Non-invasive estimation of pulmonary hypertension and clinical deterioration risk in pediatric congenital heart disease:Development and validation of predictive tools

To the Editor:Owing to the heterogeneity of congenital heart disease-associated pulmonary hypertension(CHDPH)disease and the development of the pulmonary vascular system in pediatric patients,the management of CHD-PH in children is signicantly different from that in adults.[1]Early identication and intervention of CHD-PH are of great signicance for disease management in children with CHD,and non-invasive,accurate clinical tools are urgently needed to predict PH risk in children with CHD.However,the applicability of the current risk-scoring system to pediatric CHD-PH remains unclear.Furthermore,there are presently no user-friendly,non-invasive online tools available for predicting CHD-PH,and there is a scarcity of related studies in Asian populations.This study aimed to develop and validate the prediction tools for estimating the risk of pulmonary hypertension and clinical deterioration in children with congenital heart disease.

Erythrocytic or serum hydrogen sulfide association with hypertension development in untreated essential hypertension

Background Endogenous hydrogen sulfide （H2S） plays an important role in hypertension. The aim of this study was to investigate the role of erythrocyte and serum H2S in patients with untreated essential hypertension. Methods We recruited 62 patients （age 22-74 years） with untreated prehypertension or hypertension, and 64 normotensive subjects （age 18-64 years）. We assessed the 3-mercaptopyruvate sulphurtransferase （MPST） protein expression in erythrocytes and measured the H2S production from erythrocytes and serum H2S levels, then analyzed the association of erythrocytic or serum H2S content and blood pressure or cardiovascular risk factors （e.g., age, body mass index （BMI） and dyslipidemia）. A stepwise regression analysis was used to evaluate the possible relationship of erythrocytic H2S in hypertension. Results In hypertensive patients, erythrocyte H2S production （（111.04_＋.29.20） nmol/min per 10a erythrocytes） was higher than that in controls （（78.85＋19.38） nmol/min per 108 erythrocytes）, and serum H2S was also higher. The erythrocytic H2S production was associated with increased systolic blood pressure （sBP）, diastolic blood pressure （dBP）, age, BMI, level of C-reactive protein （CRP）, as well as triglycerides （TG） and high density lipoprotein cholesterol （HDL-C） Serum H2S was not associated with age or CRP. Stepwise regression analysis showed that erythrocytic H2S production was correlated with sBP, TG, HDL-C, low density lipoprotein cholesterol （LDL-C） and blood urea nitrogen （BUN） and serum H2S was correlated with dBP and TG. Results of receiver-operating characteristic curve analysis suggested that erythrocytic H2S production was a more sensitive predictor of hypertension development than serum H2S. Conclusion Ervthrocvtic or serum H^S Production is sensitive predictor of hvDertension.

A One-pot-synthesized Double-layered Anticoagulant Hydrogel Tube

Extracorporeal membrane oxygenation(ECMO)has emerged as a viable treatment in severe cases of acute respiratory distress syndrome,acute respiratory failure,and adult respiratory distress syndrome.However,thromboembolic events stemming from the use of ECMO devices results in significant morbidity and mortality rates;the inner surface of the ECMO tubing comes into contact with the blood and can readily initiate coagulation.In addition,the tubing needs to be continually replaced due to thromboses on the inner tube wall.