Cardiopulmonary Exercise Tests in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease: Moving Beyond Risk Assessment

Hybrid Blood Purification Therapy Based on Camel Nanoantibody Immunoadsorbent on Patients with Chronic Renal Failure in Nephrology Department

This paper proposes a study on the effect of hybrid blood purification therapy based on camel nanoantibody immunoadsorbent on chronic renal failure patients in nephrology department. In this paper, the hybrid blood purification therapy based on camel nanoantibody immunoadsorbent was applied to patients with chronic renal failure, and the curative effect of the patients was studied. In order to highlight the effect, a control group was set up for comparison. In this paper, the clearance effect of small molecule toxin, middle molecular toxin, and dialysis adequacy was analyzed. This study found that the average dialysis adequacy of the control group was 1.23% and that of the experimental group was 1.26%. The dialysis adequacy of the experimental group was significantly better than that of the control group. In addition, the clearance effect of small and medium molecular toxins in the experimental group was significantly better than that in the control group. It can be seen that the hybrid blood purification therapy based on camel nanoantibody immunoadsorbent is effective in the treatment of chronic renal failure patients in the department of nephrology. Therefore, it is of great value to apply camel nanoantibody in the clinical treatment of renal failure.

The impact of combined cardiopulmonary exercise testing and SPECT myocardial perfusion imaging on downstream evaluation and management

OBJECTIVE

The diagnostic yield of combined cardiopulmonary exercise testing (CPET) and myocardial perfusion imaging (MPI) in patients referred for stress testing has received limited study.

METHODS

We evaluated consecutive patients who underwent combined CPET-MPI at a single tertiary referral center between 2011 and 2015. An abnormal CPET was defined as any of the following: reduced oxygen consumption, cardiac output impairment, or pulmonary impairment. Normal MPI was defined as the absence of resting or stress perfusion defect. The primary study outcome was change in clinical decision-making after CPET-MPI including management of pulmonary disease, management of deconditioning, heart failure management, and referral for cardiac catheterization. Outcomes of patients with normal and abnormal MPI were presented based on the specific CPET abnormality.

RESULTS

415 patients were included in the study. Of the 269 patients that had normal MPI, 206 (77%) had abnormal CPET. Patients with abnormal CPET and normal MPI, compared with patients that had normal CPET and normal MPI, were more frequently diagnosed with pulmonary disease (11.7% vs 3.2%, P = .04) and deconditioning (33.5% vs 17.4%, P = .01). Of the 146 patients that had abnormal MPI, 128 (88%) had abnormal CPET. Patients with abnormal CPET and abnormal MPI, compared with patients that had normal CPET and abnormal MPI, did not statistically differ with regard to the study outcome.

CONCLUSION

An abnormal CPET, if the MPI was normal, prompted further evaluation and led to management of pulmonary disease and deconditioning.