Cardiomyopathies represent the most common clinical and genetic heterogeneous group of diseases that affect the heart function.Though progress has been made to elucidate the process,molecular mechanisms of different c...Cardiomyopathies represent the most common clinical and genetic heterogeneous group of diseases that affect the heart function.Though progress has been made to elucidate the process,molecular mechanisms of different classes of cardiomyopathies remain elusive.This paper aims to describe the similarities and differences in molecular features of dilated cardiomyopathy(DCM)and ischemic cardiomyopathy(ICM).We firstly detected the co-expressed modules using the weighted gene co-expression network analysis(WGCNA).Significant modules associated with DCM/ICM were identified by the Pearson correlation coefficient(PCC)between the modules and the phenotype of DCM/ICM.The differentially expressed genes in the modules were selected to perform functional enrichment.The potential transcription factors(TFs)prediction was conducted for transcription regulation of hub genes.Apoptosis and cardiac conduction were perturbed in DCM and ICM,respectively.TFs demonstrated that the biomarkers and the transcription regulations in DCM and ICM were different,which helps make more accurate discrimination between them at molecular levels.In conclusion,comprehensive analyses of the molecular features may advance our understanding of DCM and ICM causes and progression.Thus,this understanding may promote the development of innovative diagnoses and treatments.展开更多
Objectives To study the relationship between plasma hemoglobin concentration and estimated glomerular filtration rate （eGFR） in elderly patients with ischemic cardiomyopathy （ICM）.Methods Clinical data of patients...Objectives To study the relationship between plasma hemoglobin concentration and estimated glomerular filtration rate （eGFR） in elderly patients with ischemic cardiomyopathy （ICM）.Methods Clinical data of patients with coronary heart disease who were discharged from The First Affiliated Hospital,Chongqing Medical University between 2005 and 2007 were analyzed retrospectively. Echocardiography results,plasma hemoglobin and creatinine concentration were abstracted from the medical records.The study included 235 Chinese Hart patients with age 60 years and older with angiography confirmed coronary heart disease,silent myocardial ischemia or angina pectoris,of whom 154 had ICM defined as left ventricular end-diastolic diameter （LVDd）,male≥56 mm,female≥51 mm （63. 51±7.70 mm） measured by M-mode echocardiography.The differences in plasma hemoglobin concentration were analyzed retrospec- tively between patients with and without ICM,and between patients with an eGFR【60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> and those with an eGFR≥60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup>.Results There were no significant differences in plasma hemoglobin concentration and eGFR between ICM and non-ICM group (118.49±20.52 g·L<sup>-1</sup> vs.115.80±23.32 g·L<sup>-1</sup> and 75.13±24.21 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> vs.79.09±28.41 ml·min<sup>- 1</sup>·1.73m<sup>-2</sup>,respectively,both P】0.05).However,in both ICM and non-ICM groups,plasma hemoglobin concentration was lower in those with an eGFR【60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> compared with compared with those with an eGFR≥60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> group (112. 29±18.61 g·L<sup>-1</sup> vs.119.92±20.74L<sup>-1</sup>,P【0.05);plasma hemoglobin concentration was related positively to eGFR.Conclusions There were no significant changes in plasma hemoglobin concentration and eGFR;however,plasma hemoglobin concentration was related to eGFR significantly positively in elderly patients with ICM due to coronary heart展开更多
Surgical ventricular restoration (SVR) procedures have been developed;however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported ...Surgical ventricular restoration (SVR) procedures have been developed;however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown;this method has a unique concept of left ventricular (LV) restoration without artificial patch materials. Here, we describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting. ESP was effective in papillary muscle approximation for avoiding heart failure;however, the noted improvement of LV wall thickening might be temporary.展开更多
Hypoglycemia is a common complication seen in patients with diabetes mellitus and has been proven to have adverse effects on cardiovascular mortality. Hypoglycemia can potentially lead to worsening of cardiac function...Hypoglycemia is a common complication seen in patients with diabetes mellitus and has been proven to have adverse effects on cardiovascular mortality. Hypoglycemia can potentially lead to worsening of cardiac function in patients with ischemic heart disease. We present a case of cardiogenic shock in a patient with hypoglycemia secondary to insulin accumulation due to worsening renal function with dramatic recovery of shock once his sugars normalized.展开更多
Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admi...Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admitted in our hospital from January 2013 to May 2016 were selected and divided them randomly into the research group and the control group. All subjects were treated with conventional therapy after admission. On this basis, the control group was given atorvastation calcium, meanwhile the research group was given trimetazidine combined with atorvastation calcium. Then analyzed the cTnI level, evaluated their cardiac and renal function (cardiac function indexes: LVEF, LVESD, LVEDD, renal function indexes: Scr, BUN and mALB) after three months treatment.Results: After treatment, the level of cTnI, LVESD and LVEDD in this two groups were decreased dramatically, the level of cTnI, LVESD and LVEDD in the research group were (0.51±0.24) ng/mL, (38.35±3.94) mm and (51.43±4.56) mm respectively, compared with the control group, these levels were significantly decreased;the level of LVEF was (51.10±4.07)% in research group, increased more obviously than the control group, and the difference was statistical significant. The Scr, BUN and mALB in two groups were decreased after treatment, the research group was significantly reduced, in addition, these levels in research group were (80.14±10.21) μmol/L, (5.89±1.06) mmol/L and (51.35±20.94) mg/24 h respectively, lower than the control group.Conclusion: The therapy of trimetazidine combined with atorvastation calcium in patients with Ischemic cardiomyopathy, was worthy of clinical application, seeing that can ameliorate effectively myocardial injury , the cardiac and renal function.展开更多
Objective:To study the effect of Danhong injection on neuroendocrine molecules and ventricular remodeling in patients with ischemic cardiomyopathy heart failure.Methods: 80 cases of patients with ischemic cardiomyopat...Objective:To study the effect of Danhong injection on neuroendocrine molecules and ventricular remodeling in patients with ischemic cardiomyopathy heart failure.Methods: 80 cases of patients with ischemic cardiomyopathy heart failure who were treated in our hospital between March 2014 and December 2016 were collected and divided into control group (n=40) and observation group (n=40) according to random number table. The control group received regular treatment, the observation group received regular + Danhong injection treatment, and both therapies lasted for 14 d a course, two sessions. Serum contents of neuroendocrine molecules and ventricular remodeling-related indexes, Doppler ultrasonic ventricular remodeling parameter levels, and so on were compared between two groups of patients before and after treatment.Results: Before treatment, serum contents of neuroendocrine molecules and ventricular remodeling-related indexes as well as Doppler ultrasonic ventricular remodeling parameter levels were not statistically different between two groups of patients. After treatment, serum neuroendocrine molecules NT-proBNP, ANP, AngⅡ, ALD and NE contents of observation group were lower than those of control group, serum ventricular remodeling indexes TGF-β1, NF-κB, CysC and FGF23 contents were lower than those of control group, and ultrasonic ventricular remodeling parameters LVMI, LVRI, RVEDV and RVESV levels were lower than those of control group.Conclusion: Adjuvant Danhong injection therapy helps optimize the neuroendocrine molecule contents and inhibit the ventricular remodeling process in patients with ischemic cardiomyopathy heart failure.展开更多
Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart f...Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class （NYHA） III-IV with a left ventricular ejection fraction （LVEF） 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy （DCM） group （n = 120） and an ischemic cardiomyopathy （ICM） group （n = 120）. Then, based on the cQTd width, the ICM group was divided into two subgroups： a QS group （cQTd ≤60 ms, n = 70） and a QL group （cQTd 〉 60 ms, n = 50）. All patients were examined by echocardiography and 12-lead electrocardiography （ECG） at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.展开更多
Ischemic heart disease is a growing cause of heart failure owing to the increasing prevalence of diabetes,hypertension,and obesity.It is important to understand the concepts of myocardial stunning and hibernation so w...Ischemic heart disease is a growing cause of heart failure owing to the increasing prevalence of diabetes,hypertension,and obesity.It is important to understand the concepts of myocardial stunning and hibernation so we as physicians can order appropriate testing on patients with ischemic heart disease,such as myocardial viability studies.Ventricular remodeling is associated with an elevated risk of death after myocardial infarction.The extent of myocardial viability determines the clinical outcome of patients after myocardial infarction.Multiple impactful clinical trials have changed the way we manage ischemic cardiomyopathy over the past few decades,and medications such as angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,beta-blockers,and aldosterone antagonists have improved outcomes in this patient population.Similarly,much has been reported on the effect of coronary artery bypass surgery on outcomes in patients with ischemic heart disease and heart failure,but further research studies are needed on the role of percutaneous coronary intervention.展开更多
基金supported by the National Natural Science Foundation of China under Grants No.61720106004 and No.61872405the Key R&D Project of Sichuan Province,China under Grants No.20ZDYF2772 and No.2020YFS0243.
文摘Cardiomyopathies represent the most common clinical and genetic heterogeneous group of diseases that affect the heart function.Though progress has been made to elucidate the process,molecular mechanisms of different classes of cardiomyopathies remain elusive.This paper aims to describe the similarities and differences in molecular features of dilated cardiomyopathy(DCM)and ischemic cardiomyopathy(ICM).We firstly detected the co-expressed modules using the weighted gene co-expression network analysis(WGCNA).Significant modules associated with DCM/ICM were identified by the Pearson correlation coefficient(PCC)between the modules and the phenotype of DCM/ICM.The differentially expressed genes in the modules were selected to perform functional enrichment.The potential transcription factors(TFs)prediction was conducted for transcription regulation of hub genes.Apoptosis and cardiac conduction were perturbed in DCM and ICM,respectively.TFs demonstrated that the biomarkers and the transcription regulations in DCM and ICM were different,which helps make more accurate discrimination between them at molecular levels.In conclusion,comprehensive analyses of the molecular features may advance our understanding of DCM and ICM causes and progression.Thus,this understanding may promote the development of innovative diagnoses and treatments.
基金the Medical Science & Technology Research fund of Health Bureau of Chongqing City,China [No.2004(53)04-2-154]the Nature Science Research fund of Chongqing Science & Technology Com-mission of Chongqing City,China (No.CSTC,2007BB5276).
文摘Objectives To study the relationship between plasma hemoglobin concentration and estimated glomerular filtration rate （eGFR） in elderly patients with ischemic cardiomyopathy （ICM）.Methods Clinical data of patients with coronary heart disease who were discharged from The First Affiliated Hospital,Chongqing Medical University between 2005 and 2007 were analyzed retrospectively. Echocardiography results,plasma hemoglobin and creatinine concentration were abstracted from the medical records.The study included 235 Chinese Hart patients with age 60 years and older with angiography confirmed coronary heart disease,silent myocardial ischemia or angina pectoris,of whom 154 had ICM defined as left ventricular end-diastolic diameter （LVDd）,male≥56 mm,female≥51 mm （63. 51±7.70 mm） measured by M-mode echocardiography.The differences in plasma hemoglobin concentration were analyzed retrospec- tively between patients with and without ICM,and between patients with an eGFR【60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> and those with an eGFR≥60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup>.Results There were no significant differences in plasma hemoglobin concentration and eGFR between ICM and non-ICM group (118.49±20.52 g·L<sup>-1</sup> vs.115.80±23.32 g·L<sup>-1</sup> and 75.13±24.21 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> vs.79.09±28.41 ml·min<sup>- 1</sup>·1.73m<sup>-2</sup>,respectively,both P】0.05).However,in both ICM and non-ICM groups,plasma hemoglobin concentration was lower in those with an eGFR【60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> compared with compared with those with an eGFR≥60 ml·min<sup>-1</sup>·1.73m<sup>-2</sup> group (112. 29±18.61 g·L<sup>-1</sup> vs.119.92±20.74L<sup>-1</sup>,P【0.05);plasma hemoglobin concentration was related positively to eGFR.Conclusions There were no significant changes in plasma hemoglobin concentration and eGFR;however,plasma hemoglobin concentration was related to eGFR significantly positively in elderly patients with ICM due to coronary heart
文摘Surgical ventricular restoration (SVR) procedures have been developed;however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown;this method has a unique concept of left ventricular (LV) restoration without artificial patch materials. Here, we describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting. ESP was effective in papillary muscle approximation for avoiding heart failure;however, the noted improvement of LV wall thickening might be temporary.
文摘Hypoglycemia is a common complication seen in patients with diabetes mellitus and has been proven to have adverse effects on cardiovascular mortality. Hypoglycemia can potentially lead to worsening of cardiac function in patients with ischemic heart disease. We present a case of cardiogenic shock in a patient with hypoglycemia secondary to insulin accumulation due to worsening renal function with dramatic recovery of shock once his sugars normalized.
文摘Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admitted in our hospital from January 2013 to May 2016 were selected and divided them randomly into the research group and the control group. All subjects were treated with conventional therapy after admission. On this basis, the control group was given atorvastation calcium, meanwhile the research group was given trimetazidine combined with atorvastation calcium. Then analyzed the cTnI level, evaluated their cardiac and renal function (cardiac function indexes: LVEF, LVESD, LVEDD, renal function indexes: Scr, BUN and mALB) after three months treatment.Results: After treatment, the level of cTnI, LVESD and LVEDD in this two groups were decreased dramatically, the level of cTnI, LVESD and LVEDD in the research group were (0.51±0.24) ng/mL, (38.35±3.94) mm and (51.43±4.56) mm respectively, compared with the control group, these levels were significantly decreased;the level of LVEF was (51.10±4.07)% in research group, increased more obviously than the control group, and the difference was statistical significant. The Scr, BUN and mALB in two groups were decreased after treatment, the research group was significantly reduced, in addition, these levels in research group were (80.14±10.21) μmol/L, (5.89±1.06) mmol/L and (51.35±20.94) mg/24 h respectively, lower than the control group.Conclusion: The therapy of trimetazidine combined with atorvastation calcium in patients with Ischemic cardiomyopathy, was worthy of clinical application, seeing that can ameliorate effectively myocardial injury , the cardiac and renal function.
文摘Objective:To study the effect of Danhong injection on neuroendocrine molecules and ventricular remodeling in patients with ischemic cardiomyopathy heart failure.Methods: 80 cases of patients with ischemic cardiomyopathy heart failure who were treated in our hospital between March 2014 and December 2016 were collected and divided into control group (n=40) and observation group (n=40) according to random number table. The control group received regular treatment, the observation group received regular + Danhong injection treatment, and both therapies lasted for 14 d a course, two sessions. Serum contents of neuroendocrine molecules and ventricular remodeling-related indexes, Doppler ultrasonic ventricular remodeling parameter levels, and so on were compared between two groups of patients before and after treatment.Results: Before treatment, serum contents of neuroendocrine molecules and ventricular remodeling-related indexes as well as Doppler ultrasonic ventricular remodeling parameter levels were not statistically different between two groups of patients. After treatment, serum neuroendocrine molecules NT-proBNP, ANP, AngⅡ, ALD and NE contents of observation group were lower than those of control group, serum ventricular remodeling indexes TGF-β1, NF-κB, CysC and FGF23 contents were lower than those of control group, and ultrasonic ventricular remodeling parameters LVMI, LVRI, RVEDV and RVESV levels were lower than those of control group.Conclusion: Adjuvant Danhong injection therapy helps optimize the neuroendocrine molecule contents and inhibit the ventricular remodeling process in patients with ischemic cardiomyopathy heart failure.
基金Acknowledgments This study was supported by the National Natural Science Foundation of China （No. 8130 1276） and the Heilongjiang Provincial Department of Education （No. 12541544）. The authors declare that there are no competing interests.
文摘Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class （NYHA） III-IV with a left ventricular ejection fraction （LVEF） 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy （DCM） group （n = 120） and an ischemic cardiomyopathy （ICM） group （n = 120）. Then, based on the cQTd width, the ICM group was divided into two subgroups： a QS group （cQTd ≤60 ms, n = 70） and a QL group （cQTd 〉 60 ms, n = 50）. All patients were examined by echocardiography and 12-lead electrocardiography （ECG） at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.
文摘Ischemic heart disease is a growing cause of heart failure owing to the increasing prevalence of diabetes,hypertension,and obesity.It is important to understand the concepts of myocardial stunning and hibernation so we as physicians can order appropriate testing on patients with ischemic heart disease,such as myocardial viability studies.Ventricular remodeling is associated with an elevated risk of death after myocardial infarction.The extent of myocardial viability determines the clinical outcome of patients after myocardial infarction.Multiple impactful clinical trials have changed the way we manage ischemic cardiomyopathy over the past few decades,and medications such as angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,beta-blockers,and aldosterone antagonists have improved outcomes in this patient population.Similarly,much has been reported on the effect of coronary artery bypass surgery on outcomes in patients with ischemic heart disease and heart failure,but further research studies are needed on the role of percutaneous coronary intervention.
