首页 > 最新文献

Heart Surgery Forum最新文献

英文 中文
Long-Term Results and Risk Factors of Treatment for Post-Infarction Ventricular Septal Rupture: A Single-Center Experience. 梗死后室间隔破裂治疗的长期结果和危险因素:单中心经验。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-07 DOI: 10.59958/hsf.5665
Keyan Zhao, Baoyin Li, Xiaodong Guo, Biao Sun, Yang Wang, Dengshun Tao, Qiguang Wang, Huishan Wang

Background: Ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare but lethal complication. We analyzed the long-term results and risk factors for survival in the treatment of VSR.

Methods: From January 2012 to December 2021, 115 consecutive patients with post-MI VSR were admitted to our hospital. Depending on different treatment methods patients were divided into following three groups: medical, transcatheter intervention, and surgical repair. During the study, relevant clinical data, operation-related conditions, and follow-up data were analyzed. The Kaplan-Meier method and log-rank test were used to determine the cumulative incidence of mortality. The independent risk factors for patient mortality were evaluated by multivariate logistic regression.

Results: The mean follow-up time was 43.4 ± 34.7 months. The overall in-hospital, 30-day, and long-term mortality rates were 24.3%, 38.3%, and 51.3%, respectively. In the medical group, the in-hospital and 30-day mortality rates were 46.7 % (21/45) and 82.2 % (37/45), respectively, with only three patients alive at follow-up. In the transcatheter intervention group, 30-day and long-term mortality rates were 12% and 28%, respectively. In the surgical repair group, 30-day and long-term mortality rates were 8.9% and 22.2%, respectively. Compared with the surgery-group patients, patients with transcatheter intervention had a longer time from VSR to intervention. Logistic regression analysis revealed that age, previous infarction, Killip class, serum creatinine, Troponin T, N-terminal pro-B-type natriuretic peptide, and medical strategy were risk factors for all-cause mortality.

Conclusions: The 30-day and long-term outcomes of patients treated with surgical repair and transcatheter intervention were significantly better than medically treated patients.

背景:心肌梗死(MI)后室间隔破裂(VSR)是一种罕见但致命的并发症。我们分析了VSR治疗的长期结果和生存风险因素。方法:自2012年1月至2021年12月,我院连续收治115例MI后VSR患者。根据不同的治疗方法,将患者分为以下三组:内科、经导管介入治疗和外科修复。在研究过程中,对相关临床数据、手术相关情况和随访数据进行了分析。Kaplan-Meier方法和对数秩检验用于确定累计死亡率。患者死亡率的独立危险因素通过多变量逻辑回归进行评估。结果:平均随访时间为43.4±34.7个月。住院总死亡率、30天死亡率和长期死亡率分别为24.3%、38.3%和51.3%。在医疗组中,住院死亡率和30天死亡率分别为46.7%(21/45)和82.2%(37/45),随访时只有3名患者存活。在经导管介入治疗组中,30天和长期死亡率分别为12%和28%。在外科修复组中,30天和长期死亡率分别为8.9%和22.2%。与手术组患者相比,经导管介入治疗的患者从VSR到介入治疗的时间更长。Logistic回归分析显示,年龄、既往梗死、Killip分级、血清肌酐、肌钙蛋白T、N-末端B型钠尿肽原和医疗策略是全因死亡率的危险因素。结论:接受外科修复和经导管介入治疗的患者的30天和长期疗效明显优于药物治疗的患者。
{"title":"Long-Term Results and Risk Factors of Treatment for Post-Infarction Ventricular Septal Rupture: A Single-Center Experience.","authors":"Keyan Zhao,&nbsp;Baoyin Li,&nbsp;Xiaodong Guo,&nbsp;Biao Sun,&nbsp;Yang Wang,&nbsp;Dengshun Tao,&nbsp;Qiguang Wang,&nbsp;Huishan Wang","doi":"10.59958/hsf.5665","DOIUrl":"10.59958/hsf.5665","url":null,"abstract":"<p><strong>Background: </strong>Ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare but lethal complication. We analyzed the long-term results and risk factors for survival in the treatment of VSR.</p><p><strong>Methods: </strong>From January 2012 to December 2021, 115 consecutive patients with post-MI VSR were admitted to our hospital. Depending on different treatment methods patients were divided into following three groups: medical, transcatheter intervention, and surgical repair. During the study, relevant clinical data, operation-related conditions, and follow-up data were analyzed. The Kaplan-Meier method and log-rank test were used to determine the cumulative incidence of mortality. The independent risk factors for patient mortality were evaluated by multivariate logistic regression.</p><p><strong>Results: </strong>The mean follow-up time was 43.4 ± 34.7 months. The overall in-hospital, 30-day, and long-term mortality rates were 24.3%, 38.3%, and 51.3%, respectively. In the medical group, the in-hospital and 30-day mortality rates were 46.7 % (21/45) and 82.2 % (37/45), respectively, with only three patients alive at follow-up. In the transcatheter intervention group, 30-day and long-term mortality rates were 12% and 28%, respectively. In the surgical repair group, 30-day and long-term mortality rates were 8.9% and 22.2%, respectively. Compared with the surgery-group patients, patients with transcatheter intervention had a longer time from VSR to intervention. Logistic regression analysis revealed that age, previous infarction, Killip class, serum creatinine, Troponin T, N-terminal pro-B-type natriuretic peptide, and medical strategy were risk factors for all-cause mortality.</p><p><strong>Conclusions: </strong>The 30-day and long-term outcomes of patients treated with surgical repair and transcatheter intervention were significantly better than medically treated patients.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E478-E484"},"PeriodicalIF":0.6,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428825","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}
引用次数: 0
Predictive Value of the Lipoprotein(a) to Prealbumin Ratio and of the NT-proBNP to LVEF Ratio for Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. 脂蛋白(a)与前白蛋白比值和NT-proBNP与LVEF比值对急性冠状动脉综合征患者经皮冠状动脉介入治疗后主要心血管不良事件的预测价值。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-10-07 DOI: 10.59958/hsf.6681
Yingqian Zhang, Fangyuan Shi

Objective: To investigate the lipoprotein(a) [Lp(a)] to prealbumin (PA) ratio and the N-terminal pro-brain natriuretic peptide (NT-proBNP) to left ventricular ejection fraction (LVEF) ratio for the prediction of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).

Methods: A 1:1 matched case-control study was performed to retrospectively analyze ACS patients who underwent PCI from January 2022 to June 2022. Patients with MACE were selected as the case group (n = 55), and age- and gender-matched patients without MACE were selected as the control group (n = 55). Clinical data for the two groups was compared by univariate and multivariate logistic regression analysis. Risk factors and the odds ratio (OR) for MACE in ACS patients were evaluated, and receiver operating characteristic curve (ROC) were used to evaluate the Lp(a)/PA ratio, the NT-proBNP/LVEF ratio, and their combination for the prediction of MACE in ACS patients.

Results: The MACE and non-MACE groups showed statistically significant differences for time from onset to PCI, LVEF, NT-proBNP, white blood cell (WBC), Lp(a), PA, Lp(a)/PA, NT-proBNP/LVEF, number of catheterizations, number of implanted stents >2, and support diameter >3 (p < 0.05). Multivariate logistic regression analysis showed that LVEF, Lp(a)/PA and NT-proBNP/LVEF were independent risk factors for MACE. ROC curve analysis for Lp(a)/PA showed that the area under the curve (AUC) for the prediction of MACE was 0.779 (0.693-0.864), the cut-off point was 1.36, the sensitivity was 69.1%, and the specificity was 74.5%. The AUC for NT-proBNP/LVEF in predicting MACE was 0.827 (0.75-0.904), the cut-off point was 61.04, the sensitivity was 65.5%, and the specificity was 92.7%. For the combination of Lp(a)/PA and NT-proBNP/LVEF, the AUC for the prediction of MACE was 0.889 (0.830-0.947), the cut-off point was 0.37, the sensitivity was 81.8%, and the specificity was 81.8%.

Conclusion: The combination of Lp(a)/PA and NT-proBNP/LVEF at admission showed good predictive value for the occurrence of MACE in ACS patients after PCI.

目的:探讨脂蛋白(a)[Lp(a)]与前白蛋白(PA)的比值和N-末端脑钠肽原(NT-proBNP)与左心室射血分数(LVEF)的比值对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后主要心血管不良事件(MACE)的预测作用对2022年1月至2022年6月接受PCI的ACS患者进行回顾性分析。有MACE的患者被选为病例组(n=55),没有MACE的年龄和性别匹配的患者被选择为对照组(n=5)。通过单变量和多变量逻辑回归分析比较两组的临床数据。评估ACS患者MACE的危险因素和比值比(OR),并使用受试者操作特征曲线(ROC)评估Lp(a)/PA比率、NT-proBNP/LVEF比率及其组合用于预测ACS患者的MACE。结果:MACE组和非MACE组从发病到PCI的时间、LVEF、NT-proBNP、白细胞(WBC)、Lp(a)、PA、Lp,Lp(a)/PA和NT-proBNP/LVEF是MACE的独立危险因素。Lp(a)/PA的ROC曲线分析显示,预测MACE的曲线下面积(AUC)为0.779(0.693-0.864),临界点为1.36,敏感性为69.1%,特异性为74.5%。NT-proBNP/LVEF预测MACE时的AUC为0.827(0.75-0.904),临界值为61.04,敏感性为65.5%,Lp(a)/PA和NT-proBNP/LVEF联合应用对ACS患者PCI术后MACE的预测AUC为0.889(0.830-0.947),临界点为0.37,敏感性为81.8%,特异性为81.8%。
{"title":"Predictive Value of the Lipoprotein(a) to Prealbumin Ratio and of the NT-proBNP to LVEF Ratio for Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome.","authors":"Yingqian Zhang,&nbsp;Fangyuan Shi","doi":"10.59958/hsf.6681","DOIUrl":"10.59958/hsf.6681","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the lipoprotein(a) [Lp(a)] to prealbumin (PA) ratio and the N-terminal pro-brain natriuretic peptide (NT-proBNP) to left ventricular ejection fraction (LVEF) ratio for the prediction of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>A 1:1 matched case-control study was performed to retrospectively analyze ACS patients who underwent PCI from January 2022 to June 2022. Patients with MACE were selected as the case group (n = 55), and age- and gender-matched patients without MACE were selected as the control group (n = 55). Clinical data for the two groups was compared by univariate and multivariate logistic regression analysis. Risk factors and the odds ratio (OR) for MACE in ACS patients were evaluated, and receiver operating characteristic curve (ROC) were used to evaluate the Lp(a)/PA ratio, the NT-proBNP/LVEF ratio, and their combination for the prediction of MACE in ACS patients.</p><p><strong>Results: </strong>The MACE and non-MACE groups showed statistically significant differences for time from onset to PCI, LVEF, NT-proBNP, white blood cell (WBC), Lp(a), PA, Lp(a)/PA, NT-proBNP/LVEF, number of catheterizations, number of implanted stents >2, and support diameter >3 (p < 0.05). Multivariate logistic regression analysis showed that LVEF, Lp(a)/PA and NT-proBNP/LVEF were independent risk factors for MACE. ROC curve analysis for Lp(a)/PA showed that the area under the curve (AUC) for the prediction of MACE was 0.779 (0.693-0.864), the cut-off point was 1.36, the sensitivity was 69.1%, and the specificity was 74.5%. The AUC for NT-proBNP/LVEF in predicting MACE was 0.827 (0.75-0.904), the cut-off point was 61.04, the sensitivity was 65.5%, and the specificity was 92.7%. For the combination of Lp(a)/PA and NT-proBNP/LVEF, the AUC for the prediction of MACE was 0.889 (0.830-0.947), the cut-off point was 0.37, the sensitivity was 81.8%, and the specificity was 81.8%.</p><p><strong>Conclusion: </strong>The combination of Lp(a)/PA and NT-proBNP/LVEF at admission showed good predictive value for the occurrence of MACE in ACS patients after PCI.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E470-E477"},"PeriodicalIF":0.6,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428858","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}
引用次数: 0
Serum Levels of Hcy, sST2 and CA-125 in CHF Patients and Their Correlation with Cardiac Function Classification. CHF患者血清Hcy、sST2和CA-125水平及其与心功能分级的相关性。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-09-20 DOI: 10.59958/hsf.5691
Wuzhi Ma, Peng Zhang, Huiqiong Hu

Background: The relationships between serum levels of homocysteine (Hcy), soluble stromelysin 2 (sST2), and tumor-associated cancer antigen 125 (CA-125) and heart failure requires further investigation. The aim of the present study was to evaluate the levels of Hcy, sST2 and CA-125 in patients with congestive heart failure and to correlate these with cardiac function, thereby providing a reference for the clinical diagnosis and treatment of heart failure.

Methods: Seventy patients with chronic heart failure (CHF) diagnosed between August 2020 and July 2022 were classified into heart failure groups II (n = 25), III (n = 23) and IV (n = 22). Seventy individuals with normal physical examination results were selected as the healthy group. Serum Hcy, sST2 and CA-125 levels for all participants were evaluated and correlated with each other and with cardiac function classification. The diagnostic value of individual Hcy, sST2, CA-125 levels for CHF was evaluated, as well as a combination of these factors.

Results: Hcy, sST2, and CA-125 levels were lower in the healthy group than in the heart failure group. Moreover, a progressive increase in Hcy, sST2, and CA-125 levels were observed in heart failure groups II, III, and IV. Individual Hcy, sST2 and CA-125 levels, as well as a combination of these factors, were significantly correlated with cardiac function classification (p < 0.05). Hcy, sST2 and CA-125 levels each showed diagnostic value for CHF, with the three combined having the best diagnostic value.

Conclusions: Abnormally high levels of Hcy, sST2 and CA-125 occur in CHF patients and are positively correlated with cardiac function classification. Individual levels of these factors, and particularly a combination of the three, show good sensitivity and specificity for CHF diagnosis that could be widely used in clinical practice.

背景:血清同型半胱氨酸(Hcy)、可溶性基质溶素2(sST2)和肿瘤相关癌症抗原125(CA-125)水平与心力衰竭之间的关系需要进一步研究。本研究旨在评估充血性心力衰竭患者Hcy、sST2和CA-125的水平,并将其与心功能联系起来,为心力衰竭的临床诊断和治疗提供参考。方法:将2020年8月至2022年7月诊断的70例慢性心力衰竭(CHF)患者分为心力衰竭II组(n=25)、III组(n=23)和IV组(n=22)。70名体检结果正常的人被选为健康组。评估所有参与者的血清Hcy、sST2和CA-125水平,并将其相互关联,并与心功能分类相关联。评估个体Hcy、sST2、CA-125水平对CHF的诊断价值,以及这些因素的组合。结果:健康组Hcy、sST2和CA-125水平低于心力衰竭组。此外,在心力衰竭组II、III和IV中观察到Hcy、sST2和CA-125水平的逐渐升高。个体Hcy、sST2和CA-125-水平以及这些因素的组合与心功能分级显著相关(p<0.05)。Hcy、ST2和CA-125均显示出对CHF的诊断价值,其中三者结合在一起具有最佳诊断价值。结论:CHF患者Hcy、sST2和CA-125水平异常增高,与心功能分级呈正相关。这些因素的个体水平,特别是三者的组合,对CHF的诊断显示出良好的敏感性和特异性,可在临床实践中广泛应用。
{"title":"Serum Levels of Hcy, sST2 and CA-125 in CHF Patients and Their Correlation with Cardiac Function Classification.","authors":"Wuzhi Ma,&nbsp;Peng Zhang,&nbsp;Huiqiong Hu","doi":"10.59958/hsf.5691","DOIUrl":"10.59958/hsf.5691","url":null,"abstract":"<p><strong>Background: </strong>The relationships between serum levels of homocysteine (Hcy), soluble stromelysin 2 (sST2), and tumor-associated cancer antigen 125 (CA-125) and heart failure requires further investigation. The aim of the present study was to evaluate the levels of Hcy, sST2 and CA-125 in patients with congestive heart failure and to correlate these with cardiac function, thereby providing a reference for the clinical diagnosis and treatment of heart failure.</p><p><strong>Methods: </strong>Seventy patients with chronic heart failure (CHF) diagnosed between August 2020 and July 2022 were classified into heart failure groups II (n = 25), III (n = 23) and IV (n = 22). Seventy individuals with normal physical examination results were selected as the healthy group. Serum Hcy, sST2 and CA-125 levels for all participants were evaluated and correlated with each other and with cardiac function classification. The diagnostic value of individual Hcy, sST2, CA-125 levels for CHF was evaluated, as well as a combination of these factors.</p><p><strong>Results: </strong>Hcy, sST2, and CA-125 levels were lower in the healthy group than in the heart failure group. Moreover, a progressive increase in Hcy, sST2, and CA-125 levels were observed in heart failure groups II, III, and IV. Individual Hcy, sST2 and CA-125 levels, as well as a combination of these factors, were significantly correlated with cardiac function classification (p < 0.05). Hcy, sST2 and CA-125 levels each showed diagnostic value for CHF, with the three combined having the best diagnostic value.</p><p><strong>Conclusions: </strong>Abnormally high levels of Hcy, sST2 and CA-125 occur in CHF patients and are positively correlated with cardiac function classification. Individual levels of these factors, and particularly a combination of the three, show good sensitivity and specificity for CHF diagnosis that could be widely used in clinical practice.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E449-E454"},"PeriodicalIF":0.6,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428861","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}
引用次数: 0
A Rare Case of an Adult Pregnant Patient with the Left Coronary Artery Originating from the Pulmonary Artery: Successful Management and Healthy Maternal-Fetal Outcome. 一例罕见的左冠状动脉起源于肺动脉的成年妊娠患者:成功的治疗和健康的母胎结局。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-09-20 DOI: 10.59958/hsf.6407
Huan Wang, Zhipan Liang, Gen Zhang, Haibing Fang, Dianyuan Li

An anomalous left coronary artery originating from the pulmonary artery (ALCAPA) refers to the abnormal origin of the left coronary artery either from the main pulmonary artery, pulmonary artery sinus, or the left and right pulmonary arteries, with the main pulmonary artery or pulmonary artery sinus being the most common sites. If not diagnosed and treated promptly, this condition can result in death within the first year of life in 90% of patients. Asymptomatic children can survive into adulthood, but they are at a high risk of sudden death. In this article, we report a case of a 24-year-old pregnant woman who was diagnosed with ALCAPA during prenatal examination. The pregnancy was successfully maintained until 36 weeks, after which a cesarean section was performed. The patient was then admitted to the cardiac surgery department to improve cardiac function, and six weeks later, a successful left coronary artery transplantation was performed. The patient was discharged and followed up for three months, during which her condition remained stable.

起源于肺动脉的异常左冠状动脉(ALCAPA)是指左冠状动脉的异常起源于主肺动脉、肺动脉窦或左右肺动脉,其中主肺动脉或肺动脉窦是最常见的部位。如果不及时诊断和治疗,这种情况可能导致90%的患者在生命的第一年内死亡。无症状儿童可以活到成年,但他们有很高的猝死风险。在这篇文章中,我们报告了一例24岁的孕妇,她在产前检查中被诊断为ALCAPA。妊娠期成功维持到36周,之后进行了剖宫产手术。患者随后被送入心脏外科以改善心脏功能,六周后,成功进行了左冠状动脉移植。患者出院并随访三个月,期间病情稳定。
{"title":"A Rare Case of an Adult Pregnant Patient with the Left Coronary Artery Originating from the Pulmonary Artery: Successful Management and Healthy Maternal-Fetal Outcome.","authors":"Huan Wang,&nbsp;Zhipan Liang,&nbsp;Gen Zhang,&nbsp;Haibing Fang,&nbsp;Dianyuan Li","doi":"10.59958/hsf.6407","DOIUrl":"10.59958/hsf.6407","url":null,"abstract":"<p><p>An anomalous left coronary artery originating from the pulmonary artery (ALCAPA) refers to the abnormal origin of the left coronary artery either from the main pulmonary artery, pulmonary artery sinus, or the left and right pulmonary arteries, with the main pulmonary artery or pulmonary artery sinus being the most common sites. If not diagnosed and treated promptly, this condition can result in death within the first year of life in 90% of patients. Asymptomatic children can survive into adulthood, but they are at a high risk of sudden death. In this article, we report a case of a 24-year-old pregnant woman who was diagnosed with ALCAPA during prenatal examination. The pregnancy was successfully maintained until 36 weeks, after which a cesarean section was performed. The patient was then admitted to the cardiac surgery department to improve cardiac function, and six weeks later, a successful left coronary artery transplantation was performed. The patient was discharged and followed up for three months, during which her condition remained stable.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E441-E448"},"PeriodicalIF":0.6,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428852","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}
引用次数: 0
Percutaneous versus Cutdown Access for Endovascular Aortic Repair. 血管内主动脉修复的经皮与切开入路。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-09-20 DOI: 10.59958/hsf.6665
Abdulmajeed Altoijry, Sultan Alsheikh, Tariq Alanezi, Badr Aljabri, Mohammed Yousef Aldossary, Talal Altuwaijri, Kaisor Iqbal

Background: This study aimed to compare the outcomes of the percutaneous femoral access and open surgical cutdown access approaches in patients undergoing thoracic/abdominal endovascular aortic repair.

Methods: We retrospectively reviewed the medical records of 59 patients who underwent a thoracic/abdominal endovascular aortic repair at a single tertiary care hospital between 2015 and 2022. Based on their femoral access type, the patients were categorized into the "percutaneous" or "cutdown" groups. Using a computerized sheet, relevant patient data (including demographic information and patient risk factors) were collected. The operative duration, complication rates, mortality rates, intensive care unit admission and stay durations, and total hospital stay were compared between the two groups. The primary outcomes were differences in the postoperative morbidity and mortality associated with the two approaches.

Results: The cutdown and percutaneous groups comprised 24 (41%) and 35 (59%) patients, respectively. The two groups displayed comparable demographic and clinical characteristics (p > 0.05). However, the vascular anatomy differed with the common femoral artery diameter being larger in the percutaneous group compared to the cutdown group (9.63 ± 1.81 mm vs. 8.49 ± 1.54 mm, p = 0.028). The ratio of the sheath diameter to the common femoral artery diameter was significantly lower in the percutaneous group than in the cutdown group (0.73 ± 0.16 vs. 0.85 ± 0.20, p = 0.027). A ratio of ≥0.74 was associated with a higher risk of complications (odds ratio, 12.0; 95% confidence interval, 1.4-102.2; p = 0.023) and mortality (odds ratio, 5.79; 95% confidence interval, 1.13-29.6; p = 0.035). Additionally, the operative duration was significantly shorter in the percutaneous group than in the cutdown group (141.43 ± 97.05 min vs. 218.46 ± 126.31 min, p = 0.001). Compared to the cutdown group, the percutaneous group experienced a shorter total hospital stay (21.54 ± 21.49 days vs. 11.60 ± 12.09 days, p = 0.022) and lower intensive care unit-admission rates (66.7% vs. 40%, p = 0.044).

Conclusion: The percutaneous approach is a viable and more time-efficient alternative to the traditional cutdown method for delivering vascular endografts. It is associated with a significantly shorter operative duration and briefer hospital stays. Additionally, the ratio of the sheath diameter to the common femoral artery diameter can help surgeons preoperatively predict and anticipate the risks of complications and mortality. Future in-depth research is necessary to better understand the association between this ratio and postoperative outcomes and complications.

背景:本研究旨在比较经皮股动脉入路和开放式切开入路在胸腹主动脉腔内修复患者中的疗效。方法:我们回顾性回顾了2015年至2022年间在一家三级护理医院接受胸腹主动脉腔内修复的59名患者的医疗记录。根据股骨入路类型,将患者分为“经皮”组或“切开”组。使用计算机化的表格,收集相关的患者数据(包括人口统计信息和患者风险因素)。比较两组的手术时间、并发症发生率、死亡率、重症监护室入院和住院时间以及总住院时间。主要结果是与两种方法相关的术后发病率和死亡率的差异。结果:切开组和经皮穿刺组分别包括24例(41%)和35例(59%)患者。两组患者的人口学和临床特征比较(p>0.05),血管解剖结构不同,经皮组股总动脉直径大于切开组(9.63±1.81mm vs.8.49±1.54mm,p=0.028)。经皮组鞘管直径与股总动脉径的比值显著低于切开组(0.73±0.16vs.0.85±0.20,p=0.027)。比值≥0.74与更高的并发症风险(比值比,12.0;95%置信区间,1.4-102.2;p=0.023)和死亡率(比值比5.79;95%可信区间,1.13-29.6;p=0.035)相关。此外,经皮组的手术时间明显短于切开组(141.43±97.05分钟vs.218.46±126.31分钟,p=0.001),经皮组总住院时间较短(21.54±21.49天vs.11.60±12.09天,p=0.022),重症监护室入院率较低(66.7%vs.40%,p=0.044)。它与手术时间明显缩短和住院时间缩短有关。此外,鞘管直径与股总动脉直径的比值可以帮助外科医生在术前预测和预测并发症和死亡率的风险。未来有必要进行深入研究,以更好地了解这一比例与术后结果和并发症之间的关系。
{"title":"Percutaneous versus Cutdown Access for Endovascular Aortic Repair.","authors":"Abdulmajeed Altoijry,&nbsp;Sultan Alsheikh,&nbsp;Tariq Alanezi,&nbsp;Badr Aljabri,&nbsp;Mohammed Yousef Aldossary,&nbsp;Talal Altuwaijri,&nbsp;Kaisor Iqbal","doi":"10.59958/hsf.6665","DOIUrl":"10.59958/hsf.6665","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the outcomes of the percutaneous femoral access and open surgical cutdown access approaches in patients undergoing thoracic/abdominal endovascular aortic repair.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 59 patients who underwent a thoracic/abdominal endovascular aortic repair at a single tertiary care hospital between 2015 and 2022. Based on their femoral access type, the patients were categorized into the \"percutaneous\" or \"cutdown\" groups. Using a computerized sheet, relevant patient data (including demographic information and patient risk factors) were collected. The operative duration, complication rates, mortality rates, intensive care unit admission and stay durations, and total hospital stay were compared between the two groups. The primary outcomes were differences in the postoperative morbidity and mortality associated with the two approaches.</p><p><strong>Results: </strong>The cutdown and percutaneous groups comprised 24 (41%) and 35 (59%) patients, respectively. The two groups displayed comparable demographic and clinical characteristics (p > 0.05). However, the vascular anatomy differed with the common femoral artery diameter being larger in the percutaneous group compared to the cutdown group (9.63 ± 1.81 mm vs. 8.49 ± 1.54 mm, p = 0.028). The ratio of the sheath diameter to the common femoral artery diameter was significantly lower in the percutaneous group than in the cutdown group (0.73 ± 0.16 vs. 0.85 ± 0.20, p = 0.027). A ratio of ≥0.74 was associated with a higher risk of complications (odds ratio, 12.0; 95% confidence interval, 1.4-102.2; p = 0.023) and mortality (odds ratio, 5.79; 95% confidence interval, 1.13-29.6; p = 0.035). Additionally, the operative duration was significantly shorter in the percutaneous group than in the cutdown group (141.43 ± 97.05 min vs. 218.46 ± 126.31 min, p = 0.001). Compared to the cutdown group, the percutaneous group experienced a shorter total hospital stay (21.54 ± 21.49 days vs. 11.60 ± 12.09 days, p = 0.022) and lower intensive care unit-admission rates (66.7% vs. 40%, p = 0.044).</p><p><strong>Conclusion: </strong>The percutaneous approach is a viable and more time-efficient alternative to the traditional cutdown method for delivering vascular endografts. It is associated with a significantly shorter operative duration and briefer hospital stays. Additionally, the ratio of the sheath diameter to the common femoral artery diameter can help surgeons preoperatively predict and anticipate the risks of complications and mortality. Future in-depth research is necessary to better understand the association between this ratio and postoperative outcomes and complications.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E455-E462"},"PeriodicalIF":0.6,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428856","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}
引用次数: 0
Bilateral Pectoralis Major Muscle Flaps in Treating Deep Sternal Wound Infection following CABG in Diabetic Patients: Two Case Reports. 双侧胸大肌瓣治疗糖尿病患者冠状动脉旁路移植术后胸骨深部感染:两例报告。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-09-06 DOI: 10.59958/hsf.5847
Zhenhao Liu, Yuyuan Hu, Xinmeng Cheng, Nan Wu, Tao Yang, Xuening Wang

Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac operations, especially after coronary artery bypass grafting (CABG) in diabetic patients. Bilateral pectoralis major muscle flaps have been performed to treat DSWI. Two diabetic patients suffering from DSWI after CABG were treated by bilateral pectoralis major muscle flaps in our hospital. Both patients were discharged with full recovery. Satisfactory results can be obtained with bilateral pectoralis major muscle flaps following tissue debridement and drainage. This procedure should be performed when DSWI occurs in diabetic patients after CABG.

胸骨深部伤口感染(DSWI)是心脏手术后的一种危及生命的并发症,尤其是糖尿病患者冠状动脉搭桥术后。双侧胸大肌皮瓣已用于治疗DSWI。我院采用双侧胸大肌皮瓣治疗2例糖尿病患者冠状动脉旁路移植术后DSWI。两名患者均已完全康复出院。双侧胸大肌皮瓣在组织清创和引流后可获得满意的效果。当糖尿病患者冠状动脉旁路移植术后出现DSWI时,应进行此手术。
{"title":"Bilateral Pectoralis Major Muscle Flaps in Treating Deep Sternal Wound Infection following CABG in Diabetic Patients: Two Case Reports.","authors":"Zhenhao Liu, Yuyuan Hu, Xinmeng Cheng, Nan Wu, Tao Yang, Xuening Wang","doi":"10.59958/hsf.5847","DOIUrl":"10.59958/hsf.5847","url":null,"abstract":"<p><p>Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac operations, especially after coronary artery bypass grafting (CABG) in diabetic patients. Bilateral pectoralis major muscle flaps have been performed to treat DSWI. Two diabetic patients suffering from DSWI after CABG were treated by bilateral pectoralis major muscle flaps in our hospital. Both patients were discharged with full recovery. Satisfactory results can be obtained with bilateral pectoralis major muscle flaps following tissue debridement and drainage. This procedure should be performed when DSWI occurs in diabetic patients after CABG.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 5","pages":"E436-E440"},"PeriodicalIF":0.6,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428802","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}
引用次数: 0
I Need You to be Me: Talking with Our Patients, Their Families, and Their Doctors. 我需要你做我:与我们的病人、他们的家人和他们的医生交谈。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-08-31 DOI: 10.59958/hsf.5879
Curt Tribble

No abstract present.

没有抽象的礼物。
{"title":"I Need You to be Me: Talking with Our Patients, Their Families, and Their Doctors.","authors":"Curt Tribble","doi":"10.59958/hsf.5879","DOIUrl":"https://doi.org/10.59958/hsf.5879","url":null,"abstract":"<p><p>No abstract present.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 4","pages":"E428-E435"},"PeriodicalIF":0.6,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238127","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}
引用次数: 0
Effects of Remote Ischemic Preconditioning on Delirium and Neurological Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized Controlled Trial. 远端缺血预处理对心脏手术患者谵妄和神经功能的影响:一项多中心随机对照试验。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-08-31 DOI: 10.59958/hsf.5875
Tingting Liu, Xinling Liu, Rong Wan

Background: Postoperative delirium (POD) and neurological dysfunction are very common following cardiac surgery and deteriorate the patient's prognosis and the outcome of surgical procedures. A clinically effective management strategy or drug is not yet available for POD. Additionally, it is unknown whether remote ischemic preconditioning (RIPC) has neuroprotective and anti-delirium benefits in patients who undergo cardiac surgery.

Methods: This study examined whether RIPC can improve POD and neurological function in cardiac surgery patients. We screened 510 consecutive adult patients aged 18 and older who underwent cardiac surgery between January 2018 and December 2022. Then, 448 of these patients were recruited in the trial as the intention to treat (ITT) group, who were then randomly assigned to receive either a control (n = 223) or RIPC treatment (n = 225). The primary outcome measures were hospitalization postoperative delirium, six-month modified Rankins scale (mRS), hospital cerebral infarction, 30-day overall mortality, neuron-specific enolase (NSE) and S-100b levels, related adverse effects, hospital costs, and hospital stay.

Results: A statistically significant variation was not observed between the two groups in terms of the baseline clinical data. In contrast to the control group, the POD in the RIPC group was considerably alleviated. RIPC treatment also decreased the levels of NSE and S-100b, which alleviated nerve injury. The adverse impacts of RIPC-induced objective indicators of tissue or neurovascular damage were similar in both groups, showing no significant variations between the two. The hospital stays and hospitalization costs also decreased significantly in the RIPC-treated patients.

Conclusion: The study findings suggested that RIPC may benefit cardiac surgery patients by reducing POD, alleviating injury, and lowering hospital expenditures and length of stay. Cardiac surgery patients can be treated with RIPC, which is an effective and safe technique.

背景:心脏手术后谵妄(POD)和神经功能障碍非常常见,并会恶化患者的预后和手术效果。目前临床上还没有有效的治疗策略或药物。此外,尚不清楚远程缺血预处理(RIPC)是否对心脏手术患者具有神经保护和抗谵妄的作用。方法:观察RIPC是否能改善心脏手术患者的POD和神经功能。我们筛选了510名18岁及以上的连续成年患者,他们在2018年1月至2022年12月期间接受了心脏手术。然后,这些患者中有448人被招募到试验中作为意向治疗(ITT)组,然后随机分配接受对照(n = 223)或RIPC治疗(n = 225)。主要结局指标为术后住院谵妄、6个月修正Rankins量表(mRS)、住院脑梗死、30天总死亡率、神经元特异性烯醇化酶(NSE)和S-100b水平、相关不良反应、住院费用和住院时间。结果:在基线临床数据方面,两组之间没有统计学上的显著差异。与对照组相比,RIPC组POD明显减轻。RIPC治疗还能降低NSE和S-100b水平,减轻神经损伤。ripc诱导的组织或神经血管损伤客观指标的不良影响在两组中相似,两者之间无显著差异。接受ripp治疗的患者住院时间和住院费用也显著降低。结论:研究结果表明,RIPC可能通过减少POD、减轻损伤、降低住院费用和住院时间而使心脏手术患者受益。心脏手术患者可以使用RIPC治疗,这是一种有效且安全的技术。
{"title":"Effects of Remote Ischemic Preconditioning on Delirium and Neurological Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized Controlled Trial.","authors":"Tingting Liu,&nbsp;Xinling Liu,&nbsp;Rong Wan","doi":"10.59958/hsf.5875","DOIUrl":"https://doi.org/10.59958/hsf.5875","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) and neurological dysfunction are very common following cardiac surgery and deteriorate the patient's prognosis and the outcome of surgical procedures. A clinically effective management strategy or drug is not yet available for POD. Additionally, it is unknown whether remote ischemic preconditioning (RIPC) has neuroprotective and anti-delirium benefits in patients who undergo cardiac surgery.</p><p><strong>Methods: </strong>This study examined whether RIPC can improve POD and neurological function in cardiac surgery patients. We screened 510 consecutive adult patients aged 18 and older who underwent cardiac surgery between January 2018 and December 2022. Then, 448 of these patients were recruited in the trial as the intention to treat (ITT) group, who were then randomly assigned to receive either a control (n = 223) or RIPC treatment (n = 225). The primary outcome measures were hospitalization postoperative delirium, six-month modified Rankins scale (mRS), hospital cerebral infarction, 30-day overall mortality, neuron-specific enolase (NSE) and S-100b levels, related adverse effects, hospital costs, and hospital stay.</p><p><strong>Results: </strong>A statistically significant variation was not observed between the two groups in terms of the baseline clinical data. In contrast to the control group, the POD in the RIPC group was considerably alleviated. RIPC treatment also decreased the levels of NSE and S-100b, which alleviated nerve injury. The adverse impacts of RIPC-induced objective indicators of tissue or neurovascular damage were similar in both groups, showing no significant variations between the two. The hospital stays and hospitalization costs also decreased significantly in the RIPC-treated patients.</p><p><strong>Conclusion: </strong>The study findings suggested that RIPC may benefit cardiac surgery patients by reducing POD, alleviating injury, and lowering hospital expenditures and length of stay. Cardiac surgery patients can be treated with RIPC, which is an effective and safe technique.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 4","pages":"E408-E416"},"PeriodicalIF":0.6,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10198282","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}
引用次数: 0
Roles of Immune and Oxidative Stress-Related Factors in the Diagnosis of Coronary Artery Disease: A Retrospective Study. 免疫和氧化应激相关因素在冠状动脉疾病诊断中的作用:回顾性研究
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-08-31 DOI: 10.59958/hsf.5799
Yue Shu, Yin Zheng, Yilong Guo, Dan Zhu, Shian Huang

Background: Coronary artery disease (CAD) is one of the main causes of sudden death, but its exact pathogenesis requires further study. Thus, this study aimed to explore the immune and oxidative stress-related factors in CAD progression and their roles in CAD diagnosis.

Methods: Bioinformatics analysis was used in this study, and the GSE23561 dataset (training set) we used contained the transcriptome sequencing results of six CAD peripheral blood samples and nine control samples. The data were obtained and analysed by querying the Gene Expression Omnibus database. First, the differentially expressed immune and oxidative stress-related genes (DEIOGs) between the groups were identified. DEIOGs were then analysed based on Gene Ontology annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment. A protein-protein interaction (PPI) network for DEIOGs was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins database, and hub genes were identified through the PPI network. Moreover, transcription factors and microRNAs (miRNAs) targeting hub genes were identified to explore the potential regulatory mechanisms of hub genes. The receiver operating characteristic (ROC) curve analysis was constructed to examine the role of hub genes in CAD diagnosis. Finally, the data of GSE23561 (validated set) were used to validate the diagnostic potential of these hub genes.

Results: Primarily, 66 DEIOGs were identified, which are involved in many important pathways related to CAD, such as the "mitogen-activated protein kinase (MAPK) signalling pathway" and "lipid and atherosclerosis". A PPI network of DEIOGs was then constructed, and 10 hub genes were identified sequentially. A total of 37 transcription factors and 481 miRNAs that played important roles in hub genes regulation were identified. The ROC curves indicated that five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could serve as potential diagnostic biomarkers for CAD.

Conclusions: Bioinformatics analysis technology was used to identify 10 hub DEIOGs that might play a crucial role in CAD progression, and five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could be regarded as potential biomarkers for CAD diagnosis. However, further studies are required to verify the functions of these hub genes.

背景:冠状动脉疾病(CAD)是导致猝死的主要原因之一,但其确切的发病机制有待进一步研究。因此,本研究旨在探讨CAD进展中的免疫和氧化应激相关因素及其在CAD诊断中的作用。方法:本研究采用生物信息学分析方法,我们使用的GSE23561数据集(训练集)包含6份CAD外周血样本和9份对照样本的转录组测序结果。通过查询Gene Expression Omnibus数据库获得数据并进行分析。首先,鉴定各组之间差异表达的免疫和氧化应激相关基因(DEIOGs)。然后基于基因本体注释和京都基因与基因组百科全书路径富集对deiog进行分析。利用相互作用基因/蛋白质数据库检索工具(Search Tool for Retrieval of Interacting Genes/Proteins)构建deiog的蛋白质-蛋白质相互作用(PPI)网络,并通过该网络识别中心基因。此外,我们还鉴定了靶向中枢基因的转录因子和microRNAs (miRNAs),以探索中枢基因的潜在调控机制。构建受试者工作特征(ROC)曲线分析,探讨枢纽基因在CAD诊断中的作用。最后,利用验证集GSE23561的数据验证这些枢纽基因的诊断潜力。结果:主要鉴定了66个deiog,它们参与了许多与CAD相关的重要途径,如“丝裂原活化蛋白激酶(MAPK)信号通路”和“脂质与动脉粥样硬化”。构建deiog的PPI网络,并依次鉴定出10个枢纽基因。共鉴定出37个在枢纽基因调控中起重要作用的转录因子和481个mirna。ROC曲线显示,五个特殊的中心基因(Fos、Il6、Jun、Mapk3和Mmp9)可以作为CAD的潜在诊断生物标志物。结论:利用生物信息学分析技术鉴定出10个可能在CAD进展中起关键作用的枢纽deiog,其中5个特殊的枢纽基因(Fos、Il6、Jun、Mapk3和Mmp9)可被视为CAD诊断的潜在生物标志物。然而,需要进一步的研究来验证这些枢纽基因的功能。
{"title":"Roles of Immune and Oxidative Stress-Related Factors in the Diagnosis of Coronary Artery Disease: A Retrospective Study.","authors":"Yue Shu,&nbsp;Yin Zheng,&nbsp;Yilong Guo,&nbsp;Dan Zhu,&nbsp;Shian Huang","doi":"10.59958/hsf.5799","DOIUrl":"https://doi.org/10.59958/hsf.5799","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is one of the main causes of sudden death, but its exact pathogenesis requires further study. Thus, this study aimed to explore the immune and oxidative stress-related factors in CAD progression and their roles in CAD diagnosis.</p><p><strong>Methods: </strong>Bioinformatics analysis was used in this study, and the GSE23561 dataset (training set) we used contained the transcriptome sequencing results of six CAD peripheral blood samples and nine control samples. The data were obtained and analysed by querying the Gene Expression Omnibus database. First, the differentially expressed immune and oxidative stress-related genes (DEIOGs) between the groups were identified. DEIOGs were then analysed based on Gene Ontology annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment. A protein-protein interaction (PPI) network for DEIOGs was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins database, and hub genes were identified through the PPI network. Moreover, transcription factors and microRNAs (miRNAs) targeting hub genes were identified to explore the potential regulatory mechanisms of hub genes. The receiver operating characteristic (ROC) curve analysis was constructed to examine the role of hub genes in CAD diagnosis. Finally, the data of GSE23561 (validated set) were used to validate the diagnostic potential of these hub genes.</p><p><strong>Results: </strong>Primarily, 66 DEIOGs were identified, which are involved in many important pathways related to CAD, such as the \"mitogen-activated protein kinase (MAPK) signalling pathway\" and \"lipid and atherosclerosis\". A PPI network of DEIOGs was then constructed, and 10 hub genes were identified sequentially. A total of 37 transcription factors and 481 miRNAs that played important roles in hub genes regulation were identified. The ROC curves indicated that five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could serve as potential diagnostic biomarkers for CAD.</p><p><strong>Conclusions: </strong>Bioinformatics analysis technology was used to identify 10 hub DEIOGs that might play a crucial role in CAD progression, and five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could be regarded as potential biomarkers for CAD diagnosis. However, further studies are required to verify the functions of these hub genes.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 4","pages":"E417-E427"},"PeriodicalIF":0.6,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10578814","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}
引用次数: 0
Unveiling immune-metabolic interaction in Atherosclerosis via Comprehensive Landscape of Hub Genes and Immune Microenvironment. 通过枢纽基因和免疫微环境的综合景观揭示动脉粥样硬化中的免疫代谢相互作用。
IF 0.6 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-08-28 DOI: 10.59958/hsf.5925
Fang Liu, Tao Li, Xiuwen Liu, Demeng Qin

Objective: Atherosclerosis (AS) as a major cause of cardiovascular diseases, is considered a chronic inflammatory disease and accelerates by inflammation, lipid metabolism disorder and other mechanisms. AS pathogenesis and its relationship with immune regulation and metabolic interactions is still not fully elucidated. The purpose of this study is to delve into the correlation between mitochondrial metabolism and immunity in AS, and identify potential therapeutic targets for clinical treatment.

Methods: Hub genes associated with mitochondrial metabolism and the pathogenesis of AS were identified by performing differentially expressed genes (DEGs) analysis and Weighted Gene Co-expression Network Analysis (WGCNA) based on two gene expression datasets (GSE100927 and GSE43292). And the biological processes and pathways of DEGs were determined through gene ontology (GO) and Gene Set Enrichment Analysis (GSEA) analysis. Then stepwise regression, random forest, and Lasso regression machine learning were used to evaluate the diagnostic value of hub genes. After that, the immune infiltration and single cell sequencing dataset GSE184073 were analyzed, and the immune cell composition in peripheral blood from AS patients using Mass Cytometry were detected to further consider the influence of immunoregulation.

Results: Ten hub genes associated with mitochondrial metabolism and AS pathogenesis were identified, including NDUFS4, AIFM3, IDUA, TNF, CHKA, SLC11A1, SLC35C1, SLC37A2, ARSB, SLC16A5. GO and GSEA analysis showed their correlation with immunity and inflammation. Lasso regression revealed that TNF and ARSB had relatively good diagnostic performance. Further exploration was conducted on the expression of these hub genes in the immune microenvironment and their correlation with different immune factors. Mass cytometry demonstrated the influence of the vascular immune microenvironment on the pathogenesis of AS.

Conclusions: Our study provides a more comprehensive understanding of the complex relationships between immune and metabolic factors and their impact on the microenvironment of AS. The identification of hub genes in AS may provide new targets for therapeutic intervention.

目的:动脉粥样硬化(AS)作为心血管疾病的主要病因,被认为是一种慢性炎症性疾病,并通过炎症、脂质代谢紊乱等机制加速。AS的发病机制及其与免疫调节和代谢相互作用的关系仍未完全阐明。本研究旨在探讨AS线粒体代谢与免疫的相关性,寻找临床治疗的潜在靶点。方法:基于两个基因表达数据集(GSE100927和GSE43292),通过差异表达基因(DEGs)分析和加权基因共表达网络分析(WGCNA),鉴定与线粒体代谢和AS发病相关的Hub基因。并通过基因本体(GO)和基因集富集分析(GSEA)分析确定了DEGs的生物学过程和途径。然后采用逐步回归、随机森林和Lasso回归机器学习来评估枢纽基因的诊断价值。之后,对免疫浸润和单细胞测序数据集GSE184073进行分析,并采用Mass Cytometry检测AS患者外周血中的免疫细胞组成,进一步考虑免疫调节的影响。结果:共鉴定出10个与线粒体代谢和AS发病相关的枢纽基因,包括NDUFS4、AIFM3、IDUA、TNF、CHKA、SLC11A1、SLC35C1、SLC37A2、ARSB、SLC16A5。GO和GSEA分析显示其与免疫和炎症相关。Lasso回归显示TNF和ARSB具有较好的诊断效果。进一步探讨这些枢纽基因在免疫微环境中的表达及其与不同免疫因子的相关性。流式细胞术证实血管免疫微环境对AS发病机制的影响。结论:我们的研究更全面地了解了免疫和代谢因素之间的复杂关系及其对AS微环境的影响。中枢基因在AS中的鉴定可能为治疗干预提供新的靶点。
{"title":"Unveiling immune-metabolic interaction in Atherosclerosis via Comprehensive Landscape of Hub Genes and Immune Microenvironment.","authors":"Fang Liu,&nbsp;Tao Li,&nbsp;Xiuwen Liu,&nbsp;Demeng Qin","doi":"10.59958/hsf.5925","DOIUrl":"https://doi.org/10.59958/hsf.5925","url":null,"abstract":"<p><strong>Objective: </strong>Atherosclerosis (AS) as a major cause of cardiovascular diseases, is considered a chronic inflammatory disease and accelerates by inflammation, lipid metabolism disorder and other mechanisms. AS pathogenesis and its relationship with immune regulation and metabolic interactions is still not fully elucidated. The purpose of this study is to delve into the correlation between mitochondrial metabolism and immunity in AS, and identify potential therapeutic targets for clinical treatment.</p><p><strong>Methods: </strong>Hub genes associated with mitochondrial metabolism and the pathogenesis of AS were identified by performing differentially expressed genes (DEGs) analysis and Weighted Gene Co-expression Network Analysis (WGCNA) based on two gene expression datasets (GSE100927 and GSE43292). And the biological processes and pathways of DEGs were determined through gene ontology (GO) and Gene Set Enrichment Analysis (GSEA) analysis. Then stepwise regression, random forest, and Lasso regression machine learning were used to evaluate the diagnostic value of hub genes. After that, the immune infiltration and single cell sequencing dataset GSE184073 were analyzed, and the immune cell composition in peripheral blood from AS patients using Mass Cytometry were detected to further consider the influence of immunoregulation.</p><p><strong>Results: </strong>Ten hub genes associated with mitochondrial metabolism and AS pathogenesis were identified, including NDUFS4, AIFM3, IDUA, TNF, CHKA, SLC11A1, SLC35C1, SLC37A2, ARSB, SLC16A5. GO and GSEA analysis showed their correlation with immunity and inflammation. Lasso regression revealed that TNF and ARSB had relatively good diagnostic performance. Further exploration was conducted on the expression of these hub genes in the immune microenvironment and their correlation with different immune factors. Mass cytometry demonstrated the influence of the vascular immune microenvironment on the pathogenesis of AS.</p><p><strong>Conclusions: </strong>Our study provides a more comprehensive understanding of the complex relationships between immune and metabolic factors and their impact on the microenvironment of AS. The identification of hub genes in AS may provide new targets for therapeutic intervention.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 4","pages":"E390-E407"},"PeriodicalIF":0.6,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10198285","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}
引用次数: 0
期刊
Heart Surgery Forum
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1