ObjectiveThe aim of our study was to evaluate the prognostic value of gated SPECT MPI in non-obstructed coronary arteries (INOCA) patients, sought to stratify patients more accurately and thus derive more reliable prognostic information.Materials and methodsIn total, 167 patients with INOCA were enrolled. The patients were divided into two groups according to their SSS. Patients were followed-up regularly in terms of major adverse cardiovascular event (MACE), including cardiac death, nonfatal myocardial infarction, stroke, re-hospitalization with angina pectoris, and recurrent angina pectoris. Kaplan-Meier curves and Cox's proportional hazards models were used to analyze survival and identify predictive factors.ResultsAdverse cardiac events occurred in 33 cases (19.8%). The rate of MACE was higher in the summed stress score (SSS) ≥4 group than in the SSS 0–3 group (30.1% vs. 9.5%, respectively, P = 0.001) and MACE-free survival was lower (annual MACE-free rates of 87.5% vs. 96.2%, respectively, P = 0.003). Event-free survival was consistently higher in patients with normal arteries than in those with non-obstructive coronary artery disease (annual MACE-free rates of 96.1% and 88.4%, P = 0.035). When the SSS and the CAG results were combined, patients with normal coronary arteries (SSS 0–3) had the best prognosis and those with non-obstructive coronary artery stenosis (SSS ≥ 4) had the worst. However, the early prognosis of patients with non-obstructive coronary artery disease and SSS of 0–3 was comparable to that of patients with normal coronary arteries and SSS ≥ 4 (annual MACE-free rates of 100%, 94.6%, 93.1%, and 78.2%, respectively). Multivariate Cox's regression indicated that the SSS [hazard ratio (HR) = 1.126, 95% confidence interval (CI) 1.042–1.217, P = 0.003] and non-obstructive coronary artery disease (HR = 2.559, 95% CI 1.249–5.246, P = 0.01) were predictors of adverse cardiac events.ConclusionSPECT MPI data were prognostic for INOCA patients, thus identifying groups at high risk. The long-term predictive efficacy of such data exceeded that of CAG data. A combination of the two measures more accurately stratified INOCA patients in terms of risk.
Purpose The prognosis of patients with ischemia and non-obstructive coronary artery disease (INOCA) remains controversial; most do not undergo accurate disease evaluation and treatment, and the symptoms recur. Here, we used single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) to evaluate patients with INOCA. We sought to stratify patients more accurately and thus derive more reliable prognostic information. Materials and methods In total, 167 patients with INOCA were enrolled. All underwent invasive coronary angiography (CAG) and SPECT MPI within 1 week. The patients were divided into different groups according to their test results. Patients were followed-up regularly in terms of major adverse cardiovascular events (MACEs), including cardiac death, nonfatal myocardial infarction, stroke, re-hospitalization with angina pectoris, and recurrent angina pectoris. Kaplan-Meier curves and Cox’s proportional hazards models were used to analyze survival and identify predictive factors. Results Adverse cardiac events occurred in 33 cases (19.8%). The rate of MACEs was higher in the summed stress score (SSS) ≥ 4 group than in the SSS 0–3 group (30.1% vs 9.5%, respectively, P = 0.001) and event-free survival was lower (annual survival of 87.5% vs 96.2%, respectively, P = 0.003). Event-free survival was consistently higher in patients with normal arteries than in those with non-obstructive coronary artery disease (annual survival rates of 96.1% and 88.4%, P = 0.035). When the SSS scores and the CAG results were combined, patients with normal coronary arteries (SSS 0–3) had the best prognosis and those with non-obstructive coronary artery stenosis (SSS ≥ 4) had the worst. However, the early prognosis of patients with non-obstructive coronary artery disease and SSS scores of 0–3 was comparable to that of patients with normal coronary arteries and SSS scores ≥ 4 (annual survival rates of 100%, 94.6%, 93.1%, and 78.2%, respectively). Multivariate Cox’s regression indicated that the SSS score (hazard ratio [HR] = 1.126, 95% confidence interval [CI] 1.042–1.217, P = 0.003) and non-obstructive coronary artery disease (HR = 2.559, 95% CI 1.249–5.246, P = 0.01) were predictors of adverse cardiac events. Conclusion SPECT MPI data were prognostic for INOCA patients, thus identifying groups at high risk. The long-term predictive efficacy of such data exceeded that of CAG data. A combination of the two measures more accurately stratified INOCA patients in terms of risk.
Purpose: To investigate the mechanism of polysaccharides from aloe vera (PAV), a main active ingredient of Aloe vera , treatment in pulpitis rats. Methods: Pulpitis were modeled by drilling the occlusal central fossa with Sprague Dawley rats. Next, the rats were treated with 20, 40, and 80 mg/kg PAV for three weeks, respectively. Computed tomography scanning assay, hematoxylin and eosin staining, and tartrate-resistant acid phosphatase staining were used to detect the pathology change. Then, levels of tumor necrosis factor-α, interleukin-1β, prostaglandin E 2 , and ciclooxigenase 2 were detected by enzyme-linked immunosorbent assay. The expressions of bone morphogenetic protein 2 human (BMP-2), osteocalcin, osterix, and runt-related transcription factor 2 (Runx2) were quantified by quantitative real-time polymerase chain reaction and Western blotting (WB). Finally, Wnt3a expression, p-GSK3β/GSK3β and p-β-catenin/β-catenin ratio were analyzed by WB. Results: PAV up regulated the bone mineral density, and reduced the breakage of the crown and cervical structures, and the necrosis of the crown and root pulp of pulpitis rats. In addition, results indicated that PAV could inhibit osteoblast formation. While osteoblasts’ number was decreased, proteins of BMP-2, osteocalcin, osterix, and Runx2 were up-regulated by PAV. Furthermore, PAV increased the Wnt3a expression and the p-β-catenin/β-catenin ratio, and decreased p-GSK3β/GSK3β ratio. Interestingly, these effects were all in dose dependence. Conclusions: PAV could inhibit pulp inflammation and promote osteoblasts differentiation via suppressing the activation of the Wnt/β-catenin signaling, enhancing the dental bone density.
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