A review article by Hao et al.(J Am Coll Cardiol 2017;69(24):2952– 66)has had huge repercussions among those familiar with traditional Chinese medicine(TCM)in the international academic community.It evaluated the eff...A review article by Hao et al.(J Am Coll Cardiol 2017;69(24):2952– 66)has had huge repercussions among those familiar with traditional Chinese medicine(TCM)in the international academic community.It evaluated the effi cacy and safety of TCM for cardiovascular disease and the pharmacological effect of active TCM ingredients on the cardiovascular system and potential mechanisms.We have several comments:Firstly,we give a brief summary addressing nonpharmacotherapy in TCM,including acupuncture,moxibustion,Qigong,and Tai Chi.Secondly,we have added traditional antiarrhythmic drug– related randomized controlled trials to make the coverage more comprehensive.Lastly,we support the concept that research into,development of,and application of active ingredients is part of modern TCM.展开更多
Background: The purpose of this study was to assess the effects of a comprehensive lifestyle intervention on modifiable cardiovascular risk factors among high-risk African Americans. Methods: The study included a rand...Background: The purpose of this study was to assess the effects of a comprehensive lifestyle intervention on modifiable cardiovascular risk factors among high-risk African Americans. Methods: The study included a randomized treatment/controlled intervention trial among 136 African Americans residing in Atlanta, GA who were overweight and had elevated blood pressure. The treatment group was exposed to 3-months of a multi-component intervention and the control to an abbreviated 6-week intervention after the completion of the treatment group’s intervention. The main outcomes included mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean waist circumference, mean body mass index (BMI), mean number of times exercise per week, mean number of servings of fruits and vegetables per day, and mean level of daily stress. Data were collected at baseline and at 6-month follow-up. Separate linear regressions were used with an established significance level of P P P = 0.002). Conclusion: These results show that a comprehensive lifestyle intervention can improve cardiovascular risk factor profile among high risk African Americans. Caregivers should encourage patients to participate in such programs and public health policymakers should allocate resources to community based health oriented organizations to implement comprehensive lifestyle program.展开更多
Objectives Most medical instruments are designed for diagnosis purpose but very few for clinical treatment. Our research aim is to design and develop a cardiovascular automatic feedback control instrument （CAFCI） fo...Objectives Most medical instruments are designed for diagnosis purpose but very few for clinical treatment. Our research aim is to design and develop a cardiovascular automatic feedback control instrument （CAFCI） for rescuing the critical patients with abnormal blood pressure. Methods The CAFCI was designed on the basis of abundant clinical experiences and on successful mathematic modeling of our blood pressure, pulmonary experimental data. The capillary wedge pressure, and rates of heart beat were measured and inputted into a computer and drugs were chosen by a doctor through a user-friendly interface with the computer. The responses to medication were rapidly acquired and feed back to the computer by automatic detection system in a close-loop system. every 7.5 sec in order to dosage The data were refreshed regulate the speed and of the medications that were given. Results The experimental results with ten dogs showed that the CAFCI system took samples promptly and accurately so that the targeted blood pressure could be reached reliably based on our input parameters and our designing requirements. Conclusions Since the dependability and accuracy of the CAFCI system are much superior to that of the traditional method, its clinical application to rescue the critical patient warrants evaluation in the future.展开更多
Diabetic cardiomyopathy is a disorder of the cardiac muscle that affects patients with diabetes.The exact mechanisms underlying diabetic cardiomyopathy are mostly unknown,but several factors have been implicated in th...Diabetic cardiomyopathy is a disorder of the cardiac muscle that affects patients with diabetes.The exact mechanisms underlying diabetic cardiomyopathy are mostly unknown,but several factors have been implicated in the pathogenesis of the disease and its progression towards heart failure,including endothelial dysfunction,autonomic neuropathy,metabolic alterations,oxidative stress,and alterations in ion homeostasis,especially calcium transients[1].In Military Medical Research,Jiang et al.[2]sought to determine the functional role of complement factor D(Adipsin)in the pathophysiology of diabetic cardiomyopathy.展开更多
BACKGROUND The combination of polycythemia vera(PV)with pathological cardiac hypertro-phy is uncommon.In this study,we describe a case of PV accompanied by pa-thological cardiac hypertrophy.It is hypothesized that the...BACKGROUND The combination of polycythemia vera(PV)with pathological cardiac hypertro-phy is uncommon.In this study,we describe a case of PV accompanied by pa-thological cardiac hypertrophy.It is hypothesized that the pronounced cardiac hypertrophy in this patient has a strong connection with PV.CASE SUMMARY In 2021,a 34-year-old Chinese man experienced chest constriction,shortness of breath,and palpitations during vigorous activity.Each episode lasted several minutes and resolved spontaneously following cessation of vigorous activity.He occasionally experienced syncope and vertigo without a headache.He underwent cardiac magnetic resonance imaging and was diagnosed with“hypertrophic cardiomyopathy(HCM)”.He was discharged after receiving symptomatic treat-ment,which resulted in an improvement.He presented to our department with chest constriction,shortness of breath,and respiratory distress for one month while climbing to the second floor in 2023.His blood pressure was 180/100 mmHg at the time of admittance,and he was receiving antihypertensive treat-ment.He had a history of PV for 2 years without treatment.Symptomatic treat-ment was implemented concurrently with the administration of hydroxyurea upon admission.Good blood pressure control was observed during the long-term follow-up,and echocardiography did not reveal any progression of myocardial hypertrophy.CONCLUSION Clinicians managing PV patients should remain highly vigilant regarding the risks of thrombosis and cardio-vascular complications,particularly in those with refractory hypertension.展开更多
The inflammatory response is involved in the pathogenesis of the most common types of heart disease. Sanguinarine （SAN） has various pharmacological properties such as anti-inflammatory, antioxidant, antibacterial, a...The inflammatory response is involved in the pathogenesis of the most common types of heart disease. Sanguinarine （SAN） has various pharmacological properties such as anti-inflammatory, antioxidant, antibacterial, antitumor, and immune-enhancing properties. However, few studies have investigated the effects of SAN on lipopolysaceharide （LPS）-induced inflammatory and apoptotic responses in H9c2 cardiomyocytes. Therefore, in this study, H9c2 cells were co-treated with SAN and LPS, and the mRNA levels of pro-inflammation markers and the apoptosis rate were measured to clarify the effect of SAN on cardiac inflammation. The underlying mechanism was further investigated by detecting the activation of Toll-like receptor （TLR）4/nuclear faetor-κB （NF-κB） signaling pathways. As a result, increased mRNA expression of interleukin （IL）-1β, IL-6, and TNFα induced by LPS was attenuated after SAN treatment; LPS-induced apoptosis ofHge2 cardiomyocytes and cleaved-caspase 8, 9, 3 were all significantly reduced by SAN. Further experiments showed that the beneficial effect of SAN on blocking the inflammation and apoptosis of H9c2 cardiomyocytes induced by LPS was associated with suppression of the TLR4/NF-κB signaling pathway. It was suggested that SAN suppressed the LPS-induced inflammation and apoptosis of H9c2 cardiomyocytes, which may be mediated by inhibition of the TLR4/NF-κB signaling pathway. Thus, SAN may be a feasible therapy to treat sepsis patients with cardiac dysfunction.展开更多
The traditional Chinese medicine Shensong Yangxin（SSYX） can improve the clinical symptoms of arrhythmia in an integrated manner. This study aimed to investigate the electrophysiological effect of SSYX on the hearts ...The traditional Chinese medicine Shensong Yangxin（SSYX） can improve the clinical symptoms of arrhythmia in an integrated manner. This study aimed to investigate the electrophysiological effect of SSYX on the hearts of myocardial-infarcted rabbits and further explore the mechanism by which SSYX alleviates myocardial fibrosis. Myocardial infarction（MI） was established in rabbits by ligation of the left circumflex coronary. The rabbits were treated with SSYX（0.5 g/kg/d） or saline for 8 weeks by oral administration. Microelectrode array（MEA） technology was used in vivo for extracellular electrophysiological recordings of the infarct border zone. Masson＇s trichrome staining was used to observe myocardial fibrosis. Western blotting was performed to evaluate the protein expression levels of collagen Ⅰ（COL Ⅰ） and collagen Ⅲ（COL Ⅲ）. Quantitative real-time polymerase chain reaction（real-time PCR） was performed to evaluate the TGF-β1 and MMP-2 m RNA expression levels. The results showed that the total activation time（TAT） and the dispersion of TAT were significantly increased and the excitation propagation markedly disordered after MI. SSYX could significantly decrease TAT and the dispersion of TAT, and significantly ameliorate the chaotic spread pattern of excitation. Furthermore, SSYX treatment could significantly decrease COL Ⅰ and COL Ⅲ protein levels and down-regulate TGF-β1 and MMP-2 m RNA expression levels in MI rabbits. It was concluded that SSYX may ameliorate cardiac electrophysiological abnormalities in infarcted hearts by decreasing the protein levels of COL Ⅰ and COL Ⅲ, down-regulating the m RNA expression levels of TGF-β1 and MMP2, and thereby reducing adverse cardiac remodeling.展开更多
Myocardin （MYOCD） is a potent transcriptional coactivator that functions primarily in cardiac muscle and smooth muscle through direct contacts with serum response factor （SRF） over cis elements known as CArG boxes...Myocardin （MYOCD） is a potent transcriptional coactivator that functions primarily in cardiac muscle and smooth muscle through direct contacts with serum response factor （SRF） over cis elements known as CArG boxes found near a number of genes encoding for contractile, ion channel, cytoskeletal, and calcium handling proteins. Since its discovery more than 10 years ago, new insights have been obtained regarding the diverse isoforms of MYOCD expressed in cells as well as the regulation of MYOCD expression and activity through transcriptional, post-transcriptional, and post-translational processes. Curiously, there are a number of functions associated with MYOCD that appear to be independent of contractile gene expression and the CArG-SRF nucleoprotein complex. Further, perturbations in MYOCD gene expression are associated with an increasing number of diseases including heart failure, cancer, acute vessel disease, and diabetes. This review summarizes the various biological and patho- logical processes associated with MYOCD and offers perspectives to several challenges and future directions for further study of this formidable transcriptional coactivator.展开更多
Background: In worldwide, the mortality rate of acute myocardial infarction(AMI) raises year by year. Although the applications of percutaneous coronary intervention(PCI) and anticoagulants effectively reduce the mort...Background: In worldwide, the mortality rate of acute myocardial infarction(AMI) raises year by year. Although the applications of percutaneous coronary intervention(PCI) and anticoagulants effectively reduce the mortality of patients with acute coronary syndrome(ACS), but also increase the incidence of bleeding. Therefore, drugs with stable anticoagulant effects are urgently required.Methods: We enrolled 894 patients with acute coronary syndrome who underwent percutaneous coronary intervention in Shenyang Northern Hospital from February 2010 to May 2012; 430 patients were included in the fondaparinux group(2.5mg/d), and 464 were included in the enoxaparin group(1mg/kg twice daily). Fondaparinux and enoxaparin were applied for 3–7 days. All patients were treated with tirofiban [10μg/kg for 3min initially and 0.15μg/(kg·min) for 1 to 3 days thereafter]. The primary efficacy endpoint was the incidence of a major adverse cerebrovascular or cardiovascular event. The primary safety endpoint was bleeding within 30 days and 1 year after percutaneous coronary intervention.Results: One-year data were available for 422 patients in the fondaparinux group and for 453 in the enoxaparin group. The incidence of a major adverse cerebrovascular or cardiovascular event(10.9% vs 12.6%, P=0.433) and cardiac mortality(0.5% vs 1.5%, P=0.116) were generally lower in the fondaparinux group than in the enoxaparin group, although the differences were not significant. Compared with the enoxaparin group, the fondaparinux group had a significantly decreased rate of bleeding at 30 days(0.9% vs 2.9%, P=0.040) and 1 year(2.4% vs 5.5%, P=0.018). In addition, the rate of major bleeding events was lower in the fondaparinux group, but this difference was not significant(0.2% vs 0.9%, 0.2% vs 1.1%).Conclusion: In tirofiban-treated patients with acute coronary syndrome undergoing percutaneous coronary intervention, fondaparinux presented similar efficacy for ischemia events as enoxaparin. However, fondaparinux significantly decreased the incidence of bleeding, thus providing safer anticoagulation therapy.展开更多
Background Combinations of coronary heart disease(CHD) and other chronic conditions complicate clinical management and increase healthcare costs. The aim of this study was to evaluate gender-specific relationships bet...Background Combinations of coronary heart disease(CHD) and other chronic conditions complicate clinical management and increase healthcare costs. The aim of this study was to evaluate gender-specific relationships between CHD and other comorbidities. Methods We analyzed data from the German Health Interview and Examination Survey(DEGS1), a national survey of 8152 adults aged 18-79 years. Female and male participants with self-reported CHD were compared for 23 chronic medical conditions. Regression models were applied to determine potential associations between CHD and these 23 conditions. Results The prevalence of CHD was 9%(547 participants): 34%(185) were female CHD participants and 66%(362) male. In women, CHD was associated with hypertension(OR = 3.28(1.81-5.9)), lipid disorders(OR = 2.40(1.50-3.83)), diabetes mellitus(OR = 2.08(1.24-3.50)), kidney disease(OR = 2.66(1.101-6.99)), thyroid disease(OR = 1.81(1.18-2.79)), gout/high uric acid levels(OR = 2.08(1.22-3.56)) and osteoporosis(OR = 1.69(1.01-2.84)). In men, CHD patients were more likely to have hypertension(OR = 2.80(1.94-4.04)), diabetes mellitus(OR = 1.87(1.29-2.71)), lipid disorder(OR = 1.82(1.34-2.47)), and chronic kidney disease(OR = 3.28(1.81-5.9)). Conclusion Our analysis revealed two sets of chronic conditions associated with CHD. The first set occurred in both women and men, and comprised known risk factors: hypertension, lipid disorders, kidney disease, and diabetes mellitus. The second set appeared unique to women: thyroid disease, osteoporosis, and gout/high uric acid. Identification of shared and unique gender-related associations between CHD and other conditions provides potential to tailor screening, preventive, and therapeutic options.展开更多
Sympathetic nerve and vagus nerve remodeling play an important part in cardiac function post-myocardial infarction （MI）. Increasing evidence indicates that neuregulin-1 （NRG-1） improves cardiac function following ...Sympathetic nerve and vagus nerve remodeling play an important part in cardiac function post-myocardial infarction （MI）. Increasing evidence indicates that neuregulin-1 （NRG-1） improves cardiac function following heart failure. Since its impact on cardiac function and neural remodeling post-MI is poorly understood, we aimed to investigate the role of NRG-1 in autonomic nervous system remodeling post-MI. Forty-five Sprague-Dawley rats were equally randomized into three groups： sham （with the left anterior descending coronary artery exposed but without ligation）, MI （left anterior descending coronary artery ligation）, and MI plus NRG-1 （left anterior descending coronary artery ligation followed by intraperitoneal injection of NRG-1 （10 lag/kg, once daily for 7 days））. At 4 weeks after MI, echocardi- ography was used to detect the rat cardiac function by measuring the left ventricular end-systolic inner diameter, left ventricular diastolic diameter, left ventricular end-systolic volume, left ventricular end-diastolic volume, left ventricular ejection fraction, and left ventricular fractional shortening, mRNA and protein expression levels of tyrosine hydroxylase, growth associated protein-43 （neuronal specific pro- tein）, nerve growth factor, choline acetyltransferase （vagus nerve marker）, and vesicular acetylcholine transporter （cardiac vagal nerve fiber marker） in ischemic myocardia were detected by real-time PCR and western blot assay to assess autonomous nervous remodeling. After MI, the rat cardiac function deteriorated significantly, and it was significantly improved after NRG-1 injection. Compared with the MI group, mRNA and protein levels of tyrosine hydroxylase and growth associated protein-43, as well as choline acetyltransferase mRNA level significantly decreased in the MI plus NRG-1 group, while mRNA and protein levels of nerve growth factor and vesicular acetylcholine transporters, as well as choline acetyltransferase protein level slightly decreased. Our results indicate that NRG- 1 can improve cardiac function and regulate sympathetic and vagus nerve remodeling post-MI, thus reaching a new balance of the autonomic nervous system to protect the heart from injury.展开更多
Most cases of sudden cardiac death are attributed to sustained ventricular tachyarrhythmias(VTs), triggered by acute coronary occlusion. Autonomic dysfunction, an important arrhythmogenic mechanism in this setting, is...Most cases of sudden cardiac death are attributed to sustained ventricular tachyarrhythmias(VTs), triggered by acute coronary occlusion. Autonomic dysfunction, an important arrhythmogenic mechanism in this setting, is being actively investigated, aiming at the advent of preventive strategies. Recent experimental studies have shown vagal withdrawal after anterior myocardial infarction, coinciding with high incidence of VTs, followed by more gradual sympathetic activation coinciding with a second arrhythmia peak. This article summarizes recent knowledge on this intriguing topic, generating hypotheses that can be investigated in future experimental and clinical studies.展开更多
AIM: To provide a structural model of the relationship between personality traits, perceived stress, coping strategies, social support, and psychological outcomes in the general population.METHODS: This is a cross sec...AIM: To provide a structural model of the relationship between personality traits, perceived stress, coping strategies, social support, and psychological outcomes in the general population.METHODS: This is a cross sectional study in which the study group was selected using multistage cluster and convenience sampling among a population of 4 million. For data collection, a total of 4763 individuals were asked to complete a questionnaire on demographics, personality traits, life events, coping with stress, social support, and psychological outcomes such as anxiety and depression. To evaluate the comprehensive relation-ship between the variables, a path model was fitted.RESULTS: The standard electronic modules showed that personality traits and perceived stress are important determinants of psychological outcomes. Social support and coping strategies were demonstrated to reduce the increasing cumulative positive effects of neuroticism and perceived stress on the psychological outcomes and enhance the protective effect of extraversion through decreasing the positive effect of perceived stress on the psychological outcomes. CONCLUSION: Personal resources play an important role in reduction and prevention of anxiety and depression. In order to improve the psychological health, it is necessary to train and reinforce the adaptive coping strategies and social support, and thus, to moderate negative personality traits.展开更多
With the rising interest in the regulatory functions of long non-coding RNAs （IncRNAs） in complex human diseases such as cardiovascular diseases, there is an increasing need in public databases offering comprehensiv...With the rising interest in the regulatory functions of long non-coding RNAs （IncRNAs） in complex human diseases such as cardiovascular diseases, there is an increasing need in public databases offering comprehensive and integrative data for all aspects of these versatile molecules. Recently, a variety of public data repositories that specialized in lncRNAs have been developed, which make use of huge high-throughput data particularly from next-generation sequencing （NGS） approaches. Here, we provide an overview of current IncRNA databases covering basic and functional annotation, IncRNA expression and regulation, interactions with other biomolecules, and genomic variants influencing the structure and function of lncRNAs. The prominent IncRNA antisense noncoding RNA in the INK4 locus （ANRIL）, which has been unequivocally associated with coronary artery disease through genome-wide association studies （GWAS）, serves as an example to demonstrate the features of each individual database.展开更多
Background:None of study mentioned about contrast-induced acute kidney injury(CI-AKI)in people who have received contrast agents twice within in a short period of time.This study is trying to identify the predictors.M...Background:None of study mentioned about contrast-induced acute kidney injury(CI-AKI)in people who have received contrast agents twice within in a short period of time.This study is trying to identify the predictors.Methods:We enrolled 607 patients between Oct.2010 and Jul.2015 who received contrast agents twice within 30 days in the Department of Cardiology of the General Hospital of Shenyang Military Region.The primary outcome was CI-AKI within 72 h after contrast agent exposure.Patients were divided into groups A(n=559)and group B(n=48)according to whether CI-AKI occurred after the second agent.Results:Patients in group B(CI-AKI occurred after the second agent)had a more rapid heart rate and more usage of diuretics and digitalis.In group B,CI-AKI occurred more frequently after the first agent.Multivariate logistic regression showed that diuretic(P=0.006)and intra-aortic balloon pump(IABP)usage(P=0.012)were independent predictors of CI-AKI after the first agent.Angiotensin-converting enzyme inhibitor/AngiotensinⅡreceptor antagonist(ACEI/ARB)usage(P=0.039),IABP usage(P=0.040)and CI-AKI occurring after administration of the first agent(P=0.015)were independent predictors of CI-AKI after the second.Furthermore,dividing the patients into tertiles of the time interval between the two agents showed that CI-AKI occurred more frequently when the second agent was administered within 1–3 days after the first exposure than within 4–6 days(12.4%vs.5.0%,P=0.008)or≥7 days(12.4%vs.6.4%,P=0.039).Conclusions:Diuretic and IABP usage are independent predictors of CI-AKI following exposure to a first contrast agent.The major predictors of CI-AKI after exposure to a second agent are time since the first contrast exposure,ACEI/ARB usage,and IABP usage.More importantly,a three-day interval between the two agents is associated with a higher incidence of CI-AKI following the second administration.展开更多
文摘A review article by Hao et al.(J Am Coll Cardiol 2017;69(24):2952– 66)has had huge repercussions among those familiar with traditional Chinese medicine(TCM)in the international academic community.It evaluated the effi cacy and safety of TCM for cardiovascular disease and the pharmacological effect of active TCM ingredients on the cardiovascular system and potential mechanisms.We have several comments:Firstly,we give a brief summary addressing nonpharmacotherapy in TCM,including acupuncture,moxibustion,Qigong,and Tai Chi.Secondly,we have added traditional antiarrhythmic drug– related randomized controlled trials to make the coverage more comprehensive.Lastly,we support the concept that research into,development of,and application of active ingredients is part of modern TCM.
文摘Background: The purpose of this study was to assess the effects of a comprehensive lifestyle intervention on modifiable cardiovascular risk factors among high-risk African Americans. Methods: The study included a randomized treatment/controlled intervention trial among 136 African Americans residing in Atlanta, GA who were overweight and had elevated blood pressure. The treatment group was exposed to 3-months of a multi-component intervention and the control to an abbreviated 6-week intervention after the completion of the treatment group’s intervention. The main outcomes included mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean waist circumference, mean body mass index (BMI), mean number of times exercise per week, mean number of servings of fruits and vegetables per day, and mean level of daily stress. Data were collected at baseline and at 6-month follow-up. Separate linear regressions were used with an established significance level of P P P = 0.002). Conclusion: These results show that a comprehensive lifestyle intervention can improve cardiovascular risk factor profile among high risk African Americans. Caregivers should encourage patients to participate in such programs and public health policymakers should allocate resources to community based health oriented organizations to implement comprehensive lifestyle program.
文摘Objectives Most medical instruments are designed for diagnosis purpose but very few for clinical treatment. Our research aim is to design and develop a cardiovascular automatic feedback control instrument （CAFCI） for rescuing the critical patients with abnormal blood pressure. Methods The CAFCI was designed on the basis of abundant clinical experiences and on successful mathematic modeling of our blood pressure, pulmonary experimental data. The capillary wedge pressure, and rates of heart beat were measured and inputted into a computer and drugs were chosen by a doctor through a user-friendly interface with the computer. The responses to medication were rapidly acquired and feed back to the computer by automatic detection system in a close-loop system. every 7.5 sec in order to dosage The data were refreshed regulate the speed and of the medications that were given. Results The experimental results with ten dogs showed that the CAFCI system took samples promptly and accurately so that the targeted blood pressure could be reached reliably based on our input parameters and our designing requirements. Conclusions Since the dependability and accuracy of the CAFCI system are much superior to that of the traditional method, its clinical application to rescue the critical patient warrants evaluation in the future.
基金National Institutes of Health(NIH):National Heart,Lung,and Blood Institute(NHLBI:R01-HL164772,R01-HL159062,R01-HL146691,T32-HL144456)National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK:R01-DK123259,R01-DK033823)+2 种基金National Center for Advancing Translational Sciences(NCATS:UL1-TR002556-06,UM1-TR004400)(to Gaetano Santulli)Diabetes Action Research and Education Foundation(to Gaetano Santulli)Monique Weill-Caulier and Irma T.Hirschl Trusts(to Gaetano Santulli).
文摘Diabetic cardiomyopathy is a disorder of the cardiac muscle that affects patients with diabetes.The exact mechanisms underlying diabetic cardiomyopathy are mostly unknown,but several factors have been implicated in the pathogenesis of the disease and its progression towards heart failure,including endothelial dysfunction,autonomic neuropathy,metabolic alterations,oxidative stress,and alterations in ion homeostasis,especially calcium transients[1].In Military Medical Research,Jiang et al.[2]sought to determine the functional role of complement factor D(Adipsin)in the pathophysiology of diabetic cardiomyopathy.
基金Supported by Jilin Province Health Research Talent Special Project,No.2020SCZ27.
文摘BACKGROUND The combination of polycythemia vera(PV)with pathological cardiac hypertro-phy is uncommon.In this study,we describe a case of PV accompanied by pa-thological cardiac hypertrophy.It is hypothesized that the pronounced cardiac hypertrophy in this patient has a strong connection with PV.CASE SUMMARY In 2021,a 34-year-old Chinese man experienced chest constriction,shortness of breath,and palpitations during vigorous activity.Each episode lasted several minutes and resolved spontaneously following cessation of vigorous activity.He occasionally experienced syncope and vertigo without a headache.He underwent cardiac magnetic resonance imaging and was diagnosed with“hypertrophic cardiomyopathy(HCM)”.He was discharged after receiving symptomatic treat-ment,which resulted in an improvement.He presented to our department with chest constriction,shortness of breath,and respiratory distress for one month while climbing to the second floor in 2023.His blood pressure was 180/100 mmHg at the time of admittance,and he was receiving antihypertensive treat-ment.He had a history of PV for 2 years without treatment.Symptomatic treat-ment was implemented concurrently with the administration of hydroxyurea upon admission.Good blood pressure control was observed during the long-term follow-up,and echocardiography did not reveal any progression of myocardial hypertrophy.CONCLUSION Clinicians managing PV patients should remain highly vigilant regarding the risks of thrombosis and cardio-vascular complications,particularly in those with refractory hypertension.
文摘The inflammatory response is involved in the pathogenesis of the most common types of heart disease. Sanguinarine （SAN） has various pharmacological properties such as anti-inflammatory, antioxidant, antibacterial, antitumor, and immune-enhancing properties. However, few studies have investigated the effects of SAN on lipopolysaceharide （LPS）-induced inflammatory and apoptotic responses in H9c2 cardiomyocytes. Therefore, in this study, H9c2 cells were co-treated with SAN and LPS, and the mRNA levels of pro-inflammation markers and the apoptosis rate were measured to clarify the effect of SAN on cardiac inflammation. The underlying mechanism was further investigated by detecting the activation of Toll-like receptor （TLR）4/nuclear faetor-κB （NF-κB） signaling pathways. As a result, increased mRNA expression of interleukin （IL）-1β, IL-6, and TNFα induced by LPS was attenuated after SAN treatment; LPS-induced apoptosis ofHge2 cardiomyocytes and cleaved-caspase 8, 9, 3 were all significantly reduced by SAN. Further experiments showed that the beneficial effect of SAN on blocking the inflammation and apoptosis of H9c2 cardiomyocytes induced by LPS was associated with suppression of the TLR4/NF-κB signaling pathway. It was suggested that SAN suppressed the LPS-induced inflammation and apoptosis of H9c2 cardiomyocytes, which may be mediated by inhibition of the TLR4/NF-κB signaling pathway. Thus, SAN may be a feasible therapy to treat sepsis patients with cardiac dysfunction.
基金supported by the National Key Basic Research Development Program of China(“973”Program)(No.2012CB518604)
文摘The traditional Chinese medicine Shensong Yangxin（SSYX） can improve the clinical symptoms of arrhythmia in an integrated manner. This study aimed to investigate the electrophysiological effect of SSYX on the hearts of myocardial-infarcted rabbits and further explore the mechanism by which SSYX alleviates myocardial fibrosis. Myocardial infarction（MI） was established in rabbits by ligation of the left circumflex coronary. The rabbits were treated with SSYX（0.5 g/kg/d） or saline for 8 weeks by oral administration. Microelectrode array（MEA） technology was used in vivo for extracellular electrophysiological recordings of the infarct border zone. Masson＇s trichrome staining was used to observe myocardial fibrosis. Western blotting was performed to evaluate the protein expression levels of collagen Ⅰ（COL Ⅰ） and collagen Ⅲ（COL Ⅲ）. Quantitative real-time polymerase chain reaction（real-time PCR） was performed to evaluate the TGF-β1 and MMP-2 m RNA expression levels. The results showed that the total activation time（TAT） and the dispersion of TAT were significantly increased and the excitation propagation markedly disordered after MI. SSYX could significantly decrease TAT and the dispersion of TAT, and significantly ameliorate the chaotic spread pattern of excitation. Furthermore, SSYX treatment could significantly decrease COL Ⅰ and COL Ⅲ protein levels and down-regulate TGF-β1 and MMP-2 m RNA expression levels in MI rabbits. It was concluded that SSYX may ameliorate cardiac electrophysiological abnormalities in infarcted hearts by decreasing the protein levels of COL Ⅰ and COL Ⅲ, down-regulating the m RNA expression levels of TGF-β1 and MMP2, and thereby reducing adverse cardiac remodeling.
文摘Myocardin （MYOCD） is a potent transcriptional coactivator that functions primarily in cardiac muscle and smooth muscle through direct contacts with serum response factor （SRF） over cis elements known as CArG boxes found near a number of genes encoding for contractile, ion channel, cytoskeletal, and calcium handling proteins. Since its discovery more than 10 years ago, new insights have been obtained regarding the diverse isoforms of MYOCD expressed in cells as well as the regulation of MYOCD expression and activity through transcriptional, post-transcriptional, and post-translational processes. Curiously, there are a number of functions associated with MYOCD that appear to be independent of contractile gene expression and the CArG-SRF nucleoprotein complex. Further, perturbations in MYOCD gene expression are associated with an increasing number of diseases including heart failure, cancer, acute vessel disease, and diabetes. This review summarizes the various biological and patho- logical processes associated with MYOCD and offers perspectives to several challenges and future directions for further study of this formidable transcriptional coactivator.
文摘Background: In worldwide, the mortality rate of acute myocardial infarction(AMI) raises year by year. Although the applications of percutaneous coronary intervention(PCI) and anticoagulants effectively reduce the mortality of patients with acute coronary syndrome(ACS), but also increase the incidence of bleeding. Therefore, drugs with stable anticoagulant effects are urgently required.Methods: We enrolled 894 patients with acute coronary syndrome who underwent percutaneous coronary intervention in Shenyang Northern Hospital from February 2010 to May 2012; 430 patients were included in the fondaparinux group(2.5mg/d), and 464 were included in the enoxaparin group(1mg/kg twice daily). Fondaparinux and enoxaparin were applied for 3–7 days. All patients were treated with tirofiban [10μg/kg for 3min initially and 0.15μg/(kg·min) for 1 to 3 days thereafter]. The primary efficacy endpoint was the incidence of a major adverse cerebrovascular or cardiovascular event. The primary safety endpoint was bleeding within 30 days and 1 year after percutaneous coronary intervention.Results: One-year data were available for 422 patients in the fondaparinux group and for 453 in the enoxaparin group. The incidence of a major adverse cerebrovascular or cardiovascular event(10.9% vs 12.6%, P=0.433) and cardiac mortality(0.5% vs 1.5%, P=0.116) were generally lower in the fondaparinux group than in the enoxaparin group, although the differences were not significant. Compared with the enoxaparin group, the fondaparinux group had a significantly decreased rate of bleeding at 30 days(0.9% vs 2.9%, P=0.040) and 1 year(2.4% vs 5.5%, P=0.018). In addition, the rate of major bleeding events was lower in the fondaparinux group, but this difference was not significant(0.2% vs 0.9%, 0.2% vs 1.1%).Conclusion: In tirofiban-treated patients with acute coronary syndrome undergoing percutaneous coronary intervention, fondaparinux presented similar efficacy for ischemia events as enoxaparin. However, fondaparinux significantly decreased the incidence of bleeding, thus providing safer anticoagulation therapy.
文摘Background Combinations of coronary heart disease(CHD) and other chronic conditions complicate clinical management and increase healthcare costs. The aim of this study was to evaluate gender-specific relationships between CHD and other comorbidities. Methods We analyzed data from the German Health Interview and Examination Survey(DEGS1), a national survey of 8152 adults aged 18-79 years. Female and male participants with self-reported CHD were compared for 23 chronic medical conditions. Regression models were applied to determine potential associations between CHD and these 23 conditions. Results The prevalence of CHD was 9%(547 participants): 34%(185) were female CHD participants and 66%(362) male. In women, CHD was associated with hypertension(OR = 3.28(1.81-5.9)), lipid disorders(OR = 2.40(1.50-3.83)), diabetes mellitus(OR = 2.08(1.24-3.50)), kidney disease(OR = 2.66(1.101-6.99)), thyroid disease(OR = 1.81(1.18-2.79)), gout/high uric acid levels(OR = 2.08(1.22-3.56)) and osteoporosis(OR = 1.69(1.01-2.84)). In men, CHD patients were more likely to have hypertension(OR = 2.80(1.94-4.04)), diabetes mellitus(OR = 1.87(1.29-2.71)), lipid disorder(OR = 1.82(1.34-2.47)), and chronic kidney disease(OR = 3.28(1.81-5.9)). Conclusion Our analysis revealed two sets of chronic conditions associated with CHD. The first set occurred in both women and men, and comprised known risk factors: hypertension, lipid disorders, kidney disease, and diabetes mellitus. The second set appeared unique to women: thyroid disease, osteoporosis, and gout/high uric acid. Identification of shared and unique gender-related associations between CHD and other conditions provides potential to tailor screening, preventive, and therapeutic options.
基金supported by a grant from the National Key Basic Research Development Program,the“973”Program,No.2012CB518604the National Natural Science Foundation of China,No.81260052+1 种基金the Natural Science Foundation of Hubei Province,No.2014CKB497,2014BKB075,and 2015BKA339the Natural Science Foundation of Henan Province of China,No.201602262
文摘Sympathetic nerve and vagus nerve remodeling play an important part in cardiac function post-myocardial infarction （MI）. Increasing evidence indicates that neuregulin-1 （NRG-1） improves cardiac function following heart failure. Since its impact on cardiac function and neural remodeling post-MI is poorly understood, we aimed to investigate the role of NRG-1 in autonomic nervous system remodeling post-MI. Forty-five Sprague-Dawley rats were equally randomized into three groups： sham （with the left anterior descending coronary artery exposed but without ligation）, MI （left anterior descending coronary artery ligation）, and MI plus NRG-1 （left anterior descending coronary artery ligation followed by intraperitoneal injection of NRG-1 （10 lag/kg, once daily for 7 days））. At 4 weeks after MI, echocardi- ography was used to detect the rat cardiac function by measuring the left ventricular end-systolic inner diameter, left ventricular diastolic diameter, left ventricular end-systolic volume, left ventricular end-diastolic volume, left ventricular ejection fraction, and left ventricular fractional shortening, mRNA and protein expression levels of tyrosine hydroxylase, growth associated protein-43 （neuronal specific pro- tein）, nerve growth factor, choline acetyltransferase （vagus nerve marker）, and vesicular acetylcholine transporter （cardiac vagal nerve fiber marker） in ischemic myocardia were detected by real-time PCR and western blot assay to assess autonomous nervous remodeling. After MI, the rat cardiac function deteriorated significantly, and it was significantly improved after NRG-1 injection. Compared with the MI group, mRNA and protein levels of tyrosine hydroxylase and growth associated protein-43, as well as choline acetyltransferase mRNA level significantly decreased in the MI plus NRG-1 group, while mRNA and protein levels of nerve growth factor and vesicular acetylcholine transporters, as well as choline acetyltransferase protein level slightly decreased. Our results indicate that NRG- 1 can improve cardiac function and regulate sympathetic and vagus nerve remodeling post-MI, thus reaching a new balance of the autonomic nervous system to protect the heart from injury.
文摘Most cases of sudden cardiac death are attributed to sustained ventricular tachyarrhythmias(VTs), triggered by acute coronary occlusion. Autonomic dysfunction, an important arrhythmogenic mechanism in this setting, is being actively investigated, aiming at the advent of preventive strategies. Recent experimental studies have shown vagal withdrawal after anterior myocardial infarction, coinciding with high incidence of VTs, followed by more gradual sympathetic activation coinciding with a second arrhythmia peak. This article summarizes recent knowledge on this intriguing topic, generating hypotheses that can be investigated in future experimental and clinical studies.
文摘AIM: To provide a structural model of the relationship between personality traits, perceived stress, coping strategies, social support, and psychological outcomes in the general population.METHODS: This is a cross sectional study in which the study group was selected using multistage cluster and convenience sampling among a population of 4 million. For data collection, a total of 4763 individuals were asked to complete a questionnaire on demographics, personality traits, life events, coping with stress, social support, and psychological outcomes such as anxiety and depression. To evaluate the comprehensive relation-ship between the variables, a path model was fitted.RESULTS: The standard electronic modules showed that personality traits and perceived stress are important determinants of psychological outcomes. Social support and coping strategies were demonstrated to reduce the increasing cumulative positive effects of neuroticism and perceived stress on the psychological outcomes and enhance the protective effect of extraversion through decreasing the positive effect of perceived stress on the psychological outcomes. CONCLUSION: Personal resources play an important role in reduction and prevention of anxiety and depression. In order to improve the psychological health, it is necessary to train and reinforce the adaptive coping strategies and social support, and thus, to moderate negative personality traits.
文摘With the rising interest in the regulatory functions of long non-coding RNAs （IncRNAs） in complex human diseases such as cardiovascular diseases, there is an increasing need in public databases offering comprehensive and integrative data for all aspects of these versatile molecules. Recently, a variety of public data repositories that specialized in lncRNAs have been developed, which make use of huge high-throughput data particularly from next-generation sequencing （NGS） approaches. Here, we provide an overview of current IncRNA databases covering basic and functional annotation, IncRNA expression and regulation, interactions with other biomolecules, and genomic variants influencing the structure and function of lncRNAs. The prominent IncRNA antisense noncoding RNA in the INK4 locus （ANRIL）, which has been unequivocally associated with coronary artery disease through genome-wide association studies （GWAS）, serves as an example to demonstrate the features of each individual database.
基金supported by Chinese Medical Doctor Association Discovery-Fund Project,Grant/Award Number(DFCMDA201417)National Basic Research Program of China,Grant/Award Number(2012CB517804)。
文摘Background:None of study mentioned about contrast-induced acute kidney injury(CI-AKI)in people who have received contrast agents twice within in a short period of time.This study is trying to identify the predictors.Methods:We enrolled 607 patients between Oct.2010 and Jul.2015 who received contrast agents twice within 30 days in the Department of Cardiology of the General Hospital of Shenyang Military Region.The primary outcome was CI-AKI within 72 h after contrast agent exposure.Patients were divided into groups A(n=559)and group B(n=48)according to whether CI-AKI occurred after the second agent.Results:Patients in group B(CI-AKI occurred after the second agent)had a more rapid heart rate and more usage of diuretics and digitalis.In group B,CI-AKI occurred more frequently after the first agent.Multivariate logistic regression showed that diuretic(P=0.006)and intra-aortic balloon pump(IABP)usage(P=0.012)were independent predictors of CI-AKI after the first agent.Angiotensin-converting enzyme inhibitor/AngiotensinⅡreceptor antagonist(ACEI/ARB)usage(P=0.039),IABP usage(P=0.040)and CI-AKI occurring after administration of the first agent(P=0.015)were independent predictors of CI-AKI after the second.Furthermore,dividing the patients into tertiles of the time interval between the two agents showed that CI-AKI occurred more frequently when the second agent was administered within 1–3 days after the first exposure than within 4–6 days(12.4%vs.5.0%,P=0.008)or≥7 days(12.4%vs.6.4%,P=0.039).Conclusions:Diuretic and IABP usage are independent predictors of CI-AKI following exposure to a first contrast agent.The major predictors of CI-AKI after exposure to a second agent are time since the first contrast exposure,ACEI/ARB usage,and IABP usage.More importantly,a three-day interval between the two agents is associated with a higher incidence of CI-AKI following the second administration.
