Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

BACKGROUND: To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment– elevation myocardial infarction by investigating the long-term prognostic impact.METHODS AND RESULTS: From January 2013 through September 2014, we studied 5966 patients with ST-segment–elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR &lt; 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36–0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34–0.67]) were significantly associated with lower 2-year mortality than STR &lt;50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal.CONCLUSIONS: Post-PPCI STR is a robust long-term prognosticator for ST-segment–elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, support-ing it as a convenient and reliable surrogate end point for defining successful PPCI.</p

Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

BACKGROUND: To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment– elevation myocardial infarction by investigating the long-term prognostic impact.METHODS AND RESULTS: From January 2013 through September 2014, we studied 5966 patients with ST-segment–elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR &lt; 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36–0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34–0.67]) were significantly associated with lower 2-year mortality than STR &lt;50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal.CONCLUSIONS: Post-PPCI STR is a robust long-term prognosticator for ST-segment–elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, support-ing it as a convenient and reliable surrogate end point for defining successful PPCI.</p

Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

BACKGROUND: To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment– elevation myocardial infarction by investigating the long-term prognostic impact.METHODS AND RESULTS: From January 2013 through September 2014, we studied 5966 patients with ST-segment–elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR &lt; 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36–0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34–0.67]) were significantly associated with lower 2-year mortality than STR &lt;50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal.CONCLUSIONS: Post-PPCI STR is a robust long-term prognosticator for ST-segment–elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, support-ing it as a convenient and reliable surrogate end point for defining successful PPCI.</p

Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

BACKGROUND: To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment– elevation myocardial infarction by investigating the long-term prognostic impact.METHODS AND RESULTS: From January 2013 through September 2014, we studied 5966 patients with ST-segment–elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR &lt; 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36–0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34–0.67]) were significantly associated with lower 2-year mortality than STR &lt;50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal.CONCLUSIONS: Post-PPCI STR is a robust long-term prognosticator for ST-segment–elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, support-ing it as a convenient and reliable surrogate end point for defining successful PPCI.</p

Ni/CeO₂ Catalyst Prepared via Microimpinging Stream Reactor with High Catalytic Performance for CO₂ Dry Reforming Methane

Methane reforming with carbon dioxide (DRM) is one promising way to achieve carbon neutrality and convert methane to syngas for high-value chemical production. Catalyst development with better performance is the key to its potential large-scale industrial application due to its deactivation caused by carbon deposition and metal sintering. Hence, a Ni/CeO2 catalyst (Ni/CeO2-M) with higher CO2 conversion and better stability is prepared, supported on CeO2 precipitated via a novel microimpinging stream reactor. A series of ex-situ or in-situ characterizations, such as CO titration measurements, two-step transient surface reaction (two-step TSR), CO2 and CH4 temperature-programmed surface reaction (CO2-TPSR and CH4-TPSR), X-ray absorption fine structure (XAFS), and in-situ Raman spectroscopy study, were used to investigate its structure and mechanism. In contrast to Ni supported on commercial CeO2 (Ni/CeO2-C), the Ni/CeO2-M catalyst with stronger lattice oxygen mobility and higher oxygen storage capacity enhances its CO2 activation ability and carbon deposition. The Ni particle size of the Ni/CeO2-M catalyst decreased, and a higher oxidation state was obtained due to the strong metal–support interaction. Besides the reaction performance improvement of the Ni/CeO2-M catalyst, the novel microimpinging stream reactor could achieve catalyst continuous production with a high preparation efficiency. This work provides a novel method for the high-performance catalyst preparation for DRM reaction and its mechanism study gives a deep insight into high-performance catalyst development via bottom-up study

Ni/CeO2 Catalyst Prepared via Microimpinging Stream Reactor with High Catalytic Performance for CO2 Dry Reforming Methane

Methane reforming with carbon dioxide (DRM) is one promising way to achieve carbon neutrality and convert methane to syngas for high-value chemical production. Catalyst development with better performance is the key to its potential large-scale industrial application due to its deactivation caused by carbon deposition and metal sintering. Hence, a Ni/CeO2 catalyst (Ni/CeO2-M) with higher CO2 conversion and better stability is prepared, supported on CeO2 precipitated via a novel microimpinging stream reactor. A series of ex-situ or in-situ characterizations, such as CO titration measurements, two-step transient surface reaction (two-step TSR), CO2 and CH4 temperature-programmed surface reaction (CO2-TPSR and CH4-TPSR), X-ray absorption fine structure (XAFS), and in-situ Raman spectroscopy study, were used to investigate its structure and mechanism. In contrast to Ni supported on commercial CeO2 (Ni/CeO2-C), the Ni/CeO2-M catalyst with stronger lattice oxygen mobility and higher oxygen storage capacity enhances its CO2 activation ability and carbon deposition. The Ni particle size of the Ni/CeO2-M catalyst decreased, and a higher oxidation state was obtained due to the strong metal&ndash;support interaction. Besides the reaction performance improvement of the Ni/CeO2-M catalyst, the novel microimpinging stream reactor could achieve catalyst continuous production with a high preparation efficiency. This work provides a novel method for the high-performance catalyst preparation for DRM reaction and its mechanism study gives a deep insight into high-performance catalyst development via bottom-up study

Left ventricular remodeling in hypertrophic cardiomyopathy patients with atrial fibrillation

Abstract Background Atrial fibrillation (AF) is the most common complication in hypertrophic cardiomyopathy (HCM). The mechanisms of AF is associated with left atrial (LA) structural remodeling in HCM patients. However, the impact of left ventricular (LV) remodeling on the presence of AF in HCM patients has not been evaluated yet. We sought to investigate effect of LV remodeling on the presence of AF assessed by cardiovascular magnetic resonance (CMR) in HCM patients. Methods A total of 394 HCM patients were enrolled into this study, including HOCM patients (n = 293) and NOHCM patients (n = 101). Patients were divided into HCM with AF (50) and HCM without AF (n = 344). Data were collected from hospital records. Results LA diameter and LV remodeling index (LVRI) were significantly higher in HCM patients with AF than that of HCM patients without AF (46.6 ± 7.4 mm versus 39.9 ± 8.0 mm, p < 0.001, and 1.46 ± 0.6 versus 1.2 ± 0.4, p = 0.002, respectively). HCM patients with AF were older than HCM patients without AF (53.6 ± 11.7 years versus 47.7 ± 13.6 years, p = 0.002). Additionally, LVRI positively correlated to LA size (r = 0.12, p = 0.02). In a multivariable logistic regression analysis, when adjusting for age and LV end diastolic mass index, LVRI and LA size remained an independent determinant of AF in HCM patients (OR = 4.7, p = 0.001 and OR = 1.13, P < 0.001). Conclusion HCM patients with AF showed significantly more LA diameter, LVRI and age than HCM patients without AF. LVRI and LA size were strong independent predictor of AF in HCM, suggesting LV remodeling may contribute to the occurrence of AF in HCM patients

Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

BACKGROUND: To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment– elevation myocardial infarction by investigating the long-term prognostic impact.METHODS AND RESULTS: From January 2013 through September 2014, we studied 5966 patients with ST-segment–elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR &lt; 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36–0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34–0.67]) were significantly associated with lower 2-year mortality than STR &lt;50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal.CONCLUSIONS: Post-PPCI STR is a robust long-term prognosticator for ST-segment–elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, support-ing it as a convenient and reliable surrogate end point for defining successful PPCI.</p

Związek między wysokim prawidłowym stężeniem tyreotropiny a stopniem ciężkości dysfunkcji rozkurczowej lewej komory u chorych z kardiomiopatią przerostową

Background: Impaired left ventricular (LV) diastolic function is a common pathophysiological feature of patients with hypertrophiccardiomyopathy (HCM). High-normal thyrotropin (thyroid-stimulating hormone, TSH) levels may alter the performanceof the left ventricle.Aim: To ascertain whether the severity of impaired LV diastolic function in HCM patients might worsen with elevating TSHlevels within the reference range.Methods: This study included 152 HCM patients and 119 healthy controls with euthyroidism. Blood samples were taken to testfor serum TSH, free triiodothyronine (FT3) and free thyroxine (FT4) levels. LV diastolic function was quantified by determiningthe ratio of the transmitral early LV filling velocity to the early diastolic mitral annulus velocity (E/Ea ratio).Results: The E/Ea ratio was significantly higher in patients with high-normal TSH levels (25.7 ± 5.6 vs. 17.7 ± 4.9, p &lt; 0.001).There was a significant correlation between the E/Ea ratio and the TSH levels within the high reference range (β = 0.268,p = 0.021). Univariate logistic regression showed that high-normal TSH levels were predictors of severe heart failure. However,after adjusting for the effect of LV diastolic dysfunction, high-normal TSH levels were no longer independent predictorsof severe heart failure.Conclusions: The HCM patients with high-normal TSH levels had a higher degree of LV diastolic dysfunction. Mild TSHlevel changes within the high reference range can influence the severity of impaired LV diastolic function. In HCM patients,high-normal TSH levels may affect the development of heart failure through their association with LV diastolic impairment.Wstęp: Upośledzenie czynności rozkurczowej lewej komory (LV) jest zaburzeniem często występującym u chorych z kardiomiopatiąprzerostową (HCM). Prawidłowe wysokie stężenie tyreotropiny (hormon stymulujący tarczycę, TSH) może wpływaćna zmianę czynności LV.Cel: Celem niniejszego badania było ustalenie, czy dysfunkcja rozkurczowa LV u chorych z HCM może się nasilać ze wzrostemstężenia TSH w zakresie wartości prawidłowych.Metody: W badaniu uczestniczyło 152 pacjentów z HCM i 119 zdrowych osób z prawidłową czynnością tarczycy, stanowiącychgrupę kontrolną. Od wszystkich pobrano próbki krwi w celu oznaczenia surowiczych stężeń TSH, wolnej trijodotyroniny (FT3)i wolnej tyroksyny (FT4). Czynność rozkurczową LV oceniano na podstawie wartości współczynnika E/Ea (stosunek prędkościmaksymalnej fali wczesnego napływu mitralnego do wczesnorozkurczowej prędkości ruchu pierścienia zastawki mitralnej).Wyniki: Współczynnik E/Ea był istotnie wyższy u chorych z wysokimi prawidłowymi stężeniami TSH (25,7 ± 5,6 vs. 17,7 ± 4.9;p &lt; 0,001). Stwierdzono istotną korelację między wartościami współczynnika E/Ea i stężeniami TSH w zakresie wysokichwartości prawidłowych (β = 0,268; p = 0,021). W modelu regresji logistycznej dla jednej zmiennej wykazano, że wysokieprawidłowe stężenia TSH były predyktorami ciężkiej niewydolności serca. Jednak po skorygowaniu pod względem wpływudysfunkcji skurczowej LV wysokie prawidłowe stężenia TSH nie zachowały wartości predykcyjnej w stosunku do ciężkiejniewydolności serca.Wnioski: U chorych z HCM, u których stężenia TSH utrzymują się w zakresie wysokich wartości prawidłowych, zaobserwowanobardziej nasiloną dysfunkcję LV. Niewielkie zmiany stężenia TSH w zakresie wysokich wartości prawidłowych mogą wpływaćna stopień ciężkości dysfunkcji rozkurczowej LV. U pacjentów z HCM wysokie prawidłowe stężenia TSH mogą przyczyniaćsię do rozwoju niewydolności serca poprzez ich związek z dysfunkcją rozkurczową LV