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Objective·To investigate the predictive value of the Clinical Frailty Scale (CFS) in the long term outcomes in acute myocardial infarction (AMI) patients who completed in-hospital cardiac rehabilitation (CR).Methods·A total of 501 AMI patients treated in the Cardiology Center of Shanghai Sixth People's Hospital, Shanghai Jiao Tong University of Medicine from May 2020 to May 2022 were prospectively enrolled, with their baseline clinical data collected. The patients completed graded in-hospital CR and were assessed by CFS based on their completion of CR before discharge. Patients were then categorized into three groups (norm group, vulnerable group and frail group) according to their CFS level. The difference in 1-year major cardiovascular event (all-cause death and re-hospitalization for heart failure) rates among the three groups was investigated. Logistic regression analysis was performed to explore the effective risk factors relevant to the outcomes, and receiver operator characteristic (ROC) curves were generated to analyze the prognostic value. Finally, an optimal prediction model was developed.Results·The CFS level in AMI patients who completed CR was positively correlated with age and peak pro-B-type natriuretic peptide (peak proBNP), and inversely correlated with gender difference (P

The electrochemical impedance method was firstly introduced to measure fractional flow reserve (FFR) and blood flow rate simultaneously in interventional treatments for cardiovascular diseases. A FFR sensor and a flow sensor based on flexible MEMS technology were developed. Firstly, these sensors were constructed on Parylene-C film into a single device, where the measurement electrodes and sensor wires were embed in. Since the total thickness is 8 µm, the device presents extremely flexibility and can work well on small curved surfaces (curvature radius of 0.2 mm). Then, the device was mounted on the surface of a catheter to form an impedance wire. Two sensors ware tested in-vitro. The impedance/flow relation of the flow sensor is favorable linearity over 0-250 mL/min. And the FFR sensor exhibits high sensitivity at the range of FFR from 0.6 to 1. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The purpose of this study was to investigate the diagnostic performance of quantitative parameters generated from dynamic myocardial perfusion CT for assessment of acute myocardial infarction (AMI) and microvascular obstruction (MVO) using cardiac MRI as a reference standard. SUBJECTS AND METHODS. Patients who underwent successful reperfusion treatment within 1 week after AMI between January 1, 2018, and May 31, 2018, were prospectively enrolled. All patients were referred for cardiac MRI and dynamic myocardial perfusion CT on the same day. Various quantitative parameters and late iodine enhancement (LIE) were analyzed for the evaluation of AMI and MVO using cardiac MRI findings as a reference standard. RESULTS. Twenty-seven patients with 442 vascular segments were ultimately included in the analysis. The mean radiation doses ± SD for dynamic myocardial perfusion CT and LIE were 3.3 ± 1.1 mSv and 2.0 ± 0.6 mSv, respectively. Myocardial blood flow (MBF) was significantly lower in segments with MVO than in those without MVO and in reference segments (23.08 ± 7.95 mL/min/100 mL vs 44.60 ± 14.97 mL/min/100 mL and 75.07 ± 7.34 mL/min/100 mL; p < 0.001). According to ROC curve analysis, MBF had the largest AUC of all parameters for identifying AMI with and without MVO as determined by late gadolinium enhancement (LGE) (AUC = 0.941 and 0.996; p < 0.001). The diagnostic accuracy of MBF-based assessment for identifying MVO was 99.2%, which outperformed other quantitative parameters and LIE. We found good correlation between the AMI area and MVO area estimated by MBF and LGE ( r = 0.95 and 0.99; p < 0.001). CONCLUSION. MBF derived from dynamic myocardial perfusion CT is accurate and outperforms other quantitative parameters and LIE in diagnosis of AMI and MVO. Area of AMI and MVO can also be accurately estimated using MBF.

Purpose: To evaluate the presence of linear intrathrombus enhancement in coronary total occlusion (CTO) lesions observed at coronary computed tomographic (CT) angiography and its correlation with the outcome of percutaneous coronary intervention (PCI)., Materials and Methods: All patients gave written informed consent, and the study protocol was approved by the hospital ethics committee. Consecutive patients with CTO confirmed at initial conventional coronary angiography were prospectively chosen to undergo a coronary CT angiography examination prior to their staged PCI. Linear intrathrombus enhancement was defined as a linear area of enhanced opacity traversing the nonopacified occluded segment with attenuation higher than 120 HU. Angiographic features, including lesion length, linear intrathrombus enhancement length, and calcification score, were measured at coronary CT angiography. Univariate and multivariate statistical tests were performed to identify variables associated with successful PCI., Results: Eighty patients with 88 CTO lesions were included in this study. Fifty-one lesions were successfully recanalized at PCI. Lesion length was longer in the PCI failure group (P = .043). Linear intrathrombus enhancement was observed in 30 (59%) of the 51 lesions successfully treated with PCI. However, linear enhancement was found in seven (19%) of 37 patients with failed PCI (P < .001 as compared with patients with successful PCI). Tortuous course was revealed to be the only angiographic parameter associated with unfavorable PCI outcome (P = .008). The presence of linear intrathrombus enhancement proved at multivariate analysis to be the only independent predictor of PCI success (odds ratio: 4.926; 95% confidence interval: 1.646, 14.74; P = .004)., Conclusion: The presence of coronary CT angiography-visible linear intrathrombus enhancement within the occluded segment predicts better outcome of PCI in CTOs.