Cardiovascular Innovations and Applications最新文献

{"title":"Canagliflozin Regulates Ferroptosis, Potentially via Activating AMPK/PGC-1α/Nrf2 Signaling in HFpEF Rats","authors":"Sai Ma, Lili He, Qingjuan Zuo, Guo-rui Zhang, Yifang Guo","doi":"10.15212/cvia.2022.0024","DOIUrl":"https://doi.org/10.15212/cvia.2022.0024","url":null,"abstract":"\u0000Aims: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been found to ameliorate major adverse cardiovascular events in patients with heart failure with preserved ejection fraction (HFpEF), but the exact mechanism is unknown. Ferroptosis is a form of programmed necrosis. Herein, we verified that canagliflozin (CANA) ameliorates heart function in HFpEF rats, partly by regulating ferroptosis, which may be activated by AMPK/PGC-1α/Nrf2 signaling.\u0000\u0000Methods: An HFpEF model was established and subjected to CANA treatment. Blood pressure was monitored, and echocardiography was performed at the 12th week. Pathological examination was performed, and expression of ferroptosis-associated proteins and AMPK/PGC-1α/Nrf2 signaling related proteins was detected.\u0000\u0000Results: CANA had an antihypertensive effect and increased E/A ratios in HFpEF rats. Myocardial pathology was ameliorated, on the basis of decreased cross-sectional area and intercellular fibrosis. Acyl-CoA synthetase long-chain family member 4 (ACSL4) expression increased, whereas ferritin heavy chain 1 (FTH1) expression decreased in HFpEF rats, which showed iron overload. CANA reversed changes in ACSL4 and FTH1, and decreased iron accumulation, but did not alter glutathione peroxidase 4 (GPX4) expression. The expression of AMPK/PGC-1α/Nrf2 signaling related proteins and heme oxygenase 1 (HO-1) in the HFpEF group decreased but was reverted after CANA treatment.\u0000\u0000Conclusions: CANA regulates ferroptosis, potentially via activating AMPK/PGC-1α/Nrf2 signaling in HFpEF rats.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44549712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Left Atrial Appendage Occlusion Therapy: Past, Present, and Future","authors":"Xinqiang Han, Jianzeng Dong, D. Benditt","doi":"10.15212/cvia.2023.0026","DOIUrl":"https://doi.org/10.15212/cvia.2023.0026","url":null,"abstract":"Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is increasing in incidence and prevalence worldwide. AF significantly increases the risk of intracardiac thrombus formation and, if left untreated, ischemic stroke. In patients with nonvalvular AF (NVAF), the left atrial appendage (LAA) has been determined to be the source of thrombus development in 91% to 99% of cases. In this regard, oral anticoagulants (OACs) have become the standard treatment for stroke prevention in most patients with AF; however, OACs are associated with a risk of bleeding complications, and their efficacy depends on optimal patient compliance. Among alternative approaches to embolic stroke prevention, surgical LAA excision for stroke prevention for valvular AF was attempted as early as the late 1940s. LAA excision remains recommended in surgical guidelines for patients with NVAF requiring open-heart coronary bypass or valvular replacement/repair surgeries. However, owing to the traumatic/invasive nature and suboptimal outcomes of conventional surgical LAA intervention, clinical application of this approach is limited in current cardiology practice. Percutaneous LAA occlusion (LAAO) is increasingly being performed as an alternative to OAC for stroke prevention, particularly in patients with elevated bleeding risk. Substantial progress has been made in percutaneous LAAO therapy since its inception approximately 20 years ago. This article systematically reviews the literature leading to the development of LAAO and the evidence-based clinical experience supporting the application of this treatment strategy for NVAF, with a focus on recently published critical evaluations of US FDA and CE mark approved LAAO devices. Future perspectives regarding knowledge and technology gaps are also discussed, recognizing the many ongoing clinical trials that are likely to be transformative and the critical unanswered questions regarding LAAO therapy.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin Treatment is Associated with Mortality in Patients with Type 2 Diabetes and Chronic Heart Failure in the Intensive Care Unit: A Retrospective Cohort Study","authors":"Qiao Guo, Weilong Hong, Jie Chen, Xiwen Zhu, Guangyou Duan, He Huang, Chenyang Duan","doi":"10.15212/cvia.2023.0042","DOIUrl":"https://doi.org/10.15212/cvia.2023.0042","url":null,"abstract":"Objective: Patients receiving intensive care often have diabetes mellitus (DM) together with chronic heart failure (CHF). In these patients, the use of metformin in intensive care is controversial. This study was aimed at assessing the mortality rates of patients with DM and CHF treated with metformin. Methods: The Medical Information Mart for Intensive Care database was used to identify patients with type 2 diabetes mellitus (T2DM) and CHF. A 90-day mortality comparison was conducted between patients who were and were not administered metformin. Propensity score matching analysis and multivariable Cox proportional hazard regression were used to ensure the robustness of our results. Results: A total of 2153 patients (180 receiving metformin and 1973 not receiving metformin) with T2DM and CHF were included in the study. The 90-day mortality rates were 30.5% (601/1971) and 5.5% (10/182) in the non-metformin and metformin groups, respectively. In the propensity score matching analyses, metformin use was associated with a 71% lower 90-day mortality (hazard ratio, 0.29; 95% confidence interval, 0.14–0.59; P < 0.001). The results were insensitive to change when sensitivity analyses were performed. Conclusion: Metformin treatment may decrease the mortality risk in critically ill patients with T2DM and CHF in the intensive care unit.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HNP-1 Reverses Hypertensive Left Ventricular Hypertrophy by Inhibiting the NF-кB Signaling Pathway","authors":"Xiaorong Duan, Zhenqiu Yu","doi":"10.15212/cvia.2023.0057","DOIUrl":"https://doi.org/10.15212/cvia.2023.0057","url":null,"abstract":"Background: Human neutrophil peptide-1 (HNP-1) is a commonly investigated therapeutic agent. However, its role in hypertensive left ventricular hypertrophy (HLVH) remains unclear. Methods: We measured HNP-1 levels in patients with hypertension and treated HLVH rat and H9c2 cell hypertrophy models with HNP-1. Cardiomyocyte hypertrophy indexes (i.e., single-cell surface area, left ventricular fibrosis area, BNP levels, and β-MHC levels) were measured with hematoxylin-eosin and Masson’s trichrome staining and WB. NF-кB signaling factors (i.e., IKKβ, p-IKKβ, IкBα, p-IкBα, p65, and p-p65) were measured with WB and qPCR. Finally, inflammatory factors (i.e., IL-6, IL-1α, and TNF-α) were measured with ELISA. Results: HNP-1 levels were lower in the exposure than the control groups (M (95% CI), 48.83 (45.64–52.26) vs. 59.03 (55.62–62.54), P = 0.000). Diminished HNP-1 was associated with HLVH occurrence in patients. HLVH rat and H9c2 cell hypertrophy models revealed elevated cardiomyocyte hypertrophy indexes and NF-кB signaling and inflammatory factors. However, each HNP-1 treatment group showed lower levels of the aforementioned indices than were observed in the model groups. Conclusion: Diminished HNP-1 is a risk factor for HLVH. HNP-1 treatment may reverse HLVH by inhibiting NF-кB signaling pathways.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Bundle Branch Ablation Guided by a Three-Dimensional Mapping System: A Novel Method for Establishing a Heart Failure Animal Model","authors":"Pengkang He, Han Jin, Yiran Hu, Sixian Weng, Sijing Cheng, Hao Huang","doi":"10.15212/cvia.2023.0066","DOIUrl":"https://doi.org/10.15212/cvia.2023.0066","url":null,"abstract":"Objective: Few studies have been conducted to establish animal models of left bundle branch block by using three-dimensional mapping systems. This research was aimed at creating a canine left bundle branch block model by using a three-dimensional mapping system. Materials and Methods: We used a three-dimensional mapping system to map and ablate the left bundle branch in beagles. Results: Ten canines underwent radiofrequency ablation, among which left bundle branch block was successfully established in eight, one experienced ventricular fibrillation, and one developed third-degree atrioventricular block. The maximum HV interval measured within the left ventricle was 29.00 ± 2.93 ms, and the LBP-V interval at the ablation site was 20.63 ± 2.77 ms. The LBP-V interval at the ablation target was 71.08% of the maximum HV interval. Conclusion: This three-dimensional mapping system is a reliable and effective guide for ablation of the left bundle branch in dogs.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-conceptualization of the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” for the Management of Perioperative Stroke in Patients with Lung Cancer","authors":"Zhen Chen, Ying Liu, Qibin Song, H. Zou","doi":"10.15212/cvia.2023.0035","DOIUrl":"https://doi.org/10.15212/cvia.2023.0035","url":null,"abstract":"The Chinese Heart Journal published the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” (hereafter referred to as “the Guidelines”) in 2021. The Guidelines were initiated by Professor Yushun Zhang of the No.1 Affiliated Hospital of Xi’an Jiaotong University, and 55 domestic experts participated in their discussion and formulation. The Guidelines focus on eight key issues in the prevention of stroke associated with patent foramen ovale (PFO), including definition and epidemiology, anatomical features, ultrasound diagnosis, clinical screening, and prevention and treatment of PFO-associated stroke. The prevention and treatment of PFO-associated stroke include pharmacological prevention, prevention of PFO with transcatheter occlusion and transcatheter occlusion of PFO. Patients with PFO are at elevated risk of perioperative stroke. In China, lung cancer ranks first in incidence among malignant tumors. The number of lung cancer surgeries is increasing each year, and the incidence of PFO in the population is approximately 25%. Although perioperative stroke in patients with lung cancer due to the presence of PFO has rarely been reported, given the high disability rate of stroke, incidence of PFO, and incidence of lung cancer, herein, we consider the Guidelines for the management of perioperative stroke in lung cancer. Our aim is to provide further perspectives in decreasing the risk of perioperative stroke in patients with lung cancer and PFO, to improve their quality of life and increase the safety of surgery.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Quality of Life and Clinical Outcomes in Patients with Heart Failure","authors":"Jingxuan Liu, Zhou Lu, Wan Xuesi, Jianzeng Dong","doi":"10.15212/cvia.2023.0046","DOIUrl":"https://doi.org/10.15212/cvia.2023.0046","url":null,"abstract":"Background: Heart failure (HF) is generally associated with poor quality of life (QoL). Limited data are available characterizing health-related QoL (HRQL) in Chinese patients with HF. Methods: We used the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to record QoL in 4082 patients with HF from China who were followed up over 12 months in the Heart Failure Registry of Patient Outcomes (HERO) study. Baseline HRQL and differences in QoL between women and men with heart failure were compared. We used multivariable Cox regression with adjustment for variables to assess the association between MLHFQ summary scores and a composite of all-cause mortality and HF hospitalization. Result: At baseline, the mean MLHFQ in the overall population was 42.9 ± 19.57; the scores for physical and emotional domains were 22.0 ± 8.69 and 8.66 ± 6.08, respectively. Women had a higher (poorer) MLHFQ summary score (44.27 ± 19.13) than men (41.63 ± 19.90) (P<0.001). Female patients also had higher MLHFQ physical and emotional scores than male patients (P<0.001). The specific scores of the questionnaire were higher in women than men. NYHA class was the strongest independent predictor of MLHFQ score (β=6.12 unit increment; P<0.001). Sex was not independently associated with higher MLHFQ scores after multivariable adjustments. The 12-month mortality in the overall cohort was 19.6%, the hospitalization rate was 24.4%, and the composite endpoint was 40.15%. A 10-point increase in MLHFQ score was associated with higher risk of mortality (female and male HRs=1.19 [95% CI 1.12–1.26]; P<0.001 and 1.18 [95% CI 1.12–1.24]; P<0.001, respectively) and composite outcomes (HRs=1.08 [95% CI 1.04–1.13]; P<0.001 and 1.11 [95% CI 1.07–1.14]; P<0.001, respectively). Females did not show a significant association between HRQL and hospitalization (HR=1.04 [95% CI 0.99–1.09]; P=0.107). Conclusion: Quality of life was largely poorer in women than men, but was similar between sexes in terms of physical burden and emotional limitation. HRQL is an independent predictor of all-cause death and HF hospitalization in patients with HF.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carcinoid Heart Disease – A Review of Pathophysiology, Clinical Manifestations, Diagnosis and Management","authors":"S. Ghanta, S. Vallurupalli","doi":"10.15212/cvia.2023.0041","DOIUrl":"https://doi.org/10.15212/cvia.2023.0041","url":null,"abstract":"Objective: Neuro-endocrine tumors (NET) resulting in syndromes of serotonin excess can lead to cardiac involvement, and substantial mortality and morbidity. This article is aimed at reviewing the pathophysiology, diagnosis and management of carcinoid heart disease (CHD). Results: The pathophysiology of CHD stems from chronic exposure to circulating vasoactive compounds. Frequent clinical evaluations, monitoring of biomarker levels and cardiac imaging play critical roles in screening and early recognition. The complexity of the disease necessitates a multidisciplinary approach, medical management and timely surgical intervention. Conclusion: Outcomes of CHD have improved, owing to advances in medical management and increased surgical expertise. Surgical valvular intervention is the only definitive therapy for the treatment of symptomatic CHD.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Safety and Efficacy of Warfarin Versus Rivaroxaban in Northern Chinese Patients with Different CHA2DS2-VASc Scores: A Retrospective Cohort Study","authors":"Shiwei Xu, Qi Zhao, Haiyu Zhang, Xianghui Li, Jing Lu, Hongyan Wang, Yuanyuan Guo, Z. Dong","doi":"10.15212/cvia.2023.0030","DOIUrl":"https://doi.org/10.15212/cvia.2023.0030","url":null,"abstract":"Purpose: This study was aimed at evaluating the safety and efficacy of warfarin versus rivaroxaban in patients with atrial fibrillation (AF) and different CHA2DS2-VASc score subgroups in northern China. Methods: A retrospective cohort study was conducted to evaluate 387 patients with AF who received treatment at our institution between September 2018 and August 2019. The patients were divided into two groups receiving either warfarin (n=194) or rivaroxaban (n=193). Follow-up data were collected, including adherence, bleeding and ischemic stroke events. Results: The group receiving rivaroxaban showed better adherence than the group receiving warfarin. In the warfarin-treated group, bleeding incidents declined with increasing scores. In the warfarin-treated group, patients with scores of 2–3 had greater adherence and fewer stroke occurrences. The events of bleeding and stroke did not significantly differ in patients in the rivaroxaban-treated group with different scores. Conclusions: Compared with patients in the warfarin group with different CHA2DS2-VASc scores, those in the rivaroxaban group had greater compliance, and fewer bleeding and stroke events. Regardless of economic considerations, rivaroxaban is preferable for anticoagulative AF treatment in northern Chinese patients.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It’s Time to Consider Ablation as First-Line Therapy for Atrial Fibrillation","authors":"S. Ross, W. Miles","doi":"10.15212/cvia.2023.0052","DOIUrl":"https://doi.org/10.15212/cvia.2023.0052","url":null,"abstract":"","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}