Acta Cardiologica Sinica最新文献

{"title":"Macrophage-Derived Exosomal MALAT1 Regulates Autophagy through miR-204-5p/ATG7 Axis in H9C2 Cardiomyocytes and Diabetic Rat Heart.","authors":"Kou-Gi Shyu, Bao-Wei Wang, Chun-Ming Pan, Wei-Jen Fang","doi":"10.6515/ACS.202505_41(3).20250224D","DOIUrl":"10.6515/ACS.202505_41(3).20250224D","url":null,"abstract":"<p><strong>Background: </strong>Autophagy activity is tightly associated with cardiovascular disease development and progression. The effect of exosomal metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) derived from macrophages treated with high levels of glucose on autophagy in cardiomyocytes and diabetic hearts is not known. We investigated the effect of autophagy and its regulatory mechanisms on H9C2 cardiomyocytes and diabetic hearts by macrophage-derived exosomal MALAT1.</p><p><strong>Methods: </strong>Mouse macrophages and rat H9C2 cardiomyocytes were cultured, and exosomes were extracted from the culture media. A diabetic model was established through the injection of streptozotocin into adult male Wistar rats. Reverse transcription real-time quantitative polymerase chain reaction, Western blotting, immunohistochemical staining, autophagosome and/or autolysosome fluorescent cell staining, and luciferase activity assays were performed.</p><p><strong>Results: </strong>High glucose significantly enhanced exosomal MALAT1 expression in cultured H9C2 cells and macrophages. Macrophage-derived exosomes significantly increased autophagy-related 7 (ATG7) and decreased miR-204-5p expressions. Silencing MALAT1 by MALAT1 small interference RNA and the overexpression of wild-type miR-204-5p significantly decreased the ATG7 expression induced by macrophage-derived exosomes. MiR-204-5p significantly decreased MALAT1 and ATG7 luciferase activity in cultured H9C2 cells treated with macrophage-derived exosomes. Streptozotocin-induced diabetes mellitus and macrophage-derived exosomes significantly enhanced MALAT1 expression to inhibit miR204-5p expression in the rat hearts. Macrophage-derived exosomes significantly enhanced ATG7 expression in the streptozotocin-induced diabetic hearts.</p><p><strong>Conclusions: </strong>In conclusion, we discovered that exosomal MALAT1 derived from macrophages after high glucose treatment could sequester miR-204-5p, leading to the upregulation of ATG7 expression, and this was linked to the regulation of autophagy in H9C2 cardiomyocytes and streptozotocin-induced diabetic hearts.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"346-360"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Fragmented QRS on Admission Electrocardiogram among Patients Hospitalized with COVID-19: A Single-Center Report, Systematic Review, and Meta-Analysis.","authors":"Mohammad Reza Dehghani, Mehdi Moeini, Mehdi Masoumi, Yousef Rezaei","doi":"10.6515/ACS.202505_41(3).20241111D","DOIUrl":"10.6515/ACS.202505_41(3).20241111D","url":null,"abstract":"<p><strong>Background: </strong>The novel coronavirus disease 2019 (COVID-19) is associated with life-threatening complications. Electrocardiogram (ECG) changes associated with COVID-19 have also been reported in the majority of critically ill patients.</p><p><strong>Methods: </strong>In this study, we aimed to investigate the prevalence of fragmented QRS (fQRS) and its prognostic value in hospitalized patients with COVID-19. In addition, we performed a systematic review and meta-analysis of the literature to evaluate the effect of fQRS on the outcomes of COVID-19 patients.</p><p><strong>Results: </strong>A total of 310 patients with a mean age of 65.7 ± 14.5 years were followed up for 3 months, of whom 139 (44.8%) had fQRS on their ECGs. The rates of in-hospital mortality (8.8% vs. 8.6%), rehospitalization during follow- up (13.7% vs. 12.3%), and 90-day mortality (6.5% vs. 5.3%) were comparable between the patients with and without fQRS, respectively. In the meta-analysis, 9 studies in addition to our study reported outcomes, with a total of 2928 patients with a mean age of 53.8 years, and 1431 (48.9%) were males. The rate of fQRS was 0.31 (95% confidence interval [CI], 0.23-0.38; I² = 95.21%). In addition, the pooled proportion of in-hospital mortality reported by 5 studies was 0.31 (95% CI, 0.12-0.51; I² = 98.36). The rate of in-hospital mortality was higher among patients with fQRS compared to those without fQRS (odds ratio, 2.33; 95% CI, 1.52-3.58; p = 0.0001; I² = 74%).</p><p><strong>Conclusions: </strong>The rate of fQRS on ECG was relatively high in COVID-19 patients, and according to the meta-analysis, it was associated with worse outcomes in hospitalized COVID-19 patients.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"323-334"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engeletin Inhibits Inflammation and Ferroptosis and Attenuates Cardiomyocyte Injury Induced by Hypoxia-Reoxygenation.","authors":"Yili Yao, Jianghong Ling, Xiaolong Wang","doi":"10.6515/ACS.202505_41(3).20250221A","DOIUrl":"10.6515/ACS.202505_41(3).20250221A","url":null,"abstract":"<p><strong>Background: </strong>Investigate the function and mechanism of engeletin in myocardial ischemia reperfusion injury (MIRI).</p><p><strong>Methods: </strong>Hypoxia-reoxygenation (HR) was achieved by subjecting H9c2 cells to 2 hours of hypoxia followed by 4 hours of reoxygenation. The viability of the H9c2 cells was measured by cell counting kit-8 assay. The expressions of interleukin-1 beta (IL-1β), interleukin-6 (IL)-6 and tumor necrosis factor-alpha (TNF-α) were detected by reverse transcription polymerase chain reaction. Reactive oxygen species (ROS) generation was detected by cell-permeable fluorogenic probe Dichloro-dihydro-fluorescein diacetate. Malondialdehyde, superoxide dismutase (SOD) and glutathione (GSH) levels were measured by corresponding kits. The accumulation of intracellular iron ions was accurately measured by the Iron Assay kit. Cell apoptosis was detected by Annexin V-FITC/Propidium Iodide staining. Protein expression was detected by Western blotting to investigate the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) signaling pathways.</p><p><strong>Results: </strong>Engeletin treatment reversed the cell viability induced by HR, and also alleviated cell inflammation by inhibiting the expression of inflammatory cytokines, specifically IL-1β, IL-6 and TNF-α. Furthermore, engeletin treatment significantly inhibited the ROS generation induced by HR, inhibited MDA expression, and promoted SOD and GSH expressions. In addition, engeletin treatment decreased the intracellular concentration of ferrous iron, and promoted both glutathione peroxidase 4 and solute carrier family 7 member 11 expressions. The cell apoptosis results illustrated that engeletin significantly inhibited the apoptosis induced by HR. The Western blotting results showed that engeletin could activate the Nrf2 pathway and downregulate the NF-κB pathway. Engeletin alleviated MIRI in a left anterior descending artery mouse myocardial infarction model.</p><p><strong>Conclusions: </strong>Engeletin functioned as a dual regulator both on NF-κB and Nrf2 pathways to alleviate the cell inflammation and ferroptosis induced by HR.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"361-371"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Coronary Artery Aneurysms and Cardiac Pseudo Tumours from IgG4 Related Disease: A Case Report.","authors":"Rodney Yu-Hang Soh, Tiong-Cheng Yeo, Robin Cherian","doi":"10.6515/ACS.202505_41(3).20250104B","DOIUrl":"10.6515/ACS.202505_41(3).20250104B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"407-410"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Remarkable Occurrence: Esophageal Necrosis Induced by Acute Coronary Syndromes - An Uncommon Encounter-Case Report.","authors":"Esma Cetinkaya, Fahri Er","doi":"10.6515/ACS.202505_41(3).20250106B","DOIUrl":"10.6515/ACS.202505_41(3).20250106B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"418-422"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Huge Post-Myocardial Infarction Left Ventricular Pseudoaneurysm: A Case Report.","authors":"No-Ting Lin, Yi-Hsin Hung, Ron-Bin Hsu, Cheng-Hsuan Tsai","doi":"10.6515/ACS.202505_41(3).20250106A","DOIUrl":"10.6515/ACS.202505_41(3).20250106A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"414-417"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Takotsubo Cardiomyopathy Following Scorpion Sting: A Rare and Life-Threatening Complication.","authors":"Ayşegül Ülgen Kunak, Bahadır Öztürk, Şakir Arslan","doi":"10.6515/ACS.202505_41(3).20250224B","DOIUrl":"10.6515/ACS.202505_41(3).20250224B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"431-434"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibacterial Envelope Prevents Cardiac Implantable Electronic Device Infections: The Largest Asia Real World Data.","authors":"Ching-Fen Chang, Wen-De Tang, Yin-Huei Chen, Chiung-Ray Lu, Wei-Hsin Chung, Cheng-Li Lin, Hung-Pin Wu, You-Cheng Chang, Pei-Chi Hung, Kuan-Cheng Chang, Yen-Nien Lin","doi":"10.6515/ACS.202505_41(3).20250107A","DOIUrl":"10.6515/ACS.202505_41(3).20250107A","url":null,"abstract":"<p><strong>Background: </strong>Cardiac implantable electronic device (CIED) infection is a serious complication of CIED therapy and has been associated with increased morbidity, mortality, and healthcare costs. The use of an absorbable antibiotic-eluting envelope (TYRX^TM, Medtronic, Minneapolis, US) has been reported to reduce the risk of CIED infection without increasing the risk of additional complications. To investigate the real-world efficacy in Taiwanese patients, we retrospectively reviewed the outcomes of CIED patients with and without the use of an envelope.</p><p><strong>Methods: </strong>A total 456 patients underwent CIED procedure from January 2022 to June 2023, including initial implantation, generator replacement, upgrade, or revision. There were 154 patients in the envelope group and 302 patients in the control group, all of whom received our standard infection prophylaxis care. Patient demographics and CIED complications during serial clinical follow-ups were analyzed.</p><p><strong>Results: </strong>Both groups demonstrated comparable characteristics including age, sex, body mass index, CIED type, and left ventricular ejection fraction. More of the envelope group were receiving dialysis (Envelope vs. Control: 13.6% vs. 7.0%, p = 0.015), anticoagulant therapy (Envelope vs. Control: 35.7% vs. 27.5%, p = 0.048), and had a longer procedure time (Envelope vs. Control: 83.4 ± 40.3 vs. 70.4 ± 31.7 minutes, p = 0.0002). CIED-related infections occurred in none of the envelope patients and 4 of the control patients (0% vs. 1.3%, p = 0.19; Kaplan-Meier estimate 0% vs. 2.02%, hazard ratio: 0.24, 95% confidence interval: 0.03-2.03, p = 0.19). Two patients reported allergic reactions to the envelope.</p><p><strong>Conclusions: </strong>The envelope group had a higher risk of CIED infections but similar infection rate , compared with the control group. However, the envelope group had a slightly longer procedure time and possibly an increased risk of allergic reaction.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 3","pages":"314-322"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Upper Gastrointestinal Bleeding in Patients Undergoing Percutaneous Coronary Intervention on Dual Antiplatelet Therapy with Assessment of Anti-Ulcer Medication Effects.","authors":"Chun-Ting Shih, Ting-Hsin Huang, Chih-Ming Liang, You-Cheng Zheng, Yi-Lin Chen, Han-Tan Chai, Po-Jui Wu, Chien-Jen Chen, Huang-Chung Chen, Shaur-Zheng Chong","doi":"10.6515/ACS.202503_41(2).20240722A","DOIUrl":"10.6515/ACS.202503_41(2).20240722A","url":null,"abstract":"<p><strong>Background: </strong>Patients in the coronary care unit (CCU) who undergo percutaneous coronary intervention (PCI) and receive dual antiplatelet treatment (DAPT) are at an increased risk of upper gastrointestinal bleeding (UGIB). The effectiveness of histamine-2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) in preventing UGIB in this context remains uncertain.</p><p><strong>Methods: </strong>This retrospective study enrolled 288 CCU patients undergoing DAPT after PCI, and the incidence of UGIB was assessed at specific timeframes: within 72 hours and beyond 72 hours post catheterization. Factors considered included patient histories, medication regimens (PPIs, H2RAs), and the absence of prophylactic UGIB medication.</p><p><strong>Results: </strong>Within 72 hours, acute UGIB occurred in 8.3% of the patients, with a history of cerebrovascular accident and higher Killip grade identified as risk factors. Excluding the acute cases, the other patients received PPIs (n = 41), H2RAs (n = 57), or no prophylactic medication (n = 166). Delayed UGIB (> 72 hours) occurred in 4.9% of the patients, with chronic kidney disease and higher Killip grade identified as significant risk factors. UGIB rates in the PPI, H2RA, and non-prophylactic groups showed no significant difference (p = 0.264), and TriMatch analysis revealed consistent rates (7.5%, 7.5%, 5.0%) (p = 0.875).</p><p><strong>Conclusions: </strong>No significant difference was found in the incidence of UGIB post PCI between the patients who did and did not receive prophylactic anti-ulcer medications. However, prophylactic medication and vigilant monitoring are suggested for high-risk UGIB patients within the critical CCU setting.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"183-191"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutual Effect of Nutritional Status and Inflammatory Processon Mortality after Superficial Artery Intervention: NAPLES Score.","authors":"Tugba Aktemur, Mehmet Altunova, Omer Tasbulak, Emine Altuntas, Ahmet Arif Yalcin, Fatih Uzun, Mehmet Erturk","doi":"10.6515/ACS.202503_41(2).20240812B","DOIUrl":"10.6515/ACS.202503_41(2).20240812B","url":null,"abstract":"<p><strong>Introduction: </strong>Superficial femoral artery (SFA) stenosis is a common type of peripheral arterial disease. Percutaneous treatment has similar long amputation rates with open surgery. There are various predictors of worse outcomes in this patient group, such as chronic kidney disease and malnutrition. The NAPLES score (NPS) is simple scoring system which consists of four elements. We aimed to investigate the role of NPS in predicting long-term mortality in patients with SFA stenosis who underwent a percutaneous intervention.</p><p><strong>Methods: </strong>A total of 567 patients who underwent percutaneous treatment for stenosis of the SFA from January 2012 to December 2020 were enrolled. The primary endpoint was mortality, and the secondary endpoints were in-hospital thrombosis, restenosis, residual stenosis and postintervention complications. The patients were divided into two groups: high NPS (3, 4) and low NPS (0, 1, 2). Each group was evaluated in terms of clinical, laboratory and technical aspects.</p><p><strong>Results: </strong>The patients with high NPS had a higher rate of mortality (34% vs. 16.3%, p < 0.05), and shorter time to (17.2 ± 14.7 vs. 29.2 ± 19.3 months, p < 0.05). In multivariate analysis, after adjusting for confounding factors, age [hazard ratio (HR): 1.049, 95% confidence interval (CI): 1.025-1.073, p < 0.001], chronic kidney disease (HR: 1.994, 95% CI: 1.347-2.951, p = 0.001), Rutherford class 5-6 (HR: 1.839, 95% CI: 1.195-2.830, p = 0.006), high C-reactive protein values (HR: 1.004, 95% CI: 1.001-1.008, p = 0.022), and estimated higher NPS (HR: 1.748, 95.5 CI: 1.189-2.572, p = 0.005) were shown to be independent risk factors of mortality.</p><p><strong>Conclusions: </strong>NPS is a simple scoring system that can be used to predict long-term mortality in this group. More strict control of risk factors is required in patients with a high NPS.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"200-209"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}