The cardiovascular system at high altitude:A bibliometric and visualization analysis

BACKGROUND When exposed to high-altitude environments,the cardiovascular system undergoes various changes,the performance and mechanisms of which remain controversial.AIM To summarize the latest research advancements and hot research points in the cardiovascular system at high altitude by conducting a bibliometric and visualization analysis.METHODS The literature was systematically retrieved and filtered using the Web of Science Core Collection of Science Citation Index Expanded.A visualization analysis of the identified publications was conducted employing CiteSpace and VOSviewer.RESULTS A total of 1674 publications were included in the study,with an observed annual increase in the number of publications spanning from 1990 to 2022.The United States of America emerged as the predominant contributor,while Universidad Peruana Cayetano Heredia stood out as the institution with the highest publication output.Notably,Jean-Paul Richalet demonstrated the highest productivity among researchers focusing on the cardiovascular system at high altitude.Furthermore,Peter Bärtsch emerged as the author with the highest number of cited articles.Keyword analysis identified hypoxia,exercise,acclimatization,acute and chronic mountain sickness,pulmonary hypertension,metabolism,and echocardiography as the primary research hot research points and emerging directions in the study of the cardiovascular system at high altitude.CONCLUSION Over the past 32 years,research on the cardiovascular system in high-altitude regions has been steadily increasing.Future research in this field may focus on areas such as hypoxia adaptation,metabolism,and cardiopulmonary exercise.Strengthening interdisciplinary and multi-team collaborations will facilitate further exploration of the pathophysiological mechanisms underlying cardiovascular changes in high-altitude environments and provide a theoretical basis for standardized disease diagnosis and treatment.

Multi-scale modeling of hemodynamics in the cardiovascular system

The human cardiovascular system is a closed- loop and complex vascular network with multi-scaled het- erogeneous hemodynamic phenomena. Here, we give a selective review of recent progress in macro-hemodynamic modeling, with a focus on geometrical multi-scale model- ing of the vascular network, micro-hemodynamic modeling of microcirculation, as well as blood cellular, subcellular, endothelial biomechanics, and their interaction with arter- ial vessel mechanics. We describe in detail the methodology of hemodynamic modeling and its potential applications in cardiovascular research and clinical practice. In addition, we present major topics for future study： recent progress of patient-specific hemodynamic modeling in clinical applica- tions, micro-hemodynamic modeling in capillaries and blood cells, and the importance and potential of the multi-scale hemodynarnic modeling.

Effects of Parasitic Diseases on the Cardiovascular System

The parasitic disease can significantly affect the cardiovascular system through various mechanisms;even though it is traditionally regarded as a disease characterized by parasitic sites’ mechanical damage and some immune responses. Recent studies have shown that the role of parasitic factors in the cause of death due to cardiovascular events cannot be ignored. Considering the worldwide prevalence of parasitic diseases, exploring the effects of parasitic diseases on the cardiovascular system becomes increasingly essential. Here we summarize the latest understanding of common parasitic infections, explore the possible mechanisms of cardiovascular responses to parasitic infections, and propose feasible strategies for preventing and treating parasite-induced cardiac reactions.

On the Blood Pressure in the Cardiovascular System

Background: Hemodynamics is a practical and complicated theoretical problem. The aim of this paper is to analyze the characteristics of blood pressure in the cardiovascular system changing with the mechanical parameters of blood vessels and the storage of some visceral organs. Method: The fluid network model was used for the study. The cardiovascular system was modeled as a system consisting of 20 segments of vessels. The main controlling parameters were determined first by using dimensional analysis. Then the responses of blood pressure of each segment of vessels were analyzed by changing the controlling parameters. Results: The parameters of the blood vessel of brain have the least influence on the pressures of other parts. The pressures of the system of blood vessels will decrease if some blood is stored in the liver or the abdominal vein system. Vice versa. The effects of regulation of blood on the variation of blood pressure are larger than the other controlling parameters. Conclusions: The controlling parameters of the abdominal aorta and ascending aorta affect greatly the blood pressure of each vessel.

Peroxisome-proliferator-activated receptors regulate redox signaling in the cardiovascular system

Peroxisome-proliferator-activated receptors(PPARs) comprise three subtypes(PPARα,δ and γ) to form a nuclear receptor superfamily.PPARs act as key transcriptional regulators of lipid metabolism,mitochondrial biogenesis,and anti-oxidant defense.While their roles in regulating lipid metabolism have been well established,the role of PPARs in regulating redox activity remains incompletely understood.Since redox activity is an integral part of oxidative metabolism,it is not surprising that changes in PPAR signaling in a specific cell or tissue will lead to alteration of redox state.The effects of PPAR signaling are directly related to PPAR expression,protein activities and PPAR interactions with their coregulators.The three subtypes of PPARs regulate cellular lipid and energy metabolism in most tissues in the body with overlapping and preferential effects on different metabolic steps depending on a specific tissue.Adding to the complexity,specific ligands of each PPAR subtype may also display different potencies and specificities of their role on regulating the redox pathways.Moreover,the intensity and extension of redoxregulation by each PPAR subtype are varied depending on different tissues and cell types.Both beneficial and adverse effects of PPAR ligands against cardiovascular disorders have been extensively studied by many groups.The purpose of the review is to summarize the effects of each PPAR on regulating redox and the underlying mechanisms,as well as to discuss the implications in the cardiovascular system.

Exercise-mediated regulation of autophagy in the cardiovascular system

Cardiovascular disease is the leading cause of human death worldwide. Autophagy is an evolutionarily conserved degradation pathway,which is a highly conserved cellular degradation process in which lysosomes decompose their own organelles and recycle the resulting macromolecules.Autophagy is critical in maintaining cardiovascular homeostasis and function, and excessive or insufficient autophagy or autophagic flux can lead to cardiovascular disease. Enormous evidence indicates that exercise training plays a beneficial role in the prevention and treatment of cardiovascular diseases. The regulation of autophagy during exercise is a bidirectional process. For cardiovascular disease caused by either insufficient or excessive autophagy, exercise training restores normal autophagy function and delays the progression of cardiovascular disease.An in-depth exploration and discussion of exercise-mediated regulation of autophagy in the cardiovascular system can broaden our view about the prevention of various autophagy-related diseases through exercise training. In this article, we review autophagy and its related signaling pathways,as well as autophagy-dependent beneficial effects of exercise in cardiovascular system.

Primary study of muscone's effect on cardiovascular system

Objective To investigate the effect of muscone on cardiovascular system.Methods Experimental animals to divide muscone high、middle、low dose group(the mouse is 20 mg·kg-1,10 mg·kg-1,5.0 mg·kg-1;the rat is 10 mg·kg-1,5.0 mg·kg-1,2.5 mg·kg-1),GT group(the mouse is 1/12 mg·kg-1;the rat is 1/24 mg·kg-1)and NS group.Intragastric administration in a week,do the mouse ant-hypoxia experiment、the drug(Pit.)produce the rat myocardial ischemia experiment and obstruct coronary artery to produce the rat myocardial ischemia experiment.The mice's survival time(t),the rat's variation of T in electrocardiogram、creatinkinase(CK)and lactate dehydrogenase(LDH)were recorded,respectively.Results The effect of Muscone is significant difference between GT and NS in a dose variation manner.Conclusions Muscone has the effect of ant-hypoxia,cutting down T peak value,reducing CK and LDH.The muscone has effect to inhibiting myocardial ischemia.

Overview of bile acid signaling in the cardiovascular system

Bile acids(BAs)are classically known to play a vital role in the metabolism of lipids and in absorption.It is now well established that BAs act as signaling molecules,activating different receptors(such as farnesoid X receptor,vitamin D receptor,Takeda G-protein-coupled receptor 5,sphingosine-1-phosphate,muscarinic receptors,and big potassium channels)and participating in the regulation of energy homeostasis and lipid and glucose metabolism.In addition,increased BAs can impair cardiovascular function in liver cirrhosis.Approximately 50%of patients with cirrhosis develop cirrhotic cardiomyopathy.Exposure to high concentrations of hydrophobic BAs has been shown to be related to adverse effects with respect to vascular tension,endothelial function,arrhythmias,coronary atherosclerotic heart disease,and heart failure.The BAs in the serum BA pool have relevant through their hydrophobicity,and the lipophilic BAs are more harmful to the heart.Interestingly,ursodeoxycholic acid is a hydrophilic BA,and it is used as a therapeutic drug to reverse and protect the harmful cardiac effects caused by hydrophobic elevated BAs.In order to elucidate the mechanism of BAs and cardiovascular function,abundant experiments have been conducted in vitro and in vivo.The aim of this review was to explore the mechanism of BAs in the cardiovascular system.

Aerobic vs anaerobic exercise training effects on the cardiovascular system

Physical exercise is one of the most effective methods to help prevent cardiovascular(CV) disease and to promote CV health. Aerobic and anaerobic exercises are two types of exercise that differ based on the intensity, interval and types of muscle fibers incorporated. In this article, we aim to further elaborate on these two categories of physical exercise and to help decipher which provides the most effective means of promoting CV health.

Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia

Objective To examine associations between cardiovascular system medication use with cognition function and diagnosis of dementia in older adults living in nursing homes in Australia. Methods As part of a cross-sectional study of 17 Australian nursing homes examining quality of life and resource use, we examined the association between cognitive impairment and cardiovascular medication use （identified using the Anatomical Therapeutic Classification System） using general linear regression and logistic regression models. People who were receiving end of life care were excluded. Results Participants included 541 residents with a mean age of 85.5 years （± 8.5）, a mean Psychogeriatric Assessment Scale–Cognitive Impairment （PAS-Cog） score of 13.3 （± 7.7）, a prevalence of cardiovascular diseases of 44% and of hypertension of 47%. Sixty-four percent of participants had been diagnosed with dementia and 72% had received cardiovascular system medications within the previous 12 months. Regression models demonstrated the use of cardiovascular medications was associated with lower （better） PAS-Cog scores [Coefficient （β） = -3.7; 95% CI： -5.2 to -2.2; P 〈 0.0001] and a lower probability of a dementia diagnosis （OR = 0.44; 95% CI： 0.26 to 0.75, P = 0.0022）. Analysis by subgroups of medications showed cardiac therapy medications （C01）, beta blocking agents （C07）, and renin-angiotensin system agents （C09） were associated with lower PAS-Cog scores （better cognition） and lower dementia diagnosis probability. Conclusions This analysis has demonstrated an association between greater cardiovascular system medication use and better cognitive status among older adults living in nursing homes. In this population, there may be differential access to health care and treatment of cardiovascular risk factors. This association warrants further investigation in large cohort studies.

Impact of Ambient Air Pollution and Meteorological Factors on Hospital Admission to the Cardiovascular System Disease on Ulaanbaatar City of Mongolia

Background: Mongolia is situated in northern Central Asia. Landlocked between China and Russia, it is a vast expanse of high attitude grassland steppe, desert, and mountain covering an area of 1,565,000 square kilometers. Air pollution is an increasingly series problem in Mongolia. Materials and Methods: This is a time-series cross over study. All health and air pollution data of 2008-2017 was used for this survey. Results: The mean level of SO2 during the cold season was 35.22 μg/m3 and during the warm season it was 4.65 μg/m3. 24 hours PM10 concentration, during the cold season daily average concentration was 226.77 μg/m3. The 8 hours average daily carbon monoxide concentration (1352.85 μg/m3 [95% CI: 1313.07 - 1396.15]) was high during the cold season, ozone concentration (39.10 μg/m3 [95% CI: 37.95 - 40.35]) was high during the warm season. Air quality depends on metrological parameters. All correlation was statistically significant during the whole year and cold season. In total, 288,832 people get admitted to the hospital due to cardiovascular system disease in Ulaanbaatar during the year of 2008-2017. In general, hospitalization is increasing year by year. Significant associations were found for SO2 with hypertensive diseases (I10 - I15), ischemic heart diseases (I20 - I25), cerebrovascular diseases (I60 - I69), diseases of pulmonary circulation and other forms of heart (I00 - I09, I26 - I52) in all lags. For NO2 was less associated with Ischemic heart diseases (I20 - I25) and diseases of pulmonary circulation and other forms of heart (I00 - I09, I26 - I52). For both PM10 and PM2.5, every disease had observed significant RR in lag 0 - 3. Significant associations were found for air pollutants such as PM10, PM2.5, CO, SO2, and O3 in all lags had a statistically significant association with cold season’s cardiovascular system disease admission. As expected during the warm season significant association was found only lag 1 with PM2.5 and lags (0, 1) CO and O3. Conclusion: As expected this study demonstrated significant correlations between cardiovascular morbidity with PM2.5, PM10, NO2, SO2, CO, O3, and some meteorological parameters.

Preeclampsia-What is to blame?The placenta,maternal cardiovascular system or both?

Preeclampsia(PE)is a pregnancy-specific syndrome,complicating 2%-8% of pregnancies.PE is a major cause of maternal mortality throughout the world with 60000 maternal deaths attributed to hypertensive disorders of pregnancy.PE also results in fetal morbidity due to prematurity and fetal growth restriction.The precise aetiology of PE remains an enigma with multiple theories including a combination of environmental,immunological and genetic factors.The conventional and leading hypotheses for the initial insult in PE is inadequate trophoblast invasion which is thought to result in incomplete remodelling of uterine spiral arteries leading to placental ischaemia,hypoxia and thus oxidative stress.The significant heterogeneity observed in pre-eclampsia cannot be solely explained by the placental model alone.Herein we critically evaluate the clinical(risk factors,placental blood flow and biomarkers)and pathological(genetic,molecular,histological)correlates for PE.Furthermore,we discuss the role played by the(dysfunctional)maternal cardiovascular system in the aetiology of PE.We review the evidence that demonstrates a role for both the placenta and the cardiovascular system in early-and late-onset PE and highlight some of the key differences between these two distinct disease entities.

Radiological features of uncommon aneurysms of the cardiovascular system

Although aortic aneurysms are the most common type encountered clinically, they do not span the entire spectrum of possible aneurysms of the cardiovascular system. As cross sectional imaging techniques with cardiac computed tomography and cardiac magnetic resonance imaging continue to improve and becomes more commonplace, once rare cardiovascular aneurysms are being encountered at higher rates. In this review, a series of uncommon, yet clinically important, cardiovascular aneurysms will be presented with review of epidemiology, clinical presentation and complications, imaging features and relevant differential diagnoses, and aneurysm management.

Effects of energy drinks on the cardiovascular system

Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.

Cardiovascular System Mortalities in Nigeria;Case Study of the University of Port Harcourt Teaching Hospital

Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.

COVID-19 and the cardiovascular system-current knowledge and future perspectives

The current coronavirus disease 2019(COVID-19) pandemic has had devastating impact on populations around the world.The high mortality rates in patients with COVID-19 has been attributed to the influence of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),its causative viral agent,on several physiological systems in human body,including the respiratory,cardiovascular,and neurological systems.There is emerging evidence on propensity of this virus to attack cardiovascular system.However,various pathophysiological mechanisms by which SARS-CoV-2 interacts with cardiovascular system and leads to high morbidity and mortality,including cardiovascular complications,are poorly understood.This mini review aims to provide an update on the current knowledge and perspectives on areas of future research.

A NON-INVASIVE AUTOMATIC DETECTING SYSTEM FOR BLOOD FLOW PARAMETERS OF CARDIOVASCULAR SYSTEM

In this paper,a non-invasive detecting system for measuring blood flow parame-ters of cardiovascular system is described.The device employs a new unique methodwhich is based on the theory of hemodynamics,ordinary measurement of blood pres-sure and pulse information of variation of pulse contour parameter Ko The sphygmo-gram is picked up from radial artery via sensor.As the blood pressure changes。

Effects of COVID-19 on the cardiovascular system:A mendelian randomization study

Infections with the coronavirus disease 2019(COVID-19)and disorders of the heart and blood vessels are causally related.To ascertain the causal relationship between COVID-19 and cardiovascular disease(CVD),we carried out a Mendelian randomization(MR)study through a method known as inverse variance weighting(IVW).When analyzing multiple SNPs,MR can meta-aggregate the effects of multiple loci by using IVW meta-pooling method.The weighted median(WM)is the median of the distribution function obtained by ranking all individual SNP effect values according to their weights.WM yields robust estimates when at least 50%of the information originates from valid instrumental variables(IVs).Directed gene pleiotropy in the included IVs is permitted because MR–Egger does not require a regression straight line through the origin.For MR estimation,IVW,WM and MR-Egger were employed.Sensitivity analysis was conducted using funnel plots,Cochran's Q test,MR–Egger intercept test,MR–PRESSO,and leave-one-out analysis.SNPs related to exposure to COVID-19 and CVD were compiled.CVD for COVID-19 infection,COVID-19 laboratory/self-reported negative,and other very severe respiratory diagnosis and population were randomly assigned using MR.The COVID-19 laboratory/self-reported negative results and other very severe respiratory confirmed cases versus MR analysis of CVD in the population(p>0.05);COVID-19 infection to CVD(p?0.033,OR?1.001,95%CI:1.000–1.001);and the MR–Egger results indicated that COVID-19 infection was associated with CVD risk.This MR study provides preliminary evidence for the validity of the causal link between COVID-19 infection and CVD.

Improving Prediction Efficiency of Machine Learning Models for Cardiovascular Disease in IoST-Based Systems through Hyperparameter Optimization

This study explores the impact of hyperparameter optimization on machine learning models for predicting cardiovascular disease using data from an IoST(Internet of Sensing Things)device.Ten distinct machine learning approaches were implemented and systematically evaluated before and after hyperparameter tuning.Significant improvements were observed across various models,with SVM and Neural Networks consistently showing enhanced performance metrics such as F1-Score,recall,and precision.The study underscores the critical role of tailored hyperparameter tuning in optimizing these models,revealing diverse outcomes among algorithms.Decision Trees and Random Forests exhibited stable performance throughout the evaluation.While enhancing accuracy,hyperparameter optimization also led to increased execution time.Visual representations and comprehensive results support the findings,confirming the hypothesis that optimizing parameters can effectively enhance predictive capabilities in cardiovascular disease.This research contributes to advancing the understanding and application of machine learning in healthcare,particularly in improving predictive accuracy for cardiovascular disease management and intervention strategies.

Combining GLP-1 receptor agonists and SGLT-2 inhibitors for cardiovascular disease prevention in type 2 diabetes:A systematic review with multiple network meta-regressions

BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.AIM To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.METHODS The systematic review was conducted according to PRISMA recommendations.The protocol was registered on PROSPERO(ID:42022385007).A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment.Effect modification of prior myocardial infarction(MI)and heart failure(HF)was also explored to provide clinical insight as to when the INTRODUCTION The macro-and micro-vascular benefits of glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are independent of their glucose-lowering effects[1].In patients with type 2 diabetes(T2D),the major cardiovascular outcome trials(CVOT)showed that dipeptidyl peptidase-4 inhibitors(DPP-4I)did not improve cardiovascular outcomes[2],whereas cardiovascular benefit of GLP-1RA or SGLT-2I was significant[3,4].Further subgroup analyses indicated that the background cardiovascular risk should be considered when examining the cardiovascular outcomes of these newer glucose-lowering medications.For instance,prevention of major adverse cardiovascular events(MACE)was only seen in those patients with baseline atherosclerotic cardiovascular disease[3,4].Moreover,a series of CVOT conducted in patients with heart failure(HF)have demonstrated that(compared with placebo)SGLT-2I significantly reduced risk of hospitalization for HF or cardiovascular death,irrespective of their history of T2D[5-8].However,similar cardiovascular benefits were not observed in those with myocardial infarction(MI)[9,10].Cardiovascular co-morbidities are not only approximately twice as common but are also associated with dispropor-tionately worse cardiovascular outcomes in patients with T2D,compared to the general population[11].Therefore,it is of clinical importance to investigate whether the combination treatment of GLP-1RA and SGLT-2I could achieve greater cardiovascular benefit,particularly when considering patients with cardiovascular co-morbidities who may not gain sufficient cardiovascular protection from the monotherapies.This systematic review with multiple network meta-regressions was mainly aimed to explore whether combining GLP-1RA and SGLT-2I can provide additional cardiovascular benefit in T2D.Cardiovascular outcomes of these newer antidiabetic medications were also estimated under effect modification of prior cardiovascular diseases.This was to provide clinical insight as to when the combination treatment might be prioritized.