A comprehensive review of heart rate variability as an indicator in the regulation of the autonomic nervous system by acupuncture:a bibliometric analysis

This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing association rule mining and network analysis.A total of 536 publications on the topic of acupuncture studies based on HRV.The disease keyword analysis revealed that HRV-related acupuncture studies were mainly related to pain,inflammation,emotional disorders,gastrointestinal function,and hypertension.A separate analysis was conducted on acupuncture prescriptions,and Neiguan(PC6)and Zusanli(ST36)were the most frequently used acupoints.The core acupoints for HRV regulation were identified as PC6,ST36,Shenmen(HT7),Hegu(LI4),Sanyinjiao(SP6),Jianshi(PC5),Taichong(LR3),Quchi(LI11),Guanyuan(CV4),Baihui(GV20),and Taixi(KI3).Additionally,the research encompassed 46 reports on acupuncture animal experiments conducted on HRV,with ST36 being the most frequently utilized acupoint.The research presented in this study offers valuable insights into the global research trend and hotspots in acupuncture-based HRV studies,as well as identifying frequently used combinations of acupoints.The findings may be helpful for further research in this field and provide valuable information about the potential use of acupuncture for improving HRV in both humans and animals.

Postpartum quality of life and mental health in women with heart disease:Integrated clinical communication and treatment

BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.

Study on Real-Time Heart Rate Detection Based on Multi-People

Heart rate is an important vital characteristic which indicates physical and mental health status.Typically heart rate measurement instruments require direct contact with the skin which is time-consuming and costly.Therefore,the study of non-contact heart rate measurement methods is of great importance.Based on the principles of photoelectric volumetric tracing,we use a computer device and camera to capture facial images,accurately detect face regions,and to detect multiple facial images using a multi-target tracking algorithm.Then after the regional segmentation of the facial image,the signal acquisition of the region of interest is further resolved.Finally,frequency detection of the collected Photo-plethysmography(PPG)and Electrocardiography(ECG)signals is completed with peak detection,Fourier analysis,and a Waveletfilter.The experimental results show that the subject’s heart rate can be detected quickly and accurately even when monitoring multiple facial targets simultaneously.

Heart Rate Variability as an Indicator of Stress in Students’ Athletes

Introduction: The wellbeing of student’s athletes has a paramount importance, a prolonged period of cognitive and physical performance that characterizes the life of student’s athletes often leads to fatigue, and a psychobiological state that increases the risk of injury and accidents. The use of Heart rate variability (HRV) has become increasingly popular as a non-invasive methodology that provides an indirect insight into the autonomic nervous system. HRV can be utilized as a diagnostic tool in detection of autonomic nervous system impairment and sympatho-vagal imbalance. HRV technology is employed to monitor the internal response of athletes to workload and identify athletes’s psychophysical stress to predict and therefore prevent injuries. Objective: The objective of the investigation is to establish whether the use of Polar H10 sensor heart rate monitors worn by athletes in a sitting position (inclination 60 degrees) during periods characterized by stress can provide a valid and non-invasive method to assess the psychophysiological state during sports competition and school exams. Method and Statistics: In the study, the HRV of 12 basketball students athletes and 4 students non-athletes was analyzed as a control group. The autonomic nervous system activity was assessed based on heart variability parameters (HRV): SDNN, rMSSD, LF, HF, and LF/HF. The measurements were made after establishing the baseline at rest, during the training phase (CT), competition phase (CC) and during the acute phase of stressors due to school exams coinciding with the competitive season (CC + E). Results: Compared to the respective values prior to the stress of the competitions and exams, a significant decrease in HRV indices was found: SDNN (P Conclusions: The analysis and examination of the data on the sample of the student population also showed a statistically significant correlation between decreased cardiac variability and injuries or indisposition to physical exertion.

Gene polymorphisms associated with sudden decreases in heart rate during extensive peritoneal lavage with distilled water after gastrectomy

BACKGROUND Our previous study found that the telomerase-associated protein 1(TEP1,rs938886 and rs1713449)and homo sapiens RecQ like helicase 5(RECQL5,rs820196)single nucleotide polymorphisms(SNPs)were associated with changes in heart rate(HR)≥30%during peritoneal lavage with distilled water after gastrectomy.This study established a single tube method for detecting these three SNPs using two-dimensional(2D)polymerase chain reaction(PCR),and investigated whether SNP-SNP and SNP-environment interactions increase the risk of high HR variability(HRV).AIM To investigate whether genotypes,genetic patterns,SNP-SNP and SNP-environment interactions were associated with HRV.METHODS 2D PCR was used to establish a single-tube method to detect TEP1 rs938886 and rs1713449 and RECQL5 rs820196,and the results were compared with those of sanger sequencing.After adjusting for confounders such as age,sex,smoking,hypertension,and thyroid dysfunction,a nonconditional logistic regression model was used to assess the associations between the genotypes and the genetic patterns(codominant,dominant,overdominant,recessive,and additive)of the three SNPs and a risk≥15%or≥30%of a sudden drop in HR during postoperative peritoneal lavage in patients with gastric cancer.Gene-gene and geneenvironment interactions were analyzed using generalized multifactor dimensionality reduction.RESULTS The coincidence rate between the 2D PCR and sequencing was 100%.When the HRV cutoff value was 15%,the patients with the RECQL5(rs820196)TC genotype had a higher risk of high HRV than those who had the TT genotype(odds ratio=1.97;95%CI:1.05-3.70;P=0.045).Under the codominant and overdominant models,the TC genotype of RECQL5(rs820196)was associated with a higher risk of HR decrease relative to the TT and TT+CC genotypes(P=0.031 and 0.016,respectively).When the HRV cutoff value was 30%,patients carrying the GC-TC genotypes of rs938886 and rs820196 showed a higher HRV risk when compared with the GG–TT genotype carriers(P=0.01).In the three-factor model of rs938886,rs820196,and rs1713449,patients carrying the GC-TC-CT genotype had a higher risk of HRV compared with the wild-type GG-TT-CC carriers(P=0.01).For rs820196,nonsmokers with the TC genotype had a higher HRV risk compared with nonsmokers carrying the TT genotype(P=0.04).When the HRV cutoff value was 15%,patients carrying the TT-TT and the TC-CT genotypes of rs820196 and rs1713449 showed a higher HRV risk when compared with TT-CC genotype carriers(P=0.04 and 0.01,respectively).Patients carrying the GC-CT-TC genotypes of rs938886,rs1713449,and rs820196 showed a higher HRV risk compared with GG-CC-TT genotype carriers(P=0.02).When the HRV cutoff value was 15%,the best-fitting models for the interactions between the SNPs and the environment were the rs820196-smoking(P=0.022)and rs820196-hypertension(P=0.043)models.Consistent with the results of the previous grouping,for rs820196,the TC genotype nonsmokers had a higher HRV risk compared with nonsmokers carrying the TT genotype(P=0.01).CONCLUSION The polymorphism of the RECQL5 and TEP1 genes were associated with HRV during peritoneal lavage with distilled water after gastrectomy.

The Probability Density Function Related to Shallow Cumulus Entrainment Rate and Its Influencing Factors in a Large-Eddy Simulation

The process of entrainment-mixing between cumulus clouds and the ambient air is important for the development of cumulus clouds.Accurately obtaining the entrainment rate(λ)is particularly important for its parameterization within the overall cumulus parameterization scheme.In this study,an improved bulk-plume method is proposed by solving the equations of two conserved variables simultaneously to calculateλof cumulus clouds in a large-eddy simulation.The results demonstrate that the improved bulk-plume method is more reliable than the traditional bulk-plume method,becauseλ,as calculated from the improved method,falls within the range ofλvalues obtained from the traditional method using different conserved variables.The probability density functions ofλfor all data,different times,and different heights can be well-fitted by a log-normal distribution,which supports the assumed stochastic entrainment process in previous studies.Further analysis demonstrate that the relationship betweenλand the vertical velocity is better than other thermodynamic/dynamical properties;thus,the vertical velocity is recommended as the primary influencing factor for the parameterization ofλin the future.The results of this study enhance the theoretical understanding ofλand its influencing factors and shed new light on the development ofλparameterization.

Heartbeat and Respiration Rate Prediction Using Combined Photoplethysmography and Ballisto Cardiography

Owing to the recent trends in remote health monitoring,real-time appli-cations for measuring Heartbeat Rate and Respiration Rate(HARR)from video signals are growing rapidly.Photo Plethysmo Graphy(PPG)is a method that is operated by estimating the infinitesimal change in color of the human face,rigid motion of facial skin and head parts,etc.Ballisto Cardiography(BCG)is a non-surgical tool for obtaining a graphical depiction of the human body’s heartbeat by inducing repetitive movements found in the heart pulses.The resilience against motion artifacts induced by luminancefluctuation and the patient’s mobility var-iation is the major difficulty faced while processing the real-time video signals.In this research,a video-based HARR measuring framework is proposed based on combined PPG and BCG.Here,the noise from the input video signals is removed by using an Adaptive Kalmanfilter(AKF).Three different algorithms are used for estimating the HARR from the noise-free input signals.Initially,the noise-free sig-nals are subjected to Modified Adaptive Fourier Decomposition(MAFD)and then to Enhanced Hilbert vibration Decomposition(EHVD)andfinally to Improved Var-iation mode Decomposition(IVMD)for attaining three various results of HARR.The obtained values are compared with each other and found that the EHVD is showing better results when compared with all the other methods.

Construction of a Computational Scheme for the Fuzzy HIV/AIDS Epidemic Model with a Nonlinear Saturated Incidence Rate

This work aimed to construct an epidemic model with fuzzy parameters.Since the classical epidemic model doesnot elaborate on the successful interaction of susceptible and infective people,the constructed fuzzy epidemicmodel discusses the more detailed versions of the interactions between infective and susceptible people.Thenext-generation matrix approach is employed to find the reproduction number of a deterministic model.Thesensitivity analysis and local stability analysis of the systemare also provided.For solving the fuzzy epidemic model,a numerical scheme is constructed which consists of three time levels.The numerical scheme has an advantage overthe existing forward Euler scheme for determining the conditions of getting the positive solution.The establishedscheme also has an advantage over existing non-standard finite difference methods in terms of order of accuracy.The stability of the scheme for the considered fuzzy model is also provided.From the plotted results,it can beobserved that susceptible people decay by rising interaction parameters.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Pulse rate estimation based on facial videos:an evaluation and optimization of the classical methods using both self-constructed and public datasets

Pulse rate is one of the important characteristics of traditional Chinese medicine pulse diagnosis,and it is of great significance for determining the nature of cold and heat in diseases.The prediction of pulse rate based on facial video is an exciting research field for getting palpation information by observation diagnosis.However,most studies focus on optimizing the algorithm based on a small sample of participants without systematically investigating multiple influencing factors.A total of 209 participants and 2,435 facial videos,based on our self-constructed Multi-Scene Sign Dataset and the public datasets,were used to perform a multi-level and multi-factor comprehensive comparison.The effects of different datasets,blood volume pulse signal extraction algorithms,region of interests,time windows,color spaces,pulse rate calculation methods,and video recording scenes were analyzed.Furthermore,we proposed a blood volume pulse signal quality optimization strategy based on the inverse Fourier transform and an improvement strategy for pulse rate estimation based on signal-to-noise ratio threshold sliding.We found that the effects of video estimation of pulse rate in the Multi-Scene Sign Dataset and Pulse Rate Detection Dataset were better than in other datasets.Compared with Fast independent component analysis and Single Channel algorithms,chrominance-based method and plane-orthogonal-to-skin algorithms have a more vital anti-interference ability and higher robustness.The performances of the five-organs fusion area and the full-face area were better than that of single sub-regions,and the fewer motion artifacts and better lighting can improve the precision of pulse rate estimation.

Targeting epicardial adipose tissue:A potential therapeutic strategy for heart failure with preserved ejection fraction with type 2 diabetes mellitus

Heart failure with preserved ejection fraction(HFpEF)is a heterogeneous syndrome with various comorbidities,multiple cardiac and extracardiac pathophysiologic abnormalities,and diverse phenotypic presentations.Since HFpEF is a heterogeneous disease with different phenotypes,individualized treatment is required.HFpEF with type 2 diabetes mellitus(T2DM)represents a specific phenotype of HFpEF,with about 45%-50% of HFpEF patients suffering from T2DM.Systemic inflammation associated with dysregulated glucose metabolism is a critical pathological mechanism of HFpEF with T2DM,which is intimately related to the expansion and dysfunction(inflammation and hypermetabolic activity)of epicardial adipose tissue(EAT).EAT is well established as a very active endocrine organ that can regulate the pathophysiological processes of HFpEF with T2DM through the paracrine and endocrine mechanisms.Therefore,suppressing abnormal EAT expansion may be a promising therapeutic strategy for HFpEF with T2DM.Although there is no treatment specifically for EAT,lifestyle management,bariatric surgery,and some pharmaceutical interventions(anti-cytokine drugs,statins,proprotein convertase subtilisin/kexin type 9 inhibitors,metformin,glucagon-like peptide-1 receptor agonists,and especially sodium-glucose cotransporter-2 inhibitors)have been shown to attenuate the inflammatory response or expansion of EAT.Importantly,these treatments may be beneficial in improving the clinical symptoms or prognosis of patients with HFpEF.Accordingly,well-designed randomized controlled trials are needed to validate the efficacy of current therapies.In addition,more novel and effective therapies targeting EAT are needed in the future.

HEART五步沟通模式对乳腺癌化疗患者心理弹性及癌因性疲乏的影响

目的探讨HEART五步沟通模式对乳腺癌化疗患者心理弹性及癌因性疲乏的影响。方法本研究为随机单盲对照试验,采用方便抽样法,选取无锡市人民医院肿瘤科于2022年1月—12月收治的84例乳腺癌化疗患者为研究对象,采用随机数字表法将其分为对照组与观察组,每组各42例。为避免组间沾染,将对照组安排至肿瘤一科,实施常规化疗护理;将观察组安排至肿瘤二科,在常规化疗护理的基础上实施HEART五步沟通模式。两组患者均化疗4个周期,比较两组患者首次化疗入院当天(干预前)、末次化疗出院当天(干预后)的心理弹性及癌因性疲乏。结果干预后,观察组的心理弹性评分明显高于对照组(P<0.05);观察组的癌因性疲乏评分明显低于对照组(P<0.05)。结论对乳腺癌化疗患者在常规化疗护理的基础上实施HEART五步沟通模式,能够明显提高患者的心理弹性,缓解患者的癌因性疲乏症状。

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial asset and clinical scenario in HF. Purpose: Recent acquisitions suggest that iron deficiency represents a concrete bias in the pathogenetic mechanism of chronic HF, so we have investigated the putative role of the hepcidin/ferroportin axis in the cardiovascular setting to advocate novel pharmacological and clinical approaches. Methods: Here, after an excursus on iron metabolism, we first reviewed the ongoing studies on novel iron targeted compounds. Then, we summarize large clinical interventional studies conducted on patient suffering from iron deficiency and HF which have tested the effects of drugging iron regard QoL, hospitalizations and cardiovascular death. Results: Novel compounds such as hepcidin agonist (PTG 300), synthetic human hepcidin (LJPC-401) and anti FPN (Vamifeport) are ongoing in iron overloaded patients, while the hepcidin blocker (PRS-080) is under investigation in anemic patients. Noteworthy, novel insights could arise from the results of a Phase IV interventional study regarding the modification of hepcidin pathway in a large cohort of HF patients (n = 1992) by sodium glucose cotransporter 2 inhibitors. To date, several studies highlight the beneficial effect of iron administration in cardiovascular setting and latest evidences consider hepcidin level as a novel biomarker of cardiac injury and atherosclerosis. Conclusions: We advocate that data from ongoing studies will suggest novel iron targeted therapies for diagnosis, prognosis and therapy transferable in selected heart failed patients.

Long-Term Mortality of Children with Congenital Heart Disease Admitted to the Departmental University Hospital of Borgou/Alibori from 2011 to 2022

Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.

Machine Learning-Based Intelligent Auscultation Techniques in CongenitalHeart Disease: Application and Development

Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival rates.While cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and omission.In recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic technology.Although there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical envir-onment.This paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD domain.The aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.

Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

Interest of Cardiac Rehabilitation in Patients with Heart Disease in a Cardiology Department in Senegal

Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.

Heart Failure-Like Reaction Is Likely Involved in the Feeding Behaviour of Blood-Sucking Leeches

Medicinal leeches have been utilized in therapy for thousands of years. However, the adaptation physiology between leeches and hosts is not fully understand. To disclose the molecular mechanisms of adaptation between leech and host, the body transcriptomes of hunger and fed blood-sucking Poecilobdella javanica, Haemadipsa cavatuses, and Hirudo nipponia leeches were obtained by RNA sequencing, after comparison, a stratified unigenes group was obtained, which closely correlated to body distension. In the group, Rfamide receptor decreased significantly (P < 0.05) while serotonin receptor increased significantly (P < 0.05). Moreover, four KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways, including cardiac muscle contraction, complement and coagulation cascades, renin-angiotensin system, and hypertrophic cardiomyopathy were significantly enriched. The unigenes annotation, neuroregulators correlation analysis and induced function of the KEGG pathways, were consistently supported the same result as: vasoconstriction and systole reaction enhance in hunger leeches and vice versa vasodilation and diastole increase in fed leeches, meanwhile, Interspecific comparison and correlative analyses of physiological function showed that the strongest reaction of induced heart failure from four KEGG occur in strongest reaction of systole in hungry P. javanica and in strongest reaction of diastole in fed H. nipponia. Overall, heart failure is likely a physiological function involved in feeding behaviour.