Cardiology discovery最新文献

The Novel Long QT Syndrome Type 2-associated F129I Mutation in the KCNH2 Gene Significantly Affects I Kr Through the hERG1 Homomeric and Heteromeric Potassium Channels KCNH2 基因中的新型长 QT 综合征 2 型相关 F129I 突变会显著影响通过 hERG1 同构和异构钾通道的 I Kr

Cardiology discovery

Pub Date : 2024-05-24 DOI: 10.1097/cd9.0000000000000125

Li Feng, Kejuan Ma, Xin Li, Nian Liu, Deyong Long, Changsheng Ma

The long QT syndrome type 2 is caused by the loss-of-function mutations in the KCNH2 gene, which encodes hERG1, the voltage-gated potassium channel. The hERG1 channels conduct rapid delayed rectifier K+ currents (I Kr) in the human cardiac tissue. KCNH2 encodes 2 main isoforms—hERG1a and hERG1b, which assemble to form the homomeric or heteromeric hERG1 channels. However, the functional characteristics of the heteromeric hERG1 channels in long QT syndrome type 2 are not clear. In this study, a novel mutation in the N-terminus of hERG1a (F129I) was identified in a proband of long QT syndrome type 2. The purpose of this study was to identify the electrophysiological change of homomeric and heteromeric hERG1 channels with the F129I-hERG1a. Candidate genes were screened by direct sequencing. F129I-hERG1a was cloned in the pcDNA3.1 vector by site-directed mutagenesis. Then, the wild-type (WT) hERG1a and/or F129I-hERG1a were transiently expressed in the HEK293 cells with or without hERG1b co-expression. The expression levels of the transgenes, cellular distribution of hERG1a and hERG1b, and the electrophysiological features of the homomeric and the heteromeric hERG1 channels with the WT-hERG1a or F129I-hERG1a were analyzed using whole-cell patch-clamp electrophysiology, western blotting, and immunofluorescence techniques. The proband was clinically diagnosed with long QT syndrome type 2 and carried a heterozygous mutation c.385T>A (F129I) in the KCNH2 gene. Electrophysiology study proved that the F129I substitution in hERG1a significantly decreased I Kr in both the homomeric and heteromeric hERG1channels by 86% and 70%, respectively (WT-hERG1a (54.88 ± 18.74) pA/pF vs. F129I-hERG1a (7.34 ± 1.90) pA/pF, P < 0.001; WT-hERG1a/hERG1b (89.92 ± 24.51) pA/pF vs. F129I-hERG1a/hERG1b (26.54 ± 9.83) pA/pF, P < 0.001). The voltage dependence of IKr activation (V½ and k) was not affected by the mutation in both the homomeric and heteromeric hERG1 channels. The peak current densities and the kinetic characteristics of IKr were comparable for both WT/F129I-hERG1a and WT-hERG1a. The channel inactivation and deactivation analysis showed that F129I substitution did not affect deactivation of the homomeric hERG1a channel, but significantly accelerated the deactivation and recovery from inactivation of the heteromeric hERG1a/hERG1b channel based on the time constants of fast and slow recovery from deactivation F129I-hERG1a/hERG1b vs. WT-hERG1a/hERG1b (P < 0.05). Western blotting and immunofluorescence labeling experiments showed that maturation and intracellular trafficking of the F129I-hERG1a protein was impaired and potentially increased the ratio of hERG1b to hERG1a in the F129I-hERG1a/hERG1b tetramer channel, thereby resulting in electrophysiological changes characteristic of the long QT syndrome type 2 pathology. I Kr was significantly reduced in the homomeric and heteromeric hERG1 channels with F129I-hERG1a. The F129I mutation significa

长 QT 综合征 2 型是由编码电压门控钾通道 hERG1 的 KCNH2 基因功能缺失突变引起的。hERG1 通道可在人体心脏组织中传导快速延迟整流 K+ 电流（I Kr）。KCNH2 编码两种主要的异构体--hERG1a 和 hERG1b，它们组装成同源或异源的 hERG1 通道。然而，长 QT 综合征 2 型中异构 hERG1 通道的功能特征尚不清楚。本研究在一名长 QT 综合征 2 型的疑似患者身上发现了 hERG1a N 端的一个新突变（F129I）。本研究的目的是鉴定带有 F129I-hERG1a 的同源和异源 hERG1 通道的电生理变化。通过直接测序筛选了候选基因。通过定点突变将 F129I-hERG1a 克隆到 pcDNA3.1 载体中。然后，将野生型（WT）hERG1a 和/或 F129I-hERG1a 在有或没有 hERG1b 共表达的 HEK293 细胞中瞬时表达。使用全细胞贴片钳电生理学、Western印迹和免疫荧光技术分析了转基因的表达水平、hERG1a和hERG1b在细胞中的分布以及与WT-hERG1a或F129I-hERG1a同源和异源hERG1通道的电生理特点。该患者被临床诊断为长 QT 综合征 2 型，携带 KCNH2 基因 c.385T>A (F129I) 杂合突变。电生理学研究证明，hERG1a 中的 F129I 置换使同源和异源 hERG1channels 的 I Kr 分别显著下降了 86% 和 70%（WT-hERG1a (54. 88 ± 18.74) pA）。88 ± 18.74) pA/pF vs. F129I-hERG1a (7.34 ± 1.90) pA/pF，P < 0.001；WT-hERG1a/hERG1b (89.92 ± 24.51) pA/pF vs. F129I-hERG1a/hERG1b (26.54 ± 9.83) pA/pF，P < 0.001）。同源和异源 hERG1 通道中，IKr 激活的电压依赖性（V½ 和 k）并没有受到突变的影响。WT/F129I-hERG1a 和 WT-hERG1a 的峰值电流密度和 IKr 的动力学特征相当。通道失活和失活分析表明，F129I取代并不影响同源hERG1a通道的失活，但根据F129I-hERG1a/hERG1b与WT-hERG1a/hERG1b失活快速和慢速恢复的时间常数比较，F129I-hERG1a/hERG1b显著加速了异源hERG1a/hERG1b通道的失活和失活恢复（P < 0.05）。Western 印迹和免疫荧光标记实验表明，F129I-hERG1a 蛋白的成熟和细胞内转运受到影响，并可能增加 F129I-hERG1a/hERG1b 四聚体通道中 hERG1b 与 hERG1a 的比例，从而导致长 QT 综合征 2 型病理特征的电生理变化。在含有 F129I-hERG1a 的同源和异源 hERG1 通道中，I Kr 明显降低。F129I 突变明显加速了异构 F129I-hERG1a/hERG1b 通道的失活和失活后的恢复。F129I-hERG1a 的成熟和细胞内转运能力受损，从而可能增加了 hERG1 四聚体通道中 hERG1b 与 hERG1a 的比例。这些变化证明了异构 hERG1 通道在长 QT 综合征 2 型病理生理学中的重要性。

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引用次数: 0

Fulminant Myocarditis Complicated by Stiff-person Syndrome: A Case Report 僵人综合征并发的暴发性心肌炎：病例报告

Cardiology discovery

Pub Date : 2024-03-27 DOI: 10.1097/cd9.0000000000000117

Peng Chen, Nana Tang, Huilan Zhang, Dao Wen Wang

This case report described a 61-year-old woman who presented with dizziness, headache, muscle ache, diplopia, and vomiting who lost consciousness. Upon hospital admission, the levels of high-sensitivity cardiac troponin I and partial pressure of carbon dioxide were increased markedly. Loss of consciousness occurred twice after removal of invasive ventilator support. Coronary angiography demonstrated no stenosis in coronary arteries. Ultrasonography revealed inactivity of respiratory muscles. Oculomotor disturbance and autonomic-nerve dysfunctions were observed. Serum antibody against glutamic acid decarboxylase was positive. The rare phenotypes of persistent stiffness of muscles in the neck, face, bilateral upper and lower limbs were observed. The patient was diagnosed with fulminant myocarditis complicated by Stiff-person syndrome. Immunomodulatory treatment (glucocorticoids and immunoglobulins) elicited satisfactory therapeutic effects. In this case report, it was found that fulminant myocarditis and Stiff-person syndrome shared a common pathogenesis: “cytokine storm”. Such patients may benefit from early treatment with immunomodulatory agents.

本病例报告描述了一名 61 岁的妇女因头晕、头痛、肌肉酸痛、复视和呕吐而失去知觉。入院时，高敏心肌肌钙蛋白 I 水平和二氧化碳分压明显升高。移除有创呼吸机支持后，患者两次失去意识。冠状动脉造影显示冠状动脉没有狭窄。超声波检查显示呼吸肌无力。观察到眼球运动障碍和自主神经功能障碍。血清谷氨酸脱羧酶抗体呈阳性。观察到颈部、面部、双上肢和双下肢肌肉持续僵硬的罕见表型。患者被诊断为暴发性心肌炎并发僵人综合征。免疫调节治疗（糖皮质激素和免疫球蛋白）取得了令人满意的疗效。本病例报告发现，暴发性心肌炎和僵人综合征有一个共同的发病机制："细胞因子风暴"。这类患者可能会受益于免疫调节药物的早期治疗。

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引用次数: 0

Predictive Value of Carotid-femoral Pulse Wave Velocity for Major Adverse Cardiovascular Events and All-cause Mortality in Different Age Groups of a Chinese Community 颈动脉-股动脉脉搏波速度对中国社区不同年龄组主要不良心血管事件和全因死亡率的预测价值

Cardiology discovery

Pub Date : 2024-03-26 DOI: 10.1097/cd9.0000000000000120

Jin Zheng, Xiaona Wang, Li Mao, Ping Ye

To investigate the predictive value of carotid-femoral pulse wave velocity (cf-PWV) for assessing major adverse cardiovascular events (MACE) and all-cause mortality in different age groups of a Chinese community. This is an observational study which enrolled 1,325 individuals from a community in Beijing from September 2007 to October 2018. They were classified based on age into <65-year-old (n = 572) and ≥65-year-old (n = 753) groups, and on cf-PWV into cf-PWV <12 m/s (n = 501) and cf-PWV≥12 m/s (n = 824) group. The incidence rates of MACE and all-cause mortality were recorded for both the groups during the follow-up period of 9.5 years. The predictive value of cf-PWV for MACE and all-cause mortality in the 2 age groups was estimated using the Cox proportional hazards regression models. The baseline cf-PWV showed positive correlation with age (r = 0.462, P < 0.001). During the follow-up period, 191 MACE and 84 all-cause mortality cases were recorded in the study population. The incidence rates of MACE (χ 2 = 27.196, P < 0.001) and all-cause mortality (χ 2 = 9.473, P = 0.002) were significantly higher in subjects with cf-PWV ≥12 m/s than in subjects with cf-PWV <12 m/s. Cox proportional hazards regression model analyses demonstrated that cf-PWV was an independent risk factor in the <65-year-old group for MACE (hazard ratio: 1.310; 95% confidence interval: 1.007–1.560; P = 0.038) and all-cause mortality (hazard ratio: 1.412; 95% confidence interval: 1.133–1.936; P = 0.005) after adjusting for several risk factors. However, both univariate and multivariate analyses demonstrated that cf-PWV was not an independent risk factor for MACE or all-cause mortality in the ≥65-year-old group (P > 0.05). cf-PWV, a measure of arterial stiffness, emerged as an independent risk factor for MACE and all-cause mortality in subjects below 65 years of age.

目的：研究颈动脉-股动脉脉搏波速度（cf-PWV）对评估中国社区不同年龄组的主要不良心血管事件（MACE）和全因死亡率的预测价值。这是一项观察性研究，从 2007 年 9 月至 2018 年 10 月，在北京的一个社区招募了 1325 人。cf-PWV是动脉僵化的一种测量指标，是65岁以下受试者MACE和全因死亡率的独立风险因素。

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引用次数: 0

Home Blood Pressure Monitoring and Its Association With Blood Pressure Control Among Hypertensive Patients With High Cardiovascular Risk in China. 中国高心血管风险高血压患者的家庭血压监测及其与血压控制的关系。

Cardiology discovery

Pub Date : 2024-03-01 Epub Date: 2024-02-14 DOI: 10.1097/CD9.0000000000000118

Jiaying Li, Aoxi Tian, Jiamin Liu, Jinzhuo Ge, Yue Peng, Xiaoming Su, Jing Li

Objective: Home blood pressure monitoring (HBPM) is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension. However, evidence remains scarce about the effectiveness of HBPM use in the real world. This study aimed to examine the associations of HBPM use with blood pressure (BP) control and medication adherence.

Methods: This prospective cohort study included hypertensive patients with high cardiovascular risk who were aged ≥50 years. At baseline, information about types of BP monitor, frequency of HBPM, perception of anti-hypertensive treatment, and measured office BP were collected. During the 1-year follow-up (visits at 1, 2, 3, 6, and 12 months), information on medication adherence was collected at each visit. The 2 major outcomes were BP control at baseline and medication adherence during the 1-year follow-up. A log-binomial regression model was used to examine the association between frequency of HBPM and outcomes, stratified by the perceptions of anti-hypertensive treatment.

Results: A total of 5,363 hypertensive patients were included in the analysis. The age was (64.6 ± 7.2) years, and 41.2% (2,208) were female. Of the total patients, 85.9% (4,606) had a home BP monitor and 47.8% (2,564) had an incorrect perception of anti-hypertensive treatment. Overall, 24.2% (1,299) of patients monitored their BP daily, 37.6% (2,015) weekly, 17.3% (926) monthly, and 20.9% (1,123) less than monthly. At baseline, the systolic BP and diastolic BP were (146.6 ± 10.8) mmHg and (81.9 ± 10.6) mmHg, respectively, and 28.5% (1,527) of patients had their BP controlled. Regardless of whether the patients had correct or incorrect perceptions of anti-hypertensive treatment, there is no significant association between HBPM frequency and BP control at baseline. During the 1-year follow-up, 23.9% (1,280) of patients had non-adherence to medications at least once. In patients with an incorrect perception of anti-hypertensive treatment, those monitoring BP most frequently (daily) had the highest non-adherence rate (29.9%, 175/585). Compared with those monitoring their BP less than monthly, patients who monitored their BP daily were more likely not to adhere to anti-hypertensive medications (adjusted relative risk = 1.38, 95% confidence interval: 1.11-1.72, P = 0.004).

Conclusions: HBPM performance among hypertensive patients in China is, in general, sub-optimal. No association was observed between using HBPM alone and hypertension control, indicating that the effects of HBPM could be conditional. Patients' misconceptions about anti-hypertensive treatment may impair the role of BP monitoring in achieving medication adherence. Fully incorporating the correct perception of hypertension into the management of hypertensive patients is needed.

目的：家庭血压监测（HBPM）被认为是初步诊断和长期治疗高血压的有利因素。然而，有关在现实世界中使用 HBPM 的有效性的证据仍然很少。本研究旨在探讨使用 HBPM 与血压（BP）控制和服药依从性之间的关系：这项前瞻性队列研究纳入了年龄≥50 岁的高心血管风险高血压患者。在基线阶段，研究人员收集了有关血压计类型、HBPM 使用频率、对抗抑郁治疗的认知以及诊室血压测量结果等信息。在为期 1 年的随访期间（1、2、3、6 和 12 个月的随访），每次随访都会收集有关服药依从性的信息。两个主要结果是基线血压控制情况和 1 年随访期间的服药依从性。我们使用对数二叉回归模型来研究 HBPM 频率与结果之间的关系，并根据抗高血压治疗的看法进行分层：共有 5363 名高血压患者参与了分析。年龄为（64.6 ± 7.2）岁，41.2%（2 208 人）为女性。在所有患者中，85.9%（4,606 人）拥有家用血压计，47.8%（2,564 人）对降压治疗的认识不正确。总体而言，24.2% 的患者（1,299 人）每天监测血压，37.6% 的患者（2,015 人）每周监测血压，17.3% 的患者（926 人）每月监测血压，20.9% 的患者（1,123 人）不到每月监测血压。基线时，收缩压和舒张压分别为 (146.6 ± 10.8) mmHg 和 (81.9 ± 10.6) mmHg，28.5%（1,527 人）的患者血压得到控制。无论患者对抗高血压治疗的认识正确与否，基线时 HBPM 频率与血压控制之间均无显著关联。在为期 1 年的随访中，23.9% 的患者（1 280 人）至少有一次没有坚持服药。在抗高血压治疗认知不正确的患者中，监测血压最频繁（每天）的患者不坚持服药的比例最高（29.9%，175/585）。与每月监测血压不足一次的患者相比，每天监测血压的患者更有可能不坚持服用抗高血压药物（调整后相对风险=1.38，95% 置信区间：1.11-1.72，P=0.004）：中国高血压患者使用 HBPM 的情况总体上并不理想。结论：中国高血压患者的 HBPM 效果普遍不理想，单独使用 HBPM 与高血压控制之间没有关联，这表明 HBPM 的效果可能是有条件的。患者对降压治疗的误解可能会影响血压监测在实现服药依从性方面的作用。需要将对高血压的正确认识充分纳入高血压患者的管理中。

{"title":"Home Blood Pressure Monitoring and Its Association With Blood Pressure Control Among Hypertensive Patients With High Cardiovascular Risk in China.","authors":"Jiaying Li, Aoxi Tian, Jiamin Liu, Jinzhuo Ge, Yue Peng, Xiaoming Su, Jing Li","doi":"10.1097/CD9.0000000000000118","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000118","url":null,"abstract":"Objective: Home blood pressure monitoring (HBPM) is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension. However, evidence remains scarce about the effectiveness of HBPM use in the real world. This study aimed to examine the associations of HBPM use with blood pressure (BP) control and medication adherence.Methods: This prospective cohort study included hypertensive patients with high cardiovascular risk who were aged ≥50 years. At baseline, information about types of BP monitor, frequency of HBPM, perception of anti-hypertensive treatment, and measured office BP were collected. During the 1-year follow-up (visits at 1, 2, 3, 6, and 12 months), information on medication adherence was collected at each visit. The 2 major outcomes were BP control at baseline and medication adherence during the 1-year follow-up. A log-binomial regression model was used to examine the association between frequency of HBPM and outcomes, stratified by the perceptions of anti-hypertensive treatment.Results: A total of 5,363 hypertensive patients were included in the analysis. The age was (64.6 ± 7.2) years, and 41.2% (2,208) were female. Of the total patients, 85.9% (4,606) had a home BP monitor and 47.8% (2,564) had an incorrect perception of anti-hypertensive treatment. Overall, 24.2% (1,299) of patients monitored their BP daily, 37.6% (2,015) weekly, 17.3% (926) monthly, and 20.9% (1,123) less than monthly. At baseline, the systolic BP and diastolic BP were (146.6 ± 10.8) mmHg and (81.9 ± 10.6) mmHg, respectively, and 28.5% (1,527) of patients had their BP controlled. Regardless of whether the patients had correct or incorrect perceptions of anti-hypertensive treatment, there is no significant association between HBPM frequency and BP control at baseline. During the 1-year follow-up, 23.9% (1,280) of patients had non-adherence to medications at least once. In patients with an incorrect perception of anti-hypertensive treatment, those monitoring BP most frequently (daily) had the highest non-adherence rate (29.9%, 175/585). Compared with those monitoring their BP less than monthly, patients who monitored their BP daily were more likely not to adhere to anti-hypertensive medications (adjusted relative risk = 1.38, 95% confidence interval: 1.11-1.72, P = 0.004).Conclusions: HBPM performance among hypertensive patients in China is, in general, sub-optimal. No association was observed between using HBPM alone and hypertension control, indicating that the effects of HBPM could be conditional. Patients' misconceptions about anti-hypertensive treatment may impair the role of BP monitoring in achieving medication adherence. Fully incorporating the correct perception of hypertension into the management of hypertensive patients is needed.","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interpretation of the Annual Report on Cardiovascular Health and Diseases in China 2022 2022中国心血管健康与疾病年度报告》解读

Cardiology discovery

Pub Date : 2024-02-23 DOI: 10.1097/cd9.0000000000000119

引用次数: 1

Implementation Research and Results of Hypertension Control Strategy and Model in Rural Areas 农村地区高血压控制策略和模式的实施研究与成果

Cardiology discovery

Pub Date : 2023-12-29 DOI: 10.1097/cd9.0000000000000102

Guozhe Sun, Jing Wu, Pengyu Zhang, Yao Yu, Yingxian Sun

引用次数: 0

Interpretation of the Annual Report on Cardiovascular Health and Diseases in China 2021 2021中国心血管健康与疾病年度报告》解读

Cardiology discovery

Pub Date : 2023-11-29 DOI: 10.1097/cd9.0000000000000107

引用次数: 0

Thirty-day Outcomes of First-in-man Implantation of a Novel Transcatheter Edge-to-edge Mitral Repair System in Patients with Severe Mitral Regurgitation 在严重二尖瓣返流患者中首次植入新型经导管边缘到边缘二尖瓣修复系统的 30 天疗效观察

Cardiology discovery

Pub Date : 2023-11-23 DOI: 10.1097/cd9.0000000000000112

Kai Xu, Yan Wang, Shaoliang Chen, X. Pan, Ben He, Ruiyan Zhang, Bin Wang, Junjie Zhang, Zhengbin Zhu, Bin Wang, D. Zhu, Yaling Han

The aim of this multicenter, prospective, single-arm pilot study (ClinicalTrials.gov number: NCT05040074) was to observe the procedural and 30-day results of the novel transcatheter mitral valve repair system, SQ-Kyrin®-M Clip (Shenqi Medical, Shanghai, China), in patients with severe mitral regurgitation (MR). The heart team considered patients from 5 centers in China with clinically significant functional mitral regurgitation ≥3+ despite optimal medical therapy or degenerative mitral regurgitation ≥3+ with high surgical risk as candidates for transcatheter repair. All patients received transcatheter edge-to-edge mitral valve repair under general anesthesia. The primary outcome was technical success, which included all of the following measured at the exit from the catheterization laboratory: (1) absence of procedural mortality; (2) successful access, delivery, and retrieval of the device delivery system; (3) successful deployment and correct positioning of the first intended device; and (4) no emergency surgery or reintervention related to the device or access procedure. The secondary outcomes included all-cause mortality, serious adverse events, device success, and procedural success 30 d after the intervention. From June 2021 to December 2021, 18 patients were enrolled in this study with age (75.7 ± 7.4) years. Fifteen (83.3%) patients had MR 4+, while 3 (16.7%) had MR 3+. Technical success was achieved in all patients, including 6 degenerative mitral regurgitation and 12 functional mitral regurgitation patients. There was no all-cause mortality at 30 d. One (5.6%) patient had single leaflet device attachment within 30 d, which was regarded as a serious adverse event, and the patient was successfully treated with reintervention by implanting another clip. Another patient’s transmitral gradient was 6 mmHg (>5 mmHg), with an effective orifice area of 2.57 cm2 after the procedure. Sixteen (88.9%) patients had device success and procedural success at 30 d postoperation. Fourteen (77.8%) patients had MR 1+, 3 (16.7%) had MR 2+, and only 1 (5.6%) patient had MR 3 + 30 d after the procedure. The results of this feasibility study showed the efficacy and safety of the SQ-Kyrin®-M device in the Chinese population with severe MR, laying a solid foundation for a subsequent large-scale confirmatory study.

这项多中心、前瞻性、单臂试验研究（ClinicalTrials.gov 编号：NCT05040074）旨在观察新型经导管二尖瓣修复系统 SQ-Kyrin®-M Clip（神麒医疗，中国上海）在重度二尖瓣反流（MR）患者中的手术和 30 天疗效。心脏团队将来自中国 5 个中心的患者视为经导管修复的候选者，这些患者尽管接受了最佳药物治疗，但临床上仍存在功能性二尖瓣反流≥3+，或退行性二尖瓣反流≥3+，且手术风险较高。所有患者都在全身麻醉下接受了经导管边缘对边缘二尖瓣修复术。主要结果是技术成功，包括从导管室出来时测量的以下所有结果：(1) 无手术死亡率；(2) 成功接入、输送和取回装置输送系统；(3) 成功部署和正确定位第一个预定装置；(4) 无与装置或接入程序相关的急诊手术或再干预。次要结果包括干预 30 天后的全因死亡率、严重不良事件、装置成功率和程序成功率。从 2021 年 6 月到 2021 年 12 月，18 名患者参与了这项研究，年龄为（75.7 ± 7.4）岁。15例（83.3%）患者患有MR 4+，3例（16.7%）患者患有MR 3+。所有患者都取得了技术成功，其中包括 6 名退行性二尖瓣反流患者和 12 名功能性二尖瓣反流患者。一名患者（5.6%）在 30 天内出现单瓣装置附着，这被视为严重不良事件，该患者通过植入另一个夹子重新介入治疗，并获得成功。另一名患者的透射阶差为 6 mmHg（>5 mmHg），术后有效孔面积为 2.57 平方厘米。16名患者（88.9%）在术后30 d时装置成功，手术成功。14名患者（77.8%）在术后 30 天出现 MR 1+，3 名患者（16.7%）出现 MR 2+，只有 1 名患者（5.6%）出现 MR 3+。这项可行性研究的结果表明，SQ-Kyrin®-M 装置在中国重度 MR 患者中具有良好的疗效和安全性，为后续的大规模确证研究奠定了坚实的基础。

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引用次数: 0

Overview of the Association between Non-Alcoholic Fatty Liver Disease and Hypertension 非酒精性脂肪肝与高血压之间的关系概述

Cardiology discovery

Pub Date : 2023-11-21 DOI: 10.1097/cd9.0000000000000113

Niki S. Kakouri, C. Thomopoulos, E. Siafi, A. Valatsou, Kyriakos Dimitriadis, Iliana P. Mani, S. Patsilinakos, Dimitrios M. Tousoulis, Konstantinos P. Tsioufis

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its prevalence is rising. NAFLD is closely associated with metabolic syndrome, with both conditions sharing common clinical characteristics such as obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and hypertriglyceridemia. Several observational studies have evaluated the relationship between NAFLD and hypertension, with the overall evidence suggesting a bidirectional relationship. It is hypothesized that activation of the sympathetic nervous and renin-angiotensin systems, observed in NAFLD with or without insulin resistance promotes the development of hypertension. In patients with hypertension, activation of these systems can lead to hepatic fibrosis and progressive inflammation through increased oxidative stress and activation of hepatic stellate cells and Kupffer cells. The present review examines the pathophysiologic and clinical evidence supporting the bidirectional association between NAFLD and hypertension.

非酒精性脂肪肝（NAFLD）是最常见的慢性肝病，其发病率呈上升趋势。非酒精性脂肪肝与代谢综合征密切相关，这两种疾病具有共同的临床特征，如肥胖、胰岛素抵抗、2 型糖尿病、高血压和高甘油三酯血症。多项观察性研究评估了非酒精性脂肪肝与高血压之间的关系，总体证据表明两者之间存在双向关系。据推测，非酒精性脂肪肝伴有或不伴有胰岛素抵抗时，交感神经系统和肾素-血管紧张素系统的激活会促进高血压的发生。在高血压患者中，这些系统的激活可通过增加氧化应激和激活肝星状细胞和 Kupffer 细胞，导致肝纤维化和进行性炎症。本综述探讨了支持非酒精性脂肪肝与高血压之间双向关联的病理生理学和临床证据。

引用次数: 0

Chronic Pulmonary Artery Stenosis: Time to Think as a Disease Entity 慢性肺动脉狭窄:是时候将其视为一种疾病实体了

Cardiology discovery

Pub Date : 2023-11-08 DOI: 10.1097/cd9.0000000000000110

Wenjie Dong, Jingwen Zhang, Hongling Su, Yunshan Cao

Chronic pulmonary artery stenosis (CPAS) is characterized by a reduction or complete obstruction of the cross-sectional area of the pulmonary artery owing to various causes. The condition exhibits similar pathophysiological progress, leading to pulmonary hypertension (PH), reduced physical endurance, right heart failure, and death. Although CPAS is often regarded as a subgroup of PH, it can manifest independently for an extended duration before the onset of PH and can significantly impact patient quality of life. It may therefore be more appropriate to consider PH as pathophysiological progression of CPAS, thereby recognizing CPAS as a distinct disease entity.

慢性肺动脉狭窄(Chronic pulmonary artery stenosis, CPAS)的特点是由于各种原因导致肺动脉横截面积减少或完全阻塞。这种疾病表现出类似的病理生理过程，导致肺动脉高压(PH)、身体耐力降低、右心衰和死亡。虽然CPAS通常被认为是PH的一个亚组，但它可以在PH发病前的较长时间内独立表现，并且可以显著影响患者的生活质量。因此，将PH视为CPAS的病理生理进展可能更合适，从而认识到CPAS是一种独特的疾病实体。

引用次数: 0