Introduction The distribution of congenital heart disease (CHD) in sub-Saharan Africa is highly imprecise and varies from one region to another due to the inequality of diagnostic facilities. The aim of this stud...Introduction The distribution of congenital heart disease (CHD) in sub-Saharan Africa is highly imprecise and varies from one region to another due to the inequality of diagnostic facilities. The aim of this study was to determine the in-hospital prevalence of congenital heart disease in children at the Mother-Child hospital of Bingerville (HME) by specifying the diagnostic, therapeutic and evolutionary aspects. Materials and methods We conducted a retrospective, descriptive, cross-sectional study at HME of Bingerville from January 2021 to December 2022. All newborns with congenital heart disease confirmed by echocardiography were included in the study. Results Of 656 admissions to the neonatology department over the study period, congenital heart disease accounted for 14.9% (98/656) of cases. In our series, 76.7% were diagnosed before the 1st week of life, with a mean chronological age of 5.18 days and extremes of 0 and 46 days. There were as many male patients (50%) as female (50%), i.e. a sex ratio of 1. These newborns were premature in 60.2% of cases, with a mean and median gestational age of 34 weeks’ amenorrhea. Most were left-right shunts (90.8%). Persistent ductus arteriosus (PDA) (48.9%) predominated, followed by atrial septal defect (38.7%), ventricular septal defect (13.3%), common trunk artery (CTA) (3.1%) and open septal pulmonary atresia (OSPA) (1%) as the primary cyanogenic heart disease. Pulmonary arterial hypertension (PAH) (50%) was primary in 38.8% and secondary (61.2%). The mortality rate was 30.6%, and all CTA patients died (100%), with a significant statistical relationship (p = 0.027). Progression under treatment was marked by clinical stabilization (68/98) in 69.4% of cases. Conclusion: Congenital heart disease is relatively common at the Bingerville HME. Access to echocardiography should be facilitated in neonatology departments for rapid diagnosis and optimal management of congenital heart disease in newborns.展开更多
CHDTEPDB(URL:http://chdtepdb.com/)is a manually integrated database for congenital heart disease(CHD)that stores the expression profiling data of CHD derived from published papers,aiming to provide rich resources for i...CHDTEPDB(URL:http://chdtepdb.com/)is a manually integrated database for congenital heart disease(CHD)that stores the expression profiling data of CHD derived from published papers,aiming to provide rich resources for investigating a deeper correlation between human CHD and aberrant transcriptome expression.The develop-ment of human diseases involves important regulatory roles of RNAs,and expression profiling data can reflect the underlying etiology of inherited diseases.Hence,collecting and compiling expression profiling data is of critical significance for a comprehensive understanding of the mechanisms and functions that underpin genetic diseases.CHDTEPDB stores the expression profiles of over 200 sets of 7 types of CHD and provides users with more convenient basic analytical functions.Due to the differences in clinical indicators such as disease type and unavoidable detection errors among various datasets,users are able to customize their selection of corresponding data for personalized analysis.Moreover,we provide a submission page for researchers to submit their own data so that increasing expression profiles as well as some other histological data could be supplemented to the database.CHDTEPDB is a user-friendly interface that allows users to quickly browse,retrieve,download,and analyze their target samples.CHDTEPDB will significantly improve the current knowledge of expression profiling data in CHD and has the potential to be exploited as an important tool for future research on the disease.展开更多
Background:Living well is as important as living longer.The objective of this study is to assess quality of life(QoL)in congenital heart disease(CHD)according to current AHA/ACC anatomical and physiological classifica...Background:Living well is as important as living longer.The objective of this study is to assess quality of life(QoL)in congenital heart disease(CHD)according to current AHA/ACC anatomical and physiological classification.Methods:Cross-sectional study examining the World Health Organization QoL Bref questionnaire(WHOQoL-Bref)in consecutive outpatient CHD patients from a single unit.Results:191 CHD patients were studied.Median age was 28±13 years and 59%were male.44(23%),115(60%)and 33(17%)CHD patients showed mild,moderate and great anatomical defects respectively while 69(36%)patients were in physiological Stage A,27(14%)in Stage B,84(44%)in Stage C and 11(6%)in Stage D.No significant differences were seen in relation the anatomical classification and the different sections of the WHOQoL-Bref questionnaire.CHD patients in Stages C and D had significant lower physical domain scores than patients in the Stage A(p<0.05).However,no significant differences were seen in the psychological,social relationships and environmental domains.The binary logistic regression analysis showed that having a higher educational level was a protective factor[OR 0.32(95%CI,0.12-0.87),p=0.026]while being married or cohabit was a risk factor[OR 3.46(95%CI,1.13-10.63),p=0.030]for having a worse rated QoL.Meanwhile,having a worse functional class(NYHA≥2)[OR 3.44(95%CI,1.20-9.81),p=0.021]was associated with dissatisfaction with health.Conclusion:Patients with advanced physiological stages scored lower on the physiological domain.No statistical significance was seen,according to the anatomical and physiological classification,in the psychological,social relationship and environmental domains.展开更多
Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twent...Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.展开更多
Objective This study aimed to investigate predictability of preconception maternal circulating folate and homocysteine concentrations,glycemic and lipid profiles to the risk of congenital heart disease(CHD)in offsprin...Objective This study aimed to investigate predictability of preconception maternal circulating folate and homocysteine concentrations,glycemic and lipid profiles to the risk of congenital heart disease(CHD)in offspring.Methods A cohort of pregnancies was derived from a single hospital where pre-and post-conceptional serum folate,homocysteine,lipids,glycemic profiling and neonatal CHD screening program were facilitated.展开更多
Waterlogged soils and submerged sediments in wetlands and agricultural lands used for rice paddies and aquaculture have anaerobic conditions that slow and prevent the photo and microbial degradation of dioxin TCDD (2,...Waterlogged soils and submerged sediments in wetlands and agricultural lands used for rice paddies and aquaculture have anaerobic conditions that slow and prevent the photo and microbial degradation of dioxin TCDD (2,3,7,8-tetracholorodibenzo-p-dioxin), enabling it to persist in environments for long periods. Over 1.6 million ha of land in southern Vietnam were sprayed with 2,4,5-T herbicides (e.g. Agent Orange) contaminated with dioxin TCDD during the Vietnam War (1961-1971);45% of these ha received four or more spray flight missions. Dioxins are endocrine disrupters and may induce cardiovascular disease, growth, and developmental defects, diabetes, hormonal dysfunctions and disruptions, certain cancers, and chloracne. Outpatient screening clinic 2020 data on Vietnamese children suspected of congenital heart disease (CHD) showed the childhood CHD prevalence rate in Vietnam of 13.356/1000, significantly elevated compared to the Asian CHD prevalence rate of 3.531/1000. CHD prevalence rate differences between North Vietnam (2.541/1000) and south of the 17<sup>th</sup> parallel (10.809/1000) were significant. Vietnamese farmers, especially pregnant women whose occupations involve daily contact with soil and sediments where dioxin TCDD persists in the environment may be at risk of dioxin accumulation from dermal exposure and bioaccumulation via diet. There is an urgent need for funded longitudinal genetic and clinical studies to assess CHD and other organ system childhood malformations due to in utero TCDD exposure. We recommend an integrated research design involving 1) site-specific locations that received high volumes and multiple spray loads of herbicides during the Vietnam War;2) soil sampling of submerged and waterlogged soils and sediments where TCDD may not have degraded;3) production areas of agriculture, fisheries, and other aquatic products;4) risk assessment dioxin levels in foods where TCDD is likely to bioaccumulate;5) child-bearing age and pregnant women with potentially high sensitivity to long-term low dose exposure, and 6) men and women in occupations that are in daily contact with contaminated soil and sediments as part of their job routines.展开更多
Background Cyanotic congenital heart disease(CCHD)is one ofthe most common birth anomaly,in which chronic hypoxia is the basic pathophysiological process.Researches in the protective mechanisms of cardiomyocytes to ch...Background Cyanotic congenital heart disease(CCHD)is one ofthe most common birth anomaly,in which chronic hypoxia is the basic pathophysiological process.Researches in the protective mechanisms of cardiomyocytes to chronic hypoxia have the potential to provide novel treatment strategies for many patients.Metabolomics is a study of metabolism at global level,which capture global biochemical events by assaying thousands of small molecules in tissues,followed by application of bioinformatics to define metabolomic signatures of the targets.In order to describe the features of metabolic remodeling of the heart of CCHD,we conducted our study on the effect of hypoxia on metabolism of human heart by using tissue from patients with CCHD compared with that from patients with non-cyanotic CHD(NCCHD).展开更多
Hepatitis C virus is one of the major health problems worldwide. It affects mainly the liver but several extrahepatic manifestations are also accounted. Chronic hepatitis C patients are at an increased risk of develop...Hepatitis C virus is one of the major health problems worldwide. It affects mainly the liver but several extrahepatic manifestations are also accounted. Chronic hepatitis C patients are at an increased risk of developing hepatic steatosis, which share many clinical features with the metabolic syndrome. Hepatic steatosis has also been associated with elevated levels of markers of inflammation such as homocysteine, identified as hyperhomocysteinemia (HHC). HHC due to Methylenetetrahydrofolate Reductase (MTHFR) gene, in particular the C677T polymorphism, was recently associated with coronary heart diseases (CHD) in chronic hepatitis C (CHC) patients. Homocysteine is an intermediate in methionine metabolism, which takes place mainly in the liver metabolism. Deficiencies of micronutrients (folate, vitamin B 6 and possibly vitamin B 12) along with mild hyperhomocysteinemia, perhaps, act synergistically with other classical risk factors to further increase the risk of CHD. Clinical data indicate that HHC is associated with an increased incidence of CHD as well as with the severity of the disease in CHC patients. In conclusion, HHC might be a potential aetiological factor of CHD in CHC patients. The aim of this review is to investigate the progression of coronary heart diseases in chronic hepatitis C patients and correlate with levels of homocysteine in concurrence to genetic defects and nutrient deficiencies. However, future studies need to clarify the mechanistic role of HHC in CHD and CHC as a useful paradigm with most interesting therapeutic implications.展开更多
文摘Introduction The distribution of congenital heart disease (CHD) in sub-Saharan Africa is highly imprecise and varies from one region to another due to the inequality of diagnostic facilities. The aim of this study was to determine the in-hospital prevalence of congenital heart disease in children at the Mother-Child hospital of Bingerville (HME) by specifying the diagnostic, therapeutic and evolutionary aspects. Materials and methods We conducted a retrospective, descriptive, cross-sectional study at HME of Bingerville from January 2021 to December 2022. All newborns with congenital heart disease confirmed by echocardiography were included in the study. Results Of 656 admissions to the neonatology department over the study period, congenital heart disease accounted for 14.9% (98/656) of cases. In our series, 76.7% were diagnosed before the 1st week of life, with a mean chronological age of 5.18 days and extremes of 0 and 46 days. There were as many male patients (50%) as female (50%), i.e. a sex ratio of 1. These newborns were premature in 60.2% of cases, with a mean and median gestational age of 34 weeks’ amenorrhea. Most were left-right shunts (90.8%). Persistent ductus arteriosus (PDA) (48.9%) predominated, followed by atrial septal defect (38.7%), ventricular septal defect (13.3%), common trunk artery (CTA) (3.1%) and open septal pulmonary atresia (OSPA) (1%) as the primary cyanogenic heart disease. Pulmonary arterial hypertension (PAH) (50%) was primary in 38.8% and secondary (61.2%). The mortality rate was 30.6%, and all CTA patients died (100%), with a significant statistical relationship (p = 0.027). Progression under treatment was marked by clinical stabilization (68/98) in 69.4% of cases. Conclusion: Congenital heart disease is relatively common at the Bingerville HME. Access to echocardiography should be facilitated in neonatology departments for rapid diagnosis and optimal management of congenital heart disease in newborns.
文摘CHDTEPDB(URL:http://chdtepdb.com/)is a manually integrated database for congenital heart disease(CHD)that stores the expression profiling data of CHD derived from published papers,aiming to provide rich resources for investigating a deeper correlation between human CHD and aberrant transcriptome expression.The develop-ment of human diseases involves important regulatory roles of RNAs,and expression profiling data can reflect the underlying etiology of inherited diseases.Hence,collecting and compiling expression profiling data is of critical significance for a comprehensive understanding of the mechanisms and functions that underpin genetic diseases.CHDTEPDB stores the expression profiles of over 200 sets of 7 types of CHD and provides users with more convenient basic analytical functions.Due to the differences in clinical indicators such as disease type and unavoidable detection errors among various datasets,users are able to customize their selection of corresponding data for personalized analysis.Moreover,we provide a submission page for researchers to submit their own data so that increasing expression profiles as well as some other histological data could be supplemented to the database.CHDTEPDB is a user-friendly interface that allows users to quickly browse,retrieve,download,and analyze their target samples.CHDTEPDB will significantly improve the current knowledge of expression profiling data in CHD and has the potential to be exploited as an important tool for future research on the disease.
文摘Background:Living well is as important as living longer.The objective of this study is to assess quality of life(QoL)in congenital heart disease(CHD)according to current AHA/ACC anatomical and physiological classification.Methods:Cross-sectional study examining the World Health Organization QoL Bref questionnaire(WHOQoL-Bref)in consecutive outpatient CHD patients from a single unit.Results:191 CHD patients were studied.Median age was 28±13 years and 59%were male.44(23%),115(60%)and 33(17%)CHD patients showed mild,moderate and great anatomical defects respectively while 69(36%)patients were in physiological Stage A,27(14%)in Stage B,84(44%)in Stage C and 11(6%)in Stage D.No significant differences were seen in relation the anatomical classification and the different sections of the WHOQoL-Bref questionnaire.CHD patients in Stages C and D had significant lower physical domain scores than patients in the Stage A(p<0.05).However,no significant differences were seen in the psychological,social relationships and environmental domains.The binary logistic regression analysis showed that having a higher educational level was a protective factor[OR 0.32(95%CI,0.12-0.87),p=0.026]while being married or cohabit was a risk factor[OR 3.46(95%CI,1.13-10.63),p=0.030]for having a worse rated QoL.Meanwhile,having a worse functional class(NYHA≥2)[OR 3.44(95%CI,1.20-9.81),p=0.021]was associated with dissatisfaction with health.Conclusion:Patients with advanced physiological stages scored lower on the physiological domain.No statistical significance was seen,according to the anatomical and physiological classification,in the psychological,social relationship and environmental domains.
基金this work was supported by Xi'an Science and technology Research Fund (GG04134)
文摘Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.
文摘Objective This study aimed to investigate predictability of preconception maternal circulating folate and homocysteine concentrations,glycemic and lipid profiles to the risk of congenital heart disease(CHD)in offspring.Methods A cohort of pregnancies was derived from a single hospital where pre-and post-conceptional serum folate,homocysteine,lipids,glycemic profiling and neonatal CHD screening program were facilitated.
文摘Waterlogged soils and submerged sediments in wetlands and agricultural lands used for rice paddies and aquaculture have anaerobic conditions that slow and prevent the photo and microbial degradation of dioxin TCDD (2,3,7,8-tetracholorodibenzo-p-dioxin), enabling it to persist in environments for long periods. Over 1.6 million ha of land in southern Vietnam were sprayed with 2,4,5-T herbicides (e.g. Agent Orange) contaminated with dioxin TCDD during the Vietnam War (1961-1971);45% of these ha received four or more spray flight missions. Dioxins are endocrine disrupters and may induce cardiovascular disease, growth, and developmental defects, diabetes, hormonal dysfunctions and disruptions, certain cancers, and chloracne. Outpatient screening clinic 2020 data on Vietnamese children suspected of congenital heart disease (CHD) showed the childhood CHD prevalence rate in Vietnam of 13.356/1000, significantly elevated compared to the Asian CHD prevalence rate of 3.531/1000. CHD prevalence rate differences between North Vietnam (2.541/1000) and south of the 17<sup>th</sup> parallel (10.809/1000) were significant. Vietnamese farmers, especially pregnant women whose occupations involve daily contact with soil and sediments where dioxin TCDD persists in the environment may be at risk of dioxin accumulation from dermal exposure and bioaccumulation via diet. There is an urgent need for funded longitudinal genetic and clinical studies to assess CHD and other organ system childhood malformations due to in utero TCDD exposure. We recommend an integrated research design involving 1) site-specific locations that received high volumes and multiple spray loads of herbicides during the Vietnam War;2) soil sampling of submerged and waterlogged soils and sediments where TCDD may not have degraded;3) production areas of agriculture, fisheries, and other aquatic products;4) risk assessment dioxin levels in foods where TCDD is likely to bioaccumulate;5) child-bearing age and pregnant women with potentially high sensitivity to long-term low dose exposure, and 6) men and women in occupations that are in daily contact with contaminated soil and sediments as part of their job routines.
文摘Background Cyanotic congenital heart disease(CCHD)is one ofthe most common birth anomaly,in which chronic hypoxia is the basic pathophysiological process.Researches in the protective mechanisms of cardiomyocytes to chronic hypoxia have the potential to provide novel treatment strategies for many patients.Metabolomics is a study of metabolism at global level,which capture global biochemical events by assaying thousands of small molecules in tissues,followed by application of bioinformatics to define metabolomic signatures of the targets.In order to describe the features of metabolic remodeling of the heart of CCHD,we conducted our study on the effect of hypoxia on metabolism of human heart by using tissue from patients with CCHD compared with that from patients with non-cyanotic CHD(NCCHD).
文摘Hepatitis C virus is one of the major health problems worldwide. It affects mainly the liver but several extrahepatic manifestations are also accounted. Chronic hepatitis C patients are at an increased risk of developing hepatic steatosis, which share many clinical features with the metabolic syndrome. Hepatic steatosis has also been associated with elevated levels of markers of inflammation such as homocysteine, identified as hyperhomocysteinemia (HHC). HHC due to Methylenetetrahydrofolate Reductase (MTHFR) gene, in particular the C677T polymorphism, was recently associated with coronary heart diseases (CHD) in chronic hepatitis C (CHC) patients. Homocysteine is an intermediate in methionine metabolism, which takes place mainly in the liver metabolism. Deficiencies of micronutrients (folate, vitamin B 6 and possibly vitamin B 12) along with mild hyperhomocysteinemia, perhaps, act synergistically with other classical risk factors to further increase the risk of CHD. Clinical data indicate that HHC is associated with an increased incidence of CHD as well as with the severity of the disease in CHC patients. In conclusion, HHC might be a potential aetiological factor of CHD in CHC patients. The aim of this review is to investigate the progression of coronary heart diseases in chronic hepatitis C patients and correlate with levels of homocysteine in concurrence to genetic defects and nutrient deficiencies. However, future studies need to clarify the mechanistic role of HHC in CHD and CHC as a useful paradigm with most interesting therapeutic implications.
