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Bariatric metabolic surgery more effective than GLP1R agonists in preventing congestive HF 在预防充血性高血压方面,减肥代谢手术比 GLP1R 激动剂更有效。
IF 49.6 1区 医学 Q1 Medicine Pub Date : 2024-05-28 DOI: 10.1038/s41569-024-01042-w
Irene Fernández-Ruiz
In patients with type 2 diabetes mellitus and obesity, bariatric metabolic surgery is associated with a lower risk of the incidence of first-ever congestive heart failure than treatment with glucagon-like peptide 1 receptor agonists, according to a new study.
一项新的研究显示,在2型糖尿病和肥胖症患者中,减肥代谢手术与胰高血糖素样肽1受体激动剂治疗相比,首次发生充血性心力衰竭的风险更低。
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引用次数: 0
Aficamten reduces symptoms in obstructive hypertrophic cardiomyopathy Aficamten 可减轻阻塞性肥厚型心肌病的症状。
IF 49.6 1区 医学 Q1 Medicine Pub Date : 2024-05-28 DOI: 10.1038/s41569-024-01044-8
Gregory B. Lim
Data from the SEQUOIA-HCM trial show that aficamten, a cardiac myosin inhibitor, increases exercise capacity and improves quality of life in patients with symptomatic obstructive hypertrophic cardiomyopathy.
SEQUOIA-HCM 试验的数据显示,心脏肌球蛋白抑制剂阿菲康坦能提高症状性阻塞性肥厚型心肌病患者的运动能力,改善生活质量。
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引用次数: 0
Artificially transplanted mitochondria in endothelial cells promote mitophagy 内皮细胞中人工移植的线粒体可促进有丝分裂。
IF 49.6 1区 医学 Q1 Medicine Pub Date : 2024-05-21 DOI: 10.1038/s41569-024-01041-x
Karina Huynh
A study in Nature describes a single-cell-type strategy for vascular cell therapies that involves the artificial transplantation of mitochondria to endothelial cells, which promotes mitophagy and facilitates the formation of functional vessels in ischaemic tissue without the need for mesenchymal stromal cell support.
自然》(Nature)杂志上的一项研究描述了一种单细胞型血管细胞疗法策略,该策略涉及将线粒体人工移植到内皮细胞,从而促进有丝分裂,并促进缺血组织中功能血管的形成,而无需间充质基质细胞的支持。
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引用次数: 0
Bile acid receptor protects against diabetic cardiomyopathy 胆汁酸受体可预防糖尿病心肌病
IF 49.6 1区 医学 Q1 Medicine Pub Date : 2024-05-20 DOI: 10.1038/s41569-024-01040-y
Irene Fernández-Ruiz
Activation of the bile acid receptor TGR5 inhibits CD36-mediated fatty acid uptake in cardiomyocytes and protects against cardiac lipotoxicity and the development of diabetic cardiomyopathy in mice, according to a new study.
一项新的研究发现,激活胆汁酸受体TGR5可抑制心肌细胞中CD36介导的脂肪酸摄取,保护小鼠免受心脏脂肪毒性和糖尿病心肌病的侵袭。
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引用次数: 0
Efferocytosis in atherosclerosis 动脉粥样硬化中的吞噬作用
IF 41.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-05-15 DOI: 10.1038/s41569-024-01037-7
Shaunak S. Adkar, Nicholas J. Leeper
Cardiovascular disease is the leading cause of death worldwide, and it commonly results from atherosclerotic plaque progression. One of the increasingly recognized drivers of atherosclerosis is dysfunctional efferocytosis, a homeostatic mechanism responsible for the clearance of dead cells and the resolution of inflammation. In atherosclerosis, the capacity of phagocytes to participate in efferocytosis is hampered, leading to the accumulation of apoptotic and necrotic tissue within the plaque, which results in enlargement of the necrotic core, increased luminal stenosis and plaque inflammation, and predisposition to plaque rupture or erosion. In this Review, we describe the different forms of programmed cell death that can occur in the atherosclerotic plaque and highlight the efferocytic machinery that is normally implicated in cardiovascular physiology. We then discuss the mechanisms by which efferocytosis fails in atherosclerosis and other cardiovascular and cardiometabolic diseases, including myocardial infarction and diabetes mellitus, and discuss therapeutic approaches that might reverse this pathological process. In this Review, Adkar and Leeper describe the mechanisms of programmed cell death and efferocytosis, discuss how efferocytosis becomes impaired in atherosclerosis and other cardiometabolic diseases, and suggest potential strategies to target these pathways for the treatment of atherosclerotic cardiovascular disease.
心血管疾病是导致全球死亡的主要原因,它通常是由动脉粥样硬化斑块进展引起的。越来越多的人认识到,动脉粥样硬化的驱动因素之一是排泄功能障碍,这是一种负责清除死亡细胞和消除炎症的平衡机制。在动脉粥样硬化中,吞噬细胞参与清除的能力受到阻碍,导致凋亡和坏死组织在斑块内积聚,从而导致坏死核心扩大、管腔狭窄和斑块炎症加重,并易导致斑块破裂或侵蚀。在这篇综述中,我们将描述动脉粥样硬化斑块中可能出现的不同形式的程序性细胞死亡,并重点介绍通常与心血管生理学有关的流出细胞机制。然后,我们讨论了在动脉粥样硬化和其他心血管及心脏代谢疾病(包括心肌梗塞和糖尿病)中,流出细胞功能失效的机制,并讨论了可能逆转这一病理过程的治疗方法。
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引用次数: 0
Illusion of revascularization: does anyone achieve optimal revascularization during percutaneous coronary intervention? 血管再通的假象:是否有人在经皮冠状动脉介入治疗过程中实现了最佳血管再通?
IF 41.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-05-07 DOI: 10.1038/s41569-024-01014-0
Simone Fezzi, Daixin Ding, Felix Mahfoud, Jiayue Huang, Alexandra J. Lansky, Shengxian Tu, William Wijns
This Perspective article is a form of ‘pastiche’, inspired by the 1993 review by Lincoff and Topol entitled ‘Illusion of reperfusion’, and explores how their concept continues to apply to percutaneous revascularization in patients with coronary artery disease and ischaemia. Just as Lincoff and Topol argued that reperfusion of acute myocardial infarction was facing unresolved obstacles that hampered clinical success in 1993, we propose that challenging issues are similarly jeopardizing the potential benefits of stent-based angioplasty today. By analysing the appropriateness and efficacy of percutaneous coronary intervention (PCI), we emphasize the limitations of relying solely on visual angiographic guidance, which frequently leads to inappropriate stenting and overtreatment in up to one-third of patients and the associated increased risk of periprocedural myocardial infarction. The lack of optimal revascularization observed in half of patients undergoing PCI confers risks such as suboptimal physiology after PCI, residual angina and long-term stent-related events, leaving an estimated 76% of patients with an ‘illusion of revascularization’. These outcomes highlight the need to refine our diagnostic tools by integrating physiological assessments with targeted intracoronary imaging and emerging strategies, such as co-registration systems and angiography-based computational methods enhanced by artificial intelligence, to achieve optimal revascularization outcomes. In 1993, Lincoff and Topol claimed that the thrombolytic treatment of ST-segment elevation myocardial infarction was suboptimal in many patients and gave an ‘illusion of reperfusion’. In this Perspective article, the authors propose that a similar illusion of revascularization exists for contemporary percutaneous revascularization in patients with coronary artery disease and ischaemia, and identify how outcomes might be improved.
这篇 "视角 "文章是一种 "模仿 "形式,灵感来自于 1993 年 Lincoff 和 Topol 题为 "再灌注的幻觉 "的评论,并探讨了他们的概念如何继续适用于冠心病和缺血患者的经皮血运重建。正如 Lincoff 和 Topol 在 1993 年认为急性心肌梗死的再灌注面临着尚未解决的障碍,这些障碍阻碍了临床成功,我们提出,具有挑战性的问题也同样危及着当今基于支架的血管成形术的潜在益处。通过分析经皮冠状动脉介入治疗(PCI)的适宜性和有效性,我们强调了单纯依赖可视血管造影引导的局限性,因为这种引导经常导致支架植入不当,多达三分之一的患者接受了过度治疗,并增加了围手术期心肌梗死的风险。在接受 PCI 治疗的患者中,有一半的患者没有得到最佳的血管再通,这就带来了风险,如 PCI 后的生理功能不达标、残留心绞痛和长期支架相关事件,估计有 76% 的患者存在 "血管再通假象"。这些结果凸显了我们需要完善诊断工具,将生理评估与有针对性的冠状动脉内成像和新兴策略(如联合注册系统和基于血管造影的人工智能计算方法)相结合,以实现最佳的血管再通效果。
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引用次数: 0
No benefit of apoA-I infusion after myocardial infarction 心肌梗死后输注载脂蛋白 A-I 无益
IF 49.6 1区 医学 Q1 Medicine Pub Date : 2024-05-03 DOI: 10.1038/s41569-024-01031-z
Gregory B. Lim
In the AEGIS-II trial, infusion of apolipoprotein A-I to increase cholesterol efflux capacity did not improve outcomes in patients with acute myocardial infarction.
在 AEGIS-II 试验中,输注脂蛋白 A-I 以提高胆固醇外流能力并不能改善急性心肌梗死患者的预后。
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引用次数: 0
Stress and cardiovascular disease: an update 压力与心血管疾病:最新进展
IF 41.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-05-02 DOI: 10.1038/s41569-024-01024-y
Viola Vaccarino, J. Douglas Bremner
Psychological stress is generally accepted to be associated with an increased risk of cardiovascular disease (CVD), but results have varied in terms of how stress is measured and the strength of the association. Additionally, the mechanisms and potential causal links have remained speculative despite decades of research. The physiological responses to stress are well characterized, but their contribution to the development and progression of CVD has received little attention in empirical studies. Evidence suggests that physiological responses to stress have a fundamental role in the risk of CVD and that haemodynamic, vascular and immune perturbations triggered by stress are especially implicated. Stress response physiology is regulated by the corticolimbic regions of the brain, which have outputs to the autonomic nervous system. Variation in these regulatory pathways might explain interindividual differences in vulnerability to stress. Dynamic perturbations in autonomic, immune and vascular functions are probably also implicated as CVD risk mechanisms of chronic, recurring and cumulative stressful exposures, but more data are needed from prospective studies and from assessments in real-life situations. Psychological assessment remains insufficiently recognized in clinical care and prevention. Although stress-reduction interventions might mitigate perceived stress levels and potentially reduce cardiovascular risk, more data from randomized trials are needed. Physiological responses to stress are thought to increase the risk of cardiovascular disease via haemodynamic, vascular and immune perturbations. In this Review, Vaccarino and Bremner focus on issues with the measurement of psychological stress and the underlying pathobiology connecting stress to the risk of cardiovascular disease.
人们普遍认为,心理压力与心血管疾病(CVD)风险的增加有关,但在压力的测量方法和关联强度方面,结果却各不相同。此外,尽管进行了数十年的研究,但其机制和潜在的因果关系仍是猜测性的。人们对压力的生理反应已经有了很好的认识,但实证研究却很少关注这些反应对心血管疾病的发生和发展所起的作用。有证据表明,压力的生理反应在心血管疾病的风险中起着根本性的作用,而压力引发的血流动力学、血管和免疫扰动尤其与此有关。应激反应生理学受大脑皮质边缘区域的调节,该区域可输出至自主神经系统。这些调节途径的差异可能解释了个体间对压力的脆弱性差异。自律神经、免疫和血管功能的动态扰动很可能也与长期、反复和累积的压力暴露有关,成为心血管疾病的风险机制,但还需要从前瞻性研究和现实生活中的评估中获得更多数据。心理评估在临床护理和预防中仍未得到充分认可。尽管减压干预措施可能会减轻感知到的压力水平,并有可能降低心血管风险,但还需要更多来自随机试验的数据。
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引用次数: 0
Screening for Helicobacter pylori infection in patients with cardiovascular and gastrointestinal disease 筛查心血管和胃肠道疾病患者的幽门螺旋杆菌感染。
IF 41.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-05-02 DOI: 10.1038/s41569-024-01028-8
Jonatan Wärme, Martin O. Sundqvist, Stefan James, Robin Hofmann
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引用次数: 0
Reply to ‘Screening for Helicobacter pylori infection in patients with cardiovascular and gastrointestinal disease’ 对 "心血管和胃肠道疾病患者幽门螺杆菌感染筛查 "的答复
IF 41.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-05-02 DOI: 10.1038/s41569-024-01029-7
Azita H. Talasaz, Behnood Bikdeli
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引用次数: 0
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Nature Reviews Cardiology
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