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Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction. 非st段抬高急性心肌梗死的常规侵入策略和虚弱负担。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.005
Albert Ariza-Solé, Juan Andrés Bermeo, Francesc Formiga, Héctor Bueno, Gemma Miñana, Oriol Alegre, David Martí, Manuel Martínez-Sellés, Laura Domínguez-Pérez, Pablo Díez-Villanueva, José A Barrabés, Francisco Marín, Adolfo Villa, Marcelo Sanmartín, Cinta Llibre, Alessandro Sionís, Antoni Carol, Sergio García-Blas, María José Morales Gallardo, Jaime Elízaga, Iván Gómez-Blázquez, Fernando Alfonso, Bruno García Del Blanco, Julio Núñez, Juan Sanchis

Objective: To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the MOSCA-FRAIL clinical trial.

Methods: The MOSCA-FRAIL trial randomized 167 frail patients, defined by a Clinical Frailty Scale (CFS) ≥ 4, with NSTEMI to an invasive or conservative strategy. The primary endpoint was the number of days alive and out of hospital (DAOH) one year after discharge. For this subanalysis, we compared the impact of an invasive strategy on the outcomes between vulnerable (CFS = 4, n = 43) and frail (CFS > 4, n = 124) patients.

Results: Compared to vulnerable patients, frail patients presented lower values of DAOH (289.8 vs. 320.6, P = 0.146), more readmissions (1.03 vs. 0.58, P = 0.046) and higher number of days spent at the hospital during the first year (10.8 vs. 3.8, P = 0.014). The causes of readmission were mostly non-cardiac (56%). Among vulnerable patients, DAOH were similar regardless of strategy (invasive vs. conservative: 325.7 vs. 314.7, P = 0.684). Among frailest patients, the invasive group tended to have less DAOH (267.7 vs. 311.1, P = 0.117). Indeed, patients with CFS > 4, invasively managed lived 29 days less than their conservative counterparts. In contrast, there were no differences in the subgroup with CFS = 4.

Conclusions: Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty. A routine invasive strategy does not improve outcomes and might be harmful to the frailest patients.

目的:从mosca -虚弱临床试验中评估常规侵入策略对非st段抬高型心肌梗死(NSTEMI)患者虚弱负担的预后影响。方法:mosca -虚弱试验随机选择167例虚弱患者,临床虚弱量表(CFS)≥4分,NSTEMI为侵入性或保守性策略。主要终点是出院后一年的存活和出院天数(DAOH)。在这个亚组分析中,我们比较了侵入性策略对易感(CFS = 4, n = 43)和虚弱(CFS bbb4, n = 124)患者预后的影响。结果:与易感患者相比,体弱患者第一年的DAOH值较低(289.8比320.6,P = 0.146),再入院率较高(1.03比0.58,P = 0.046),住院天数较高(10.8比3.8,P = 0.014)。再入院原因以非心源性为主(56%)。在易感患者中,无论采取何种策略,DAOH都相似(侵袭性vs保守性:325.7 vs 314.7, P = 0.684)。在最虚弱的患者中,侵入组的DAOH倾向较少(267.7比311.1,P = 0.117)。事实上,有创治疗的CFS患者比保守治疗的患者少活29天。相比之下,CFS = 4的亚组无差异。结论:成年衰弱患者和NSTEMI患者根据衰弱程度的不同,预后不同。常规的侵入性策略并不能改善预后,而且可能对最虚弱的患者有害。
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引用次数: 0
Potential role of peripheral blood mononuclear cell ' s mitochondrial respiratory dysfunction in heart failure severity prediction in patients with cardioverter-defibrillator implantation indications. 外周血单个核细胞线粒体呼吸功能障碍在心律转复除颤器植入适应症患者心力衰竭严重程度预测中的潜在作用。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.006
Tariel A Atabekov, Sergey N Krivolapov, Mikhail S Khlynin, Viacheslav A Korepanov, Tatiana Yu Rebrova, Elvira F Muslimova, Sergey A Afanasiev, Roman E Batalov, Sergey V Popov

Background: It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis. We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.

Methods: In this single-center study patients with HF of New York Heart Association (NYHA) I-III functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PBMC. Mitochondrial respiration rate (MRR) indicators (pyruvate + malate + adenosine diphosphate; succinate + adenosine diphosphate; pyruvate + malate - adenosine diphosphate [V4.1]; succinate - adenosine diphosphate) were calculated. Correlations between HF NYHA FC, TTE and MRR indicators were evaluated. Based on our data, we developed a risk model regarding HF severity.

Results: Of 53 (100.0%) HF patients, 33 (62.3%) had mild exercise intolerance (1st group) and 20 (37.7%) had moderate-to-severe exercise intolerance (2nd group). Patients with mild exercise intolerance were likely to have a higher V4.1 (P < 0.001) values. V4.1 was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR = 0.932, 95% CI: 0.891-0.975, P < 0.001).

Conclusions: The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications. Our HF severity risk model including V4.1 parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance. Further investigations of their predictive significance are warranted.

研究背景:线粒体呼吸功能障碍(MRD)是影响心力衰竭(HF)发病的重要机制。我们试图评估外周血单个核细胞(PBMC) MRD在心律转复除颤器植入指征患者HF严重程度预测中的潜在作用。方法:在这项单中心研究中,纽约心脏协会(NYHA) I-III功能等级(FC)的心衰患者和心律转复除颤器植入适应症患者接受经胸超声心动图(TTE)和PBMC MRD评估。线粒体呼吸速率(MRR)指标(丙酮酸+苹果酸+二磷酸腺苷;琥珀酸+二磷酸腺苷;丙酮酸+苹果酸-二磷酸腺苷[V4.1];琥珀酸-二磷酸腺苷)。评估HF NYHA FC、TTE和MRR指标的相关性。根据我们的数据,我们建立了一个关于心衰严重程度的风险模型。结果:53例(100.0%)HF患者中,轻度运动不耐受33例(62.3%)(第一组),中重度运动不耐受20例(37.7%)(第二组)。轻度运动不耐受患者可能有更高的V4.1值(P < 0.001)。在单因素和多因素logistic回归中,V4.1与中重度运动不耐受独立相关(OR = 0.932, 95% CI: 0.891-0.975, P < 0.001)。结论:心律转复除颤器植入指征患者HF的严重程度与PBMC线粒体呼吸功能障碍相关。我们的HF严重程度风险模型包含V4.1参数,能够区分轻度和中重度运动不耐受患者。对其预测意义的进一步研究是有必要的。
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引用次数: 0
Cardiometabolic and panvascular multimorbidity associated with motoric cognitive risk syndrome in older adults. 与老年人运动认知危险综合征相关的心脏代谢和泛血管多病
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.001
Rui She, Zhong-Rui Yan, Peng Wang, Ya-Jun Liang, Cheng-Xuan Qiu

Background: Motoric cognitive risk (MCR) syndrome as a pre-dementia syndrome often co-occurring with chronic health conditions. This study aims to investigate the prevalence of MCR and its association with cardiometabolic and panvascular multimorbidity among older people living in rural China.

Methods: This population-based study included 1450 participants who were aged ≥ 60 years (66.2% women) and who undertook the second wave examination of the Confucius Hometown Aging Project in Shandong, China when information to define MCR was collected. Data were collected through in-person interviews, clinical examinations, and laboratory tests. Cardiometabolic and panvascular multimorbidity were defined following the international criteria. MCR was defined as subjective cognitive complaints and slow gait speed in individuals free of dementia and functional disability. Multivariable logistic regression models were used to examine the associations of MCR with multimorbidity.

Results: MCR was present in 6.3% of all participants, and the prevalence increased with advancing age. Cerebrovascular disease, ischemic heart disease, heart failure, and increased serum cystatin C were associated with increased likelihoods of MCR (multivariable-adjusted odds ratio range: 1.90-3.02, P < 0.05 for all). Furthermore, there was a dose-response relationship between the number of cardiometabolic diseases and panvascular diseases and the likelihood of MCR. The multivariable-adjusted odds ratio (95% CI) of MCR associated with cardiometabolic and panvascular multimorbidity were 2.47 (1.43-4.26) and 3.85 (2.29-6.47), respectively.

Conclusions: Older adults with cardiometabolic and panvascular multimorbidity are at a higher likelihood of MCR. These findings may have implications for identifying older adults at pre-dementia state as targets for early preventive interventions to delay dementia onset.

背景:运动认知风险(MCR)综合征是一种常与慢性健康状况共存的痴呆前综合征。本研究旨在调查中国农村老年人MCR患病率及其与心脏代谢和泛血管多病的关系。方法:本研究以人群为基础,纳入1450名年龄≥60岁(66.2%为女性)的参与者,这些参与者在收集MCR定义信息时接受了中国山东孔子家乡老龄化项目的第二波检查。通过面对面访谈、临床检查和实验室测试收集数据。根据国际标准定义心脏代谢和泛血管多发病。MCR被定义为无痴呆和功能残疾个体的主观认知抱怨和慢速步态。采用多变量logistic回归模型来检验MCR与多发病的关系。结果:6.3%的参与者存在MCR,患病率随着年龄的增长而增加。脑血管疾病、缺血性心脏病、心力衰竭和血清胱抑素C升高与MCR的可能性增加相关(多变量校正比值比范围:1.90-3.02,P < 0.05)。此外,心脏代谢疾病和泛血管疾病的数量与MCR的可能性之间存在剂量-反应关系。MCR与心脏代谢和泛血管多病相关的多变量校正比值比(95% CI)分别为2.47(1.43-4.26)和3.85(2.29-6.47)。结论:患有心脏代谢和泛血管多病的老年人发生MCR的可能性更高。这些发现可能对识别处于痴呆症前期状态的老年人作为早期预防干预的目标,以延缓痴呆症的发作具有启示意义。
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引用次数: 0
The impact of cerebral small vessel disease burden on prognosis in patients with acute coronary syndrome. 急性冠脉综合征患者脑血管疾病负担对预后的影响
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.003
Xiao-Jun Ding, Yu Zhao, Ze-Ya Li, Yong-Bo Zhang, An-Qi Yang, Yi He, Rong-Chong Huang

Background: Acute coronary syndrome (ACS) presents with a variable prognosis, posing significant public health challenges. This study investigated the potential link between cerebral small vessel disease (CSVD) burden and outcomes in patients with ACS.

Methods: In this retrospective cohort study, ACS patients admitted to Beijing Friendship Hospital, Capital Medical University, Beijing, China from January 2020 to October 2021, were analyzed. CSVD burden was assessed using magnetic resonance imaging markers, including white matter lesions, lacunar infarcts, cerebral microbleeds, and enlarged perivascular spaces. The correlation between CSVD burden and clinical outcomes, including major adverse cardiovascular and cerebrovascular events, myocardial infarction (MI), target vessel revascularization, stroke, and mortality was examined over a one-year follow-up.

Results: Out of 248 patients, 216 patients were categorized into the low score group (LSG-CSVD) and 32 patients were categorized into the high score group (HSG-CSVD). Patients in the HSG-CSVD group exhibited significantly worse prognosis, with an elevated risk of major adverse cardiovascular and cerebrovascular events, MI, and target vessel revascularization. After adjusting for age, sex, hypertension, troponin T, and estimated glomerular filtration rate, a significantly higher risk of MI was observed in the HSG-CSVD group (HR = 4.51, 95% CI: 1.53-13.26, P = 0.006). Subgroup analysis by age and sex consistently demonstrated increased adverse outcomes in the HSG-CSVD.

Conclusions: The study highlights a direct association between increased CSVD burden and poorer ACS outcomes, particularly in MI risk. These findings underscore the importance of considering CSVD burden as a crucial prognostic factor in ACS management, facilitating risk stratification and guiding personalized treatment strategies.

背景:急性冠状动脉综合征(ACS)预后多变,对公共卫生构成重大挑战。本研究探讨了ACS患者脑血管疾病(CSVD)负担与预后之间的潜在联系。方法:对2020年1月至2021年10月在首都医科大学附属北京友谊医院住院的ACS患者进行回顾性队列研究。使用磁共振成像标记物评估CSVD负担,包括白质病变、腔隙性梗死、脑微出血和血管周围间隙扩大。在为期一年的随访中,研究了CSVD负担与临床结果(包括主要不良心脑血管事件、心肌梗死(MI)、靶血管重建术、卒中和死亡率)之间的相关性。结果:248例患者中,低评分组(LSG-CSVD) 216例,高评分组(HSG-CSVD) 32例。HSG-CSVD组患者预后明显较差,主要不良心脑血管事件、心肌梗死和靶血管重建术的风险升高。在调整了年龄、性别、高血压、肌钙蛋白T和肾小球滤过率后,HSG-CSVD组发生心肌梗死的风险明显更高(HR = 4.51, 95% CI: 1.53-13.26, P = 0.006)。按年龄和性别划分的亚组分析一致显示HSG-CSVD的不良结局增加。结论:该研究强调了心血管疾病负担增加与ACS预后较差之间的直接关联,特别是在心肌梗死风险方面。这些发现强调了将心血管疾病负担作为ACS管理的关键预后因素,促进风险分层和指导个性化治疗策略的重要性。
{"title":"The impact of cerebral small vessel disease burden on prognosis in patients with acute coronary syndrome.","authors":"Xiao-Jun Ding, Yu Zhao, Ze-Ya Li, Yong-Bo Zhang, An-Qi Yang, Yi He, Rong-Chong Huang","doi":"10.26599/1671-5411.2024.10.003","DOIUrl":"https://doi.org/10.26599/1671-5411.2024.10.003","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) presents with a variable prognosis, posing significant public health challenges. This study investigated the potential link between cerebral small vessel disease (CSVD) burden and outcomes in patients with ACS.</p><p><strong>Methods: </strong>In this retrospective cohort study, ACS patients admitted to Beijing Friendship Hospital, Capital Medical University, Beijing, China from January 2020 to October 2021, were analyzed. CSVD burden was assessed using magnetic resonance imaging markers, including white matter lesions, lacunar infarcts, cerebral microbleeds, and enlarged perivascular spaces. The correlation between CSVD burden and clinical outcomes, including major adverse cardiovascular and cerebrovascular events, myocardial infarction (MI), target vessel revascularization, stroke, and mortality was examined over a one-year follow-up.</p><p><strong>Results: </strong>Out of 248 patients, 216 patients were categorized into the low score group (LSG-CSVD) and 32 patients were categorized into the high score group (HSG-CSVD). Patients in the HSG-CSVD group exhibited significantly worse prognosis, with an elevated risk of major adverse cardiovascular and cerebrovascular events, MI, and target vessel revascularization. After adjusting for age, sex, hypertension, troponin T, and estimated glomerular filtration rate, a significantly higher risk of MI was observed in the HSG-CSVD group (HR = 4.51, 95% CI: 1.53-13.26, <i>P</i> = 0.006). Subgroup analysis by age and sex consistently demonstrated increased adverse outcomes in the HSG-CSVD.</p><p><strong>Conclusions: </strong>The study highlights a direct association between increased CSVD burden and poorer ACS outcomes, particularly in MI risk. These findings underscore the importance of considering CSVD burden as a crucial prognostic factor in ACS management, facilitating risk stratification and guiding personalized treatment strategies.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 10","pages":"972-980"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aortic disease and peripheral artery disease. 主动脉疾病和外周动脉疾病。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.008
Sheng-Shou Hu
<p><p>The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of car-diovascular health in China. In connection with the previous section, this 10<sup>th</sup> section of the report offers a comprehensive analysis of aortic disease and peripheral artery disease. Aortic dissection is a critical disease, with a higher incidence in men than in women. The main risk factors include hypertension, gene mutations, and so on. Recent studies suggest that young patients with aortic dissection have a higher body mass index, and there is a significant correlation between low ambient temperature and sudden temperature drop and the onset of dissection. The main hazards are aortic rupture or poor branch perfusion, which is life threatening. According to the lesion location, it is divided into Stanford A type (involving the ascending aorta) and Stanford B type (not involving the ascending aorta). The treatment of type A dissection is mainly open surgery, while the treatment of type B dissection is preferably endovascular treatment. In recent years, with the continuous development of endovascular technique, the treatment of aortic arch lesions has transformed gradually from open to hybrid, and then to total endovascular treatment. The prevalence of abdominal aortic aneurysm is relatively low (< 1%), and its risk factors mainly include smoking, hypertension, dyslipidemia, etc. The main hazard is the rupture of the aneurysm leading to death. Currently, treatment methods include endovascular repair and open surgery. According to data from Hospital Quality Monitoring System (HQMS), in the past five years, the number of open and endovascular operations for aortic disease in China has shown an upward trend, which may be due to the popularization of diagnostic and therapeutic techniques and increased attention to aortic disease. The in-hospital mortality rates of thoracic endovascular aortic repair, endovascular aortic repair, and Bentall operations are relatively low (all < 2%). Due to the complexity and difficulty of the operation, the in-hospital mortality of total arch replacement is 5.9%-7.4%. Overall, the in-hospital mortality decreased while the number of surgeries increased. This section also elaborates on the five peripheral artery diseases (PADs): lower extremity artery disease (LEAD), carotid atherosclerotic disease, subclavian artery stenosis, mesenteric artery disease and renal artery stenosis, from the perspectives of epidemiology, risk factors, evaluation methods, diagnosis, and treatment. PAD is common among middle-aged and elderly people, and is significantly related to the risk factors of cardiovascular disease. Diagnosis and treatment methods are constantly being improved and updated. Besides traditional evaluation methods, artificial intelligence, molecular biology and other methods have been continuously developed, improving diagnostic sensitivity and specificity. Treatment methods include risk factor control, medication,
《中国心血管健康与疾病年度报告(2022)》中国心血管健康的复杂图景。结合上一节,本报告第10节全面分析了主动脉疾病和外周动脉疾病。主动脉夹层是一种危重疾病,男性的发病率高于女性。其主要危险因素包括高血压、基因突变等。近年研究表明,年轻主动脉夹层患者体重指数较高,环境温度低、体温骤降与夹层发生有显著相关性。主要的危险是主动脉破裂或分支灌注不良,这是危及生命的。根据病变部位分为Stanford A型(累及升主动脉)和Stanford B型(不累及升主动脉)。A型夹层的治疗以开放手术为主,B型夹层的治疗以血管内治疗为主。近年来,随着血管内技术的不断发展,主动脉弓病变的治疗逐渐从开放到混合式,再到全血管内治疗。腹主动脉瘤患病率相对较低(< 1%),其危险因素主要有吸烟、高血压、血脂异常等。主要的危险是动脉瘤破裂导致死亡。目前的治疗方法包括血管内修复和开放手术。医院质量监测系统(HQMS)数据显示,近五年来,中国主动脉疾病的切开和血管内手术数量呈上升趋势,这可能与诊疗技术的普及和对主动脉疾病的重视程度提高有关。胸主动脉腔内修复术、主动脉腔内修复术和本特尔手术的住院死亡率相对较低(均< 2%)。由于手术的复杂性和难度,全弓置换术的住院死亡率为5.9%-7.4%。总体而言,住院死亡率下降,而手术次数增加。本节还从流行病学、危险因素、评价方法、诊断和治疗等方面对下肢动脉疾病(LEAD)、颈动脉粥样硬化性疾病、锁骨下动脉狭窄、肠系膜动脉疾病和肾动脉狭窄这五种外周动脉疾病(pad)进行了阐述。PAD常见于中老年人,与心血管疾病危险因素显著相关。诊断和治疗方法不断改进和更新。在传统的评估方法之外,人工智能、分子生物学等方法不断发展,提高了诊断的敏感性和特异性。治疗方法包括控制危险因素、药物治疗、血运重建术(经皮血管内介入及手术治疗)、运动等。新的治疗方法,如细胞工程和异种血管移植也显示出治疗铅的希望。
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引用次数: 0
Intravascular lithotripsy successfully open recurrent in-stent chronic occlusion lesion combined with circular calcification. 血管内碎石术成功打开复发性支架内慢性闭塞病变合并圆形钙化。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.004
Yu Zhao, Xue-Qing Dong, Jun-Jie Li, Ji Qiu, Jia-Hui Liu, Hui-Juan Li, Ying Liu, Meng-Ying Wang, Hai-Yan Wang, Wen-Hui Fan, Yuan-Yang Jia, Jing Bai
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引用次数: 0
Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chronic kidney disease. 全身炎症指数作为慢性肾脏疾病患者冠状动脉疾病严重程度的预测指标
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.26599/1671-5411.2024.10.002
Meng-Qi Zhao, Yang Zhang, Xin Huang, Jian-Jun Peng

Objective: To evaluate the correlation between the inflammatory intensity, as indicated by the systemic inflammatory index (SII), and the severity of coronary artery disease (CAD) in patients with chronic kidney disease (CKD).

Methods: A total of 280 CKD patients who underwent coronary angiography were enrolled. CAD was evaluated using the Gensini score (GS). Patients were divided into the low, medium and high SII groups according to the tertiles of the SII values. Logistic regression analysis was conducted to analyze the relationship between SII and GS. The cutoff points for the sensitivity and specificity of SII in predicting GS were estimated by performing the receiver operating characteristic curve analysis.

Results: Patients in the higher SII group had a higher prevalence of CAD (P = 0.013). In addition, the high SII group had more patients with complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more patients required revascularization (P < 0.05). Correlation analysis suggested a positive relationship between SII and GS, and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, SII displayed a stronger correlation with GS (r = 0.332, P < 0.001). Multifactorial logistic regression analysis revealed that SII is independently associated with the severity of CAD (adjusted OR = 1.14, 95% CI: 1.08-1.21, P < 0.01), particularly among elderly patients (age ≥ 65 years). Receiver operating characteristic curve analysis indicated that the optimal cutoff value for SII in predicting severe coronary artery stenosis (GS > 60) was 6.01 (sensitivity: 76.30%, specificity: 53.50%), with an area under the curve (AUC) of 0.705 (95% CI: 0.642-0.768, P < 0.001), which was statistically significantly better than platelet-to-lymphocyte ratio (AUC = 0.646, 95% CI: 0.579-0.713, P < 0.001) and neutrophil-to-lymphocyte ratio (AUC = 0.643, 95% CI: 0.574-0.712, P < 0.001).

Conclusions: In patients with CKD, SII is independently associated with the severity of CAD, especially in individuals aged 65 years or older. Furthermore, SII functions as a predictive marker for the severity of coronary lesions.

目的:探讨慢性肾脏疾病(CKD)患者全身炎症指数(SII)显示的炎症强度与冠状动脉疾病(CAD)严重程度的相关性。方法:共纳入280例接受冠状动脉造影的CKD患者。采用Gensini评分(GS)评价CAD。根据SII值的位数分为低、中、高SII组。采用Logistic回归分析SII与GS之间的关系。通过进行受试者工作特征曲线分析,估计SII预测GS的敏感性和特异性的截止点。结果:高SII组患者冠心病患病率较高(P = 0.013)。此外,高SII组出现复杂CAD(三支血管病变和/或左主干狭窄)和慢性全闭塞病变的患者较多,需要血运重建术的患者较多(P < 0.05)。相关分析显示SII与GS呈正相关,且与中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值相比,SII与GS的相关性更强(r = 0.332, P < 0.001)。多因素logistic回归分析显示,SII与冠心病严重程度独立相关(调整后OR = 1.14, 95% CI: 1.08-1.21, P < 0.01),尤其是老年患者(年龄≥65岁)。受试者工作特征曲线分析显示,SII预测严重冠状动脉狭窄的最佳临界值(GS bbb60)为6.01(敏感性76.30%,特异性53.50%),曲线下面积(AUC)为0.705 (95% CI: 0.642 ~ 0.768, P < 0.001),显著优于血小板与淋巴细胞比值(AUC = 0.646, 95% CI: 0.579 ~ 0.713, P < 0.001)和中性粒细胞与淋巴细胞比值(AUC = 0.643, 95% CI: 0.574 ~ 0.712, P < 0.001)。结论:在CKD患者中,SII与CAD的严重程度独立相关,特别是在65岁或以上的个体中。此外,SII可作为冠状动脉病变严重程度的预测指标。
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引用次数: 0
The role of multimodality imaging in calcified valves with infective endocarditis. 多模态成像在感染性心内膜炎钙化瓣膜中的作用。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-28 DOI: 10.26599/1671-5411.2024.09.006
Aker Amir, Alexander Fuks, Salim Adawi, Yuval Avidan, Vsevolod Tabachnikov, Amnon Eitan, Avinoam Shiran
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引用次数: 0
Causal effect of psoriasis on aortic valve stenosis: a two-sample Mendelian randomization study. 银屑病对主动脉瓣狭窄的因果效应:双样本孟德尔随机研究。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-28 DOI: 10.26599/1671-5411.2024.09.002
Ke-Xin Jiang, Yan Wang, Yu-Tong Liu, Yanjiani Xu, Fang-Yang Huang, Mao Chen

Background: Epidemiological studies have suggested a potential connection between psoriasis and an increased risk of aortic valve stenosis (AS), though the impact of psoriasis on AS progression remains uncertain. The study aims to investigate the causal relationship between psoriasis and AS using Mendelian randomization (MR) analysis, as well as to uncover potential mechanisms underlying this association.

Methods: A two-sample MR analysis was conducted using publicly available summary statistics from genome-wide association studies (GWAS) of psoriasis and AS. Cis-eQTL and significant genes were identified for each causal single-nucleotide polymorphisms (SNPs), followed by pathway enrichment and protein-protein interaction (PPI) analysis for functional evaluation. Hub genes were pinpointed by Cytospace. The transcriptional profile of AS population was acquired, and interconnected genes networks were clustered using Molecular Complex Detection (MCODE).

Results: Our results demonstrate a significant causal relationship between psoriasis and AS, with a genetic predisposition to psoriasis associated with a higher AS risk (odds ratio: 1.46). Pathway and PPI analyses unveiled 15 hub genes, including HLA-C, HLA-B, ISG15, IFIT3, and MX2, along with immune-related pathways linking psoriasis and AS. Moreover, the transcriptional profiling of the AS database highlighted the significant involvement of adaptive immune cells in AS development. Notably, among the 15 hub genes, ISG15, MX2, OAS3, OASL, IFI6, and EPSTI1 exhibited higher expression in the AS population.

Conclusion: Our study provides compelling evidence supporting a causal relationship between psoriasis and AS. Furthermore, the identified hub genes and immune-related pathways may play an important role in the development of both diseases.

背景:流行病学研究表明,银屑病与主动脉瓣狭窄(AS)风险增加之间存在潜在联系,但银屑病对AS进展的影响仍不确定。本研究旨在利用孟德尔随机分析法(MR)研究银屑病与主动脉瓣狭窄之间的因果关系,并揭示这种关联的潜在机制:方法:利用公开的银屑病和强直性脊柱炎全基因组关联研究(GWAS)的汇总统计数据,进行了双样本 MR 分析。为每个因果单核苷酸多态性(SNPs)确定了顺式-eQTL和重要基因,然后进行了通路富集和蛋白-蛋白相互作用(PPI)分析,以进行功能评估。枢纽基因由 Cytospace 确定。获得了AS群体的转录谱,并利用分子复杂性检测(MCODE)对相互关联的基因网络进行了聚类:结果:我们的研究结果表明,银屑病与强直性脊柱炎之间存在明显的因果关系,银屑病的遗传易感性与较高的强直性脊柱炎风险相关(几率比:1.46)。通路和PPI分析揭示了15个枢纽基因,包括HLA-C、HLA-B、ISG15、IFIT3和MX2,以及连接银屑病和强直性脊柱炎的免疫相关通路。此外,对强直性脊柱炎数据库进行的转录剖析突显了适应性免疫细胞在强直性脊柱炎发病过程中的重要参与。值得注意的是,在15个枢纽基因中,ISG15、MX2、OAS3、OASL、IFI6和EPSTI1在AS人群中的表达量较高:我们的研究提供了令人信服的证据,证明银屑病与强直性脊柱炎之间存在因果关系。结论:我们的研究为银屑病和强直性脊柱炎之间的因果关系提供了令人信服的证据。此外,所发现的枢纽基因和免疫相关通路可能在这两种疾病的发展过程中发挥着重要作用。
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引用次数: 0
Development and validation of a 6-gene signature derived from RNA modification-associated genes for the diagnosis of Acute Stanford Type A Aortic Dissection. 开发并验证用于诊断急性斯坦福 A 型主动脉夹层的 6 个基因特征,这些特征来自 RNA 修饰相关基因。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-28 DOI: 10.26599/1671-5411.2024.09.007
Ting-Ting Zhang, Qun-Gen Li, Zi-Peng Li, Wei Chen, Chang Liu, Hai Tian, Jun-Bo Chuai

Background: Acute Stanford Type A Aortic Dissection (ATAAD) is a critical medical emergency characterized by significant morbidity and mortality. This study aims to identify specific gene expression patterns and RNA modification associated with ATAAD.

Methods: The GSE153434 dataset was obtained from the Gene Expression Omnibus (GEO) database. Differential expression analysis was conducted to identify differential expression genes (DEGs) associated with ATAAD. To validate the involvement of RNA modification in ATAAD, RNA modification-related genes (M6A, M1A, M5C, APA, A-to-I) were acquired from GeneCards, following by Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis. A gene prediction signature consisting of key genes was established, and Real-time PCR was used to validate the gene expression in clinical samples. The patients were then divided into high and low-risk groups, and subsequent enrichment analysis, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Set Enrichment Analysis (GSEA), Gene Set Variation Analysis (GSVA), and assessments of immune infiltration. A co-expression network analysis (WGCNA) was performed to explore gene-phenotype relationships and identify key genes.

Results: A total of 45 RNA modification genes were acquired. Six gene signatures (YTHDC1, WTAP, CFI, ADARB1, ADARB2, TET3) were developed for ATAAD diagnosis and risk stratification. Enrichment analysis suggested the potential involvement of inflammation and extracellular matrix pathways in the progression of ATAAD. The incorporation of pertinent genes from the GSE147026 dataset into the six-gene signature further validated the model's effectiveness. A significant upregulation in WTAP, ADARB2, and TET3 expression, whereas YTHDC1 exhibited a noteworthy downregulation in the ATAAD group.

Conclusion: Six-gene signature could serve as an efficient model for predicting the diagnosis of ATAAD.

背景:急性斯坦福A型主动脉夹层(ATAAD)是一种危重急症,具有显著的发病率和死亡率。本研究旨在确定与ATAAD相关的特定基因表达模式和RNA修饰:方法:GSE153434 数据集来自基因表达总库(GEO)数据库。方法:从基因表达总库(GEO)数据库获取 GSE153434 数据集,进行差异表达分析,以确定与 ATAAD 相关的差异表达基因(DEGs)。为了验证RNA修饰是否参与了ATAAD,研究人员从基因卡片(GeneCards)中获取了RNA修饰相关基因(M6A、M1A、M5C、APA、A-to-I),然后进行了最小绝对收缩和选择操作器(LASSO)回归分析。建立了由关键基因组成的基因预测特征,并使用实时 PCR 验证了临床样本中的基因表达。然后将患者分为高风险组和低风险组,并进行富集分析,包括基因本体(GO)、京都基因和基因组百科全书(KEGG)、基因组富集分析(GSEA)、基因组变异分析(GSVA)和免疫浸润评估。为了探索基因与表型的关系并确定关键基因,还进行了共表达网络分析(WGCNA):结果:共获得 45 个 RNA 修饰基因。结果:共获得了45个RNA修饰基因,其中6个基因(YTHDC1、WTAP、CFI、ADARB1、ADARB2、TET3)被用于ATAAD的诊断和风险分层。富集分析表明,炎症和细胞外基质通路可能参与了 ATAAD 的进展。将 GSE147026 数据集中的相关基因纳入六基因特征进一步验证了该模型的有效性。在ATAAD组中,WTAP、ADARB2和TET3的表达明显上调,而YTHDC1则出现了明显的下调:六基因特征可作为预测 ATAAD 诊断的有效模型。
{"title":"Development and validation of a 6-gene signature derived from RNA modification-associated genes for the diagnosis of Acute Stanford Type A Aortic Dissection.","authors":"Ting-Ting Zhang, Qun-Gen Li, Zi-Peng Li, Wei Chen, Chang Liu, Hai Tian, Jun-Bo Chuai","doi":"10.26599/1671-5411.2024.09.007","DOIUrl":"10.26599/1671-5411.2024.09.007","url":null,"abstract":"<p><strong>Background: </strong>Acute Stanford Type A Aortic Dissection (ATAAD) is a critical medical emergency characterized by significant morbidity and mortality. This study aims to identify specific gene expression patterns and RNA modification associated with ATAAD.</p><p><strong>Methods: </strong>The GSE153434 dataset was obtained from the Gene Expression Omnibus (GEO) database. Differential expression analysis was conducted to identify differential expression genes (DEGs) associated with ATAAD. To validate the involvement of RNA modification in ATAAD, RNA modification-related genes (M6A, M1A, M5C, APA, A-to-I) were acquired from GeneCards, following by Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis. A gene prediction signature consisting of key genes was established, and Real-time PCR was used to validate the gene expression in clinical samples. The patients were then divided into high and low-risk groups, and subsequent enrichment analysis, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Set Enrichment Analysis (GSEA), Gene Set Variation Analysis (GSVA), and assessments of immune infiltration. A co-expression network analysis (WGCNA) was performed to explore gene-phenotype relationships and identify key genes.</p><p><strong>Results: </strong>A total of 45 RNA modification genes were acquired. Six gene signatures (YTHDC1, WTAP, CFI, ADARB1, ADARB2, TET3) were developed for ATAAD diagnosis and risk stratification. Enrichment analysis suggested the potential involvement of inflammation and extracellular matrix pathways in the progression of ATAAD. The incorporation of pertinent genes from the GSE147026 dataset into the six-gene signature further validated the model's effectiveness. A significant upregulation in WTAP, ADARB2, and TET3 expression, whereas YTHDC1 exhibited a noteworthy downregulation in the ATAAD group.</p><p><strong>Conclusion: </strong>Six-gene signature could serve as an efficient model for predicting the diagnosis of ATAAD.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"21 9","pages":"884-898"},"PeriodicalIF":1.8,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Geriatric Cardiology
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