Frontiers in Cardiovascular Medicine最新文献

Background: Cardiovascular biomarkers are crucial for monitoring cancer therapy-related cardiac toxicity, but the effects on early stage are still inadequate. To screen biomarkers in patients with breast cancer who receive anthracycline-containing chemotherapy, we studied the behavior of six biomarkers during chemotherapy and their association with chemotherapy-related cardiac toxicity.

Methods: In a prospective cohort of 73 patients treated with anthracycline-containing chemotherapy, soluble suppression of tumorigenicity 2 (sST2), high-sensitivity cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), myoglobin, creatine kinase isoenzyme MB, and heart-fatty acid binding protein were measured at baseline, during chemotherapy cycle (C1-C6). According to whether arrhythmia occurred, patients were divided into two groups (healthy group or arrhythmias group), and basic clinical characteristics were collected and compared. Logistic regression analyses and receiver operating characteristic (ROC) curves were conducted to investigate the association between the changes in biomarkers and arrhythmia.

Results: sST2 levels increased significantly from baseline to C1 (P < 0.01). NT-proBNP levels decreased from baseline to C1 and C5 (P < 0.01). The logistic regression analysis showed a greater risk of arrhythmia was associated with interval changes in sST2 [odds ratio (OR): 1.27; 95% CI: 1.03-1.56; P = 0.024] and NT-proBNP (OR: 0.83; 95% CI: 0.70-0.98; P = 0.029). The ROC curves showed that ΔsST2, ΔNT-proBNP, and ΔsST2 + ΔNT-proBNP had good predictive value for arrhythmia (areas under the curves were 0.631, 0.633, and 0.735, respectively, P < 0.05).

Conclusions: Early changes in sST2 and NT-proBNP levels offer additive information for early arrhythmia prediction in breast cancer patients who receive anthracycline-containing chemotherapy.

Objective: To analyze the risk factors for coronary heart disease (CHD) in patients hospitalized in general hospitals in the Tacheng Prefecture, Xinjiang, and to construct and verify the nomogram prediction model for the risk of CHD.

Methods: From June 2022 to June 2023, 489 CHD patients (CHD group) and 520 non-CHD individuals (control group) in Tacheng, Xinjiang, were retrospectively selected. Using a 7:3 ratio, patients were divided into a training group (706 cases) and a validation group (303 cases). General clinical data were compared, and key variables were screened using logistic regression (AIC). A CHD risk nomogram for Tacheng was constructed. Model performance was assessed using ROC AUC, calibration curves, and DCA.

Results: In the training group, non-Han Chinese (OR = 2.93, 95% CI: 2.0-4.3), male (OR = 1.65, 95% CI: 1.0-2.7), alcohol consumption (OR = 1.82, 95% CI: 1.2-2.9), hyperlipidemia (OR = 2.41, 95% CI: 1.7-3.5), smoking (OR = 1.61, 95% CI: 1.0-2.6), diabetes mellitus (OR = 1.62, 95% CI: 1.1-2.4), stroke (OR = 2.39, 95% CI: 1.6-3.7), older age (OR = 1.08, 95% CI: 1.1-1.2), and larger waist circumference (OR = 1.04, 95% CI: 1.0-1.1) were the risk factors for coronary heart disease (all P < 0.05). The area under the curve (AUC) of the work characteristics of the subjects in the training group and the validation group were 0.80 (95% CI: 0.8-0.8) and 0.82 (95% CI: 0.8-0.9), respectively. The Hosmer-Lemeshow test indicated P = 0.325 for the training group and P = 0.130 for the validation group, with calibration curves closely fitting the ideal curve. The predicted values aligned well with actual values, and decision curve analysis results suggest that the model offers a net clinical benefit.

Conclusion: The CHD risk prediction model developed in this study for general hospitals in Tacheng Prefecture, Xinjiang, demonstrates strong predictive performance and serves as a simple, user-friendly, cost-effective tool for medical personnel to identify high-risk groups for CHD.

Introduction: Patients with acute myocardial infarction (AMI) are at high risk of progressing to heart failure (HF). Recent research has shown that lipid droplet-related genes (LDRGs) play a crucial role in myocardial metabolism following MI, thereby influencing the progression to HF.

Methods: Weighted gene co-expression network analysis (WGCNA) and differential expression gene analysis were used to screen a transcriptome dataset of whole blood cells from AMI patients with (AMI HF, n = 16) and without progression (AMI no-HF, n = 16). Functional enrichment analysis were performed to observe the involved function. Machine learning methods were used to screen the genes related to prognosis. Transcriptional factors (TF) were predicted by using relevant databases. ROC curves were drawn to evaluate the TF-LDRG pair in predicting HF in the validation dataset (n = 16) and the clinical trial (n = 13).

Results: The 235 identified genes were primarily involved in pathways related to fatty acid and energy metabolism. 22 genes were screened out that they were strongly associated with prognosis. 35 corresponding transcription factors were predicted. The TF-LDRG pair, ABHD5-ARID3a, was demonstrated good predictive accuracy.

Discussion: Our findings suggest that ABHD5-ARID3a have significant potential as predictive biomarkers for heart failure post-AMI which also provides a foundation for further exploration into the molecular mechanisms underlying the progression from AMI to HF.

Background: Hypertension can damage multiple target organs. The younger the age of onset of hypertension is, the greater the risk of cardiovascular disease (CVD) and cardiovascular death. Chronic kidney disease (CKD) is a complication of hypertension, but few studies have investigated the relationship between the age of onset of hypertension and CKD.

Objective: We investigated the relationship between the age of onset of hypertension and CKD.

Method: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. A total of 30,613 participants were assigned to one of four groups. Group 1, no hypertension (n = 19,516); Group 2, age of onset <35 years (n = 2,180); Group 3, 35≤ age of onset <45 years (n = 2,128); and Group 4, age of onset ≥45 years (n = 6,789). Logistic regression analysis was used to evaluate the relationship between the age of onset of hypertension and CKD.

Results: After adjusting for potential confounders, a younger age at onset of hypertension was associated with a greater risk of developing CKD compared with the absence of hypertension (Group 2 OR: 2.52, 95% CI: 1.53-4.14, P < 0.001; Group 3 OR: 1.59, 95% CI: 1.01-2.51, P = 0.048; Group 4 OR: 1.54, 95% CI: 1.00-2.38, P = 0.050).

Conclusions: There was a strong association between the age of onset of hypertension and CKD. The younger the age of onset of hypertension is, the greater the risk of CKD.

Objective: This study compared the value of different systemic immune-inflammatory markers for evaluating coronary collateralization (CC) in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO).

Methods: Systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune-inflammation value (PIV) were calculated at admission in 1409 T2DM patients with CTO. The degree of coronary collaterals was estimated using the Rentrop scoring system and categorized into poor (Rentrop score 0 or 1) or good (Rentrop score 2 or 3) CC. The predictors of poor CC were determined by multivariate regression analysis, and the diagnostic potential of these indexes was analyzed by Receiver Operating Characteristic (ROC) curves.

Results: SII, SIRI and PIV levels increased stepwise across Rentrop score 0-3, with significantly higher levels in patients with poor CC than in those with good CC (P < 0.001). After adjusting for confounders, SII, SIRI and PIV (per tertile) remained independent factors for poor CC. SII predicted poor CC better than SIRI and PIV (AUC: 0.758 vs. 0.680 and 0.698, all P < 0.001). There existed an interaction between blood concentration of HbA1c and SII (P < 0.001), with high SII levels being associated with a greater risk (OR: 5.058 vs. 2.444) and providing a better predictive ability for poor CC (AUC: 0.817 vs. 0.731) in patients with HbA1c < 6.5% compared to those with HbA1c ≥ 6.5%.

Conclusion: Our study shows that elevated SII provides a better prediction for poor CC in T2DM patients with CTO especially at good glycemic control.

[This corrects the article DOI: 10.3389/fcvm.2024.1428457.].

Introduction: The use of cardiopulmonary bypass (CPB) can induce sterile systemic inflammation that contributes to morbidity and mortality, especially in children. Patients have been found to have increased expression of cytokines and transmigration of leukocytes during and after CPB. Previous work has demonstrated that the supraphysiologic shear stresses existing during CPB are sufficient to induce proinflammatory behavior in non-adherent monocytes. The interactions between shear stimulated monocytes and vascular endothelial cells have not been well studied and have important translational implications. With these studies, we tested the hypothesis that non-physiological shear stress experienced by monocytes during CPB affects the integrity and function of the endothelial monolayer.

Methods: We have used an in vitro CPB model to study the interaction between THP-1 monocyte-like cells and human neonatal dermal microvascular endothelial cells (HNDMVECs). THP-1 cells were sheared in polyvinyl chloride (PVC) tubing at 2.1 Pa, twice of the physiological shear stress, for 2 h. ELISA, adhesion and transmigration assays, qPCR, and RNA silencing were used to assess the interactions between THP-1 cells and HNDMVECs were characterized after co-culture.

Results: We found that sheared THP-1 cells adhered to and transmigrated through the HNDMVEC monolayer more readily than static THP-1 controls. Sheared THP-1 cells disrupted the VE-cadherin and led to the reorganization of cytoskeletal F-actin of HNDMVECs. A higher level of IL-8 was detected in the sheared THP-1 and HNDMVEC co-culture medium compared to the static THP-1 and HNDMVEC medium. Further, treating HNDMVECs with IL-8 resulted in increased adherence of non-sheared THP-1 cells, and upregulation in HNDMVECs of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1). Finally, inhibition of HNDMVECs CXCR2/IL-8 receptor with Reparixin and of IL-8 expression with siRNA blocked sheared THP-1 cell adhesion to the endothelial monolayer.

Conclusions: These results suggest that CPB-like sheared monocytes promote IL-8 production followed by increased endothelium permeability, and monocyte adhesion and transmigration. This study revealed a novel mechanism of post-CPB inflammation and will contribute to the development of targeted therapeutics to prevent and repair the damage to neonatal patients.

Objective: To investigate the long-term impact of cardiac surgery on the quality of life in adults with congenital heart disease (ACHDs).

Methods: Patients who had undergone cardiac surgery for congenital heart disease (CHD) at the age of 18 years or more were recruited in a single-center, cross-sectional study. The enrolled subjects completed online questionnaires to assess patient-reported outcomes: perceived health status and life satisfaction, psychological functioning, health behaviors, and illness perception. Clinical variables were correlated to the score results, and results were compared to representative samples from international and German national surveys of healthy subjects and ACHDs.

Results: We enrolled 196 ACHDs (54% women), including 55% with more than one cardiac surgery during their lifetime. The median age at the survey was 43 years, with a median of 13 years since their last cardiac surgery. The majority of patients reported improved subjective wellbeing after cardiac operation and were in functional New York Heart Association class I or II. The severity of underlying CHD, number of previous cardiac operations, and beta-blocker medication had the most substantial negative effects on illness perception. Measured quality of life and health risk behaviors were within the range of values internationally reported for healthy and CHD subjects, respectively.

Conclusions: ACHD, several years after cardiac surgery, reported a subjective improvement in their wellbeing, a life satisfaction comparable to that of healthy individuals, and low health risk behaviors. Illness perception is strongly correlated with the severity of the underlying CHD.

Bicuspid aortic valve (BAV), the most common congenital cardiac anomaly, predisposes individuals to aortic stenosis and regurgitation due to valve degeneration. Abnormal hemodynamics, arterial wall characteristics, and genetic factors contribute to ascending aorta dilatation, potentially leading to severe complications like aortic dissection. Presently, the most recent guidelines propose that individuals with BAV requiring valve replacement due to valve dysfunction should undergo simultaneous replacement of the ascending aorta when the diameter of aortic dilatation exceeds 4.5 cm. A 60-year-old female patient previously underwent mechanical aortic valve replacement and ascending aortoplasty at our center due to aortic stenosis and a 4.3 cm diameter ascending aorta. In the sixth postoperative year, she was readmitted due to ascending aorta rupture, resulting in blood entering the right atrium and causing acute right heart failure. We performed repair of the rupture and concomitant ascending aorta replacement to prevent further exacerbation of the patient's condition.

[This corrects the article DOI: 10.3389/fcvm.2023.1181285.].