Background:Risk assessment and treatment stratification for three-vessel coronary disease(TVD)remain challenging.This study aimed to investigate the prognostic value of left atrial volume index(LAVI)with the Synergy B...Background:Risk assessment and treatment stratification for three-vessel coronary disease(TVD)remain challenging.This study aimed to investigate the prognostic value of left atrial volume index(LAVI)with the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score II,and its association with the long-term prognosis after three strategies(percutaneous coronary intervention[PCI],coronary artery bypass grafting[CABG],and medical therapy[MT])in patients with TVD.Methods:This study was a post hoc analysis of a large,prospective cohort of patients with TVD in China,that aimed to determine the long-term outcomes after PCI,CABG,or optimal MT alone.A total of 8943 patients with TVD were consecutively enrolled between 2004 and 2011 at Fuwai Hospital.A total of 7818 patients with available baseline LAVI data were included in the study.Baseline,procedural,and follow-up data were collected.The primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),which was a composite of all-cause death,myocardial infarction(MI),and stroke.Secondary endpoints included all-cause death,cardiac death,MI,revascularization,and stroke.Long-term outcomes were evaluated among LAVI quartile groups.Results:During a median follow-up of 6.6 years,a higher LAVI was strongly associated with increased risk of MACCE(Q3:hazard ratio[HR]1.20,95%confidence interval[CI]1.06-1.37,P=0.005;Q4:HR 1.85,95%CI 1.64-2.09,P<0.001),all-cause death(Q3:HR 1.41,95%CI 1.17-1.69,P<0.001;Q4:HR 2.54,95%CI 2.16-3.00,P<0.001),and cardiac death(Q3:HR 1.81,95%CI 1.39-2.37,P<0.001;Q4:HR 3.47,95%CI 2.71-4.43,P<0.001).Moreover,LAVI significantly improved discrimination and reclassification of the SYNTAX score II.Notably,there was a significant interaction between LAVI quartiles and treatment strategies for MACCE.CABG was associated with lower risk of MACCE than MT alone,regardless of LAVI quartiles.Among patients in the fourth quartile,PCI was associated with significantly increased risk of cardiac death compared with CABG(HR展开更多
用“准三维”数值模拟方法研究吹气发泡法制备泡沫铝的过程中,单个气泡在铝熔液搅拌流场中的运动与变形。液体流场采用多重参考系法进行三维模拟,对气泡运动的二维模拟则在三维流场中的一个通过搅拌轴的特征平面上进行。这样既能捕获气...用“准三维”数值模拟方法研究吹气发泡法制备泡沫铝的过程中,单个气泡在铝熔液搅拌流场中的运动与变形。液体流场采用多重参考系法进行三维模拟,对气泡运动的二维模拟则在三维流场中的一个通过搅拌轴的特征平面上进行。这样既能捕获气泡在搅拌流场中运动的基本特征,又能大大降低计算成本。应用流体体积分数(volume of fluid,VOF)方法对气液两相之间的界面进行追踪。通过对不同表面张力气泡的计算,总结出流场中关于气泡运动路径和导致气泡变形直至破碎的三种主要机理。展开更多
基金supported by National Program on Key Basic Research Project(973 Program,No.2010CB732601)National High-Tech Research and Development Program of China(863 Program,No.2015AA020407)+5 种基金Beijing Municipal Science&Technology Commission(No.Z191100006619106)National Natural Science Foundation of China(Nos.81470380 and 81770365)National Key Research and Development Program of the Ministry of Science and Technology of China during the"13^(th)Five-Year Plan"(No.2016YFC1301301)National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(No.NCRC2020013)Key Project of Yunnan National Regional Medical Center for Cardiovascular Diseases(No.202002AA310100-14)Beijing United Heart Foundation(No.BJUHFCSOARF201901-19)
文摘Background:Risk assessment and treatment stratification for three-vessel coronary disease(TVD)remain challenging.This study aimed to investigate the prognostic value of left atrial volume index(LAVI)with the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score II,and its association with the long-term prognosis after three strategies(percutaneous coronary intervention[PCI],coronary artery bypass grafting[CABG],and medical therapy[MT])in patients with TVD.Methods:This study was a post hoc analysis of a large,prospective cohort of patients with TVD in China,that aimed to determine the long-term outcomes after PCI,CABG,or optimal MT alone.A total of 8943 patients with TVD were consecutively enrolled between 2004 and 2011 at Fuwai Hospital.A total of 7818 patients with available baseline LAVI data were included in the study.Baseline,procedural,and follow-up data were collected.The primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),which was a composite of all-cause death,myocardial infarction(MI),and stroke.Secondary endpoints included all-cause death,cardiac death,MI,revascularization,and stroke.Long-term outcomes were evaluated among LAVI quartile groups.Results:During a median follow-up of 6.6 years,a higher LAVI was strongly associated with increased risk of MACCE(Q3:hazard ratio[HR]1.20,95%confidence interval[CI]1.06-1.37,P=0.005;Q4:HR 1.85,95%CI 1.64-2.09,P<0.001),all-cause death(Q3:HR 1.41,95%CI 1.17-1.69,P<0.001;Q4:HR 2.54,95%CI 2.16-3.00,P<0.001),and cardiac death(Q3:HR 1.81,95%CI 1.39-2.37,P<0.001;Q4:HR 3.47,95%CI 2.71-4.43,P<0.001).Moreover,LAVI significantly improved discrimination and reclassification of the SYNTAX score II.Notably,there was a significant interaction between LAVI quartiles and treatment strategies for MACCE.CABG was associated with lower risk of MACCE than MT alone,regardless of LAVI quartiles.Among patients in the fourth quartile,PCI was associated with significantly increased risk of cardiac death compared with CABG(HR
文摘用“准三维”数值模拟方法研究吹气发泡法制备泡沫铝的过程中,单个气泡在铝熔液搅拌流场中的运动与变形。液体流场采用多重参考系法进行三维模拟,对气泡运动的二维模拟则在三维流场中的一个通过搅拌轴的特征平面上进行。这样既能捕获气泡在搅拌流场中运动的基本特征,又能大大降低计算成本。应用流体体积分数(volume of fluid,VOF)方法对气液两相之间的界面进行追踪。通过对不同表面张力气泡的计算,总结出流场中关于气泡运动路径和导致气泡变形直至破碎的三种主要机理。
