ObjectiveTo establish a simple two-compartment model for glomerular filtration rate (GFR) and renal plasma flow (RPF) estimations by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Materials and MethodsA total of eight New Zealand white rabbits were included in DCE-MRI. The two-compartment model was modified with the impulse residue function in this study. First, the reliability of GFR measurement of the proposed model was compared with other published models in Monte Carlo simulation at different noise levels. Then, functional parameters were estimated in six healthy rabbits to test the feasibility of the new model. Moreover, in order to investigate its validity of GFR estimation, two rabbits underwent acute ischemia surgical procedure in unilateral kidney before DCE-MRI, and pixel-wise measurements were implemented to detect the cortical GFR alterations between normal and abnormal kidneys.ResultsThe lowest variability of GFR and RPF measurements were found in the proposed model in the comparison. Mean GFR was 3.03±1.1 ml/min and mean RPF was 2.64±0.5 ml/g/min in normal animals, which were in good agreement with the published values. Moreover, large GFR decline was found in dysfunction kidneys comparing to the contralateral control group.ConclusionResults in our study demonstrate that measurement of renal kinetic parameters based on the proposed model is feasible and it has the ability to discriminate GFR changes in healthy and diseased kidneys.

Objective: This study was aimed at investigating the effects of preoperative treatment with a loading dose of statinscombined with a PCSK9 inhibitor on coronary blood perfusion and short-term cardiovascular adverse events in patientswith ST-segment elevation myocardial infarction (STEMI).Method: Sixty-five patients with STEMI who had visited the Shanxi Cardiovascular Disease Hospital between May2018 and May 2021 were enrolled in the study. The enrolled patients had no history of oral statins or antiplatelet therapy.The patients were divided into a combined treatment group (loading dose of statins combined with PCSK9 inhibitors, 35patients) and a routine treatment group (loading dose of statins only, 30 patients). The primary endpoints were thrombolysisin myocardial infarction (TIMI) blood flow grading, corrected TIMI frame count (CTFC), and TIMI myocardial perfusiongrading (TMPG), immediately after and 30 days after the operation. The secondary endpoint was a composite endpoint ofcardiovascular death, nonfatal myocardial infarction, and target vessel revascularization 30 days after the operation.Results: The combined treatment group had significantly lower CTFC (14.09 ± 8.42 vs 26 ± 12.42, P = 0.04) and betterTMPG (2.74 ± 0.61 vs 2.5 ± 0.73, P = 0.04) than the routine treatment group immediately after the operation. Similarly,the combined treatment group had a significantly lower CTFC (16.29 ± 7.39 vs 26.23 ± 11.53, P = 0.04) and significantlybetter TMPG (2.94 ± 0.24 vs 2.76 ± 0.43, P = 0.01) than the routine treatment group 1 month after the operation.Conclusion: Preoperative treatment with a loading dose of high-intensity statins combined with PCSK9 inhibitorsincreased coronary blood flow and myocardial perfusion after emergency thrombus aspiration in patients withSTEMI. However, the treatment did not significantly decrease the incidence of cardiovascular death, nonfatal myocardialinfarction, or target vessel revascularization.

Cardiogenic shock occurs when the heart is unable to pump enough blood for the needs of the body. Hypopituitarism is a condition in which the pituitary gland does not produce enough of one or more hormones, and it rarely occurs with thyrotoxicosis. We report a rare case of cardiogenic shock induced by anterior pituitary hypofunction and thyrotoxicosis. A 47-year-old woman was admitted twice to the hospital due to generalized worsening muscle pain for 13 days, and accompanied by a transient loss of consciousness. Cardiogenic shock developed during hospitalization, which improved with active resuscitative measures. Laboratory tests showed thyrotoxicosis. Pituitary magnetic resonance imaging (MRI) and relevant hormone tests confirmed anterior pituitary hypofunction. The patient was given hormone replacement therapy, which stabilized her condition. We believe cardiogenic shock may be a serious complication of hypopituitarism. We recommend establishing an expert system (ES) to facilitate the early diagnosis and treatment of cardiogenic shock, improve the professional skills of primary care physicians, and optimize treatment plans.

No abstract