Publications by authors named "Bao Bingyuan"
Discrimination Between Anterior and Posterior Left Atrial Roof Area Ablation by a Cryoballoon.
Circ Arrhythm Electrophysiol
December 2024
Article Synopsis
- The study investigates the heart's energy dynamics during acute heart failure (HF) to understand what happens during decompensation, which is when the heart can't pump effectively.
- It involved 50 patients with decompensated HF, measuring intracardiac energy loss (EL) using echo-vector flow mapping at both admission and discharge, comparing results with 40 stable patients who do not have HF.
- Findings showed that energy loss in the left ventricle increased significantly in decompensated HF cases compared to compensated ones, indicating energy inefficiency in the heart, especially among patients with preserved ejection fraction.
Article Synopsis
- The study focused on how different settings of cryoballoon ablation affect the size of frozen lesions in porcine hearts, particularly examining application duration and push-up technique.
- Results showed that longer application durations (at least 150 seconds) and the push-up technique (especially at 20 seconds post-freezing) significantly increase lesion size.
- Interestingly, the absence of laminar flow didn't lead to larger lesions, even though it resulted in lower balloon temperatures.
Reliable focal and rotational activations in CARTOFINDER mapping using the OctaRay catheter.
J Cardiovasc Electrophysiol
February 2024
Article Synopsis
- * OctaRay identified more focal and rotational activation sites than PentaRay, but had lower reproducibility and stability rates for these activations after pulmonary vein isolation in persistent AF patients.
- * Ultimately, the OctaRay catheter was found to provide high-resolution and reliable identification of focal and rotational activations, which are associated with shorter AF-cycle lengths and increased activation frequency.
Article Synopsis
- The study investigates the effects of long-term β-blocker therapy, specifically carvedilol, in patients with ST-segment elevation myocardial infarction (STEMI) and mildly reduced left ventricular ejection fraction (LVEF, ≥40%).
- Conducted as part of the CAPITAL-RCT trial, researchers analyzed 794 patients, splitting them into two LVEF groups to evaluate the outcomes of β-blocker therapy versus no therapy.
- Results indicated that while there was no significant impact on overall mortality and major adverse cardiac events, patients with mildly reduced LVEF did experience a statistically significant lower rate of cardiac-related events when treated with carvedilol, suggesting potential benefits for this specific group.
Article Synopsis
- The study aimed to investigate the relationship between intracardiac dynamics during atrial fibrillation (AF) in patients with heart failure (HF) using echo-vector flow mapping.
- 76 patients were categorized into high and low NT-proBNP groups based on their serum levels, which helped assess energy loss during AF and sinus rhythms.
- Results showed that the high NT-proBNP group had significantly greater energy loss during AF, but this improved after restoring sinus rhythm, indicating a link between energy inefficiency and serum NT-proBNP levels.
Background: Despite its recommendation by the current guidelines, the role of long-term oral beta-blocker therapy has never been evaluated by randomized trials in uncomplicated ST-segment elevation myocardial infarction (STEMI) patients without heart failure, left ventricular dysfunction or ventricular arrhythmia who underwent primary percutaneous coronary intervention (PCI).
Methods And Results: In a multi-center, open-label, randomized controlled trial, STEMI patients with successful primary PCI within 24 hours from the onset and with left ventricular ejection fraction (LVEF) ≥40% were randomly assigned in a 1-to-1 fashion either to the carvedilol group or to the no beta-blocker group within 7 days after primary PCI. The primary endpoint is a composite of all-cause death, myocardial infarction, hospitalization for heart failure, and hospitalization for acute coronary syndrome.
Article Synopsis
- Current drug-coated balloons (DCBs) lose some of their coated drug during delivery, prompting research on improving drug delivery with nanoparticle technology and PDMS as new materials.
- The study tested a new DCB that was coated with 5.6mg of paclitaxel-loaded nanoparticles, showing promising results in a swine model, where it significantly reduced area stenosis after 28 days compared to the control group.
- The findings suggest that this innovative DCB reduces smooth muscle cell proliferation, indicating a potential for more effective treatments in coronary interventions.
Article Synopsis
- A new guidewire-integrated filter device (IFD) was developed for better capturing emboli during catheter interventions, addressing challenges of using traditional distal protection devices due to their maneuverability issues.
- In experiments, both in vitro and in vivo, the IFD showed a high capture success rate of 94% compared to only 35% for the Spider FX device, with all in vivo procedures successful and no complications reported.
- The study found the IFD's delivery and retrieval times were reasonable, though further improvements and research are still needed to enhance its effectiveness.
Article Synopsis
- The study aimed to create a new swine model for testing coronary bifurcation lesions, which is crucial for understanding atherosclerotic plaques typically found in human patients.
- A specially designed directional heat injury catheter was tested on four healthy pigs, focusing on how neointimal growth occurred at bifurcation sites after applying heat-induced injury.
- Results showed that the neointimal area and stenosis percentage were significantly larger on the side opposite the carina compared to the carina side, confirming the model's efficacy for future stent testing.
Article Synopsis
- TAVI is a minimally invasive procedure for patients unable or at high risk for open heart surgery, primarily performed through the transfemoral approach, which may be limited by vascular issues.
- Researchers developed the looped Inoue balloon technique to simplify a similar approach (transseptal) for TAVI, successfully testing it in an animal model and a clinical case.
- The technique was tested on two pigs, both of which underwent successful valve implantation but unfortunately died shortly after due to complications, suggesting that while the technique shows promise, it requires further refinement and study.
Article Synopsis
- Pericardiocentesis is a procedure to remove fluid from around the heart, which can risk injury to nearby tissues; a new method using an ultrathin endoscope was developed to make this process safer, particularly for patients with normal pericardiums.
- The study tested this new device on healthy pigs, involving a team of five operators who successfully performed the procedure, achieving a 100% success rate and an average time of about 65 seconds per procedure without complications.
- Results demonstrate that the ultrathin endoscopy-guided approach is both feasible and safe for accessing the normal pericardial space, which could enhance clinical practice for heart-related procedures.
Article Synopsis
- The study investigated the effects of downstream coronary stenoses on the left main coronary artery (LMCA) stenosis using new mathematical equations to predict true fractional flow reserve (FFR).
- Two equations were developed: one for LMCA stenosis with a single downstream stenosis and another for multiple downstream stenoses in neighboring arteries.
- Validation of these equations showed they accurately predict FFR, with results indicating that more severe downstream stenoses have a greater impact on LMCA stenosis.
Percutaneous coronary intervention (PCI) for anomalous coronary arteries is often difficult because the support provided by the guide catheter is insufficient. We encountered a patient with severe three-vessel coronary disease including a totally occluded anomalous right coronary artery (RCA) originating from the left sinus of Valsalva. Initial PCI for the anomalous RCA via the transradial approach failed.
View Article and Find Full Text PDFBackground: Donor artery fractional flow reserve (FFR) often improves after treatment of recipient artery stenosis, but the physiological mechanism underlying this phenomenon has not been elucidated. This study aimed to assess two novel equations that explain the donor-recipient artery interaction.
Method: Eq.
Article Synopsis
- Coronary collateral circulation provides an alternative blood supply to the heart when normal flow is insufficient, and the collateral flow index (CFI) can predict patient outcomes during angioplasty for heart disease.
- A new mathematical equation was derived to calculate CFI without needing to occlude the coronary artery, simplifying the measurement process.
- The study validated this equation using an in vitro model and found a strong correlation (r = 0.90, p < 0.0001) between the predicted and actual CFI, confirming the equation's accuracy.
Article Synopsis
- Balloon aortic valvuloplasty (BAV) is being used more frequently for severe aortic stenosis, especially with the rise of transcatheter aortic valve implantation (TAVI), despite its limited past role.
- The "looped Inoue balloon technique" simplifies the BAV procedure by creating a loop in the left atrium using two stylets, which was successfully applied in an 83-year-old woman with severe aortic stenosis and multiple health issues.
- After the BAV procedure, the patient's aortic valve area improved significantly from 0.39 cm² to 1.15 cm², demonstrating the effectiveness of the new technique without any complications.
Article Synopsis
- This study compared the effectiveness of a scoring balloon catheter (Scoreflex) with a conventional balloon catheter in expanding calcified lesions.
- The experiment involved inflating both types of catheters in vitro using calcium tubes of varying thickness to measure the pressure needed to induce cracks.
- Results showed that the Scoreflex required lower inflation pressure to crack the lesions and had a higher stress concentration at scoring elements, explaining its superior ability to dilate heavily calcified plaques.
Article Synopsis
- Myocardial fractional flow reserve (FFR) is important for evaluating coronary interventions but can misrepresent the severity of stenosis when multiple lesions are present due to their interactions.
- Two novel equations were developed to accurately predict the true FFR for each individual stenosis and after releasing a stenosis in complex cases.
- Validation of these equations showed strong correlations between predicted and true FFR values, demonstrating their effectiveness over traditional methods in an in vitro model.
Aims: To assess when and how the microcatheter-facilitated reverse wire technique should be applied to cross the guidewire into side branches in coronary bifurcations.
Methods And Results: Three interventional cardiologists with different levels of experience performed in vitro bench testing using an originally developed coronary bifurcation simulator which had six coronary bifurcations. The bifurcation angles were 90, 105, 120, 135, 150 and 165 degrees (°).
Article Synopsis
- Anemia's impact on patients undergoing elective percutaneous coronary intervention (PCI) with chronic kidney disease (CKD) remains largely unclear, prompting this study involving 7299 patients from the CREDO-Kyoto registry.
- The study found that 20% of patients had mild anemia and 10.1% had moderate-to-severe anemia, both of which were linked to significantly higher rates of major adverse cardiac events (MACE) over three years compared to those without anemia.
- The results indicated that even mild anemia can worsen clinical outcomes, and the presence of CKD further increases the risk for MACE, suggesting a need for close monitoring in these patient groups.
Article Synopsis
- The study evaluated a new device and method for antegrade percutaneous balloon aortic valvuloplasty (BAV) using a swine model to see if it was practical.
- Antegrade BAV has notable advantages over the retrograde method, but it is technically more challenging.
- The results showed a 100% success rate among operators with no complications, suggesting that the new technique could simplify the procedure.
Article Synopsis
- A study involving 5288 patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI) aimed to assess the impact of β-blocker therapy on patient outcomes over three years.
- Among the patients, 1117 were prescribed β-blockers at discharge, while 4171 did not receive them; those on β-blockers had a higher incidence of cardiac death or myocardial infarction (MI) at 4.9% compared to 3.4%.
- The results suggested that β-blocker therapy was linked to an increased risk of adverse outcomes, highlighting the need for further research to determine which patients may actually benefit from using β-blockers after PCI.
The effect of β-blockers in ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI) has not been adequately evaluated. Using a large multi-center registry in Japan, we identified 3,692 patients who underwent PCI within 24 h from onset of STEMI and were discharged alive from 2005 to 2007. Three-year cardiovascular outcomes were compared between the 2 groups of patients with (N = 1,614) or without (N = 2,078) β-blocker prescription at discharge.
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