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A New Mechanism of Supraventricular Tachycardia: Gene Mutation. 室上性心动过速的一种新机制:基因突变。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-20 DOI: 10.2174/011573403X320610250108113731
Jie Gao, Rong Luo, Xiaoping Li

Background: Supraventricular tachycardia (SVT) is very common in daily clinical practice, especially in the emergency department, with rapid onset and urgent management. The review highlights the recent genetic predispositions and mechanisms in SVT.

Methods: Through analysis of epidemiology, familial clustering, and gene mutations of the relevant literature,the review elucidates the genetic properties and potential pathophysiology of SVT.

Results: There are many pathophysiological mechanisms related to atrioventricular node reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT). Currently, there is relatively little research on inappropriate sinus tachycardia (IST), atrial tachycardia (AT), and congenital junctional ectopic tachycardia (CJET). It seems that every type of SVT has gene mutations in ion channels, with three types of SVT having gene mutations in signaling pathways, and others including gene mutations in beta-adrenergic-receptor autoantibodies, autonomic nervous system, and AV node structure.

Conclusion: SVT has certain genetic characteristics and is often associated with other heart diseases. From the analysis of mutated genes in SVT, it appears to be a type of cardiac ion channel disease. Unlike common ion channel diseases, it is more insidious and more susceptible to external factors. The confirmation of the genetic basis of SVT provides direction for future hazard stratification assessment and gene targeted therapy drug research.

背景:室上性心动过速(SVT)在日常临床实践中非常常见,特别是在急诊科,起病迅速,处理紧急。本文综述了最近SVT的遗传易感性和机制。方法:通过对相关文献的流行病学分析、家族聚类分析和基因突变分析,阐述SVT的遗传特性和潜在的病理生理。结果:房室结折返性心动过速(AVNRT)和房室折返性心动过速(AVRT)存在多种病理生理机制。目前对不适宜性窦性心动过速(IST)、房性心动过速(AT)和先天性结位异位心动过速(CJET)的研究相对较少。似乎每种类型的SVT在离子通道上都有基因突变,其中三种类型的SVT在信号通路上有基因突变,其他类型的SVT包括β -肾上腺素能受体自身抗体、自主神经系统和房室结结构的基因突变。结论:SVT具有一定的遗传特征,常与其他心脏疾病相关。从对SVT突变基因的分析来看,它似乎是一种心脏离子通道疾病。与常见的离子通道疾病不同,它更隐蔽,更容易受到外界因素的影响。SVT遗传基础的确认为今后的危险分层评价和基因靶向治疗药物研究提供了方向。
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引用次数: 0
Unlocking Platelet Mechanisms through Multi-Omics Integration: A Brief Review. 通过多指标整合揭示血小板机制:简评。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-13 DOI: 10.2174/011573403X334382241210064101
Muhammad Mazhar Fareed, Maryam Qasmi, Zarmina Khan, Haider Ali, Stavros Stavrakis, Carola Y Förster, Sergey Shityakov

Platelets, tiny cell fragments measuring 2-4 μm in diameter without a nucleus, play a crucial role in blood clotting and maintaining vascular integrity. Abnormalities in platelets, whether genetic or acquired, are linked to bleeding disorders, increased risk of blood clots, and cardiovascular diseases. Advanced proteomic techniques offer profound insights into the roles of platelets in hemostasis and their involvement in processes such as inflammation, metastasis, and thrombosis. This knowledge is vital for drug development and identifying diagnostic markers for platelet activation. Platelet activation is an exceptionally rapid process characterized by various posttranslational modifications, including protein breakdown and phosphorylation. By utilizing multiomics technologies and biochemical methods, researchers can thoroughly investigate and define these posttranslational pathways. The absence of a nucleus in platelets significantly simplifies mass spectrometry-based proteomics and metabolomics, as there are fewer proteins to analyze, streamlining the identification process. Additionally, integrating multiomics approaches enables a comprehensive examination of the platelet proteome, lipidome, and metabolome, providing a holistic understanding of platelet biology. This multifaceted analysis is critical for elucidating the complex mechanisms underpinning platelet function and dysfunction. Ultimately, these insights are crucial for advancing therapeutic strategies and improving diagnostic tools for platelet-related disorders and cardiovascular diseases. The integration of multi-omics technologies is paving the way for a deeper understanding of platelet mechanisms, with significant implications for biomedical research and clinical applications.

血小板是一种直径为2-4 μm的微小细胞碎片,没有细胞核,在血液凝固和维持血管完整性中起着至关重要的作用。血小板异常,无论是遗传性的还是后天的,都与出血性疾病、血栓风险增加和心血管疾病有关。先进的蛋白质组学技术为血小板在止血中的作用及其在炎症、转移和血栓形成等过程中的参与提供了深刻的见解。这些知识对于药物开发和血小板活化诊断标志物的识别至关重要。血小板活化是一个异常快速的过程,其特点是各种翻译后修饰,包括蛋白质分解和磷酸化。利用多组学技术和生物化学方法,研究人员可以深入研究和定义这些翻译后通路。血小板中细胞核的缺失极大地简化了基于质谱的蛋白质组学和代谢组学,因为需要分析的蛋白质更少,简化了鉴定过程。此外,整合多组学方法可以对血小板蛋白质组、脂质组和代谢组进行全面检查,从而全面了解血小板生物学。这种多方面的分析对于阐明血小板功能和功能障碍的复杂机制至关重要。最终,这些见解对于推进血小板相关疾病和心血管疾病的治疗策略和改进诊断工具至关重要。多组学技术的整合为更深入地了解血小板机制铺平了道路,对生物医学研究和临床应用具有重要意义。
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引用次数: 0
Molecular and Functional Significance of Growth Differentiation Factor-15: A Review on Cardiovascular-Kidney-Metabolic Biomarker. 生长分化因子-15的分子和功能意义:心血管-肾脏-代谢生物标志物研究进展
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-07 DOI: 10.2174/011573403X332671241121063641
Krishna Tiwari, Aswini Saravanan, Abhishek Anil, Vikas Kumar Tiwari, Muhammad Aaqib Shamim, Surjit Singh, Pradeep Dwivedi, Surender Deora, Shoban Babu Varthya

Cardiovascular-kidney-metabolic (CKM) syndrome is the association between obesity, diabetes, CKD (chronic kidney disease), and cardiovascular disease. GDF-15 mainly acts through the GFRAL (Glial cell line-derived neurotrophic factor Family Receptor Alpha-Like) receptor. GDF-15 and GDFRAL complex act mainly through RET co-receptors, further activating Ras and phosphatidylinositol-3-kinase (PI3K)/Akt pathways through downstream signaling. GDF-15 decreases cardiac dysfunction and hypertrophy by inducing HIF-α (hypoxia-inducible factor-1α). It causes increased fractional shortening and a significant decrease in ventricular dilation through the induction of the SMAD 2/3. GDF-15 prevents hyperglycemia-induced apoptosis in diabetes mellitus. GDF-15 causes anorexia by influencing the central systems regulating metabolism and appetite. Therefore, targeting GDF-15 can be useful for the treatment of anorexia caused by cancer as well as the prevention of resulting weight loss. GDF-15 has an important role in predicting mortality in acute kidney injury. Its high levels are related to eGFR decline and also have a prognostic role in CKD patients. Growth differentiation factor-15 (GDF-15) is a vital biomarker for diagnosis, treatment, and prognosis of CKM syndrome. Elevated GDF-15 levels can be utilised as a biomarker to determine the suitable metformin dosage. In light chain amyloidosis, a raised level of GDF-15 predicts early death in heart failure and renal disease patients. In vivo, studies using GDF-15 analogs and antibodies against GFRAL to affect metabolic parameters and ventricular dilatation have shown potential for GDF-15-based therapeutic interventions. This review aims to study the role of GDF-15 in CKM syndrome and establish it as a CKM biomarker.

心血管-肾代谢(CKM)综合征是肥胖、糖尿病、CKD(慢性肾脏疾病)和心血管疾病之间的关联。GDF-15主要通过GFRAL(胶质细胞系来源的神经营养因子家族受体α样)受体起作用。GDF-15和GDFRAL复合物主要通过RET共受体起作用,通过下游信号进一步激活Ras和磷脂酰肌醇-3激酶(PI3K)/Akt通路。GDF-15通过诱导HIF-α(缺氧诱导因子-1α)减少心功能障碍和肥厚。它通过诱导SMAD 2/3导致分数缩短和心室扩张显著降低。GDF-15可预防高血糖诱导的糖尿病细胞凋亡。GDF-15通过影响调节新陈代谢和食欲的中枢系统导致厌食症。因此,靶向GDF-15可用于治疗由癌症引起的厌食症以及预防由此导致的体重减轻。GDF-15在预测急性肾损伤死亡率方面具有重要作用。它的高水平与eGFR下降有关,在CKD患者中也有预后作用。生长分化因子-15 (Growth differentiation factor-15, GDF-15)是CKM综合征诊断、治疗和预后的重要生物标志物。GDF-15水平升高可作为确定合适二甲双胍剂量的生物标志物。在轻链淀粉样变中,GDF-15水平升高预示着心力衰竭和肾病患者的早期死亡。在体内,使用GDF-15类似物和抗GFRAL抗体影响代谢参数和心室扩张的研究显示了基于GDF-15的治疗干预的潜力。本文旨在研究GDF-15在CKM综合征中的作用,并将其作为CKM的生物标志物。
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引用次数: 0
Successful Use of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in Hypertriglyceridemia-induced Acute Pancreatitis: A Case Report. 蛋白转化酶枯草杆菌素/可欣9型抑制剂在高甘油三酯血症诱导的急性胰腺炎中的成功应用:1例报告
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-03 DOI: 10.2174/011573403X343784241115055037
Rundi Qi, Hailei Liu, Xin Li, Minglong Chen

Background: Managing hypertriglyceridemia-induced acute pancreatitis (HTG-AP) can be challenging, particularly due to the need for rapid triglyceride reduction to below 500mg/dL (5.645mmol/L).

Case report: This is a case describing a 39-year-old female patient who presented to the Emergency Department with acute abdominal pain resulting from severe HTG-AP. However, under conventional therapy with oral lipid-lowering drugs, the triglyceride levels remained uncontrolled. Oral moderate-intensity statins could not only reduce low-density lipoprotein cholesterol (LDLc) by 25%-50%. However, increasing the dose could not further reduce blood lipids while increasing the risk of liver damage. After the administration of proprotein convertase subtilisin/ kexin type 9 inhibitor (PCSK9i), the triglyceride levels were well controlled with no additional side effects, and the symptoms of the patients were completely relieved.

Conclusions: In cases of unsatisfactory lipid control under conventional therapy, PCSK9i may offer a viable option for managing HTG-AP.

背景:管理高甘油三酯血症引起的急性胰腺炎(HTG-AP)可能具有挑战性,特别是由于需要将甘油三酯快速降低到500mg/dL (5.645mmol/L)以下。病例报告:这是一个39岁的女性患者,因严重HTG-AP引起的急性腹痛而就诊于急诊科。然而,在口服降脂药物的常规治疗下,甘油三酯水平仍然不受控制。口服中等强度他汀类药物不仅能降低低密度脂蛋白胆固醇(LDLc) 25%-50%。然而,增加剂量并不能进一步降低血脂,反而会增加肝损伤的风险。给予蛋白转化酶枯草杆菌素/克辛9型抑制剂(PCSK9i)后,甘油三酯水平得到很好的控制,无其他副作用,患者症状完全缓解。结论:在常规治疗下脂质控制不理想的情况下,PCSK9i可能是治疗HTG-AP的可行选择。
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引用次数: 0
The Intersection of Heart Failure and Iron Deficiency Anemia: Diagnostic and Therapeutic Approaches. 心衰和缺铁性贫血的交叉:诊断和治疗方法。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-03 DOI: 10.2174/011573403X331380241111091452
Maleesha Bw Thammitage, Naji Moussa, Ali Rezvani, Damandeep Kaur Dhillon, Miryam Lisseth Obando Gamarra, Kanwaraj Singh, Abdul Hawwa, Alejandra Felix Vincente, Sehajpreet Kaur, Kiranmayee Seshasai Nemalapuri, Devika Poonwassie, Manju Rai

Iron deficiency anemia (IDA) is highly prevalent among individuals with heart failure (HF), impacting 40-70% of patients and serving as a significant prognostic indicator. Linked with oxidative metabolism and myocardial cell damage, IDA exacerbates HF symptoms, including reduced exercise capacity, diminished quality of life, and heightened cardiovascular morbidity. This review explores the diagnosis, treatment, clinical outcomes, prognostic indicators, and forthcoming challenges associated with IDA in HF patients. Crucially, addressing IDA in HF is critical for enhancing prognosis, including clinical outcomes, quality of life, hospitalizations, and survival rates. While oral iron therapy shows efficacy in reducing mortality and hospitalizations, it falls short in improving exercise capacity and quality of life, often deterring patients due to side effects. In contrast, intravenous (IV) iron therapy is highly effective in enhancing hematological parameters, functional capacity, and reducing HF hospitalizations. Optimizing IV iron dosing based on individual patient characteristics is essential for balancing treatment efficacy and adverse effects. Emphasizing individualized approaches, with IV iron emerging as a superior option, underscores the necessity for ongoing research to refine dosing strategies and explore novel therapies. Compliance remains paramount for positive outcomes with IDA treatment, with oral supplementation being cost-effective and easily accessible. However, parenteral supplementation proves beneficial for patients intolerant to oral therapy. Addressing IDA through tailored interventions, including oral or parenteral supplementation, is pivotal in averting complications and improving outcomes in HF patients. This paper consolidates insights into the diagnosis, treatment, impact, pathophysiology, clinical outcomes, research gaps, and future directions concerning IDA in HF patients, drawing on extensive literature to offer a comprehensive understanding of this critical issue.

缺铁性贫血(IDA)在心力衰竭(HF)患者中非常普遍,影响40-70%的患者,并作为一个重要的预后指标。IDA与氧化代谢和心肌细胞损伤相关,可加重心衰症状,包括运动能力下降、生活质量下降和心血管发病率升高。这篇综述探讨了心衰患者IDA的诊断、治疗、临床结果、预后指标和即将面临的挑战。至关重要的是,解决心衰IDA对改善预后至关重要,包括临床结果、生活质量、住院率和生存率。虽然口服铁治疗在降低死亡率和住院率方面显示出疗效,但在提高运动能力和生活质量方面却存在不足,往往因副作用而使患者望而却步。相比之下,静脉(IV)铁治疗在提高血液学参数、功能能力和减少心衰住院率方面非常有效。根据患者个体特征优化IV铁剂量对于平衡治疗效果和不良反应至关重要。强调个体化治疗方法,静脉注射铁作为一种更好的选择,强调了不断研究以完善剂量策略和探索新疗法的必要性。依从性对于IDA治疗的积极结果仍然至关重要,口服补充具有成本效益且易于获得。然而,肠外补充证明对口服治疗不耐受的患者有益。通过量身定制的干预措施(包括口服或肠外补充)来解决IDA问题,对于避免心衰患者的并发症和改善预后至关重要。本文整合了对HF患者IDA的诊断、治疗、影响、病理生理学、临床结果、研究空白和未来方向的见解,并利用大量文献对这一关键问题进行了全面的了解。
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引用次数: 0
Identifying Biomarkers for Atherosclerosis via Gene Expression and Biological Networking. 通过基因表达和生物网络识别动脉粥样硬化的生物标志物。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-03 DOI: 10.2174/011573403X340118241113025519
Sangeeta Chhotaray, Soumya Jal

Background: Atherosclerosis is a chronic disease caused by the accumulation of lipids, inflammatory cells, and fibrous elements in arterial walls, leading to plaque formation and cardiovascular conditions like coronary artery disease, stroke, and peripheral arterial disease. Factors like hyperlipidemia, hypertension, smoking, and diabetes contribute to its development. Diagnosis relies on imaging and biomarkers, while management includes lifestyle modifications, pharmacotherapy, and surgical interventions. Computational biology is transforming biological knowledge into clinical practice by identifying biomarkers that can predict clinical outcomes. This involves omics data, predictive modeling, and data integration. Statistical analysis-based methods are also being developed to develop and integrate methods for screening, diagnosing, and prognosing atherosclerosis.

Methodology: The present work aimed to uncover critical genes and pathways to enhance the understanding of the mechanism of atherosclerosis. GSE23746 was analyzed to find differentially expressed genes (DEGs) using 19 control samples and 76 atherosclerotic samples.

Result: A total of 76 DEGs were identified. Analysed DEGs using Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) to generate enrichment datasets. A Protein- Protein Interaction (PPI) network of DEGs was created utilizing the Search Tool for the Retrieval of Interacting Genes (STRING).

Conclusion: Ten hub genes, namely EGR1, PTGS2, TNF, NFKBIA, CXCL8, TNFAIP3, CCL3, IL1B, PTPRC, and CD83, were found to be significantly linked to atherosclerosis. Furthermore, the metabolic pathway analysis through KEGG and STRING provides potential targets for therapeutic interventions through HUB genes to diagnose the illness at an early stage, which aids in the reduction of cardiovascular risk. From risk factor profiling to the discovery of novel biomarkers, several components such as phospholipids, ANGPTL3, LCAT, and the proteinencoded OCT-1 gene, play a vital role in crucial processes. These compounds are potential therapeutic targets for early diagnosis of atherosclerotic lesions and future novel biomarkers.

背景:动脉粥样硬化是一种慢性疾病,由脂质、炎症细胞和纤维成分在动脉壁的积累引起,导致斑块形成和心血管疾病,如冠状动脉疾病、中风和外周动脉疾病。诸如高脂血症、高血压、吸烟和糖尿病等因素都有助于其发展。诊断依赖于影像和生物标志物,而管理包括生活方式的改变、药物治疗和手术干预。计算生物学通过识别可以预测临床结果的生物标记物,将生物学知识转化为临床实践。这涉及组学数据、预测建模和数据集成。基于统计分析的方法也正在发展,以发展和整合筛查、诊断和预后动脉粥样硬化的方法。方法:本研究旨在揭示动脉粥样硬化的关键基因和途径,以提高对动脉粥样硬化机制的理解。在19个对照样本和76个动脉粥样硬化样本中分析GSE23746以寻找差异表达基因(DEGs)。结果:共鉴定出76个deg。利用基因本体(GO)和京都基因与基因组百科全书(KEGG)对基因进行分析,生成富集数据集。利用相互作用基因检索工具(STRING)建立了一个蛋白质-蛋白质相互作用(PPI)网络。结论:EGR1、PTGS2、TNF、NFKBIA、CXCL8、TNFAIP3、CCL3、IL1B、PTPRC、CD83等10个枢纽基因与动脉粥样硬化有显著相关性。此外,通过KEGG和STRING进行代谢途径分析,为通过HUB基因进行治疗干预提供了潜在靶点,从而在早期诊断疾病,有助于降低心血管风险。从风险因素分析到新生物标志物的发现,磷脂、ANGPTL3、LCAT和蛋白质编码的OCT-1基因等成分在关键过程中起着至关重要的作用。这些化合物是动脉粥样硬化病变早期诊断的潜在治疗靶点和未来的新型生物标志物。
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引用次数: 0
Unlocking the Potential: Phytoestrogens and Cardiovascular Health. 释放潜力:植物雌激素和心血管健康。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-02 DOI: 10.2174/011573403X333952241203050033
Arvind Gulati, Himanshi Banker, Alina Amin Muhammad, Fnu Anamika, Rohit Jain

Phytoestrogens are plant-derived compounds resembling human estrogen and have recently gained attention due to their potential role in improving cardiovascular health. These compounds exert their effects through various mechanisms, including interactions with estrogen receptors, growth factor receptors, inflammatory mediators, thrombogenic reactions, and apoptotic pathways. This results in cardioprotective effects like modulating endothelial function, decreasing vessel tone, reducing inflammation, altering lipid profiles, and influencing arrhythmogenesis. Recent studies indicate the intricate and multidimensional association between phytoestrogens and cardiovascular disease. Despite the overwhelming evidence that phytoestrogen intake lowers the risk of myocardial infarction (MI), prevents atherosclerosis, improves cardiac function, prevents hypertension, and reduces the risk of arrhythmias, there have been studies that show contradictory outcomes. For this reason, the therapeutic use of phytoestrogens for the treatment of cardiovascular diseases, which appears to be extremely promising, should be handled cautiously, considering the individual variances, dosage, and the specific components of phytoestrogens. This review consolidates findings on the effects of phytoestrogens on the heart and blood vessels, explores the mechanisms behind these interactions, and seeks to determine the best methods for using phytoestrogens as a supplement in managing and preventing cardiovascular disease. By understanding these aspects, we can better evaluate the potential of phytoestrogens in cardiovascular health and develop guidelines for their safe and effective use.

植物雌激素是一种类似于人类雌激素的植物源化合物,最近因其在改善心血管健康方面的潜在作用而受到关注。这些化合物通过多种机制发挥作用,包括与雌激素受体、生长因子受体、炎症介质、血栓形成反应和凋亡途径的相互作用。这导致心脏保护作用,如调节内皮功能,降低血管张力,减少炎症,改变脂质谱,并影响心律失常。最近的研究表明,植物雌激素与心血管疾病之间存在复杂而多维的关联。尽管有大量证据表明植物雌激素摄入可以降低心肌梗死(MI)的风险,预防动脉粥样硬化,改善心功能,预防高血压,降低心律失常的风险,但也有研究显示出相互矛盾的结果。因此,植物雌激素用于治疗心血管疾病的治疗性使用似乎非常有希望,但应谨慎处理,考虑到个体差异、剂量和植物雌激素的特定成分。这篇综述整合了植物雌激素对心脏和血管的影响的研究结果,探讨了这些相互作用背后的机制,并试图确定使用植物雌激素作为管理和预防心血管疾病的补充剂的最佳方法。通过了解这些方面,我们可以更好地评估植物雌激素在心血管健康中的潜力,并制定其安全有效使用的指南。
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引用次数: 0
Serum Cortisol and Cardiovascular Disease Risk-A Potential Biomarker. 血清皮质醇与心血管疾病风险-一个潜在的生物标志物。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.2174/011573403X328499241106064553
Wei Jet Oo, Chooi Ling Lim, Mun Hon Goh, Rhun Yian Koh

Cardiovascular Disease [CVD], the leading cause of death globally, poses a significant burden on the healthcare sector. Its association with stress and Cushing's Syndrome has driven cortisol, the 'stress hormone,' to be a potential candidate in determining CVD risk. Cortisol synthesis and release through the hypothalamic-pituitary-adrenal [HPA] axis are regulated by several hormones and receptors involved in the pathological cascade towards CVD. Evidence suggests that metabolic syndrome plays a major role in cortisol-mediated CVD risk. On the other hand, non-metabolic features are also implicated when the association between cortisol and CVD risk remains significant upon normalisation of metabolic parameters. Correspondingly, the treatment for hypercortisolism is often found effective in lowering CVD risk. Despite available evidence, several factors continue to hinder the clinical use of cortisol as a risk biomarker for CVD. This review provides an insight into the role of serum cortisol in CVD progression and risk, with emphasis on the mechanistic features and parameters.

心血管疾病[CVD]是全球死亡的主要原因,对医疗保健部门造成了重大负担。它与压力和库欣综合征(Cushing's Syndrome)之间的关联,促使“压力激素”皮质醇成为决定心血管疾病风险的潜在候选因素。通过下丘脑-垂体-肾上腺[HPA]轴的皮质醇合成和释放受几种激素和受体的调节,这些激素和受体参与了CVD的病理级联。有证据表明,代谢综合征在皮质醇介导的心血管疾病风险中起主要作用。另一方面,当代谢参数正常化后,皮质醇与心血管疾病风险之间的关联仍然显著时,非代谢特征也被牵连。相应地,高皮质醇血症的治疗经常被发现能有效降低心血管疾病的风险。尽管已有证据,但仍有几个因素阻碍了皮质醇作为心血管疾病风险生物标志物的临床应用。这篇综述提供了血清皮质醇在CVD进展和风险中的作用,重点是机制特征和参数。
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引用次数: 0
Disparities in Peripheral Artery Disease-related Mortality in Chronic Inflammatory Disease in the United States from 1999 to 2020. 1999年至2020年美国慢性炎症性疾病中外周动脉疾病相关死亡率的差异
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-10 DOI: 10.2174/011573403X353038241125050631
April Olson, Hoang Nhat Pham, Ramzi Ibrahim, Mohammed Salih, Amitoj Singh, Mamas A Mamas

Introduction: Peripheral arterial disease (PAD) is a marker of significant atherosclerotic cardiovascular disease and is associated with greater healthcare burden and worse prognosis in individuals with chronic inflammatory disease (CID). We aimed to investigate temporal trends and disparities of PAD-related mortality in populations with CID from 1999-2020 across six common CIDs (i.e., chronic viral hepatitis, human immunodeficiency virus, inflammatory bowel disease, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus).

Methods: United States (US) PAD and CID-related mortality and demographic data from 1999- 2020 were extracted from the CDC database through the multiple-cause-of-death files. Ageadjusted mortality rates (AAMR) per 1,000,000 and 95% confidence intervals were standardized to the 2000 US population. The mortality trends were analyzed using Joinpoint Regression.

Results: A total of 22,175 PAD-related deaths were recorded in the population with CID between 1999 and 2020. Mortality remained stable during the 22-year period (AAPC -0.04%, p=0.95) with a cumulative AAMR of 4.64. Mortality was highest in rural counties (AAMR 5.27), and among non-Hispanic Black populations (AAMR 7.06). Among the CID subtypes, PAD mortality was highest in populations with RA (AAMR 2.48) and lowest in populations with psoriasis (AAMR 0.11).

Conclusion: Our findings highlight the disparities of PAD mortality in patients with CID, with the Black population and rural communities disproportionately affected. Further investigation with individual- level data is warranted to identify the contributing factors for the observed disparities.

外周动脉疾病(PAD)是严重动脉粥样硬化性心血管疾病的标志,与慢性炎症性疾病(CID)患者更大的医疗负担和更差的预后相关。我们的目的是调查1999-2020年间6种常见CID(即慢性病毒性肝炎、人类免疫缺陷病毒、炎症性肠病、牛皮癣、类风湿性关节炎和系统性红斑狼疮)CID人群中pad相关死亡率的时间趋势和差异。方法:通过多死因文件从CDC数据库中提取1999- 2020年美国PAD和cid相关死亡率和人口统计数据。每100万人的年龄调整死亡率(AAMR)和95%置信区间标准化到2000年美国人口。采用关节点回归分析死亡率趋势。结果:1999年至2020年期间,CID人群中共记录了22175例pad相关死亡。22年期间死亡率保持稳定(AAPC -0.04%, p=0.95),累积AAMR为4.64。死亡率最高的是农村县(AAMR 5.27)和非西班牙裔黑人(AAMR 7.06)。在CID亚型中,RA患者的PAD死亡率最高(AAMR为2.48),牛皮癣患者的PAD死亡率最低(AAMR为0.11)。结论:我们的研究结果强调了CID患者中PAD死亡率的差异,黑人和农村社区受到的影响不成比例。有必要对个人水平的数据进行进一步调查,以确定观察到的差异的影响因素。
{"title":"Disparities in Peripheral Artery Disease-related Mortality in Chronic Inflammatory Disease in the United States from 1999 to 2020.","authors":"April Olson, Hoang Nhat Pham, Ramzi Ibrahim, Mohammed Salih, Amitoj Singh, Mamas A Mamas","doi":"10.2174/011573403X353038241125050631","DOIUrl":"https://doi.org/10.2174/011573403X353038241125050631","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral arterial disease (PAD) is a marker of significant atherosclerotic cardiovascular disease and is associated with greater healthcare burden and worse prognosis in individuals with chronic inflammatory disease (CID). We aimed to investigate temporal trends and disparities of PAD-related mortality in populations with CID from 1999-2020 across six common CIDs (i.e., chronic viral hepatitis, human immunodeficiency virus, inflammatory bowel disease, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus).</p><p><strong>Methods: </strong>United States (US) PAD and CID-related mortality and demographic data from 1999- 2020 were extracted from the CDC database through the multiple-cause-of-death files. Ageadjusted mortality rates (AAMR) per 1,000,000 and 95% confidence intervals were standardized to the 2000 US population. The mortality trends were analyzed using Joinpoint Regression.</p><p><strong>Results: </strong>A total of 22,175 PAD-related deaths were recorded in the population with CID between 1999 and 2020. Mortality remained stable during the 22-year period (AAPC -0.04%, p=0.95) with a cumulative AAMR of 4.64. Mortality was highest in rural counties (AAMR 5.27), and among non-Hispanic Black populations (AAMR 7.06). Among the CID subtypes, PAD mortality was highest in populations with RA (AAMR 2.48) and lowest in populations with psoriasis (AAMR 0.11).</p><p><strong>Conclusion: </strong>Our findings highlight the disparities of PAD mortality in patients with CID, with the Black population and rural communities disproportionately affected. Further investigation with individual- level data is warranted to identify the contributing factors for the observed disparities.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atrial Fibrillation Ablation in Heart Failure and Preserved Ejection Fraction: An Observational Study of Risk Factors for Heart Failure Hospitalization. 房颤消融治疗心力衰竭和保留射血分数:心力衰竭住院危险因素的观察性研究
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-09 DOI: 10.2174/011573403X348844241129111639
Rundi Qi, Hailei Liu, Yue Zhu, Nan Wu, Kexin Wang, Xiangwei Ding, Zhoushan Gu, Mingfang Li, Hongwu Chen, Weizhu Ju, Xin Li, Minglong Chen

Introduction: Long-term heart failure hospitalization (HFH) after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients with heart failure and preserved ejection fraction (HFpEF) and its risk factors remain to be investigated.

Methods: AF patients with HFpEF who underwent RFCA from January, 2014 to December, 2018 from three centers were retrospectively included. Patients were assigned to the training and testing cohorts, respectively. In the training cohort, logistic regression analyses were performed to discriminate those with and without HFH. A scoring system was developed accordingly and validated.

Results: A total of 417 AF patients with HFpEF receiving RFCA were enrolled. About 35 patients (8.4%) had HFH for 6 years. In the training cohort, the use of diuretics, atrial tachycardia (AT)/AF recurrence, prior HFH, and female sex were independent predictors of HFH in the multivariable analysis. A DAPF score (ranging from 0 to 9.0) was developed. The area under the receiver operating characteristic curve (AUC) of the DAPF score was 0.880 (95% CI, 0.830- 0.929). A DAPF score ≥3.5 could predict HFH with a sensitivity of 81.8% and a specificity of 74.6%. The performance in the testing cohort remained robust (AUC, 0.858; 95% CI, 0.749- 0.967).

Conclusion: HFH in patients with AF and HFpEF after RFCA is not rare. The DAPF score could predict the risk of HFH in AF patients with HFpEF after RFCA and guide our treatment strategy.

导读:心房颤动(AF)合并心力衰竭和保留射血分数(HFpEF)患者射频导管消融(RFCA)后长期心力衰竭住院(HFH)及其危险因素仍有待研究。方法:回顾性分析2014年1月至2018年12月来自三个中心的房颤合并HFpEF患者行RFCA的病例。患者分别被分配到训练组和测试组。在培训队列中,进行逻辑回归分析以区分患有和不患有HFH的人。据此开发并验证了评分系统。结果:共纳入417例接受RFCA治疗的HFpEF AF患者。约35例(8.4%)患者患有6年HFH。在训练队列中,在多变量分析中,利尿剂的使用、心房心动过速(AT)/房颤复发、既往HFH和女性性别是HFH的独立预测因素。制定DAPF评分(0 ~ 9.0)。DAPF评分的受试者工作特征曲线下面积(AUC)为0.880 (95% CI, 0.830 ~ 0.929)。DAPF评分≥3.5可预测HFH,敏感性为81.8%,特异性为74.6%。在测试队列中的表现仍然稳健(AUC, 0.858;95% ci, 0.749- 0.967)。结论:房颤合并HFpEF术后并发HFH并不少见。DAPF评分可以预测AF合并HFpEF患者RFCA后HFH的发生风险,指导我们的治疗策略。
{"title":"Atrial Fibrillation Ablation in Heart Failure and Preserved Ejection Fraction: An Observational Study of Risk Factors for Heart Failure Hospitalization.","authors":"Rundi Qi, Hailei Liu, Yue Zhu, Nan Wu, Kexin Wang, Xiangwei Ding, Zhoushan Gu, Mingfang Li, Hongwu Chen, Weizhu Ju, Xin Li, Minglong Chen","doi":"10.2174/011573403X348844241129111639","DOIUrl":"https://doi.org/10.2174/011573403X348844241129111639","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term heart failure hospitalization (HFH) after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients with heart failure and preserved ejection fraction (HFpEF) and its risk factors remain to be investigated.</p><p><strong>Methods: </strong>AF patients with HFpEF who underwent RFCA from January, 2014 to December, 2018 from three centers were retrospectively included. Patients were assigned to the training and testing cohorts, respectively. In the training cohort, logistic regression analyses were performed to discriminate those with and without HFH. A scoring system was developed accordingly and validated.</p><p><strong>Results: </strong>A total of 417 AF patients with HFpEF receiving RFCA were enrolled. About 35 patients (8.4%) had HFH for 6 years. In the training cohort, the use of diuretics, atrial tachycardia (AT)/AF recurrence, prior HFH, and female sex were independent predictors of HFH in the multivariable analysis. A DAPF score (ranging from 0 to 9.0) was developed. The area under the receiver operating characteristic curve (AUC) of the DAPF score was 0.880 (95% CI, 0.830- 0.929). A DAPF score ≥3.5 could predict HFH with a sensitivity of 81.8% and a specificity of 74.6%. The performance in the testing cohort remained robust (AUC, 0.858; 95% CI, 0.749- 0.967).</p><p><strong>Conclusion: </strong>HFH in patients with AF and HFpEF after RFCA is not rare. The DAPF score could predict the risk of HFH in AF patients with HFpEF after RFCA and guide our treatment strategy.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Current Cardiology Reviews
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