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A case report of Cogan's syndrome with recurrent coronary stenosis 科根综合征合并复发性冠状动脉狭窄的病例报告
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-12 DOI: 10.3389/fcvm.2024.1451113
Gao Na, Zhang Nan, Meng Jingjing, Pan Lili
Cogan's syndrome (CS) is recognized as a form of variable vasculitis. This report presents the case of a middle-aged woman experiencing recurrent coronary artery stenosis, accompanied by a history of non-syphilis keratitis, vestibular auditory symptoms, and venous thrombosis. Positron emission tomography/computed tomography revealed an elevated uptake of (18)F-fluorodeoxyglucose in the subclavian artery, common carotid artery, aortic arch, and thoracic aorta. A diagnosis of Cogan's syndrome was made. The aim of this study was to increase clinicians’ awareness of the vascular manifestations in CS and to emphasize the importance of thorough history taking. CS should be included in the differential diagnosis when patients present with recurrent coronary artery stenosis.
科根综合征(Cogan's Syndrome,CS)被认为是一种可变性血管炎。本报告介绍了一名中年女性的病例,她反复出现冠状动脉狭窄,并伴有非梅毒性角膜炎病史、前庭听觉症状和静脉血栓形成。正电子发射断层扫描/计算机断层扫描显示,锁骨下动脉、颈总动脉、主动脉弓和胸主动脉的(18)F-氟脱氧葡萄糖摄取量升高。诊断结果为科根综合征。本研究旨在提高临床医生对 CS 血管表现的认识,并强调全面采集病史的重要性。当患者出现反复冠状动脉狭窄时,应将 CS 列入鉴别诊断。
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引用次数: 0
Exploring the effect of lifestyle behaviors and socioeconomic status on atrial fibrillation: the mediating role of 91 inflammatory cytokines 探讨生活方式行为和社会经济地位对心房颤动的影响:91 种炎症细胞因子的中介作用
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-12 DOI: 10.3389/fcvm.2024.1401384
Yiheng Liu, Mingsheng Huang, Yue Sun, Weiran Dai
BackgroundAtrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias and has a significant economic and social burden. Whether it is associated with lifestyle behaviors and socioeconomic status is currently poorly understood. This study aimed to explore the relationship among these factors and determine the role of inflammatory cytokines.MethodWe investigated the causal effects of lifestyle behaviors and socioeconomic status on AF using bidirectional two-sample Mendelian randomization (MR). Instrumental variables were obtained from a publicly available genome-wide association study. A two-step MR was conducted to determine the mediating role of 91 inflammatory cytokines. Inverse variance weighted was used as the main method with four supplementary MR methods. To obtain more robust results, several sensitivity analyses were conducted.ResultThe results indicated that seven of the lifestyle behaviors [smoking initiation, vegetable intake, coffee consumption (cups/day), dozing, lifetime smoking index, napping, and alcohol abuse] were potential risk factors for AF. One socioeconomic status, education attainment (years of education), was causally associated with a decreased risk of AF. Moreover, we found that thymic stromal lymphopoietin, CD40l receptor, C-X-C motif chemokine 6, and C-X-C motif chemokine 11 levels mediated the causal effect, at proportions of 13.6%, 4.1%, 4.3%, and 6.9%, respectively.ConclusionOur findings provide insight into the relationship between lifestyle behaviors, socioeconomic status, and AF. Inflammatory cytokines are potential mediators of this relationship.
背景心房颤动(房颤)是最常见的心律失常之一,对经济和社会造成了重大负担。目前,人们对心房颤动是否与生活方式和社会经济状况有关还知之甚少。本研究旨在探讨这些因素之间的关系,并确定炎性细胞因子的作用。方法我们采用双向双样本孟德尔随机化(MR)方法研究了生活方式行为和社会经济地位对房颤的因果效应。工具变量来自一项公开的全基因组关联研究。为确定 91 种炎症细胞因子的中介作用,进行了两步 MR。反方差加权法作为主要方法,并辅以四种 MR 方法。结果表明,7种生活方式行为(开始吸烟、蔬菜摄入量、咖啡饮用量(杯/天)、打瞌睡、终生吸烟指数、午睡和酗酒)是房颤的潜在风险因素。教育程度(受教育年限)这一社会经济地位与房颤风险的降低存在因果关系。此外,我们发现胸腺基质淋巴细胞生成素、CD40l 受体、C-X-C 矩阵趋化因子 6 和 C-X-C 矩阵趋化因子 11 水平介导了因果效应,比例分别为 13.6%、4.1%、4.3% 和 6.9%。炎性细胞因子是这一关系的潜在介导因素。
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引用次数: 0
Racial disparities in TAVR outcomes in patients with cancer 癌症患者 TAVR 结果的种族差异
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1416092
Ethan D. Kotloff, Yash Desai, Rohan Desai, Christopher Messner, Sergey Gnilopyat, Mark Sonbol, Abdullah Aljudaibi, Ai Tarui, Juwan Ives, Nisarg Shah, Ishan Vaish, Diljon Chahal, Brian Barr, Manu Mysore
BackgroundAdvances in cancer therapies and improvement in survival of cancer patients have led to a growing number of patients with both cancer and severe aortic stenosis (AS). Transcatheter aortic valve replacement (TAVR) has been shown to be a safe and effective treatment option for this patient population. There are established racial disparities in utilization and outcomes of both cancer treatments and TAVR. However, the effect of race on TAVR outcomes in cancer patients has not been studied.ObjectivesThe purpose of this study was to investigate racial disparities in outcomes of TAVR in cancer patients.Methods343 patients with cancer who underwent TAVR at a single center over a 6-year period were included in the study. The primary endpoint was a composite of 1-year mortality, stroke, and bleeding. Secondary outcomes included individual components of the primary endpoint as well as 30-day mortality, structural complications, vascular access complications, and conduction system complications. Outcomes were compared between black and white patients by comparing incidence rates.ResultsBaseline characteristics including age, sex, BMI, medical comorbidities, STS score, and echocardiographic parameters were similar between races, aside from significantly higher rates of CKD (50.0% vs. 26.6%, p = 0.005) and ESRD (18.4% vs. 4.9%, p = 0.005) in black compared to white cancer patients. There was a trend toward worse outcomes in black cancer patients with regard to a composite endpoint of 1-year mortality, stroke, and major bleeding (35.7% vs. 22.6%, p = 0.095), primarily driven by higher 1-year mortality (31.0% vs. 17.6%, p = 0.065). 30-day mortality was twice as high in black cancer patients than in white cancer patients (4.8% vs. 2.3%, p = 0.018).ConclusionsThere is a trend toward worse TAVR outcomes in black cancer patients, with higher periprocedural complication rates and mortality, compared to white cancer patients. Further studies are needed to elucidate the structural, socioeconomic, and biological factors that contribute to racial differences in outcomes.
背景癌症疗法的进步和癌症患者生存率的提高导致越来越多的患者同时患有癌症和严重的主动脉瓣狭窄(AS)。经导管主动脉瓣置换术(TAVR)已被证明是此类患者的一种安全有效的治疗选择。在癌症治疗和经导管主动脉瓣置换术的使用和疗效方面,种族差异已得到证实。本研究的目的是调查癌症患者 TAVR 治疗结果的种族差异。方法:研究纳入了 343 名癌症患者,他们在一个中心接受了为期 6 年的 TAVR 治疗。主要终点是 1 年死亡率、中风和出血的综合结果。次要结果包括主要终点的各个组成部分以及30天死亡率、结构并发症、血管通路并发症和传导系统并发症。结果不同种族的基线特征(包括年龄、性别、体重指数、内科合并症、STS 评分和超声心动图参数)相似,但黑人癌症患者的 CKD(50.0% 对 26.6%,P = 0.005)和 ESRD(18.4% 对 4.9%,P = 0.005)发病率明显高于白人。在1年死亡率、中风和大出血的复合终点方面,黑人癌症患者的预后呈恶化趋势(35.7% vs. 22.6%,p = 0.095),主要原因是1年死亡率较高(31.0% vs. 17.6%,p = 0.065)。黑人癌症患者的30天死亡率是白人癌症患者的两倍(4.8% vs. 2.3%,p = 0.018)。结论与白人癌症患者相比,黑人癌症患者的TAVR结果有恶化趋势,围手术期并发症发生率和死亡率更高。还需要进一步研究,以阐明导致结果种族差异的结构、社会经济和生物学因素。
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引用次数: 0
Efficacy and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with acute heart failure: a systematic review and meta-analysis 钠-葡萄糖共转运体 2 (SGLT2) 抑制剂对急性心力衰竭患者的疗效和安全性:系统综述和荟萃分析
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1388337
Jingjin Hou, Li Ren, Qingbin Hou, Xiaodong Jia, Zhu Mei, Jiaxin Xu, Zheming Yang, Yiming Li, Chenghui Yan
BackgroundThe effectiveness and safety of a novel class of hypoglycemic medications known as sodium-glucose cotransporter 2 (SGLT2) inhibitors have not been completely established in relation to acute heart failure (AHF). Consequently, we sought to compare the prognostic and safety outcomes of patients administered SGLT2 inhibitors for the treatment of AHF.MethodsAn extensive search of the Web of Science, PubMed, and EMBASE was conducted for randomized controlled trials and observational studies that have evaluated the use of SGLT2 inhibitors in AHF from the inception of these drugs to the present. We compiled data related to cardiovascular safety and prognosis. Aggregated risk ratios (RR), mean differences (MD), or standardized mean differences (SMD) were generated for all outcomes, with 95% confidence intervals (CIs), to evaluate the predictive significance of SGLT2 inhibitors in patients with AHF.ResultsWe identified 4,053 patients from 13 studies. Patients experienced a substantial reduction in all-cause mortality (RR = 0.82, 95% CI: 0.70–0.96, P = 0.01), readmission rates (RR = 0.85, 95% CI: 0.74–0.98, P = 0.02), the number of heart failure exacerbation events (RR = 0.69, 95% CI: 0.50–0.95, P = 0.02), and the number of rehospitalization events due to heart failure (RR = 0.71, 95% CI: 0.58–0.86, P &lt; 0.05) in the SGLT2 inhibitors-treatment group compared to a placebo or standard care (control group). SGLT2 inhibitors improved patient quality of life (SMD = −0.24, 95% CI: −0.40 to −0.09, P = 0.002). SGLT2 inhibitors were associated with enhanced diuresis in patients with AHF (MD = 2.83, 95% CI: 1.36–4.29, P &lt; 0.05). Overall, treatment with SGLT2 inhibitors significantly reduced the level of serum NT-proBNP (MD = −497.62, 95% CI: −762.02 to −233.21, P &lt; 0.05) and did not increase the incidence of adverse events (RR = 0.91, 95% CI: 0.82–1.01, P = 0.06).ConclusionsThis meta-analysis suggests that treatment with SGLT2 inhibitors is associated with a better prognosis in patients with AHF than in patients not treated with SGLT2 inhibitors. It is safe and effective to initiate SGLT2 inhibitors in patients with AHF.Systematic Review Registrationhttps://www.doi.org/10.37766/inplasy2024.9.0015, identifier (INPLASY202490015).
背景一类名为钠-葡萄糖共转运体 2(SGLT2)抑制剂的新型降糖药物对急性心力衰竭(AHF)的有效性和安全性尚未完全确定。因此,我们试图对使用 SGLT2 抑制剂治疗 AHF 的患者的预后和安全性结果进行比较。我们在 Web of Science、PubMed 和 EMBASE 中进行了广泛搜索,以查找从 SGLT2 抑制剂问世至今评估其在 AHF 中使用情况的随机对照试验和观察性研究。我们汇编了与心血管安全性和预后相关的数据。我们为所有结果生成了综合风险比 (RR)、平均差 (MD) 或标准化平均差 (SMD) 以及 95% 置信区间 (CI),以评估 SGLT2 抑制剂对 AHF 患者的预测意义。患者的全因死亡率(RR = 0.82,95% CI:0.70-0.96,P = 0.01)、再入院率(RR = 0.85,95% CI:0.74-0.98,P = 0.02)、心衰加重次数(RR = 0.69,95% CI:0.50-0.95,P = 0.02),以及与安慰剂或标准护理(对照组)相比,SGLT2 抑制剂治疗组因心衰而再次住院的次数(RR = 0.71,95% CI:0.58-0.86,P &lt; 0.05)。SGLT2 抑制剂改善了患者的生活质量(SMD = -0.24,95% CI:-0.40 至 -0.09,P = 0.002)。SGLT2 抑制剂与增强 AHF 患者的利尿作用有关(MD = 2.83,95% CI:1.36-4.29,P &lt; 0.05)。总体而言,使用 SGLT2 抑制剂治疗可显著降低血清 NT-proBNP 水平(MD = -497.62,95% CI:-762.02 至 -233.21,P &lt; 0.05),并且不会增加不良事件的发生率(RR = 0.91,95% CI:0.82-1.01,P = 0.06)。结论这项荟萃分析表明,与未接受 SGLT2 抑制剂治疗的患者相比,接受 SGLT2 抑制剂治疗的 AHF 患者预后较好。对AHF患者启用SGLT2抑制剂是安全有效的。系统综述注册https://www.doi.org/10.37766/inplasy2024.9.0015,标识符(INPLASY202490015)。
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引用次数: 0
Comparison of glucagon-like peptide-1 receptor agonists vs. placebo on any cardiovascular events in overweight or obese non-diabetic patients: a systematic review and meta-analysis 胰高血糖素样肽-1 受体激动剂与安慰剂对超重或肥胖非糖尿病患者心血管事件的影响比较:系统综述与荟萃分析
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1453297
Raveena Kelkar, Nishad A. Barve, Rohan Kelkar, Sanjeev Kharel, Shalmi Khanapurkar, Rukesh Yadav
IntroductionGlucagon-like peptide 1 receptor agonists (GLP-1 RA) have been extensively used to treat obesity in recent years. These novel drugs are effective at reducing body weight and also the risk of major adverse cardiovascular events in individuals with type 2 diabetes. However, the data of its efficacy in reducing cardiovascular events in individuals without type 2 diabetes is not as robust. We aim to update and conduct a systematic review and meta-analysis to assess the same.MethodsThe study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guideline. Researchers searched PubMed, EMBASE, and Clinicaltrails.gov for English literature from inception to 2024. Randomized Controlled trails enrolling adult participants (age ≥ 18 years) who are overweight or obese (BMI &gt; 25 Kg/m2) with a comparison of all cardiovascular events between patients taking GLP1-RA and placebo were included. The analysis was done by Revman version 5.4.ResultsA total of 17 RCTs among 34,419 participants were included in the analysis. The pooled risk ratio from 17 studies illustrated that patients with GLP-1 RA had a significantly lower risk of cardiovascular events compared to patients who had a placebo (RR = 0.75; 95% confidence interval 0.64–0.89, p-value = 0.0008). Semaglutide was found to have a statistically significant greatest risk reduction than other drug types.ConclusionsThis meta-analysis found that GLP-1 RA significantly reduced all types of cardiovascular events in overweight and obese patients without diabetes. Semaglutide was found to be superior to others in CV event reductions. But still, the results of ongoing trials are needed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=553048, PROSPERO (CRD42024553048).
导言近年来,胰高血糖素样肽 1 受体激动剂(GLP-1 RA)被广泛用于治疗肥胖症。这些新型药物能有效减轻体重,同时降低 2 型糖尿病患者发生主要不良心血管事件的风险。然而,有关其在减少非 2 型糖尿病患者心血管事件方面疗效的数据却不那么可靠。我们旨在更新并开展一项系统综述和荟萃分析,以评估同样的效果。方法本研究根据 PRISMA(系统综述和荟萃分析首选报告项目)指南进行。研究人员检索了 PubMed、EMBASE 和 Clinicaltrails.gov 中从开始到 2024 年的英文文献。研究人员纳入了纳入超重或肥胖(体重指数&gt; 25 Kg/m2)成年参与者(年龄≥18岁)的随机对照试验,并比较了服用GLP1-RA和安慰剂患者的所有心血管事件。分析由 Revman 5.4 版完成。结果 共有 17 项研究的 34,419 名参与者参与了分析。17项研究的风险比汇总结果表明,与服用安慰剂的患者相比,服用GLP-1 RA的患者发生心血管事件的风险显著降低(RR = 0.75;95% 置信区间为0.64-0.89,P值 = 0.0008)。结论这项荟萃分析发现,GLP-1 RA能显著减少无糖尿病的超重和肥胖患者的各类心血管事件。在减少心血管事件方面,塞马鲁肽优于其他药物。但仍需要正在进行的试验结果。系统综述注册https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=553048,PROSPERO(CRD42024553048)。
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引用次数: 0
Unveiling the role of TRPA1 in cardiovascular health and disease: a mini review 揭示 TRPA1 在心血管健康和疾病中的作用:微型综述
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1416698
Islam Gellani, Chunqi Qian, Shuangtao Ma
The transient receptor potential ankyrin 1 (TRPA1) ion channel has emerged as significant regulators of cardiovascular physiology and pathology. TRPA1 is a non-selective cation channel permeable to calcium ions. A unique feature of the channel is its function as a sensor of various temperature, chemical and mechanical stimuli, while it can also be activated by endogenous inflammatory mediators and reactive oxygen species. Over the last two decades, much progress has been made in illuminating the role of TRPA1 in the regulation of cardiovascular physiology and pathophysiology in addition to its important function in pain sensation. This review provides a comprehensive analysis of recent studies investigating the involvement of TRPA1 channels in various cardiovascular diseases, including myocardial infarction, ischemia-reperfusion injury, myocardial fibrosis, and response to environmental toxins. We discuss the diverse roles of TRPA1 channels in cardiac pathology and highlight their potential as therapeutic targets for cardiovascular disorders. Moreover, we explore the challenges and opportunities linked with targeting TRPA1 channels for treating cardiovascular diseases, alongside future research directions.
瞬时受体电位锑蛋白 1(TRPA1)离子通道已成为心血管生理和病理的重要调节因子。TRPA1 是一种可渗透钙离子的非选择性阳离子通道。该通道的一个独特功能是作为各种温度、化学和机械刺激的传感器,同时也可被内源性炎症介质和活性氧激活。在过去的二十年中,除了在痛觉中的重要功能外,在阐明 TRPA1 在心血管生理和病理生理学调节中的作用方面也取得了很大进展。本综述全面分析了最近有关 TRPA1 通道参与各种心血管疾病(包括心肌梗塞、缺血再灌注损伤、心肌纤维化和对环境毒素的反应)的研究。我们讨论了 TRPA1 通道在心脏病理学中的各种作用,并强调了它们作为心血管疾病治疗靶点的潜力。此外,我们还探讨了靶向 TRPA1 通道治疗心血管疾病的挑战和机遇,以及未来的研究方向。
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引用次数: 0
Heart failure biomarkers in revascularized patients with stable coronary heart disease as clinical outcome predictors 稳定型冠心病血管再通患者的心力衰竭生物标志物作为临床结果预测指标
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1458120
Ivica Bošnjak, Dražen Bedeković, Kristina Selthofer-Relatić, Hrvoje Roguljić, Ivica Mihaljević, Darko Dukić, Ines Bilić-Ćurčić
IntroductionThe aim of this study was to investigate serum levels of galectin-3 (Gal-3) and N-terminal pro-brain Natriuretic Peptide (NT-proBNP) in patients with stable obstructive coronary artery disease, as well as their potential to predict clinical outcomes.MethodsThis was a single-center cross-sectional cohort study. 168 patients were divided into three groups: percutaneous coronary intervention (PCI) group (N 64), coronary artery bypass graft surgery (CABG) group (N 57), and group with no coronary stenosis (N 47). Gal-3 and NT-proBNP levels were measured and the Syntax score (Ss) was calculated.ResultsThe mean value of Gal-3 was 19.98 ng/ml and 9.51 ng/ml (p &lt; 0.001) in the study group and control group, respectively. Highest value of Gal-3 was found in the group of subjects with three-vessel disease (p &lt; 0.001). The mean value of NT-proBNP in the study group was 401.3 pg/ml, and in the control group 100.3 pg/ml (p = 0.159). The highest value of NT-proBNP was found in the group of subjects with three-vessel disease (p = 0.021). There was a statistically significant association between Gal-3, NT-proBNP and occurrence of adverse cardiovascular event (p = 0.0018; p = 0.0019).ConclusionGal-3 and NT-proBNP could be used as an additional tool for diagnosis and severity assessment of stable obstructive coronary artery disease. Furthermore, it could help identify high-risk patients who could experience major adverse cardiovascular events.
引言 本研究旨在探讨稳定型阻塞性冠状动脉疾病患者血清中加列特蛋白-3(Gal-3)和N-末端前脑钠尿肽(NT-proBNP)的水平及其预测临床结果的潜力。168 名患者分为三组:经皮冠状动脉介入治疗(PCI)组(64 人)、冠状动脉旁路移植手术(CABG)组(57 人)和无冠状动脉狭窄组(47 人)。结果研究组和对照组的 Gal-3 平均值分别为 19.98 ng/ml 和 9.51 ng/ml (p &lt; 0.001)。研究组和对照组的 Gal-3 值分别为 19.98 ng/ml 和 9.51 ng/ml(p &;lt;0.001),其中三血管疾病组的 Gal-3 值最高(p &;lt;0.001)。研究组的 NT-proBNP 平均值为 401.3 pg/ml,对照组为 100.3 pg/ml(p = 0.159)。三血管疾病患者组的 NT-proBNP 值最高(p = 0.021)。结论 Gal-3和NT-proBNP可作为诊断和评估稳定型阻塞性冠状动脉疾病严重性的额外工具。结论Gal-3和NT-proBNP可作为诊断和评估稳定型阻塞性冠状动脉疾病严重程度的额外工具,而且有助于识别可能发生重大不良心血管事件的高危患者。
{"title":"Heart failure biomarkers in revascularized patients with stable coronary heart disease as clinical outcome predictors","authors":"Ivica Bošnjak, Dražen Bedeković, Kristina Selthofer-Relatić, Hrvoje Roguljić, Ivica Mihaljević, Darko Dukić, Ines Bilić-Ćurčić","doi":"10.3389/fcvm.2024.1458120","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1458120","url":null,"abstract":"IntroductionThe aim of this study was to investigate serum levels of galectin-3 (Gal-3) and N-terminal pro-brain Natriuretic Peptide (NT-proBNP) in patients with stable obstructive coronary artery disease, as well as their potential to predict clinical outcomes.MethodsThis was a single-center cross-sectional cohort study. 168 patients were divided into three groups: percutaneous coronary intervention (PCI) group (N 64), coronary artery bypass graft surgery (CABG) group (N 57), and group with no coronary stenosis (N 47). Gal-3 and NT-proBNP levels were measured and the Syntax score (Ss) was calculated.ResultsThe mean value of Gal-3 was 19.98 ng/ml and 9.51 ng/ml (<jats:italic>p</jats:italic> &amp;lt; 0.001) in the study group and control group, respectively. Highest value of Gal-3 was found in the group of subjects with three-vessel disease (<jats:italic>p</jats:italic> &amp;lt; 0.001). The mean value of NT-proBNP in the study group was 401.3 pg/ml, and in the control group 100.3 pg/ml (<jats:italic>p</jats:italic> = 0.159). The highest value of NT-proBNP was found in the group of subjects with three-vessel disease (<jats:italic>p</jats:italic> = 0.021). There was a statistically significant association between Gal-3, NT-proBNP and occurrence of adverse cardiovascular event (<jats:italic>p</jats:italic> = 0.0018; <jats:italic>p</jats:italic> = 0.0019).ConclusionGal-3 and NT-proBNP could be used as an additional tool for diagnosis and severity assessment of stable obstructive coronary artery disease. Furthermore, it could help identify high-risk patients who could experience major adverse cardiovascular events.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A neural perspective on the treatment of hypertension: the neurological network excitation and inhibition (E/I) imbalance in hypertension 从神经角度看高血压的治疗:高血压的神经网络兴奋和抑制(E/I)失衡
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1436059
Min Xia, Tianyu Wang, Yizhu Wang, Tingting Hu, Defang Chen, Bin Wang
Despite the increasing number of anti-hypertensive drugs have been developed and used in the clinical setting, persistent deficiencies persist, including issues such as lifelong dosage, combination therapy. Notwithstanding receiving the treatment under enduring these deficiencies, approximately 4 in 5 patients still fail to achieve reliable blood pressure (BP) control. The application of neuromodulation in the context of hypertension presents a pioneering strategy for addressing this condition, con-currently implying a potential central nervous mechanism underlying hypertension onset. We hypothesize that neurological networks, an essential component of maintaining appropriate neurological function, are involved in hypertension. Drawing on both peer-reviewed research and our laboratory investigations, we endeavor to investigate the underlying neural mechanisms involved in hypertension by identifying a close relationship between its onset of hypertension and an excitation and inhibition (E/I) imbalance. In addition to the involvement of excitatory glutamatergic and GABAergic inhibitory system, the pathogenesis of hypertension is also associated with Voltage-gated sodium channels (VGSCs, Nav)-mediated E/I balance. The overloading of glutamate or enhancement of glutamate receptors may be attributed to the E/I imbalance, ultimately triggering hypertension. GABA loss and GABA receptor dysfunction have also proven to be involved. Furthermore, we have identified that abnormalities in sodium channel expression and function alter neural excitability, thereby disturbing E/I balance and potentially serving as a mechanism underlying hypertension. These insights are expected to furnish potential strategies for the advancement of innovative anti-hypertensive therapies and a meaningful reference for the exploration of central nervous system (CNS) targets of anti-hypertensives.
尽管已开发出越来越多的抗高血压药物并应用于临床,但仍存在持续的不足,包括终身剂量、联合疗法等问题。尽管在克服这些不足的情况下接受了治疗,但每 5 名患者中仍有约 4 人无法获得可靠的血压(BP)控制。在高血压的治疗中应用神经调控技术是一种开创性的治疗策略,同时也暗示了高血压发病的潜在中枢神经机制。我们假设,神经网络是维持适当神经功能的重要组成部分,与高血压有关。根据同行评审的研究和我们的实验室调查,我们努力研究高血压的潜在神经机制,确定高血压发病与兴奋和抑制(E/I)失衡之间的密切关系。除了兴奋性谷氨酸能和 GABAergic 抑制系统的参与,高血压的发病机制还与电压门控钠通道(VGSCs,Nav)介导的 E/I 平衡有关。谷氨酸的超载或谷氨酸受体的增强可能是E/I失衡的原因,最终引发高血压。GABA 缺失和 GABA 受体功能障碍也被证明与此有关。此外,我们还发现钠通道表达和功能异常会改变神经兴奋性,从而扰乱E/I平衡,并可能成为高血压的潜在机制。这些发现有望为创新抗高血压疗法的发展提供潜在策略,并为探索抗高血压药物的中枢神经系统(CNS)靶点提供有意义的参考。
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引用次数: 0
Three-dimensional computed tomography analysis of the mitral annulus for mitral annuloplasty in 100 cases of robotic mitral valve repair 对 100 例机器人二尖瓣修复术中二尖瓣瓣环成形术的三维计算机断层扫描分析
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.3389/fcvm.2024.1369801
Yosuke Takahashi, Akimasa Morisaki, Yoshito Sakon, Kenta Nishiya, Goki Inno, Takumi Kawase, Yukihiro Nishimoto, Munehide Nagao, Noriaki Kishimoto, Kazuki Noda, Toshihiko Shibata
ObjectivesThis study aimed to evaluate the efficacy of preoperative computed tomography in assessing mitral annulus anatomy and the posterior annular plication rate in mitral valve repair with annuloplasty.MethodsFrom July 2018 to August 2023, we performed robotic mitral valve repair with ring annuloplasty using a semi-rigid ring in 100 patients. Preoperative anatomical assessment of the mitral annulus was conducted by three-dimensional computed tomography. The ring size was selected based on the perioperative commissure-to-commissure length or the anterior leaflet area.ResultsThe mean commissure-to-commissure length, posterior mitral annular length, and minimum distance between the left circumflex artery and mitral annulus values were 31, 109, and 3.8 mm, respectively. No postoperative left circumflex artery injury or ring detachment was recorded. The mean plication rate (length of the posterior side of the prosthetic ring/posterior annular length) was 0.68, and it did not differ among each prosthetic ring size. The posterior plication rate (duplicate ring size 19.4) was a factor influencing the postoperative transmitral mean pressure gradient of 5 mmHg or higher. Freedom from moderate or severe mitral regurgitation was not different between the two groups above and below the posterior plication rate × ring size of 19.4 (p = 0.73), with an event-free rate of 97% vs. 96% in 3 years, respectively.ConclusionsPreoperative evaluation of the mitral annular anatomy is useful for safe mitral valve repair with ring annuloplasty. Determining ring size by focusing on the posterior annular plication rate may be a new method for ring size selection.
目的本研究旨在评估术前计算机断层扫描在二尖瓣环成形术二尖瓣修复术中评估二尖瓣瓣环解剖和后瓣环成形率的效果。方法2018年7月至2023年8月,我们对100例患者进行了机器人二尖瓣修复术,并使用半硬环进行了环成形术。术前通过三维计算机断层扫描对二尖瓣瓣环进行解剖评估。结果 平均汇合点到汇合点长度、二尖瓣环后部长度以及左侧周动脉与二尖瓣环之间的最小距离分别为31、109和3.8毫米。术后没有左环动脉损伤或环脱落的记录。平均植入率(人工瓣环后侧长度/人工瓣环后侧长度)为0.68,不同尺寸的人工瓣环之间没有差异。后侧折叠率(重复假体环尺寸 19.4)是影响术后透射平均压力梯度达到或超过 5 mmHg 的一个因素。中度或重度二尖瓣反流的发生率在后覆膜率×环尺寸 19.4 以上和以下的两组之间没有差异(P = 0.73),3 年内无事件发生率分别为 97% 和 96%。通过关注后瓣瓣环成形率来确定瓣环大小可能是选择瓣环大小的一种新方法。
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引用次数: 0
Cardiovascular disease in thymic cancer patients 胸腺癌患者的心血管疾病
IF 3.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-10 DOI: 10.3389/fcvm.2024.1393631
Abhishek Khemka, Suparna C. Clasen, Patrick J. Loehrer, Anna R. Roberts, Lilian Golzarri-Arroyo, Sunil S. Badve, Subha V. Raman, Siu L. Hui, Titus K. L. Schleyer
IntroductionCancer patients may have increased risk for adverse cardiac events, but our understanding of cardiovascular risk in thymic cancer patients is not clear. We sought to characterize baseline cardiometabolic risk factors before thymic cancer diagnosis and the potential association between cancer treatment and subsequent cardiac events.MethodsThis was a retrospective cohort study evaluating patients with thymic cancer from 2003 to 2020 compared to age- and sex-matched controls without cancer. Baseline cardiovascular risk factors, cancer characteristics, and incidence of cardiac events were collected from the health information exchange. Multivariable regression was used to examine the impact of cardiovascular risk factors and cancer therapies.ResultsWe compared 296 patients with pathology-confirmed thymic cancer to 2,960 noncancer controls. Prior to cancer diagnosis, thymic cancer patients (TCPs) had lower prevalence of hypertension, dyslipidemia, and diabetes mellitus and similar rates of obesity, tobacco use, and pre-existing cardiovascular disease (CVD) compared to controls. After diagnosis, high-risk TCPs (&gt;2 cardiovascular risk factors or pre-existing CVD) had higher risk for cardiac events (HR 3.73, 95% CI 2.88–4.83, p &lt; 0.001). In the first 3 years after diagnosis, TCPs had higher incidence of cardiac events (HR 1.38, 95% CI 1.01–1.87, p = 0.042). High-risk TCPs who received radiotherapy or chemotherapy had higher risk of cardiac events (HR 4.99, 95% CI 2.30–10.81, p &lt; 0.001; HR 6.24, 95% CI 2.84–13.72, p &lt; 0.001).Discussion/conclusionCompared to noncancer controls, TCPs experienced more cardiac events when adjusted for risk factors. Patients with multiple cardiovascular risk factors receiving radiotherapy or chemotherapy had higher incidence of cardiac events.
导言癌症患者发生不良心脏事件的风险可能会增加,但我们对胸腺癌患者的心血管风险尚不清楚。我们试图描述胸腺癌诊断前的基线心血管代谢风险因素以及癌症治疗与后续心脏事件之间的潜在关联。方法这是一项回顾性队列研究,评估了 2003 年至 2020 年期间胸腺癌患者与年龄和性别匹配的非癌症对照组的对比情况。基线心血管风险因素、癌症特征和心脏事件发生率均通过健康信息交换系统收集。结果我们将296名病理确诊的胸腺癌患者与2960名非癌症对照者进行了比较。与对照组相比,胸腺癌患者(TCPs)在癌症确诊前的高血压、血脂异常和糖尿病患病率较低,肥胖、吸烟和原有心血管疾病(CVD)患病率相似。确诊后,高风险 TCPs(&gt;2 个心血管风险因素或原有心血管疾病)发生心脏事件的风险更高(HR 3.73,95% CI 2.88-4.83,p&lt; 0.001)。在确诊后的头 3 年,TCPs 的心脏事件发生率更高(HR 1.38,95% CI 1.01-1.87,p = 0.042)。接受放疗或化疗的高危 TCP 患者发生心脏事件的风险更高(HR 4.99,95% CI 2.30-10.81,pamp;lt; 0.001;HR 6.24,95% CI 2.84-13.72,pamp;lt; 0.001)。有多种心血管风险因素的患者在接受放疗或化疗时发生心脏事件的几率更高。
{"title":"Cardiovascular disease in thymic cancer patients","authors":"Abhishek Khemka, Suparna C. Clasen, Patrick J. Loehrer, Anna R. Roberts, Lilian Golzarri-Arroyo, Sunil S. Badve, Subha V. Raman, Siu L. Hui, Titus K. L. Schleyer","doi":"10.3389/fcvm.2024.1393631","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1393631","url":null,"abstract":"IntroductionCancer patients may have increased risk for adverse cardiac events, but our understanding of cardiovascular risk in thymic cancer patients is not clear. We sought to characterize baseline cardiometabolic risk factors before thymic cancer diagnosis and the potential association between cancer treatment and subsequent cardiac events.MethodsThis was a retrospective cohort study evaluating patients with thymic cancer from 2003 to 2020 compared to age- and sex-matched controls without cancer. Baseline cardiovascular risk factors, cancer characteristics, and incidence of cardiac events were collected from the health information exchange. Multivariable regression was used to examine the impact of cardiovascular risk factors and cancer therapies.ResultsWe compared 296 patients with pathology-confirmed thymic cancer to 2,960 noncancer controls. Prior to cancer diagnosis, thymic cancer patients (TCPs) had lower prevalence of hypertension, dyslipidemia, and diabetes mellitus and similar rates of obesity, tobacco use, and pre-existing cardiovascular disease (CVD) compared to controls. After diagnosis, high-risk TCPs (&amp;gt;2 cardiovascular risk factors or pre-existing CVD) had higher risk for cardiac events (HR 3.73, 95% CI 2.88–4.83, <jats:italic>p</jats:italic> &amp;lt; 0.001). In the first 3 years after diagnosis, TCPs had higher incidence of cardiac events (HR 1.38, 95% CI 1.01–1.87, <jats:italic>p</jats:italic> = 0.042). High-risk TCPs who received radiotherapy or chemotherapy had higher risk of cardiac events (HR 4.99, 95% CI 2.30–10.81, <jats:italic>p</jats:italic> &amp;lt; 0.001; HR 6.24, 95% CI 2.84–13.72, <jats:italic>p</jats:italic> &amp;lt; 0.001).Discussion/conclusionCompared to noncancer controls, TCPs experienced more cardiac events when adjusted for risk factors. Patients with multiple cardiovascular risk factors receiving radiotherapy or chemotherapy had higher incidence of cardiac events.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","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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Frontiers in Cardiovascular Medicine
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