Cardiovascular diagnosis and therapy最新文献

{"title":"Age-related wall shear stress changes assessed by vascular vector flow mapping in the carotid arteries of healthy adults: a cross-sectional study.","authors":"Lan He, Yundan Cai, Yuhong Feng, Tienan Feng, Filippo Cademartiri, E Shen","doi":"10.21037/cdt-24-134","DOIUrl":"https://doi.org/10.21037/cdt-24-134","url":null,"abstract":"<p><strong>Background: </strong>Wall shear stress (WSS) is related to the pathogenesis of atherosclerosis. WSS is affected by a variety of hemodynamic factors, and there is still a lack of accurate and objective methods for measuring it. This study sought to evaluate hemodynamic changes in WSS_{maximum (max)}, WSS_mean, WSS_{minimum (min)} in the common carotid artery of healthy adults of different ages using vascular vector flow mapping (VFM).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 70 healthy volunteers aged 20-89 years who were recruited from our Ultrasound Department between February 2021 and June 2021. An ultrasound system with a 3-15 MHz probe was used to determine regions of interest (ROIs) of the common carotid artery. VFM-based WSS measurements were obtained by selecting ROIs with optimal image quality from three full cardiac cycles. The participants were divided into the following seven age groups: the 20s group, the 30s group, the 40s group, the 50s group, the 60s group, the 70s group, and the 80s group. The WSS parameters were compared among the age groups. An analysis of variance or a Kruskal-Wallis test was used to evaluate the difference among the groups, and a Pearson analysis and linear regression were used for the correlation and trend analysis.</p><p><strong>Results: </strong>The WSS parameters were quantified using vascular VFM software. The WSS_max, WSS_mean, WSS_min differed among the age groups and gradually decreased with age, the elderly were significantly lower than the young. The Pearson correlation coefficient of the WSS_max and age was -0.556 (P<0.001), that of the WSS_mean and age was -0.461 (P<0.001), and that of the WSS_min and age was -0.308 (P<0.001). The WSS parameters with age are negatively correlated the carotid intima-media thickness differed between the groups.</p><p><strong>Conclusions: </strong>The carotid WSS_max, WSS_mean, WSS_min can be quantitatively and visually analyzed using the vascular VFM technique. In healthy adults of different ages, the carotid WSS_max, WSS_mean, WSS_min decreased with age. Our findings about the normal values of carotid WSS maybe have clinical reference value for future studies.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"668-678"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of clinical characteristics of patients with pulmonary hypertension in Chaya County, Chamdo, Tibet.","authors":"Ruimin Dong, Xing Shui, Juan Zhang, Zhu Dun","doi":"10.21037/cdt-23-486","DOIUrl":"https://doi.org/10.21037/cdt-23-486","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a critical health issue marked by high blood pressure in the pulmonary arteries, with limited data on its clinical characteristics in the Tibetan population. The objective of this study was to examine the clinical characteristics of PH patients among Tibetan population residing in Chaya County, Changdu, Tibet.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study. A total of 94 PH patients diagnosed via echocardiography at the Internal Medicine Department of Chaya County People's Hospital in Changdu (Tibet, China) between March 2019 and October 2020 were included. Additionally, 52 non-PH inpatients were selected as the control group. Patient medical records were reviewed for demographic and clinical data, lab results, and echocardiographic findings. Student's <i>t</i>-test/chi-squared test between PH and control group, one-way analysis of variance (ANOVA) among control and PH subgroups, Pearson's and Spearman's correlation coefficient were used to analysis the results.</p><p><strong>Results: </strong>Out of 1,689 inpatients in the Internal Medicine Department, 94 were identified as PH patients for analysis. The average hemoglobin level among PH patients (150.64±21.67 g/L) was similar to that observed in the normal population (146.65±17.51 g/L) at high altitude (P=0.28). Abnormal liver function indexes were observed, with 51.06% of PH patients exhibiting hyperuricemia (P<0.001 compared to control's 15.38%). The PH group demonstrated significantly elevated red blood cell distribution width (RDW)-standard deviation (50.59±6.49 <i>vs.</i> 43.67±3.40 fL, P<0.001) and RDW-coefficient of variation of (16.18%±3.04% <i>vs.</i> 13.52%±1.32%, P<0.001), along with a decreased platelet level compared to the control group [(202.55±73.67) <i>vs.</i> (256.63±72.85) ×10⁹/L]. Furthermore, echocardiographic indicators related to right heart function showed correlations with red blood cell count, bilirubin, albumin, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (multiple significant correlation coefficient r, magnitude from 0.22 to 0.54).</p><p><strong>Conclusions: </strong>Chronic pulmonary disease and left heart disease were identified as common etiologies of PH among Tibetan patients residing in high-altitude regions. The Tibetan population residing in high-altitude regions and diagnosed with PH displayed abnormal changes in numerous liver functional and metabolic indices, which were correlated with the morphological indices observed via cardiac ultrasound.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"462-477"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning prediction of no reflow in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Lin Wang, Pei Bao, Xiaochen Wang, Banglong Xu, Zeyan Liu, Guangquan Hu","doi":"10.21037/cdt-24-83","DOIUrl":"https://doi.org/10.21037/cdt-24-83","url":null,"abstract":"<p><strong>Background: </strong>No-reflow (NRF) phenomenon is a significant challenge in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Accurate prediction of NRF may help improve clinical outcomes of patients. This retrospective study aimed at creating an optimal model based on machine learning (ML) to predict NRF in these patients, with the additional objective of guiding pre- and intra-operative decision-making to reduce NRF incidence.</p><p><strong>Methods: </strong>Data were collected from 321 STEMI patients undergoing pPCI between January 2022 and May 2023, with the dataset being randomly divided into training and internal validation sets in a 7:3 ratio. Selected features included pre- and intra-operative demographic data, laboratory parameters, electrocardiogram, comorbidities, patients' clinical status, coronary angiographic data, and intraoperative interventions. Post comprehensive feature cleaning and engineering, three logistic regression (LR) models [LR-classic, LR-random forest (LR-RF), and LR-eXtreme Gradient Boosting (LR-XGB)], a RF model and an eXtreme Gradient Boosting (XGBoost) model were developed within the training set, followed by performance evaluation on the internal validation sets.</p><p><strong>Results: </strong>Among the 261 patients who met the inclusion criteria, 212 were allocated to the normal flow group and 49 to the NRF group. The training group consisted of 183 patients, while the internal validation group included 78 patients. The LR-XGB model, with an area under the curve (AUC) of 0.829 [95% confidence interval (CI): 0.779-0.880], was selected as the representative model for logistic regression analyses. The LR model had an AUC slightly lower than XGBoost model (AUC 0.835, 95% CI: 0.781-0.889) but significantly higher than RF model (AUC 0.731, 95% CI: 0.660-0.802). Internal validation underscored the unique advantages of each model, with the LR model demonstrating the highest clinical net benefit at relevant thresholds, as determined by decision curve analysis. The LR model encompassed seven meaningful features, and notably, thrombolysis in myocardial infarction flow after initial balloon dilation (TFAID) was the most impactful predictor in all models. A web-based application based on the LR model, hosting these predictive models, is available at https://l7173o-wang-lyn.shinyapps.io/shiny-1/.</p><p><strong>Conclusions: </strong>A LR model was successfully developed through ML to forecast NRF phenomena in STEMI patients undergoing pPCI. A web-based application derived from the LR model facilitates clinical implementation.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"547-562"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub-acute stent thrombosis in a bifurcation lesion: the devil is in the details.","authors":"Andreas Y Andreou","doi":"10.21037/cdt-24-183","DOIUrl":"https://doi.org/10.21037/cdt-24-183","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"735-739"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential treatment of N-acetylcysteine as an antioxidant in the radiation-induced heart disease.","authors":"Yan-Ling Li, Gang Wang, Bo-Wen Wang, Yong-Hong Li, Yong-Xia Ma, Yuan Huang, Wen-Ting Yan, Ping Xie","doi":"10.21037/cdt-24-19","DOIUrl":"https://doi.org/10.21037/cdt-24-19","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced heart disease (RIHD) is a serious complication of thoracic tumor radiotherapy that substantially affects the quality of life of cancer patients. Oxidative stress plays a pivotal role in the occurrence and progression of RIHD, which prompted our investigation of an innovative approach for treating RIHD using antioxidant therapy.</p><p><strong>Methods: </strong>We used 8-week-old male Sprague-Dawley (SD) rats as experimental animals and H9C2 cells as experimental cells. N-acetylcysteine (NAC) was used as an antioxidant to treat H9C2 cells after X-ray irradiation in this study. In the present study, the extent of cardiomyocyte damage caused by X-ray exposure was determined, alterations in oxidation/antioxidation levels were assessed, and changes in the expression of genes related to mitochondria were examined. The degree of myocardial tissue and cell injury was also determined. Dihydroethidium (DHE) staining, reactive oxygen species (ROS) assays, and glutathione (GSH) and manganese superoxide dismutase (Mn-SOD) assays were used to assess cell oxidation/antioxidation. Flow cytometry was used to determine the mitochondrial membrane potential and mitochondrial permeability transition pore (mPTP) opening. High-throughput transcriptome sequencing and bioinformatics analysis were used to elucidate the expression of mitochondria-related genes in myocardial tissue induced by X-ray exposure. Polymerase chain reaction (PCR) was used to verify the expression of differentially expressed genes.</p><p><strong>Results: </strong>X-ray irradiation damaged myocardial tissue and cells, resulting in an imbalance of oxidative and antioxidant substances and mitochondrial damage. NAC treatment increased cell counting kit-8 (CCK-8) levels (P=0.02) and decreased lactate dehydrogenase (LDH) release (P=0.02) in cardiomyocytes. It also reduced the level of ROS (P=0.002) and increased the levels of GSH (P=0.04) and Mn-SOD (P=0.01). The mitochondrial membrane potential was restored (P<0.001), and mPTP opening was inhibited (P<0.001). Transcriptome sequencing and subsequent validation analyses revealed a decrease in the expression of mitochondria-related genes in myocardial tissue induced by X-ray exposure, but antioxidant therapy did not reverse the related DNA damage.</p><p><strong>Conclusions: </strong>Antioxidants mitigated radiation-induced myocardial damage to a certain degree, but these agents did not reverse the associated DNA damage. These findings provide a new direction for future investigations by our research group, including exploring the treatment of RIHD-related DNA damage.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"509-524"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, effectiveness, and complications of the first-in-human minimally invasive transthoracic ventricular septal defect closure using a bioabsorbable occluder: a cohort study with 12-month follow-up.","authors":"Qiang Zhang, Jing Zhou, Shanliang Zhu, Hao Liu, Yu Mao, Ying Tang, Xuming Mo, Jun Chen","doi":"10.21037/cdt-23-361","DOIUrl":"https://doi.org/10.21037/cdt-23-361","url":null,"abstract":"<p><strong>Background: </strong>Ventricular septal defect (VSD) is one of the most common congenital heart diseases. This study aims to evaluate the clinical value and benefit of transesophageal echocardiography (TEE) in transthoracic minimally invasive closure of VSDs using a completely biodegradable occluders, summarize the main points of surgical procedures, and analyze the follow-up results of short-term and medium-term treatment.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 24 pediatric cases of VSD, successfully treated with TEE-guided minimally invasive closure using fully biodegradable occluders between June 2019 and June 2022. The preoperative TEE meticulously examined the defect's location, size, and surrounding anatomical relationships, aiding in the selection of appropriate occluders and guiding the entire closure process. All patients were followed up for 1 year.</p><p><strong>Results: </strong>In our cohort, 13 cases were perimembranous inlet VSDs, and 11 involved VSDs with membranous aneurysm formation. The effective shunt size of VSD measured by TEE preoperatively ranged from 2.8 to 4.9 mm, with the defect located 2-6 mm from the aortic valve. Occluders used were 6-8 mm in diameter. All 24 procedures were successful. TEE confirmed that the occluders were tightly fitted at the edges of the VSDs. Twenty-three cases had no residual shunt post-surgery, while one case exhibited a small left-to-right shunt (<1.5 mm) at the occluder's edge. Follow-up was conducted on postoperative day 3, and in months 1, 3, 6, and 12, showing that the occluder's position remained normal in all patients. Except for one child who had a 1.2 mm left-to-right shunt at the edge of the occluder, no residual shunts were observed in the others. The occluder started to degrade from month 6, and the sizes of the left and right occluder discs were significantly smaller compared to those on postoperative day 3 (P=0.003).</p><p><strong>Conclusions: </strong>TEE-guided minimally invasive VSD occlusion using fully biodegradable occluders has the advantages of minimal trauma, high safety, and few complications, with satisfactory recent efficacy, and good prospects for clinical safety applications.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"630-641"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical strategy and long-term outcomes of dissected carotid artery with false lumen thrombus in acute type A aortic dissection.","authors":"Hongyuan Lin, Hongyan Zhou, Xiaoning Huo, Hongwei Guo, Yi Chang","doi":"10.21037/cdt-23-464","DOIUrl":"https://doi.org/10.21037/cdt-23-464","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of involved common carotid artery (CCA) with false-lumen thrombus remains unclear in aortic dissection patients. We aim to investigate outcomes and compare different surgical strategies.</p><p><strong>Methods: </strong>This is a retrospective cohort study and the institutional database of acute type A aortic dissection was reviewed. The patients with CCA involvement and extended false-lumen thrombus were enrolled and grouped according to the management of CCA: extra-thoracic carotid artery replacement (CAR) and reconstruction in situ (RIS). Multivariate logistic regression analysis was used to investigate the effect of management on neurological outcomes. Kaplan-Meier method was used for survival analysis and log-rank test was used to compare the difference on survival rate.</p><p><strong>Results: </strong>From March 2011 to December 2019, 68 patients were enrolled (24 in the CAR group and 44 in the RIS group). The overall operative mortality was 7.4% (5 patients) and 21 patients had the incidence of postoperative neurological deficit was (30.9%). The rates of main postoperative complications were similar between the two groups. Twenty-five (56.8%) patients in the RIS group had residual false-lumen thrombus at discharge. In multivariate analysis, CAR was the only independent protective factor of postoperative neurological deficit [odds ratio (OR) =0.03, 95% confidence interval (CI): 0.0-0.61, P=0.02] and age was the only risk factor (OR =1.34, 95% CI: 1.11-1.62, P=0.002). The median follow-up time was 40 (interquartile range, 24-69) months and some of the patients received imaging follow-up. The overall survival rates at 5 and 10 years were 95.8%, and 95.8% in the CAR group and 84.1%, and 76.4% in the RIS group, with no significant difference (P=0.22). No cerebrovascular accident and reintervention occurred and 20 (90.9%) patients with residual false-lumen thrombus had reabsorption of thrombus during the follow-up period.</p><p><strong>Conclusions: </strong>CAR was a thorough technique and could protect patients from postoperative neurological deficit than RIS. Patients in either group could have a satisfying long-term prognosis after surviving from perioperative period. Most patients had reabsorption of residual false-lumen thrombus after anticoagulant therapy.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"525-536"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-related differences in left atrial strain mechanics and exercise capacity in hypertrophic cardiomyopathy: a propensity-score matched study from the Cleveland Clinic.","authors":"Bo Xu, Yoshihito Saijo, Nicholas G Smedira, Erik Van Iterson, Maran Thamilarasan, Zoran B Popović, Milind Y Desai","doi":"10.21037/cdt-24-147","DOIUrl":"https://doi.org/10.21037/cdt-24-147","url":null,"abstract":"<p><strong>Background: </strong>Male and female patients with hypertrophic cardiomyopathy (HCM) differ in physiologic characteristics and hemodynamics. Little is known about gender-related differences in left atrial (LA) strain and exercise capacity. The aim of this study was to assess the gender-related differences in the relationship between exercise capacity and cardiac function including LA function in patients with HCM.</p><p><strong>Methods: </strong>Five hundred and thirty-two patients with HCM undergoing exercise stress echocardiography and cardiopulmonary exercise testing (CPET) were prospectively recruited between October 2015 and April 2019 as part of a cohort study in a quaternary referral center. To reduce potential confounding factors, propensity score (PS) matching was performed in 420 patients. LA strain mechanics were evaluated using speckle-tracking echocardiography.</p><p><strong>Results: </strong>The majority of patients were male, comprising 58% of the total. Female HCM patients were older (54±14 <i>vs</i>. 50±15 years, P=0.002). After PS matching, percent-predicted peak VO₂ was similar between the genders (67.5%±20.7% <i>vs</i>. 65.8%±21.8%, P=0.41), even though female HCM patients had lower peak VO₂ (17.7±5.9 <i>vs</i>. 24.1±8.3 mL/kg/min, P<0.001). Left ventricular (LV) diastolic function was worse for female HCM patients. This is shown by worse E/e' ratio (15.0±5.9 <i>vs</i>. 12.9±6.4, P<0.001) and larger LA volume in respect to LV (0.88±0.35 <i>vs</i>. 0.74±0.31, P<0.001), compared with male HCM patients. The gender-related differences in LA reservoir strain were more evident for patients aged 60 years and older (27.5%±8.8% <i>vs</i>. 30.9%±9.1%, P=0.03). LA reservoir strain was found to have a significant association with exercise capacity in both male and female HCM patients (for females, β=0.27, P=0.001; for males, β=0.27, P<0.001), independent of LV diastolic dysfunction and stroke volume.</p><p><strong>Conclusions: </strong>Gender-related differences in LA reservoir strain were increasingly evident for older HCM patients aged 60 years and older. LA reservoir strain was an independent determinant of percent-predicted peak VO₂ in male and female patients, underpinning the importance of LA function in determining exercise capacity in HCM.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"609-620"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnoflorine attenuates Ang II-induced cardiac remodeling via promoting AMPK-regulated autophagy.","authors":"Meili Zhu, Jiangbiao Hu, Yifan Pan, Qian Jiang, Chang Shu","doi":"10.21037/cdt-24-130","DOIUrl":"https://doi.org/10.21037/cdt-24-130","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains one of the most common events in the progression of hypertension. Magnoflorine (MNF) has been shown beneficial effects on the cardiovascular system. However, the action of MNF on angiotensin (Ang) II-induced cardiac remodeling and its underlying mechanisms have not yet been characterised. Here, we assessed the action of MNF in the development of hypertension-related HF.</p><p><strong>Methods: </strong>C57BL/6 male mice were subjected to Ang II through a micro-osmotic pump infusion continuously for 4 weeks to induce hypertensive HF. MNF (10 and 20 mg/kg) was administered in the final 2 weeks. Ang II content was measured by enzyme-linked immunosorbent assay (ELISA) kit. Values of ejection fraction (EF) and fractional shortening (FS) were detected using an ultrasound diagnostic instrument. The mRNA levels of hypertrophic and fibrotic genes were determined by real-time quantitative polymerase chain reaction (RT-qPCR). Haematoxylin and eosin (H&E), wheat germ agglutinin (WGA), Masson trichrome, and Sirius Red staining were used to analyse pathologic changes in heart tissues. The expression levels of phosphorylated AMP-activated protein kinase (AMPK), light chain 3 microtubule associated protein II (LC3 II) to LC3 I, and p62 were detected by western blot assay.</p><p><strong>Results: </strong>MNF significantly improved cardiac dysfunction and the content of creatine kinase-MB without altering blood pressure in Ang II-challenged mice. MNF obviously corrected the phenotypes of cardiac hypertrophy and fibrosis, including the high mRNA levels of atrial natriuretic peptide (<i>Anp</i>), brain natriuretic peptide (<i>Bnp</i>), collagen1a (<i>Col1a1</i>), transforming growth factor beta (<i>Tgfb1</i>), enlarged myocardial areas, and increased positive areas of Masson trichrome and Sirius Red staining. In addition, MNF alleviated oxidative injury, reflected by the upregulation of glutathione and the downregulation of reactive oxygen species and malondialdehyde. The activation of AMPK was elevated accompanied by an increased level of autophagy by MNF in hypertensive heart tissues. The therapeutic action of MNF was confirmed in Ang II-challenged H9c2 cells. Specifically, the AMPK inhibitor could eliminate the autophagy pathway in which MNF is involved.</p><p><strong>Conclusions: </strong>MNF has benefits in hypertension-induced cardiac remodeling, which was partially associated with the improvement of oxidative stress via the mediation of the AMPK/autophagy axis.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"576-588"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum cystatin C level and major adverse cardiovascular events in patients with percutaneous coronary intervention.","authors":"Zhibin Xiao, Aoge Riletu, Xiaoyu Yan, Qi Meng, Weiru Zhang, Na Zhang, Chi Ma, Xin Guo, Jiatong Han, Huijuan Nie, Hui Deng, Jing Liu, Jianping Chen, Yu Dong, Tianlong Liu","doi":"10.21037/cdt-23-482","DOIUrl":"https://doi.org/10.21037/cdt-23-482","url":null,"abstract":"<p><strong>Background: </strong>Recurrent acute myocardial infarction requiring unplanned percutaneous coronary intervention (PCI) is one of the major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) after PCI. There is a continuing controversy about the association between serum cystatin C, a biomarker for the evaluation of renal function, and the prognosis of ACS patients following PCI. The retrospective study evaluated the association between serum cystatin C level and MACE in ACS patients after PCI.</p><p><strong>Methods: </strong>Data were retrieved for 330 patients with ACS for primary PCI in a single center. Serum cystatin C levels were measured before PCI. All patients underwent regular follow-ups after PCI, and the studied endpoint was MACE, defined as the need for a repeat revascularization in the heart. The predictive value of serum cystatin C for MACE was analyzed using univariate and multivariate analysis. Restricted cubic spline (RCS) analysis was applied to evaluate the dose-response relationship between serum cystatin C level and MACE in ACS patients following PCI.</p><p><strong>Results: </strong>After a median follow-up of 63 months (range, 1-148 months), 121 of the 330 patients experienced MACE. Compared to patients who did not have MACE, patients who had MACE showed a significant decrease in serum cystatin C levels (0.99±0.32 <i>vs.</i> 1.15±0.78 mg/L, P=0.03). In multivariate regression analysis, serum cystatin C level was an independent risk factor for MACE. According to the serum cystatin C level, patients were divided into 4 categories, Cox regression analysis illustrated that the second quartile of serum cystatin C level indicated an increased risk of MACE in patients with PCI for primary ACS compared to the highest quartile [Q2: adjusted hazard ratio (HR) =2.109; 95% confidence interval (CI): 1.193-3.727; P=0.01]. RCS analysis showed a significant U-shaped dose-response relationship between cystatin C level and MACE in patients with PCI for ACS (P for non-linearity =0.004).</p><p><strong>Conclusions: </strong>These results indicated an association between serum cystatin C level and post-PCI MACE in ACS patients.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"621-629"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}