Currently,clinically available coronary CT angiography(CCTA)derived fractional flow reserve(CT-FFR)is time-consuming and complex.We propose a novel artificial intelligence-based fully-automated,on-site CT-FFR technolo...Currently,clinically available coronary CT angiography(CCTA)derived fractional flow reserve(CT-FFR)is time-consuming and complex.We propose a novel artificial intelligence-based fully-automated,on-site CT-FFR technology,which combines the automated coronary plaque segmentation and luminal extraction model with reduced order 3 dimentional(3D)computational fluid dynamics.A total of 463 consecutive patients with 600 vessels from the updated China CT-FFR study in Cohort 1 undergoing both CCTA and invasive fractional flow reserve(FFR)within 90 d were collected for diagnostic performance evaluation.For Cohort 2,a total of 901 chronic coronary syndromes patients with index CT-FFR and clinical outcomes at 3-year follow-up were retrospectively analyzed.In Cohort 3,the association between index CT-FFR from triple-rule-out CTA and major adverse cardiac events in patients with acute chest pain from the emergency department was further evaluated.The diagnostic accuracy of this CT-FFR in Cohort 1 was 0.82 with an area under the curve of 0.82 on a per-patient level.Compared with the manually dependent CT-FFR techniques,the operation time of this technique was substantially shortened by 3 times and the number of clicks from about 60 to 1.This CT-FFR technique has a highly successful(>99%)calculation rate and also provides superior prediction value for major adverse cardiac events than CCTA alone both in patients with chronic coronary syndromes and acute chest pain.Thus,the novel artificial intelligencebased fully automated,on-site CT-FFR technique can function as an objective and convenient tool for coronary stenosis functional evaluation in the real-world clinical setting.展开更多
目的:观察阿托伐他汀(ATO)干预后,LPS作用的Krüppel样因子4(KLF4)过表达的RAW264.7细胞株的表型相关基因的变化,探讨ATO对RAW264.7细胞表型调控的作用及机制。方法:将野生型RAW264.7细胞、空载体RAW264.7细胞(Lenti-pLVX细胞)、KLF...目的:观察阿托伐他汀(ATO)干预后,LPS作用的Krüppel样因子4(KLF4)过表达的RAW264.7细胞株的表型相关基因的变化,探讨ATO对RAW264.7细胞表型调控的作用及机制。方法:将野生型RAW264.7细胞、空载体RAW264.7细胞(Lenti-pLVX细胞)、KLF4过表达的RAW264.7细胞(Lenti-KLF4细胞)均分为对照组、ATO组、LPS组、ATO+LPS组,其中ATO干预6 h、LPS刺激3 h后,提取细胞总RNA反转录成cDNA,RT-PCR检测各组细胞巨噬细胞表型相关基因IL-10、Arg-1、NF-κB的mRNA表达量的变化并进行统计分析。结果:ATO干预野生型RAW264.7细胞后KLF4 mRNA的表达量明显高于对照组(3.72±0.71 vs 1.00±0.00,P<0.05)。ATO干预后,LPS诱导Lenti-KLF4细胞与Lenti-pLVX细胞相比,表型相关基因IL-10、Arg-1的mRNA表达量增加,分别升高约2倍(2.85±0.41 vs 1.34±0.08)、3.6倍(9.84±0.96 vs 2.75±0.57)(P<0.01);NF-κB基因的mRNA表达量降低了55%(0.39±0.09 vs 0.87±0.02,P<0.01)。结论:他汀类药物可能通过KLF4途径对巨噬细胞的极化进行调控,进而发挥其抗炎、抗纤维化作用。展开更多
基金supported by the National Key Research and Development Program of China(2022YFC2010004)Jiangsu Province Key Project of Comprehensive Prevention and Control of Chronic Diseases(BE2020699)Top Talent Support Program for young and middle-aged people of Wuxi Health Committee(BJ2023044).
文摘Currently,clinically available coronary CT angiography(CCTA)derived fractional flow reserve(CT-FFR)is time-consuming and complex.We propose a novel artificial intelligence-based fully-automated,on-site CT-FFR technology,which combines the automated coronary plaque segmentation and luminal extraction model with reduced order 3 dimentional(3D)computational fluid dynamics.A total of 463 consecutive patients with 600 vessels from the updated China CT-FFR study in Cohort 1 undergoing both CCTA and invasive fractional flow reserve(FFR)within 90 d were collected for diagnostic performance evaluation.For Cohort 2,a total of 901 chronic coronary syndromes patients with index CT-FFR and clinical outcomes at 3-year follow-up were retrospectively analyzed.In Cohort 3,the association between index CT-FFR from triple-rule-out CTA and major adverse cardiac events in patients with acute chest pain from the emergency department was further evaluated.The diagnostic accuracy of this CT-FFR in Cohort 1 was 0.82 with an area under the curve of 0.82 on a per-patient level.Compared with the manually dependent CT-FFR techniques,the operation time of this technique was substantially shortened by 3 times and the number of clicks from about 60 to 1.This CT-FFR technique has a highly successful(>99%)calculation rate and also provides superior prediction value for major adverse cardiac events than CCTA alone both in patients with chronic coronary syndromes and acute chest pain.Thus,the novel artificial intelligencebased fully automated,on-site CT-FFR technique can function as an objective and convenient tool for coronary stenosis functional evaluation in the real-world clinical setting.
文摘目的:观察阿托伐他汀(ATO)干预后,LPS作用的Krüppel样因子4(KLF4)过表达的RAW264.7细胞株的表型相关基因的变化,探讨ATO对RAW264.7细胞表型调控的作用及机制。方法:将野生型RAW264.7细胞、空载体RAW264.7细胞(Lenti-pLVX细胞)、KLF4过表达的RAW264.7细胞(Lenti-KLF4细胞)均分为对照组、ATO组、LPS组、ATO+LPS组,其中ATO干预6 h、LPS刺激3 h后,提取细胞总RNA反转录成cDNA,RT-PCR检测各组细胞巨噬细胞表型相关基因IL-10、Arg-1、NF-κB的mRNA表达量的变化并进行统计分析。结果:ATO干预野生型RAW264.7细胞后KLF4 mRNA的表达量明显高于对照组(3.72±0.71 vs 1.00±0.00,P<0.05)。ATO干预后,LPS诱导Lenti-KLF4细胞与Lenti-pLVX细胞相比,表型相关基因IL-10、Arg-1的mRNA表达量增加,分别升高约2倍(2.85±0.41 vs 1.34±0.08)、3.6倍(9.84±0.96 vs 2.75±0.57)(P<0.01);NF-κB基因的mRNA表达量降低了55%(0.39±0.09 vs 0.87±0.02,P<0.01)。结论:他汀类药物可能通过KLF4途径对巨噬细胞的极化进行调控,进而发挥其抗炎、抗纤维化作用。
