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Chen S, Jiang H, Hou Z, Yue Y, Zhang Y, Zhao F, Xu Z, Li Y, Mou X, Li L, Wang T, Zhao J, Han C, Sui Y, Wang M, Yang Z, Lu Y, Zhu Y, Li J, Shen X, Sun F, Chen Q, Yuan Y. Higher serum VGF protein levels discriminate bipolar depression from major depressive disorder. J Neurosci Res 2018; 97:597-606. [PMID: 30575991 DOI: 10.1002/jnr.24377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Misdiagnosis between major depressive disorder (MDD) and bipolar depression (BD) is quite common. Our previous study found significantly lower serum VGF (non-acronymic) in MDD patients. However, it is unclear whether same changes occur in BD patients. Therefore, we aimed to investigate the relationship between serum VGF levels in BD and MDD patients. General information, scores of 17-item Hamilton Depression Rating Scale (HDRS), and fasting blood samples of all participants including 30 MDD patients, 20 BD patients, and 30 healthy controls (HC) were collected. Serum VGF levels were measured by Enzyme-linked immunosorbent assay kits. Pearson correlation analysis was used to analyze correlations between serum VGF levels and clinical information. Receiver operating characteristic (ROC) curve and likelihood ratios (LRs) were used to analyze the differential potential of serum VGF. Serum VGF levels were significantly lower in MDD patients but higher in BD patients compared with HC (both PTukey < 0.01). No correlation was found between serum VGF levels and any data of subjects. The optimal cutoff for serum VGF in discriminating BD patients from MDD patients was ≥1093.85 pg/ml (AUC = 0.990, sensitivity of 95%, specificity of 100% and accuracy of 95%). LRs further confirmed the differential efficiency of serum VGF in distinguishing BD and MDD patients with +LR of infinity and -LR of 0. The results suggest that serum VGF level changed significantly in MDD and BD patients and serum VGF may be an indicator for differentiating BD patients from MDD patients.
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Affiliation(s)
- Suzhen Chen
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Haitang Jiang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Zhenhua Hou
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Yuqun Zhang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Fuying Zhao
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Zhi Xu
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Yinghui Li
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Xiaodong Mou
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Lei Li
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Tianyu Wang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
| | - Jingjing Zhao
- Department of Psychiatry, Brain Hospital, Nanjing Medical University, Nanjing, PR China
| | - Chongyang Han
- Department of Psychiatry, Brain Hospital, Nanjing Medical University, Nanjing, PR China
| | - Yuxiu Sui
- Department of Psychiatry, Brain Hospital, Nanjing Medical University, Nanjing, PR China
| | - Ming Wang
- Department of Psychiatry, The Third People's Hospital of Changshu, Suzhou, PR China
| | - Zhong Yang
- Department of Psychiatry, The Third People's Hospital of Changshu, Suzhou, PR China
| | - Yan Lu
- Department of Psychiatry, The Fourth People's Hospital of Zhangjiagang, Suzhou, PR China
| | - Yifeng Zhu
- Department of Psychiatry, The Fourth People's Hospital of Zhangjiagang, Suzhou, PR China
| | - Jianhua Li
- Department of Psychiatry, The Third People's Hospital of Huzhou, Huzhou, PR China
| | - Xinhua Shen
- Department of Psychiatry, The Third People's Hospital of Huzhou, Huzhou, PR China
| | - Fei Sun
- Department of Psychiatry, The Second People's Hospital of Jingjiang, Taizhou, PR China
| | - Qingsong Chen
- Department of Psychiatry, The Second People's Hospital of Jingjiang, Taizhou, PR China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, Medical School of Southeast University, Nanjing, PR China.,Institute of Psychosomatics, Medical School of Southeast University, Nanjing, PR China
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Takeshita M, Shinoda N, Takashima H, Kurita A, Ando H, Harada K, Uetani T, Gosho M, Murohara T, Amano T. Noninvasive mathematical analysis of spectral electrocardiographic components for coronary lesions of intermediate to obstructive stenosis severity-relationship with classic and functional SYNTAX score. Catheter Cardiovasc Interv 2015; 86:21-9. [PMID: 25824322 DOI: 10.1002/ccd.25924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 03/08/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the relationship between the multifunction cardiogram (MCG), and SYNTAX score (SS) and functional SYNTAX score (FSS) in detecting the presence of intermediate to obstructive coronary lesions. BACKGROUND Performing coronary angiography (CAG) and measuring fractional flow reserve (FFR) to calculate the SS and FSS is inherently invasive and adds complexity. METHODS The MCG was obtained and analyzed before performing CAG in 87 consecutive subjects with suspected coronary artery disease who were scheduled for elective CAG. The patients were divided into three groups according to risk based on high, borderline, and low MCG scores. The SS was determined, as well as FSS but only by counting lesions prone to functional ischemia (FFR ≤ 0.8). The relationship between the MCG and the SS and FSS was evaluated. RESULTS The MCG was the only test significantly associated with the SS (odds ratio, 2.92 [1.60 - 5.31], P < 0.001) and FSS (odds ratio, 3.66 [1.95 - 6.87], P < 0.001). A high MCG score had a specificity of 92.6% (89.0-96.2%) and 92.3% (89.0-95.6%), and a predictive accuracy of 72.4% (67.6-77.2%) and 82.8% (78.7-86.8%) for the prediction of SS and FSS, respectively. CONCLUSIONS The MCG showed high specificity and predictive accuracy especially for the FSS, suggesting that it is useful not only in identifying functionally significant ischemia but also in reducing unnecessary CAGs.
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Affiliation(s)
| | | | | | - Akiyoshi Kurita
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
| | - Hirohiko Ando
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
| | - Ken Harada
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan
| | - Tadayuki Uetani
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan
| | - Masahiko Gosho
- Advanced Medical Research Center, Aichi Medical University, Nagakute, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
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Kawaji T, Shiomi H, Morimoto T, Nishikawa R, Yano M, Higami H, Tazaki J, Imai M, Saito N, Makiyama T, Shizuta S, Ono K, Kimura T. Noninvasive Detection of Functional Myocardial Ischemia: Multifunction Cardiogram Evaluation in Diagnosis of Functional Coronary Ischemia Study (MED-FIT). Ann Noninvasive Electrocardiol 2015; 20:446-53. [PMID: 25594689 DOI: 10.1111/anec.12251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Multifunction cardiogram (MCG) is a computer-enhanced, resting electrocardiogram analysis developed to detect hemodynamically relevant coronary artery disease (CAD). Based on data from previous studies suggesting excellent diagnostic accuracy in detecting CAD, MCG (approved by the Food and Drugs Administration) received a Current Procedure Terminology (CPT) code in 2010 in United States. However, there is no previous study validating MCG by using fractional flow reserve (FFR) as the reference standard. METHODS Multifunction cardiogram Evaluation in Diagnosis of Functional coronary Ischemia sTudy (MED-FIT) was designed as a single-center, prospective study enrolling 100 stable patients with suspected CAD scheduled for coronary angiography. The primary and secondary analyses evaluated the diagnostic performance of the MCG severity score to detect functional myocardial ischemia by FFR ≤0.80, and angiographically significant coronary stenosis (percent diameter stenosis ≥50%) by quantitative coronary angiography. RESULTS The current analysis set consisted of 91 patients in whom MCG data with adequate quality was obtained. The prevalence of positive functional myocardial ischemia and angiographically significant stenosis in the current study was 42.7% and 41.8%, respectively. Area under the receiver operating characteristics curve (AUC) of the MCG severity score for functional myocardial ischemia and angiographically significant stenosis was low (AUC 0.51, 95% confidence interval [CI] 0.38-0.63, and AUC 0.58, 95%CI 0.46-0.70, respectively). Sensitivity, and specificity of the MCG severity score for functional myocardial ischemia and angiographically significant stenosis was also low (32%/67%, and 37%/72%) using a cutoff value of 4.0. CONCLUSIONS Diagnostic performance of the MCG severity score was poor for both functional myocardial ischemia, and angiographically significant stenosis.
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Affiliation(s)
- Tetsuma Kawaji
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Morimoto
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Japan
| | - Ryusuke Nishikawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mariko Yano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirooki Higami
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junichi Tazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Imai
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naritatsu Saito
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koh Ono
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Amano T, Shinoda N, Kunimura A, Harada K, Uetani T, Takashima H, Ando H, Kumagai S, Gosho M, Murohara T. Non-invasive assessment of functionally significant coronary stenoses through mathematical analysis of spectral ECG components. Open Heart 2014; 1:e000144. [PMID: 25469309 PMCID: PMC4248141 DOI: 10.1136/openhrt-2014-000144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 08/26/2014] [Accepted: 11/04/2014] [Indexed: 11/07/2022] Open
Abstract
Objectives The aim of this study was to evaluate the accuracy of the Multifunction CardioGram (MCG) in detecting the presence of functionally significant coronary ischaemia. Methods and results This prospective study evaluated the accuracy of the MCG, a new ECG analysis device used to diagnose ischaemic coronary artery disease (CAD). A consecutive 112 participants suspected to have CAD who were scheduled for elective coronary angiography (CAG) from October 2012 to December 2013 were examined. Their predictive values of relevant ischaemia were measured by MCG, standard ECG and Framingham Risk Score (FRS) and compared. Five levels of ischaemia based on CAG findings adjusted by fractional flow reserve (FFR) values and three levels of MCG score of high, borderline or low were used. The MCG (OR=2.67 (1.60 to 4.44), p<0.001) was the only test significantly associated with ischaemia level. The FFR values for individual MCG scores with low, borderline and high were 0.77 (0.70 to 0.86), 0.78 (0.71 to 0.82) and 0.69 (0.65 to 0.77), respectively, p=0.042. A high MCG score had a specificity of 90.4% (87.0% to 93.9%) in model 1 adjusted by FFR≤0.8 threshold and of 87.0% (83.2% to 90.8%) in model 2 adjusted by FFR≤0.75 threshold, and a negative predictive value of 82.5% (78.3% to 86.7%) in model 1 and of 83.8% (79.6% to 87.9%) in model 2 for the prediction of severe ischaemia. Conclusions The MCG showed high specificity with a high negative predictive value, suggesting that the MCG could be used not only to identify functionally significant ischaemia but to reduce unnecessary CAGs. Trial registration number UMIN ID: 000009992.
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Affiliation(s)
- Tetsuya Amano
- Department of Cardiology , Aichi Medical University , Nagakute , Japan
| | - Norihiro Shinoda
- Department of Cardiology , Chubu Rosai Hospital , Nagoya , Japan
| | - Ayako Kunimura
- Department of Cardiology , Chubu Rosai Hospital , Nagoya , Japan
| | - Ken Harada
- Department of Cardiology , Chubu Rosai Hospital , Nagoya , Japan
| | - Tadayuki Uetani
- Department of Cardiology , Chubu Rosai Hospital , Nagoya , Japan
| | - Hiroaki Takashima
- Department of Cardiology , Aichi Medical University , Nagakute , Japan
| | - Hirohiko Ando
- Department of Cardiology , Aichi Medical University , Nagakute , Japan
| | - Soichiro Kumagai
- Department of Cardiology , Aichi Medical University , Nagakute , Japan
| | - Masahiko Gosho
- Advanced Medical Research Center , Aichi Medical University , Nagakute , Japan
| | - Toyoaki Murohara
- Department of Cardiology , Nagoya University Graduate School of Medicine , Nagoya , Japan
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