Ran Liu, Zhaolin Fu, J. Yao, Yunfeng Yan, Guang-Lai Song
Transcatheter aortic valve replacement (TAVR) is currently a widely used option for patients with severe symptomatic aortic stenosis with high to low surgical risk. However, aortic regurgitation (AR) remains an “off-label” indication for TAVR, particularly for patients with mild or absent leaflet calcification or aortic annulus dimensions beyond the size of the bioprosthesis, which increase the risk of dislocation. With advances in transcatheter heart valve devices, the safety and efficacy of TAVR in treating patients with severe pure native AR has gained acceptance. This review examines current evidence and clinical practice, and presents technological advancements in devices for AR.
{"title":"Transcatheter Aortic Valve Replacement for Aortic Regurgitation – A Review","authors":"Ran Liu, Zhaolin Fu, J. Yao, Yunfeng Yan, Guang-Lai Song","doi":"10.15212/cvia.2023.0033","DOIUrl":"https://doi.org/10.15212/cvia.2023.0033","url":null,"abstract":"Transcatheter aortic valve replacement (TAVR) is currently a widely used option for patients with severe symptomatic aortic stenosis with high to low surgical risk. However, aortic regurgitation (AR) remains an “off-label” indication for TAVR, particularly for patients with mild or absent leaflet calcification or aortic annulus dimensions beyond the size of the bioprosthesis, which increase the risk of dislocation. With advances in transcatheter heart valve devices, the safety and efficacy of TAVR in treating patients with severe pure native AR has gained acceptance. This review examines current evidence and clinical practice, and presents technological advancements in devices for AR.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is a major global public health concern whose disease burden affects an estimated 1.4 billion people worldwide and is associated with 10.8 million deaths annually. Despite substantial advances in medical care, the prevalence of hypertension has markedly increased, owing to population aging; poor treatment adherence; and increases in risk factors, such as excessive salt intake, and overweight and obesity. Consequently, the disability-adjusted life years have increased by 40%, primarily because of elevated risk of stroke, coronary atherosclerosis, heart failure, and kidney failure. Major outstanding problems associated with the treatment and management of hypertension include determining optimal blood pressure targets, developing innovative antihypertensive medications and devices, and implementing effective and feasible hypertension management strategies. To address these challenges, numerous clinical trials are currently underway. This article highlights the most influential ten clinical studies on hypertension in 2022. The rational use of antihypertensive medications is concluded to be important for effective hypertension management. Important considerations include medication types and dosing times; optimal blood pressure targets; the development of new drugs and therapeutic devices; specific community characteristics, such as village doctor-led care; and healthful diets.
{"title":"Top Ten Breakthroughs in Clinical Hypertension Research in 2022","authors":"Qiaoxi Yang, Jun Cai","doi":"10.15212/cvia.2023.0054","DOIUrl":"https://doi.org/10.15212/cvia.2023.0054","url":null,"abstract":"Hypertension is a major global public health concern whose disease burden affects an estimated 1.4 billion people worldwide and is associated with 10.8 million deaths annually. Despite substantial advances in medical care, the prevalence of hypertension has markedly increased, owing to population aging; poor treatment adherence; and increases in risk factors, such as excessive salt intake, and overweight and obesity. Consequently, the disability-adjusted life years have increased by 40%, primarily because of elevated risk of stroke, coronary atherosclerosis, heart failure, and kidney failure. Major outstanding problems associated with the treatment and management of hypertension include determining optimal blood pressure targets, developing innovative antihypertensive medications and devices, and implementing effective and feasible hypertension management strategies. To address these challenges, numerous clinical trials are currently underway. This article highlights the most influential ten clinical studies on hypertension in 2022. The rational use of antihypertensive medications is concluded to be important for effective hypertension management. Important considerations include medication types and dosing times; optimal blood pressure targets; the development of new drugs and therapeutic devices; specific community characteristics, such as village doctor-led care; and healthful diets.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joshua P Latner, Ahmad N. Nusairat, Mustafa A. Abuelsamen, M. Al-Ani
A clinical approach to new cardiomyopathy entails defining patient phenotype and disease pathophysiology. After echocardiography, invasive assessments to define hemodynamics and coronary anatomy are usually pursued. In selected non-ischemic cases, endomyocardial biopsies are performed in search for an etiology. Fortunately, advances in cardiac imaging allow for a multifaceted cardiac evaluation in a single study, reducing cost, lead time to diagnosis, and procedural adverse events while still providing supreme accuracy. As the stream of science and clinical practice worldwide emphasizes personalized and high-value care, noninvasive imaging has emerged as a new standard to prevent, diagnose, and guide the treatment of cardiac disease, reserving invasive procedures to cases where an intervention is required. Given their versatility and precision compared to nuclear imaging and echocardiography, we elected to focus on computed tomography (CT) and cardiac magnetic resonance (CMR) in this monograph. Given the many etiologies and phenotypes of heart disease, the most
{"title":"Multimodality Imaging for Cardiomyopathies in the Era of Precision Medicine","authors":"Joshua P Latner, Ahmad N. Nusairat, Mustafa A. Abuelsamen, M. Al-Ani","doi":"10.15212/cvia.2023.0053","DOIUrl":"https://doi.org/10.15212/cvia.2023.0053","url":null,"abstract":"A clinical approach to new cardiomyopathy entails defining patient phenotype and disease pathophysiology. After echocardiography, invasive assessments to define hemodynamics and coronary anatomy are usually pursued. In selected non-ischemic cases, endomyocardial biopsies are performed in search for an etiology. Fortunately, advances in cardiac imaging allow for a multifaceted cardiac evaluation in a single study, reducing cost, lead time to diagnosis, and procedural adverse events while still providing supreme accuracy. As the stream of science and clinical practice worldwide emphasizes personalized and high-value care, noninvasive imaging has emerged as a new standard to prevent, diagnose, and guide the treatment of cardiac disease, reserving invasive procedures to cases where an intervention is required. Given their versatility and precision compared to nuclear imaging and echocardiography, we elected to focus on computed tomography (CT) and cardiac magnetic resonance (CMR) in this monograph. Given the many etiologies and phenotypes of heart disease, the most","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: ACEI therapy decreases mortality in patients with acute MI. However, the effects of ACEIs on CR are unclear. Methods: A comprehensive search of PUBMED, EMBASE, ISI Web of Science, MEDLINE and the Cochrane Register of Controlled Trials before July 2022 was conducted to identify all RCTs on ACEIs that recorded CR as an outcome. Review Manager 5.3 was used to analyze the data. Results: Five RCTs including 26,383 patients with MI were identified; 71 of the 13,159 patients receiving ACEIs and 107 of the 13,224 control patients were verified to have CR. ACEI therapy started within 24 hours after the onset of acute MI significantly decreased the risk of CR, by 33% (RR: 0.67, 95% CI: 0.50–0.90, P=0.008). Conclusions: Early administration of ACEIs (within 24 hours after the onset of acute MI) decreased the incidence of CR in patients with acute MI.
背景:ACEI治疗可降低急性心肌梗死患者的死亡率。然而，ACEI对CR的影响尚不清楚。方法:对2022年7月前的PUBMED、EMBASE、ISI Web of Science、MEDLINE和Cochrane Register of Controlled Trials进行综合检索，以确定所有将CR记录为结果的acei随机对照试验。使用Review Manager 5.3对数据进行分析。结果:共纳入5项随机对照试验，共纳入26383例心肌梗死患者;13159例接受ACEI治疗的患者中有71例发生CR, 13224例对照患者中有107例发生CR。急性心肌梗死发病后24小时内开始ACEI治疗可显著降低CR的风险，降低33% (RR: 0.67, 95% CI: 0.50-0.90, P=0.008)。结论:早期给予acei(急性心肌梗死发生后24小时内)可降低急性心肌梗死患者的CR发生率。
{"title":"Angiotensin-converting Enzyme Inhibitors Decrease the Risk of Cardiac Rupture after Acute Myocardial Infarction: A Meta-analysis of Randomized Controlled Trials","authors":"Siyi Li, Jinan Wang, Yan Yan, W. Gong, S. Nie","doi":"10.15212/cvia.2023.0040","DOIUrl":"https://doi.org/10.15212/cvia.2023.0040","url":null,"abstract":"Background: ACEI therapy decreases mortality in patients with acute MI. However, the effects of ACEIs on CR are unclear. Methods: A comprehensive search of PUBMED, EMBASE, ISI Web of Science, MEDLINE and the Cochrane Register of Controlled Trials before July 2022 was conducted to identify all RCTs on ACEIs that recorded CR as an outcome. Review Manager 5.3 was used to analyze the data. Results: Five RCTs including 26,383 patients with MI were identified; 71 of the 13,159 patients receiving ACEIs and 107 of the 13,224 control patients were verified to have CR. ACEI therapy started within 24 hours after the onset of acute MI significantly decreased the risk of CR, by 33% (RR: 0.67, 95% CI: 0.50–0.90, P=0.008). Conclusions: Early administration of ACEIs (within 24 hours after the onset of acute MI) decreased the incidence of CR in patients with acute MI.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liang Jianchao, Zhao Yu, Tao Chunjing, Zhang Sisi, Ding Rongjing
Objective: This research was aimed at determining research hotspots and major topics in the field of international home-based cardiac rehabilitation (HBCR) over the past 20 years, and exploring future trends in HBCR. Methods: A total of 757 research articles from 2002 to 2022, with themes of home-based cardiac rehabilitation, were included in the core collection database of Web of Science. CiteSpace software was used for literature metrology and visualization analysis. Results: (1) The total number of research articles on HBCR is increasing. (2) Research hotspots in HBCR include the effectiveness of rehabilitation after coronary heart disease or heart failure; quality of life; mental health; and home rehabilitation after COVID-19. (3) Research trends in HBCR include wearable intelligent technology; telerehabilitation; lifestyle interventions; and home-based rehabilitation prescriptions for exercise, nutrition, psychology and continuous management. Conclusion: The effects of HBCR have been continuously verified. Research has focused primarily on secondary prevention and rehabilitation after coronary heart disease and heart failure. More attention must be paid to improving patients’ quality of life by HBCR. Telerehabilitation based on wearable intelligent technology, home-based lifestyle interventions and continuous management are future trends of HBCR development.
目的:本研究旨在确定近20年来国际家庭心脏康复(HBCR)领域的研究热点和重大课题，并探讨未来HBCR的发展趋势。方法:将2002 ~ 2022年以家庭心脏康复为主题的研究论文757篇纳入Web of Science核心馆藏数据库。采用CiteSpace软件进行文献计量和可视化分析。结果:(1)HBCR的研究文章总数在不断增加。(2) HBCR的研究热点包括冠心病或心力衰竭后的康复效果;生活质量;心理健康;以及COVID-19后的家庭康复。(3) HBCR的研究趋势包括可穿戴智能技术;telerehabilitation;生活方式干预;以及以家庭为基础的康复处方，包括运动、营养、心理和持续管理。结论:HBCR的效果不断得到验证。研究主要集中在冠心病和心力衰竭后的二级预防和康复。通过HBCR提高患者的生活质量必须得到更多的重视。基于可穿戴智能技术的远程康复、基于家庭的生活方式干预和持续管理是HBCR未来发展的趋势。
{"title":"Research Hotspots and Trends in Home-Based Cardiac Rehabilitation: A Bibliometric Visualization Analysis","authors":"Liang Jianchao, Zhao Yu, Tao Chunjing, Zhang Sisi, Ding Rongjing","doi":"10.15212/cvia.2023.0045","DOIUrl":"https://doi.org/10.15212/cvia.2023.0045","url":null,"abstract":"Objective: This research was aimed at determining research hotspots and major topics in the field of international home-based cardiac rehabilitation (HBCR) over the past 20 years, and exploring future trends in HBCR. Methods: A total of 757 research articles from 2002 to 2022, with themes of home-based cardiac rehabilitation, were included in the core collection database of Web of Science. CiteSpace software was used for literature metrology and visualization analysis. Results: (1) The total number of research articles on HBCR is increasing. (2) Research hotspots in HBCR include the effectiveness of rehabilitation after coronary heart disease or heart failure; quality of life; mental health; and home rehabilitation after COVID-19. (3) Research trends in HBCR include wearable intelligent technology; telerehabilitation; lifestyle interventions; and home-based rehabilitation prescriptions for exercise, nutrition, psychology and continuous management. Conclusion: The effects of HBCR have been continuously verified. Research has focused primarily on secondary prevention and rehabilitation after coronary heart disease and heart failure. More attention must be paid to improving patients’ quality of life by HBCR. Telerehabilitation based on wearable intelligent technology, home-based lifestyle interventions and continuous management are future trends of HBCR development.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mitochondria are essential for cell growth, fission, differentiation, and survival, particularly in undivided cells with high energy requirements, such as cardiomyocytes. The morphology and position of mitochondria change with the activity of mitochondrial fission proteins and mitochondrial fusion proteins. These regulatory mechanisms substantially affect cardiomyocyte energy supply and normal function. In mitochondrial fission, dynamin-related protein 1 (Drp1) is involved in the separation and degradation of damaged mitochondria, and accurately regulates mitochondrial renewal and number. Recent studies have revealed a variety of post-translational modification (PTMs) of Drp1, including phosphorylation, SUMOylation, acetylation, O-GlcNAcylation, and S-sulfhydration. These modifications ensure that Drp1 continues to function normally in various signaling pathways, by modulating its activity, stability, and subcellular localization. This article provides an overview of the relationship between Drp1 PTMs and cardiovascular diseases such as heart failure, myocardial infarction, and myocardial ischemia-reperfusion, and describes how these modifications can be targeted and regulated, to help guide cardiovascular disease treatment.
线粒体对细胞生长、裂变、分化和存活至关重要，特别是在能量需求高的未分裂细胞中，如心肌细胞。线粒体的形态和位置随线粒体裂变蛋白和线粒体融合蛋白的活性而改变。这些调节机制实质上影响心肌细胞的能量供应和正常功能。在线粒体分裂过程中，动力蛋白相关蛋白1 (dynamin-related protein 1, Drp1)参与受损线粒体的分离和降解，准确调控线粒体的更新和数量。最近的研究揭示了Drp1的多种翻译后修饰(PTMs)，包括磷酸化、SUMOylation、乙酰化、o - glcnac酰化和s -巯基化。这些修饰通过调节Drp1的活性、稳定性和亚细胞定位，确保Drp1在各种信号通路中继续正常发挥作用。本文综述了Drp1 PTMs与心衰、心肌梗死、心肌缺血再灌注等心血管疾病的关系，并描述了如何靶向和调节这些修饰，以帮助指导心血管疾病的治疗。
{"title":"Post-Translational Modification of Drp1 is a Promising Target for Treating Cardiovascular Diseases","authors":"Yingjie Ji, Han Zhou, Chen Yang, Jingjie Li","doi":"10.15212/cvia.2023.0043","DOIUrl":"https://doi.org/10.15212/cvia.2023.0043","url":null,"abstract":"Mitochondria are essential for cell growth, fission, differentiation, and survival, particularly in undivided cells with high energy requirements, such as cardiomyocytes. The morphology and position of mitochondria change with the activity of mitochondrial fission proteins and mitochondrial fusion proteins. These regulatory mechanisms substantially affect cardiomyocyte energy supply and normal function. In mitochondrial fission, dynamin-related protein 1 (Drp1) is involved in the separation and degradation of damaged mitochondria, and accurately regulates mitochondrial renewal and number. Recent studies have revealed a variety of post-translational modification (PTMs) of Drp1, including phosphorylation, SUMOylation, acetylation, O-GlcNAcylation, and S-sulfhydration. These modifications ensure that Drp1 continues to function normally in various signaling pathways, by modulating its activity, stability, and subcellular localization. This article provides an overview of the relationship between Drp1 PTMs and cardiovascular diseases such as heart failure, myocardial infarction, and myocardial ischemia-reperfusion, and describes how these modifications can be targeted and regulated, to help guide cardiovascular disease treatment.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haimei Wang, Zhaorui Yang, Y. Qi, Yulin Huang, Luoxi Xiao, Yiming Hao, Jia-yi Sun, Miaoyang Wang, Q. Deng, Y. Hao, N. Yang, Jing Liu
Objective: This study aimed to examine whether integrating risk-enhancing factors into the Chinese Society of Cardiology-recommended clinical risk assessment tool (i.e., the CSC model) for atherosclerotic cardiovascular disease (ASCVD) might improve 10-year ASCVD risk stratification in Chinese adults. Methods: A total of 4910 Chinese participants who were 50–79 years of age and free of cardiovascular disease in the 2007–2008 Survey from the Chinese Multi-provincial Cohort Study were included. We assessed the updated model’s clinical utility (i.e., Harrell’s C-index and net reclassification improvement [NRI]) by adding risk-enhancing factors individually or the number of risk-enhancing factors to the CSC model, for all individuals or those at intermediate risk. Risk-enhancing factors, including a family history of CVD, triglycerides ≥2.3 mmol/L, high-sensitivity C-reactive protein ≥2 mg/L, Lipoprotein (a) ≥50 mg/dL, non-high-density lipoprotein cholesterol ≥4.9 mmol/L, overweight/obesity, and central obesity, were evaluated. ASCVD events were defined as a composite endpoint comprising ischemic stroke and acute coronary heart disease events (including nonfatal acute myocardial infarction and all coronary deaths). Results: During a median 10-year follow-up, 449 (9.1%) ASCVD events were recorded. Addition of ≥2 risk-enhancing factors to the CSC model yielded a significant improvement in the C-index (1.0%, 95% confidence interval [CI]: 0.2–1.7%) and a modest improvement in the NRI (2.0%, 95% CI: −1.2–5.4%) in the total population. For intermediate-risk individuals, particularly individuals at high risk of developing ASCVD, significant improvements in NRI were observed after adding ≥2 risk-enhancing factors (17.4%, 95% CI: 5.6–28.5%) to the CSC model. Conclusions: Addition of ≥2 risk-enhancing factors refined 10-year ASCVD risk stratification, particularly for intermediate-risk individuals, supporting their potential in helping tailor targeted interventions in clinical practice.
{"title":"Addition of Risk-enhancing Factors Improves Risk Assessment of Atherosclerotic Cardiovascular Disease in Middle-aged and Older Chinese Adults: Findings from the Chinese Multi-provincial Cohort Study","authors":"Haimei Wang, Zhaorui Yang, Y. Qi, Yulin Huang, Luoxi Xiao, Yiming Hao, Jia-yi Sun, Miaoyang Wang, Q. Deng, Y. Hao, N. Yang, Jing Liu","doi":"10.15212/cvia.2023.0036","DOIUrl":"https://doi.org/10.15212/cvia.2023.0036","url":null,"abstract":"Objective: This study aimed to examine whether integrating risk-enhancing factors into the Chinese Society of Cardiology-recommended clinical risk assessment tool (i.e., the CSC model) for atherosclerotic cardiovascular disease (ASCVD) might improve 10-year ASCVD risk stratification in Chinese adults. Methods: A total of 4910 Chinese participants who were 50–79 years of age and free of cardiovascular disease in the 2007–2008 Survey from the Chinese Multi-provincial Cohort Study were included. We assessed the updated model’s clinical utility (i.e., Harrell’s C-index and net reclassification improvement [NRI]) by adding risk-enhancing factors individually or the number of risk-enhancing factors to the CSC model, for all individuals or those at intermediate risk. Risk-enhancing factors, including a family history of CVD, triglycerides ≥2.3 mmol/L, high-sensitivity C-reactive protein ≥2 mg/L, Lipoprotein (a) ≥50 mg/dL, non-high-density lipoprotein cholesterol ≥4.9 mmol/L, overweight/obesity, and central obesity, were evaluated. ASCVD events were defined as a composite endpoint comprising ischemic stroke and acute coronary heart disease events (including nonfatal acute myocardial infarction and all coronary deaths). Results: During a median 10-year follow-up, 449 (9.1%) ASCVD events were recorded. Addition of ≥2 risk-enhancing factors to the CSC model yielded a significant improvement in the C-index (1.0%, 95% confidence interval [CI]: 0.2–1.7%) and a modest improvement in the NRI (2.0%, 95% CI: −1.2–5.4%) in the total population. For intermediate-risk individuals, particularly individuals at high risk of developing ASCVD, significant improvements in NRI were observed after adding ≥2 risk-enhancing factors (17.4%, 95% CI: 5.6–28.5%) to the CSC model. Conclusions: Addition of ≥2 risk-enhancing factors refined 10-year ASCVD risk stratification, particularly for intermediate-risk individuals, supporting their potential in helping tailor targeted interventions in clinical practice.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"42 6 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67306705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Symptom-driven electrocardiogram (ECG) recording plays a significant role in the detection of post-ablation atrial fibrillation recurrence (AFR). However, making timely medical contact whenever symptoms occur may not be practical. Herein, a deep learning (DL)-based handheld device was deployed to facilitate symptom-driven monitoring. Methods: A cohort of patients with paroxysmal atrial fibrillation (AF) was trained to use a DL-based handheld device to record ECG signals whenever symptoms presented after the ablation. Additionally, 24-hour Holter monitoring and 12-lead ECG were scheduled at 3, 6, 9, and 12 months post-ablation. The detection of AFR by the different modalities was explored. Results: A total of 22 of 67 patients experienced AFR. The handheld device and 24-hour Holter monitor detected 19 and 8 AFR events, respectively, five of which were identified by both modalities. A larger portion of ECG tracings was recorded for patients with than without AFR [362(330) vs. 132(133), P=0.01)], and substantial numbers of AFR events were recorded from 18:00 to 24:00. Compared to Holter, more AFR events were detected by the handheld device in earlier stages (HR=1.6, 95% CI 1.2–2.2, P<0.01). Conclusions: The DL-based handheld device-enabled symptom-driven recording, compared with the conventional monitoring strategy, improved AFR detection and enabled more timely identification of symptomatic episodes.
目的:症状驱动型心电图(ECG)记录在消融后房颤复发(AFR)的检测中具有重要意义。然而，只要出现症状就及时进行医疗联系可能不切实际。在此，部署了基于深度学习(DL)的手持设备，以促进症状驱动的监测。方法:一组阵发性心房颤动(AF)患者接受训练，使用基于dl的手持设备记录消融后出现症状时的心电图信号。此外，消融后3、6、9和12个月进行24小时动态心电图监测和12导联心电图。探讨了不同方法检测AFR的方法。结果:67例患者中22例发生AFR。手持设备和24小时动态心电图分别检测到19例和8例AFR事件，其中5例由两种方式识别。有AFR的患者比没有AFR的患者记录了更多的心电图描记[362(330)对132(133)，P=0.01)]，并且从18:00到24:00记录了大量的AFR事件。与Holter相比，手持设备在早期检测到更多的AFR事件(HR=1.6, 95% CI 1.2 ~ 2.2, P<0.01)。结论:与传统的监测策略相比，基于dl的手持设备支持的症状驱动记录提高了AFR的检测，能够更及时地识别症状发作。
{"title":"Deep Learning-based Handheld Device-Enabled Symptom-driven Recording: A Pragmatic Approach for the Detection of Post-ablation Atrial Fibrillation Recurrence","authors":"Lai-Te Chen, Chenyang Jiang","doi":"10.15212/cvia.2023.0048","DOIUrl":"https://doi.org/10.15212/cvia.2023.0048","url":null,"abstract":"Objective: Symptom-driven electrocardiogram (ECG) recording plays a significant role in the detection of post-ablation atrial fibrillation recurrence (AFR). However, making timely medical contact whenever symptoms occur may not be practical. Herein, a deep learning (DL)-based handheld device was deployed to facilitate symptom-driven monitoring. Methods: A cohort of patients with paroxysmal atrial fibrillation (AF) was trained to use a DL-based handheld device to record ECG signals whenever symptoms presented after the ablation. Additionally, 24-hour Holter monitoring and 12-lead ECG were scheduled at 3, 6, 9, and 12 months post-ablation. The detection of AFR by the different modalities was explored. Results: A total of 22 of 67 patients experienced AFR. The handheld device and 24-hour Holter monitor detected 19 and 8 AFR events, respectively, five of which were identified by both modalities. A larger portion of ECG tracings was recorded for patients with than without AFR [362(330) vs. 132(133), P=0.01)], and substantial numbers of AFR events were recorded from 18:00 to 24:00. Compared to Holter, more AFR events were detected by the handheld device in earlier stages (HR=1.6, 95% CI 1.2–2.2, P<0.01). Conclusions: The DL-based handheld device-enabled symptom-driven recording, compared with the conventional monitoring strategy, improved AFR detection and enabled more timely identification of symptomatic episodes.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoqiang Sun, Zhuqing Li, Li Wang, Yanxin Wang, Chengzhi Lu
Background: Diabetic cardiomyopathy is a multifaceted complication of diabetes that lacks effective treatments. Berberine (BBR), a bioactive compound from Rhizoma coptidis , has potential therapeutic implications, but its precise role in diabetic cardiomyopathy remains to be defined. Methods: In this study, a diabetic cardiomyopathy model was established by administration of a high-fat diet and streptozotocin injection to C57BL/6J mice. Concurrently, the mice received BBR treatment daily for a duration of 8 weeks. After the treatment period, myocardial injury, cardiac function, and the levels of oxidative stress and apoptosis were assessed. Results: BBR significantly ameliorated cardiac dysfunction and histopathological damage caused by diabetic cardiomyopathy. This treatment also elevated serum superoxide dismutase levels while decreasing malondialdehyde levels. The anti-apoptotic activity of BBR was evidenced by a decrease in TUNEL-positive cells and the percentage of apoptotic cells, as determined by flow cytometry, in conjunction with diminished levels of BCL2-associated X protein/B cell lymphoma 2 (BAX/BCL2) in heart tissues. Mechanistically, BBR was found to ameliorate diabetic cardiomyopathy by upregulating the expression of myocardial methionine sulfoxide reductase A (MsrA) and concurrently suppressing cardiac CaMKII oxidation. Conclusions: BBR alleviates diabetic cardiomyopathy by inhibiting myocardial apoptosis and oxidative stress through the MsrA and CaMKII signaling pathways.
{"title":"Berberine Ameliorates Diabetic Cardiomyopathy in Mice by Decreasing Cardiomyocyte Apoptosis and Oxidative Stress","authors":"Xiaoqiang Sun, Zhuqing Li, Li Wang, Yanxin Wang, Chengzhi Lu","doi":"10.15212/cvia.2023.0064","DOIUrl":"https://doi.org/10.15212/cvia.2023.0064","url":null,"abstract":"Background: Diabetic cardiomyopathy is a multifaceted complication of diabetes that lacks effective treatments. Berberine (BBR), a bioactive compound from Rhizoma coptidis , has potential therapeutic implications, but its precise role in diabetic cardiomyopathy remains to be defined. Methods: In this study, a diabetic cardiomyopathy model was established by administration of a high-fat diet and streptozotocin injection to C57BL/6J mice. Concurrently, the mice received BBR treatment daily for a duration of 8 weeks. After the treatment period, myocardial injury, cardiac function, and the levels of oxidative stress and apoptosis were assessed. Results: BBR significantly ameliorated cardiac dysfunction and histopathological damage caused by diabetic cardiomyopathy. This treatment also elevated serum superoxide dismutase levels while decreasing malondialdehyde levels. The anti-apoptotic activity of BBR was evidenced by a decrease in TUNEL-positive cells and the percentage of apoptotic cells, as determined by flow cytometry, in conjunction with diminished levels of BCL2-associated X protein/B cell lymphoma 2 (BAX/BCL2) in heart tissues. Mechanistically, BBR was found to ameliorate diabetic cardiomyopathy by upregulating the expression of myocardial methionine sulfoxide reductase A (MsrA) and concurrently suppressing cardiac CaMKII oxidation. Conclusions: BBR alleviates diabetic cardiomyopathy by inhibiting myocardial apoptosis and oxidative stress through the MsrA and CaMKII signaling pathways.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Electrocardiograms (ECGs) have the potential to be used as a reliable source of information for human identity recognition due to their universality, portability, and unique and stable biological identification features. This method enriches and refines existing biometric identification techniques, and is suitable for customer identity identification in the insurance industry. This article has the following objectives: 1) to introduce biometric identification techniques commonly used in the insurance industry, including ECG biometric identification techniques, and their advantages; 2) to discuss major aspects of ECG biometric identification techniques; 3) to systematically review the most recent advances in ECG identification and extraction characteristics from research in China and other countries; 4) to outline the technical aspects of using ECGs for recognizing client identity in the insurance industry; and 5) to discuss the future of ECGs in identity recognition. This article is aimed at further promoting the application of living personal ECG identification techniques in the insurance industry, and extending it to areas including medical insurance, banking, justice, public security, military, government, enterprises, and other departments and areas in which identification is needed to promote social stability and national security.
{"title":"Expert Consensus on ECG Identification Applied in the Insurance Industry✰","authors":"Zhongjian Li, Kangyin Chen, Shifeng Li, Tong Liu","doi":"10.15212/cvia.2023.0061","DOIUrl":"https://doi.org/10.15212/cvia.2023.0061","url":null,"abstract":"Electrocardiograms (ECGs) have the potential to be used as a reliable source of information for human identity recognition due to their universality, portability, and unique and stable biological identification features. This method enriches and refines existing biometric identification techniques, and is suitable for customer identity identification in the insurance industry. This article has the following objectives: 1) to introduce biometric identification techniques commonly used in the insurance industry, including ECG biometric identification techniques, and their advantages; 2) to discuss major aspects of ECG biometric identification techniques; 3) to systematically review the most recent advances in ECG identification and extraction characteristics from research in China and other countries; 4) to outline the technical aspects of using ECGs for recognizing client identity in the insurance industry; and 5) to discuss the future of ECGs in identity recognition. This article is aimed at further promoting the application of living personal ECG identification techniques in the insurance industry, and extending it to areas including medical insurance, banking, justice, public security, military, government, enterprises, and other departments and areas in which identification is needed to promote social stability and national security.","PeriodicalId":41559,"journal":{"name":"Cardiovascular Innovations and Applications","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135846121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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