 5 years. Given the results, we conclude that PH with severe hemodynamic impairment can occur in patients with bilateral bronchiectasis, and PAH therapy might improve hemodynamics in such patients. Prospective clinical trials focusing on this patient population are warranted. more...
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- 2016
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36. Can the diastolic pulmonary pressure gradient provide cardiopulmonary capacity information in patients with pulmonary hypertension and left heart disease?
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Qin-Hua Zhao, Jinming Liu, Xiu-jun Zhong, Jie Tang, Lan Wang, Rong Jiang, and Su-Gang Gong
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medicine.medical_specialty ,Heart Diseases ,business.industry ,Hypertension, Pulmonary ,Diastole ,Heart ,Prognosis ,medicine.disease ,Pulmonary hypertension ,Pulmonary pressure ,Internal medicine ,Cardiology ,medicine ,Humans ,In patient ,Pulmonary Wedge Pressure ,Left heart disease ,Cardiology and Cardiovascular Medicine ,business ,Pulmonary wedge pressure - Published
- 2020
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37. Characteristics of cardiopulmonary exercise testing of patients with borderline mean pulmonary artery pressure
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Bigyan Pudasaini, Su-Gang Gong, Wen-Hui Wu, Qin-Hua Zhao, Jin-Ming Liu, Cheng Wu, Lan Wang, Hui Liu, Hong-Ling Qiu, Zhi-Cheng Jing, Ping Yuan, Rui Zhang, Jing He, Rong Jiang, Jian Guo, Ci-Jun Luo, and Jian-Lin Xu more...
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,China ,Hypertension, Pulmonary ,Oxygen pulse ,Hemodynamics ,Exercise intolerance ,Pulmonary Artery ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Genetics (clinical) ,Aged ,business.industry ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Respiratory Function Tests ,Logistic Models ,030228 respiratory system ,Echocardiography ,Case-Control Studies ,Pulmonary artery ,Cardiology ,Breathing ,Exercise Test ,Female ,medicine.symptom ,business ,Anaerobic exercise - Abstract
Background Pulmonary hypertension patients with mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg had impaired cardiopulmonary exercise testing (CPET). Borderline mean pulmonary pressures (boPAP; 21-24 mm Hg) represent early pulmonary vasculopathy. The CPET characteristics of boPAP are a matter of discussion. We aimed to determine the CPET profile of such borderline hemodynamics. Methods A matched case-control study was conducted on consecutive boPAP patients at the Shanghai Pulmonary Hospital between Jan 2012 and Jan 2017. Hemodynamics, echocardiography, the pulmonary function test (PFT) and CPET parameters were compared between boPAP patients and normal mPAP patients which were matched 1:1 by sex and age. Conditional logistic regression analysis was performed to determine the efficacy of CPET in detecting boPAP. Results A total of 48 patients underwent RHC and CPET (24 Normal, 24 boPAP). There were no differences in the demographics, echocardiography and PFT. BoPAP patients had significantly decreased VO2 at the anaerobic threshold and peak VO2 /kg (858.4 ± 246.5 mL/min vs 727.9 ± 228.0 mL/min, P = 0.037; 21.1 ± 6.4 mL/min/kg vs. 15.5 ± 5.6 mL/min/kg, P = 0.001, respectively). Significant differences were not observed in ventilation efficiency. A trend of impaired oxygen pulse and submaximal exercise tolerance were observed in boPAP patients. Conditional logistical regression analysis revealed the risk of boPAP increased by 2.493 (95% confident interval: 1.388 to 4.476, P = 0.002) with every 5 mL/min/kg decrease in peak VO2 /kg. Conclusions Patients with boPAP have a greater prevalence of exercise intolerance, a trend of impaired oxygen pulse and submaximal exercise tolerance. more...
- Published
- 2018
38. Diving patterns and decompression sickness among South Korean fishery divers
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Man Joong Jeon, Su Gang Cha, Joon Sakong, and Young Seok Byun
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Adult ,Male ,diving ,Fisheries ,decompression sickness ,Logistic regression ,Decompression sickness ,Risk Factors ,Surveys and Questionnaires ,Field Study ,Republic of Korea ,medicine ,Humans ,Sex Distribution ,business.industry ,Incidence (epidemiology) ,Incidence ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Fishery ,Occupational Diseases ,Logistic Models ,Female ,business ,human activities - Abstract
Objectives We aimed to report the characteristics of diving practice and the incidence of decompression sickness (DCS) among South Korean fishery divers. Methods We sent out questionnaires to 215 registered boat owners, and 196 of the fishery divers responded. The questionnaire was comprised of demographical characteristics, diving‐related characteristics, and experiences with DCS. DCS was classified into types I and II based on the symptoms. Results Their average length of career in fishery diving was 18.1 ± 8.5 years. They were working for 10.8 ± 1.9 months per year. The average bottom time was 74.7 ± 23.3 minutes, the average depth was 23.6 ± 6.8 m, and the average surface interval time was 20.7 ± 12.5 minutes. The incidence of DCS symptoms among the total participants was 84.7%. The incidence increased as working days per month and dives per day increased (P more...
- Published
- 2018
39. Transition from Ambrisentan to Bosentan in Pulmonary Arterial Hypertension: A Single-Center Prospective Study
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Wen-Hui Wu, Qin-Hua Zhao, Jing He, Cai-cun Zhou, Rong Jiang, Su-Gang Gong, Rui Zhang, Ping Yuan, Lan Wang, Jinming Liu, and Bigyan Pudasaini
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,Article Subject ,Ambrisentan ,Adolescent ,medicine.medical_treatment ,Hypertension, Pulmonary ,Hemodynamics ,Walk Test ,030204 cardiovascular system & hematology ,Single Center ,03 medical and health sciences ,Diseases of the respiratory system ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Antihypertensive Agents ,Cardiac catheterization ,Aged ,RC705-779 ,Phenylpropionates ,business.industry ,Drug Substitution ,Bosentan ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Pyridazines ,030228 respiratory system ,Echocardiography ,Cardiology ,Female ,Liver function ,business ,medicine.drug ,Research Article - Abstract
Background and objective: Two endothelin receptor antagonists (ETRAs), bosentan and ambrisentan, are approved for patients with pulmonary arterial hypertension (PAH). However, there is little information about the transition strategy between these two ETRAs. We aimed to evaluate the safety and efficacy from ambrisentan to bosentan. Methods: Twenty PAH patients were enrolled into the single-center, open-labelled prospective study. Echocardiogram, WHO functional class (WHO-FC), 6-minute walking distance (6MWD), right heart catheterization, and hemotology were collected. After receiving oral 5 mg ambrisentan daily initially for one year, the patients were divided into two arms: eight patients switched to bosentan, while the remaining 12 patients continued ambrisentan. Characteristics at baseline, 1-and 2-year follow-up points were compared. Results: There were no significant differences in echocardiogram, WHO-FC, hemodynamics, demographics and liver function at baseline, 1-and 2-year points in both arms. 6MWD in bosentan group was significantly shorter at baseline. But there were no significant differences of 6MWD at 1- and 2-year points. Conclusions: It is safe for stable PAH patients to transition from ambrisentan to bosentan without hemodynamic or hematologic deterioration. more...
- Published
- 2018
40. Oxygen uptake is more efficient in idiopathic pulmonary arterial hypertension than in chronic thromboembolic pulmonary hypertension
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Jian Guo, Jinming Liu, Wenlan Yang, Xiaofang Shi, Rikesh Sapkota, Su-Gang Gong, Wenjing Xiang, Lan Wang, Xing-Guo Sun, and Hui Liu
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung ,business.industry ,Hemodynamics ,030204 cardiovascular system & hematology ,medicine.disease ,Vascular occlusion ,Pulmonary hypertension ,Pulmonary embolism ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Internal medicine ,medicine.artery ,Pulmonary artery ,Vascular resistance ,medicine ,Cardiology ,medicine.symptom ,business - Abstract
Background and objective The responses of oxygen uptake efficiency (OUE) during cardiopulmonary exercise training (CPET) have not been reported in patients with pulmonary hypertension. We aimed to investigate the differences in OUE between patients with idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods Forty-four patients with IPAH and 29 patients with CTEPH were retrospectively enrolled into our study. All patients underwent right-heart catheterization, pulmonary function test and performed the 6-min walk test and CPET. Results We found that oxygen uptake efficiency plateau (OUEP) and oxygen uptake efficiency at anaerobic threshold (OUE@AT) was significantly higher in IPAH than that in CTEPH (both P = 0.002). However, patients with CTEPH had lower mean pulmonary artery pressure, pulmonary vascular resistance and transpulmonary gradient (all P 0.05) in patients with IPAH. In patients with CTEPH, both anaerobic threshold (r = 0.307, P > 0.05) and VE_AT (r = −0.709, P more...
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- 2015
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41. Torque Ripple Suppression Method for BLDCM Drive Based on Four-Switch Three-Phase Inverter
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Wang Xiuli, Beibei Wang, Pan Lei, Hexu Sun, Peng Guili, and Su Gang
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Engineering ,Vector control ,Observer (quantum physics) ,business.industry ,Stator ,DC motor ,law.invention ,Control and Systems Engineering ,law ,Control theory ,Control system ,Inverter ,Torque ripple ,Electrical and Electronic Engineering ,business ,DC bias - Abstract
A novel inverter fault-tolerant control scheme is proposed to drive brushless DC motor. A fault-tolerant inverter and its three fault-tolerant schemes (i.e., phase A fault-tolerant, phase B fault-tolerant, and phase C fault-tolerant) are analyzed. Eight voltage vectors are summarized and a voltage vector selection table is used in the control scheme to improve the midpoint current of the split capacitors. A stator flux observer is proposed. The observer can improve flux estimation, which does not require any speed adaptation mechanism and is immune to speed estimation error. Global stability of the flux observer is guaranteed by the Lyapunov stability analysis. A novel stator resistance estimator is incorporated into the sensorless drive to compensate for the effects of stator resistance variation. DC offset effects are mitigated by introducing an integral component in the observer gains. Finally, a control system based on the control scheme is established. Simulation and experiment results show that the method is correct and feasible. more...
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- 2015
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42. Comparative effectiveness of sildenafil for pulmonary hypertension due to left heart disease with HFrEF
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Jin-Ming Liu, Rong Jiang, Qin-Hua Zhao, Jing He, Ping Yuan, Bigyan Pudasaini, Changtai Zhu, Lan Wang, Su-Gang Gong, and Qing-Hua Hu
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medicine.medical_specialty ,Physiology ,Sildenafil ,Hypertension, Pulmonary ,White coat hypertension ,Sildenafil Citrate ,Ventricular Function, Left ,Prehypertension ,chemistry.chemical_compound ,Oxygen Consumption ,Pharmacotherapy ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Heart Failure ,business.industry ,Stroke Volume ,Stroke volume ,Phosphodiesterase 5 Inhibitors ,medicine.disease ,Pulmonary hypertension ,respiratory tract diseases ,chemistry ,Heart failure ,Exercise Test ,Quality of Life ,cardiovascular system ,Cardiology ,Left heart disease ,Cardiology and Cardiovascular Medicine ,business - Abstract
There is no cure for pulmonary hypertension due to left heart disease (PH-LHD), but the rationale for using sildenafil to treat pulmonary arterial hypertension with heart failure with reduced ejection fraction (HFrEF) has been supported by short-term studies. We performed a meta-analysis to evaluate the effectiveness of sildenafil for PH-LHD with HFrEF. A systematic literature search of PubMed, EMBASE and the Cochrane Central Register of Controlled Trials was conducted from inception through October 2014 for randomized trials and for observational studies with control groups, evaluating the effectiveness of sildenafil to treat PH-LHD with HFrEF. Sildenafil therapy decreased pulmonary arterial systolic pressure both at the acute phase and at the 6-month follow-up (weighted mean difference (WMD): -6.03 mm Hg, P=0.02; WMD: -11.47 mm Hg, P0.00001, respectively). Sildenafil was found to reduce mean pulmonary artery pressure (WMD: -3 mm Hg, P=0.0004) and pulmonary vascular resistance (WMD: -60.0 dynes cm(-5), P=0.01) at the 3-month follow-up. Oxygen consumption at peak significantly increased to 3.66 ml min(-1) kg(-1) (P0.00001), 3.36 ml min(-1) kg(-1) (P0.00001) and 2.60 ml min(-1) kg(-1) (P=0.03) at 3, 6 and 12 months, respectively. There were significant reductions in ventilation to CO2 production slope of -2.00, -4.68 and -7.12 at 3, 6 and 12 months, respectively (P0.00001). Sildenafil was superior to placebo regarding left ventricular ejection fraction at the 6-month follow-up (WMD: 4.35, P0.00001), and it significantly improved quality of life. Sildenafil therapy could effectively improve pulmonary hemodynamics and cardiopulmonary exercise testing measurements of PH-LHD with HFrEF, regardless of acute or chronic treatment. more...
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- 2015
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43. Health interventions focused on sex workers
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Su Gang and Elaine Jeffreys
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business.industry ,Environmental health ,Psychological intervention ,Sex workers ,Medicine ,business - Published
- 2017
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44. Men who have sex with men
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Elaine Jeffreys and Su Gang
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business.industry ,Medicine ,business ,Demography ,Men who have sex with men - Published
- 2017
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45. AIDS and the sex industry
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Elaine Jeffreys and SU Gang
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Acquired immunodeficiency syndrome (AIDS) ,Condom ,business.industry ,law ,medicine ,medicine.disease ,business ,Demography ,law.invention - Published
- 2017
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46. Sex-specific cardiopulmonary exercise testing indices related to hemodynamics in idiopathic pulmonary arterial hypertension
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Si-Jin Zhang, Ping Yuan, Jinming Liu, Wen-Hui Wu, Qin-Hua Zhao, Jie Zhang, Qing-Hua Hu, Tian-Xiang Chen, Bigyan Pudasaini, Su-Gang Gong, Jian Guo, Rong Jiang, Lan Wang, and Jing He
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,China ,sex difference ,PVR ,Hemodynamics ,030204 cardiovascular system & hematology ,Severity of Illness Index ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Oxygen Consumption ,Sex Factors ,CPET ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Familial Primary Pulmonary Hypertension ,Cardiac Output ,Original Research ,lcsh:RC705-779 ,IPAH ,business.industry ,Idiopathic Pulmonary Arterial Hypertension ,Cardiopulmonary exercise testing ,lcsh:Diseases of the respiratory system ,Carbon Dioxide ,Middle Aged ,Prognosis ,Sex specific ,CO ,030228 respiratory system ,Cardiology ,Physical therapy ,Exercise Test ,Regression Analysis ,Female ,business - Abstract
Background: Many studies have highlighted sex preponderance in idiopathic pulmonary arterial hypertension (IPAH). It is well established that there are differences in exercise capacities in the two sexes but how much of that difference reflects on disease severity or correlates to markers of severity in the two sexes is still not clear. Right heart catheterization (RHC) and cardiopulmonary exercise testing (CPET) have been widely used for assessing functional capacity, prognosis and treatment response in IPAH. We aimed to investigate the ‘sex-specific’ CPET parameters in relation to hemodynamics in IPAH. Methods: Data were retrieved from 30 males and 53 females [mean ± standard deviation (SD) age: 39.6 ± 17.2 and 37.5 ± 12.0] stable IPAH patients who underwent both RHC and CPET at Shanghai Pulmonary Hospital from 2010 to 2016. Univariate and forward/backward multiple stepwise regression analysis was performed to assess the prognostic value of CPET and hemodynamic parameters. Results: There were no significant differences in clinical variables between men and women. Peak workload, peak oxygen uptake, anaerobic threshold (AT), peak minute ventilation, carbon dioxide output, O2 pulse and oxygen uptake efficiency slope were significantly higher in men compared with women ( p < 0.05). Several CPET indexes correlated with hemodynamics. Pulmonary vascular resistance (PVR) and cardiac output (CO) were distinctly different between the sexes. Peak end-tidal partial pressure of CO2 (PETCO2) was an independent predictor of PVR elevation in all patients and in men. Peak maximum oxygen consumption (VO2) was independently predictive of CO decline in all patients and in men. Only peak O2 pulse was an independent predictor of increased PVR and decreased CO in women. Conclusions: Even after adjusting for age, body mass index and World Health Organization functional class, different CPET parameters correlated with PVR elevation and CO decline in men and women differently, which could potentially better predict severity in men and women with IPAH. more...
- Published
- 2017
47. Efficacy and safety of a calcium sensitizer, levosimendan, in patients with right heart failure due to pulmonary hypertension
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Rui Zhang, Jin-Ming Liu, Rong Jiang, Ping Yuan, Jing He, Wen-Hui Wu, Hong-Ling Qiu, Qin-Hua Zhao, Ci-Jun Luo, Su-Gang Gong, and Lan Wang
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Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,China ,Cardiotonic Agents ,Adolescent ,Hypertension, Pulmonary ,030204 cardiovascular system & hematology ,Sudden death ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Prospective Studies ,Pulmonary Wedge Pressure ,Pulmonary wedge pressure ,Prospective cohort study ,Adverse effect ,Survival rate ,Genetics (clinical) ,Simendan ,Aged ,Heart Failure ,Dose-Response Relationship, Drug ,business.industry ,Hydrazones ,Levosimendan ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Pyridazines ,Survival Rate ,Treatment Outcome ,030228 respiratory system ,Anesthesia ,Heart failure ,Acute Disease ,Injections, Intravenous ,Cardiology ,Ventricular Function, Right ,business ,Receptors, Calcium-Sensing ,medicine.drug - Abstract
Background: Despite using vasoactive and PH specific therapies, the in-hospital mortality of severe pulmonary hypertension (PH) with right heart failure (RHF) is high. We conducted a prospective analysis evaluating the efficacy and safety of levosimendan in PH patients with severe acute RHF. Methods: Forty-five PH patients hospitalized between Jan 2016 to Nov 2016 were recruited into a single arm, prospective, open-label study. Levosimendan was administered at the rate of 0.05-0.1 μg/kg/min, up to a total dose of 12.5 mg. The primary endpoints were changes of World Health Organization Function Class (WHO-FC) and Borg dyspnoea scores. Secondary endpoints included changes in 6-min walk distance (6-MWD), biochemical markers and right heart structure and function together with adverse events on day 7, and incidence of major cardiovascular events (death or re-admission due to RHF) on day 30. Results: Forty-five PH patients were enrolled. On the 7th day after levosimendan infusion, seven out of 13 PH patients with WHO-FC IV improved by one class (P = 0.008). Borg dyspnoea scores, 6-MWD and NT-proBNP improved significantly (P more...
- Published
- 2017
48. Chronotropic Incompetence and its Relation to Exercise Intolerance in Chronic Obstructive Pulmonary Disease
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Su-Gang Gong, Jian Guo, Lan Wang, Wenlan Yang, Jing He, Qin-Hua Zhao, Hai-jian Liu, and Jinming Liu
- Subjects
Chronotropic ,Male ,endocrine system ,medicine.medical_specialty ,Chronotropic incompetence ,Pulmonary disease ,Exercise intolerance ,030204 cardiovascular system & hematology ,Pulmonary function testing ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Heart Rate ,Internal medicine ,Heart rate ,medicine ,Humans ,030212 general & internal medicine ,Exercise ,COPD ,business.industry ,VO2 max ,Heart ,General Medicine ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Respiratory Function Tests ,Case-Control Studies ,Cardiology ,Exercise Test ,Female ,medicine.symptom ,Blood Gas Analysis ,business - Abstract
Background To study the relationship between chronotropic incompetence (CI) and disease severity and to assess the effect of CI on exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods Arterial blood gas analysis, pulmonary function test and cardiopulmonary exercise testing were conducted in 60 patients with stable COPD and 45 healthy volunteers. CI was defined using the chronotropic response index (CRI = (peak heart rate-resting heart rate) / (220-age-resting heart rate). Based on CRI, patients with COPD were divided into the normal chronotropic group ( n = 23) and CI group ( n = 37). Results CI was present in 61.7% of the patients with COPD. Exercise capacity (peak oxygen uptake as percentage of predicted value, peak VO 2 %pred), peak heart rate and CRI were significantly lower in patients with COPD than in controls. However, resting heart rate was significantly higher than in controls. FEV 1 %pred and exercise capacity were significantly decreased in the CI group when compared with those in the normotropic group. There was significant association between CRI with FEV 1 %pred and peak VO 2 %pred. Multivariate regression analysis showed that CRI and FEV 1 %pred were independent predictors of exercise capacity in patients with COPD. A cutoff of 0.74 for the CRI showed a specificity of 94.1% in predicting patients with a peak VO 2 %pred Conclusions CRI was associated with disease severity in patients with COPD. CI may be an important parameter to reflect exercise capacity in patients with COPD. more...
- Published
- 2016
49. Oxygen Uptake Efficiency Slope, an Objective Submaximal Parameter in Evaluating Exercise Capacity in Pulmonary Thromboembolism
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Jinming Liu, Bigyan Pudasaini, Lan Wang, Shujuan Chen, Su-Gang Gong, Wenlan Yang, Jian Guo, and Qin-Hua Zhao
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Adult ,Male ,medicine.medical_specialty ,China ,030204 cardiovascular system & hematology ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Respiratory system ,Exercise ,Peak exercise ,Aged ,business.industry ,VO2 max ,General Medicine ,Exercise capacity ,Middle Aged ,Oxygen uptake ,Respiratory Function Tests ,Oxygen ,030228 respiratory system ,Physical therapy ,Cardiology ,Exercise Test ,Female ,business ,Pulmonary Embolism ,Warming up ,Anaerobic exercise - Abstract
Objective The objective of this article was to study the oxygen uptake efficiency, an index of cardiopulmonary functional reserve that can be based upon a submaximal exercise effort, in pulmonary thromboembolism (PE) by performing the cardiopulmonary exercise test. Materials and Methods The cardiopulmonary exercise test with simultaneous respiratory gas measurement was performed in 50 patients with PE and in 50 healthy individuals. All subjects also underwent the pulmonary function test. Peak oxygen uptake (peak VO 2 ), anaerobic threshold (AT), oxygen uptake efficiency slope (OUES), oxygen uptake efficiency plateau (OUEP) and oxygen uptake efficiency at anaerobic threshold (OUE@AT), were determined. Results (1) Compared with the controls, the patients with PE had lower peak VO 2 , AT, OUES, OUEP and OUE@AT ( P 2 /VE) at warming up, AT and peak exercise but not rest, were indicated statistically lower than the controls. The OUE in normal subjects increased as unloaded exercise began, and then increased further to OUEP just before the AT. Thereafter, the OUE decreased gradually until peak exercise. In contrast, the rate of changes of the OUE in patients with PE was relatively mild during exercise. (3) Of all the submaximal parameters, OUES correlated best with peak VO 2 ( r = 0.712, P Conclusions The oxygen uptake efficiency of patients with PE was lower than the controls during exercise. The OUE is an objective measure of cardiopulmonary reserve that does not require a maximal exercise effort. Therefore, OUES could be helpful to assess exercise performance in patients with PE who are unable to perform a maximal exercise test in early recovery stage. more...
- Published
- 2016
50. Voltage Control Method Research of PV Power System Based on Small Signal Model
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Wei Gong, Lei Pan, Dong Lin Wang, Bei Bei Wang, and Su Gang
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Engineering ,business.industry ,Photovoltaic system ,General Engineering ,Control engineering ,Converters ,Transfer function ,Maximum power point tracking ,Electric power system ,Control system ,Electronic engineering ,Grid-connected photovoltaic power system ,business ,Nominal power (photovoltaic) - Abstract
In photovoltaic power systems, both photovoltaic modules and switching-mode converters present nonlinear and time-variant characteristics, which result in a difficult control problem. This paper presents an in-depth analysis and modeling to discover the inherent features of a photovoltaic (PV) power system and proposes a control method for PV power system based on small-signal model. This paper also presents a state equation and transfer function of PV power system and a stable control system for regulating the photovoltaic voltage. Simulation and experiment results demonstrate the effectiveness of the presented analysis, design, and implementation. more...
- Published
- 2012
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