Lin Li

Right ventricular (RV) dysfunction in patients with coronary artery disease (CAD) and concomitant pulmonary hypertension (PH) is associated with poor outcomes, yet its short-term reversibility after percutaneous coronary intervention (PCI) remains unclear. Identifying echocardiographic predictors of RV functional improvement may inform tailored therapeutic strategies. This single-center retrospective cohort study enrolled 160 CAD patients with systolic pulmonary artery pressure (sPAP > 65 mm Hg) undergoing PCI between January 2024 and February 2025. Echocardiography was performed within 7 days before and after PCI, assessing RV function via tricuspid annular plane systolic excursion (TAPSE), Tei index, and speckle-tracking-derived RV free wall strain (RVFWS) and global strain (RVGS). The primary outcome was ≥ 1-level improvement in NYHA class. At 7-day follow-up, 57.5% of patients improved, with increased TAPSE (13.8 mm to 15.1 mm, P = .004) and RVFWS (−17.0% to − 19.6%, P < .001), and decreased Tei index (0.45–0.41, P = .031) and sPAP (68 mm Hg to 62 mm Hg, P = .026). Multivariable analysis showed higher baseline TAPSE (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.03–1.86; P = .029) and lower Tei index (OR 0.70, 95% CI 0.51–0.96; P = .037) independently predicted RV recovery. The model demonstrated good discrimination (AUC = 0.78, 95% CI 0.71–0.85) and calibration (Hosmer–Lemeshow P = .735). Subgroup analysis confirmed consistent findings in preserved left ventricular ejection fraction and severe symptoms. In CAD patients with elevated pulmonary pressure, PCI facilitated early RV improvement, with baseline TAPSE and Tei index serving as useful predictors for risk stratification.

(1) Background: Our aim was to evaluate left atrial (LA) volumes and function in patients with newly diagnosed, treatment-naive type 2 diabetes mellitus (T2DM) using Four-Dimensional Automated Left Atrial Quantificative (four-dimensional auto LAQ) analysis and to explore the independent factors influencing left atrial function in diabetic patients. (2) Method: A total of 62 treatment-naive, newly diagnosed T2DM patients without hypertension or obesity and 50 healthy controls were prospectively enrolled in the study. All participants underwent laboratory analyses, routine echocardiography and 4D LAQ assessment. The parameters were compared between the two groups, and independent factors influencing left atrial function in diabetic patients were investigated through univariate and multivariate linear regression analyses. (3) Results: Despite no significant difference in LA end-systolic anteroposterior diameter between groups, LA volume parameters (LAVmax, LAVmin, LAVpreA, and LAVmaxI) were significantly increased in T2DM patients (all p < 0.05). Regarding LA strain, reservoir and conduit function were significantly impaired in T2DM patients, as reflected by lower LASr, LAScd, LASr-c, and LAScd-c (all p < 0.05). Conversely, circumferential contractile strain (LASct-c) was significantly higher in the T2DM group (p = 0.029), while longitudinal contractile strain (LASct) did not differ significantly between groups (p = 0.146). Multivariate analysis revealed that HbA1c and E/e’ ratio were independently associated with multiple LA strain parameters (all p < 0.05). (4) Conclusion: Newly diagnosed, treatment-naive patients with T2DM exhibited increased LA volumes, decreased left atrial ejection fraction (LAEF), and impaired reservoir and conduit functions, accompanied by a compensatory increase in contractile function. Furthermore, HbA1c and E/e’ demonstrated an independent correlation with 4D strain parameters. 4D Auto LAQ echocardiography may serve as a sensitive tool for early detection of diabetic atrial myopathy.

Background: Non-invasive identification of coronary stenosis in stable coronary artery disease (CAD) patients lacking regional wall motion abnormalities (RWMA) remains challenging. This study aimed to develop and validate a myocardial work-derived nomogram for predicting significant coronary stenosis in these patients. Methods: In this retrospective study, 181 consecutive patients with angiographically confirmed CAD, preserved LVEF (≥55%), and no resting wall motion abnormalities were enrolled. Global myocardial work efficiency (GWE) was assessed using echocardiographic pressure–strain loop analysis. A multivariable-derived nomogram incorporating GWE and clinical biomarkers was developed and externally validated for predicting severe coronary stenosis. Results: The nomogram incorporating GWE, lipoprotein-associated phospholipase A2 (LP-PLA2), N-terminal pro brain natriuretic peptide (NT-proBNP), and serum creatinine (Scr) demonstrated favorable discrimination in both the training set (AUC 0.916, 95% CI 0.866–0.952) and validation set (AUC 0.911, 95% CI 0.853–0.951), with good calibration (mean absolute error: 1.9% vs 3.2% in training vs validation, respectively). Decision curve analysis confirmed clinical utility across all probability thresholds. Conclusions: Our nomogram provides a non-invasive tool for preoperative risk stratification and optimizes the use of invasive diagnostics in stable CAD patients without RWMA.

Background: Postpartum hemorrhage is a life-threatening pregnancy complication and we want to evaluate the safety and efficacy of autologous blood transfusion during cesarean section in women with placenta previa to deal with postpartum hemorrhage. Methods: We conducted a retrospective study concentrating on all cases of placenta previa using autologous blood recovery during cesarean section in a single-center from August 2016 to July 2018, and then grouped and compared the clinical and patient characteristics. Linear regression analysis was conducted to analyze the linear relationships between estimated blood loss and recovered autologous blood volume, recovered autologous blood volume and transfused autologous blood volume, and transfused autologous blood volume and estimated blood loss. Results: In our study, autologous blood recovery technology was used during cesarean section for 294 patients with placenta previa, and a total of 266,660 mL of blood was collected and 134,342 mL of autologous blood was transfused, saving 746 U of red blood cell suspension. Recovered and transfused blood volumes were higher in patients with suspected placenta accreta and resection of the uterus. There were no serious adverse reactions related to autologous blood recovery and transfusion. Conclusions: The use of autologous blood transfusion during cesarean section in patients with placenta previa is safe and can save blood resources.

Objectives Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall-motion abnormality (RWMA) by three-dimensional echocardiography (3-DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS). Methods Sixty-one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD-16, TmsvSD-12, and TmsvSD-6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R-SDI, 12R-SDI, 6R-SDI) using 3-DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low-GS ≤20, mid-GS >20 and ≤48, and high-GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed. Results Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R-SDI, and 6R-SDI were prolonged in the high-GS group compared with the low- and mid-GS groups. 16R-SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R-SDI was an independent predictor of the GS. 16R-SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high-GS. Conclusion Three-dimensional echocardiography is a noninvasive technique to detect LVD in non-RWMA CAD patients, and the parameter 16R-SDI was significantly correlated with CAD severity.

Neuropathic pain, resulting from somatosensory nervous system dysfunction, remains a serious public health problem worldwide. microRNAs are involved in the physiological processes of neuropathic pain. However, the biological roles of miR‐98 in neuropathic pain development have not been investigated. Therefore, in our current study, we focused on the effects of miR‐98 in neuropathic pain. It was shown that miR‐98 was significantly downregulated in chronic sciatic nerve injury (CCI) rat models. In addition, high mobility group A2 (HMGA2) was obviously upregulated in CCI rats. Overexpression of miR‐98 inhibited neuropathic pain progression, including mechanical and thermal hyperalgesia. By a bioinformatics analysis, HMGA2 was predicted as a direct target of miR‐98. The negative correlation between miR‐98 and HMGA2 was validated in our present study. Furthermore, overexpression of miR‐98 dramatically repressed HMGA2 protein and messenger RNA (mRNA) expression. Neuroinflammation participates in neural‐immune interactions, which can contribute to the neuropathic pain development. Meanwhile, we found that inflammatory cytokine (interleukin [IL]‐6, IL‐1β, and COX‐2) protein expression in rats infected with LV‐miR‐98 was greatly suppressed. Taking these results together, we concluded that miR‐98 might depress neuropathic pain development through modulating HMGA2.