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Renal Denervation Ameliorates Cardiomyocyte Apoptosis in Myocardial Ischemia-Reperfusion Injury Through Regulating Mitochondria-Endoplasmic Reticulum Contact. 肾脏去神经通过调节线粒体-内质网接触改善心肌缺血再灌注损伤中的心肌细胞凋亡
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-01 DOI: 10.14744/AnatolJCardiol.2024.3579
Zheng Zhao, Faquan Li, Yiyao Jiang, Chengzhi Lu

Background: Myocardial ischemia-reperfusion injury (I/R) has been improved with drugs and effective reperfusion, but it still cannot be prevented.

Methods: To investigate whether renal denervation (RDN) reduces cardiomyocyte apoptosis by ameliorating endoplasmic reticulum stress, 60 male specific pathogen-free (SPF) Wistar rats were randomly divided into 6 groups (n = 6). We established the I/R rat model by ligating the left anterior descending artery. The I/R+ angiotensin receptor neprilysin inhibitors (ARNI) group received ARNIs for 2 weeks until euthanasia.

Results: The I/R+RDN and I/R+ARNI groups have significantly ameliorated left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) and reversed expansion of the left ventricular end-systolic diameter (LVSD) and left ventricular end diastolic diameter (LVDD) compared to the I/R group. The levels of norepinephrine (NE), angiotensin II, and aldosterone (ALD) increased significantly in the I/R group, but decreased significantly after RDN and ARNI intervention. In the I/R+RDN and I/R+ARNI groups, the myocardial tissue edema was alleviated. The infarct size was smaller in the I/R+RDN and I/R+ARNI groups compared to the I/R group. Apoptosis of cardiomyocytes and fibroblasts in myocardial tissue increased significantly in the I/R group, which was greatly diminished by RDN and ARNI. The expression of Bax, caspase-3, CHOP, PERK, and ATF4 protein was significantly increased in the I/R group, which compared to other groups, and the level of CHOP, PERK, and ATF4 gene expression increased. After RDN intervention, these expression levels recovered to varying degrees.

Conclusion: The effect of RDN may be associated with regulating the endoplasmic reticulum stress PERK/ATF4 signaling pathway.

背景:心肌缺血再灌注损伤(I/R心肌缺血再灌注损伤(I/R)已通过药物和有效的再灌注得到改善,但仍无法预防:为了研究肾脏去神经(RDN)是否能通过改善内质网应激减少心肌细胞凋亡,我们将60只雄性无特异性病原体(SPF)Wistar大鼠随机分为6组(n = 6)。我们通过结扎左前降支动脉建立了 I/R 大鼠模型。I/R+血管紧张素受体肾素抑制剂(ARNI)组接受ARNIs治疗2周,直至安乐死:结果:与I/R组相比,I/R+RDN组和I/R+ARNI组的左室射血分数(LVEF)和左室缩短率(LVFS)明显改善,左室收缩末期直径(LVSD)和左室舒张末期直径(LVDD)的扩大得到逆转。I/R组的去甲肾上腺素(NE)、血管紧张素II和醛固酮(ALD)水平显著升高,但在RDN和ARNI干预后显著降低。在 I/R+RDN 组和 I/R+ARNI 组,心肌组织水肿得到缓解。与I/R组相比,I/R+RDN组和I/R+ARNI组的梗死面积较小。心肌组织中心肌细胞和成纤维细胞的凋亡在 I/R 组明显增加,而 RDN 和 ARNI 则大大减少。与其他组相比,I/R 组 Bax、caspase-3、CHOP、PERK 和 ATF4 蛋白的表达明显增加,CHOP、PERK 和 ATF4 基因的表达水平也有所增加。RDN干预后,这些表达水平均有不同程度的恢复:结论:RDN的作用可能与调节内质网应激PERK/ATF4信号通路有关。
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引用次数: 0
Early Menarche as a Protective Factor Against Cardiovascular Events: A Systematic Review and Meta-analysis. 月经初潮早是心血管事件的保护因素:系统回顾与元分析》。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-01 DOI: 10.14744/AnatolJCardiol.2024.3996
Clinton Sudjono, Kiara Hanna Quinncilla, Ms Qonita, Nicholas Jason Wijaya, Dave Kurnain

Background: Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially identified as one of the significant CVD risk factor. However, there is still limited comprehensive evidence addressing this issue. This systematic review and meta-analysis aimed to investigate how early menarche affects the outcome of all-cause mortality, CVD mortality, total cardiovascular disease event, stroke (ischemic, hemorrhagic, and total stroke), and coronary heart disease (CHD).

Method: The Cochrane Library, MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched from March 2013 to March 2023 for cohorts investigating the effect of early onset of menarche on CVD events with a minimum follow-up period of 5 years. Studies that observed specific population and/or included women with a history of CVD at baseline were excluded. The Newcastle-Ottawa scale was used for risk of bias assessment for each cohort included. The data were presented as dichotomous measure using risk ratios. I2 statistics were utilized to evaluate the heterogeneity of presented data.

Results: Thirteen cohorts included 18 626 799 female patients with ages ranging from 43 to 62.6 years. These reported 6 estimates each for CHD (5 483 298 patients) and all-cause mortality (1 595 878 patients), 5 estimates each for total stroke (2 941 321 patients) and CVD mortality (1 706 742 patients), 4 estimates each for total CVD events (3 988 311 patients) and ischemic stroke (2 434 580 patients), and 1 estimate for hemorrhagic stroke (66 104 patients). Our study found that events of CHD were significantly lower in early menarche (RR 0.57; 95% CI 0.41-0.78; P <.00001), as well as total stroke (RR 0.51; 95% CI 0.35-0.73; P =.0003), CVD mortality (RR 0.47; 95% CI 0.22-0.98; P =.04), total CVD events (RR 0.44; 95% CI 0.25-0.76; P =.003), ischemic stroke (RR 0.31; 95% CI 0.15-0.61; P <.0008), and hemorrhagic stroke (RR 0.12; 95% CI 0.07-0.20; P <.00001); and insignificantly higher in all-cause mortality (RR 0.90, 95% CI 0.76-1.06, P =.20).

Conclusion: In our study, cardiovascular events are lower in women with early menarche; hence, the later age of menarche is a potential risk factor to be considered when assessing CVD risk in a patient. However, our sample characteristics were heterogenous, and we did not consider other female hormonal factors that might potentially contribute to the CVD outcomes observed; thus, further studies are needed to clarify.

背景:在心血管健康预防方面,女性往往被忽视。初潮年龄(AAM)与女性心血管疾病(CVD)有关,并有可能被确定为重要的心血管疾病风险因素之一。然而,针对这一问题的全面证据仍然有限。本系统综述和荟萃分析旨在研究初潮过早如何影响全因死亡率、心血管疾病死亡率、心血管疾病总事件、中风(缺血性、出血性和总中风)和冠心病(CHD)的结果:方法:从 2013 年 3 月至 2023 年 3 月,在 Cochrane Library、MEDLINE、Embase、ScienceDirect 和 Google Scholar 数据库中检索了调查初潮提前对心血管疾病事件影响的队列研究,随访期至少为 5 年。排除了观察特定人群和/或包括基线时有心血管疾病史的女性的研究。采用纽卡斯尔-渥太华量表对纳入的每个队列进行偏倚风险评估。数据以风险比的二分法表示。利用I2统计量评估所列数据的异质性:13 个队列共纳入 18 626 799 名女性患者,年龄从 43 岁到 62.6 岁不等。这些研究报告了 CHD(5 483 298 例患者)和全因死亡率(1 595 878 例患者)各 6 个估计值,总中风(2 941 321 例患者)和心血管疾病死亡率(1 706 742 例患者)各 5 个估计值,心血管疾病总事件(3 988 311 例患者)和缺血性中风(2 434 580 例患者)各 4 个估计值,出血性中风(66 104 例患者)1 个估计值。我们的研究发现,月经初潮早期发生的心血管疾病事件明显较少(RR 0.57;95% CI 0.41-0.78;P 结论:我们的研究发现,月经初潮早期发生的心血管疾病事件明显较少:在我们的研究中,初潮早的女性发生心血管事件的几率较低;因此,在评估患者的心血管疾病风险时,初潮年龄较晚是一个需要考虑的潜在风险因素。然而,我们的样本特征是异质性的,而且我们没有考虑可能导致心血管疾病结果的其他女性荷尔蒙因素;因此,还需要进一步的研究来加以澄清。
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引用次数: 0
Large Language Models: Could They Be the Next Generation of Clinical Decision Support Systems in Cardiovascular Diseases? 大型语言模型:它们能否成为下一代心血管疾病临床决策支持系统?
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4469
Yasin Celal Güneş, Turay Cesur
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引用次数: 0
Monogenic Hypertension Linked to the Renin-Angiotensin-Aldosterone System. 与肾素-血管紧张素-醛固酮系统有关的单基因高血压。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4480
Murat Özdede

Mendelian forms of renin-angiotensin-aldosterone system (RAAS)-related hypertension, commonly referred to as monogenic hypertension, represent a rare but significant subset of hypertensive disorders characterized by genetic mutations that disrupt the normal physiological mechanisms of blood pressure regulation. This review focuses on elucidating the germline mutations affecting RAAS pathways that lead to distinct forms of heritable hypertension. By understanding the pathophysiological basis of conditions such as Gordon's syndrome, Liddle syndrome, congenital adrenal hyperplasia, and familial hyperaldosteronism types, this review aims to highlight the unique clinical features, diagnostic challenges, and therapeutic implications associated with these disorders. Recognizing specific clinical presentations and family histories indicative of monogenic hypertension is crucial for diagnosis, particularly as it often manifests as early-onset hypertension, abnormalities in potassium and blood pH, and occasionally, abnormal sexual development or related syndromes. Therefore, employing a targeted diagnostic approach through next-generation sequencing is essential to pinpoint the responsible genetic mutations, enabling accurate and individualized treatment plans. The critical importance of certain readily available specific channel blockers, such as thiazides or low-dose corticosteroids, in managing these disorders must be emphasized, as they play a key role in preventing serious complications, including cerebrovascular events. As advancements in genetic and molecular sciences continue to evolve, a deeper comprehension of the mechanisms underlying RAAS-related monogenic hypertension promises to revolutionize the management of this complex disorder, offering hope for more effective and individualized treatment options.

与肾素-血管紧张素-醛固酮系统(RAAS)相关的孟德尔型高血压通常被称为单基因高血压,是高血压疾病中罕见但重要的一个亚型,其特点是基因突变破坏了血压调节的正常生理机制。本综述重点阐述影响 RAAS 通路的种系突变导致不同形式的遗传性高血压。通过了解戈登综合征、利德尔综合征、先天性肾上腺皮质增生症和家族性醛固酮增多症等疾病的病理生理基础,本综述旨在强调与这些疾病相关的独特临床特征、诊断难题和治疗意义。识别单基因高血压的特殊临床表现和家族病史对诊断至关重要,尤其是这种疾病通常表现为早发性高血压、血钾和血液 pH 值异常,偶尔还会出现性发育异常或相关综合征。因此,通过下一代测序技术采用有针对性的诊断方法对于确定基因突变的原因、制定准确的个体化治疗方案至关重要。必须强调的是,某些现成的特异性通道阻滞剂(如噻嗪类药物或小剂量皮质类固醇)对治疗这些疾病至关重要,因为它们在预防包括脑血管事件在内的严重并发症方面发挥着关键作用。随着遗传和分子科学的不断进步,对 RAAS 相关单基因高血压发病机制的深入了解有望彻底改变这种复杂疾病的治疗方法,为更有效和个性化的治疗方案带来希望。
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引用次数: 0
Reply to Letter to the Editor: 'More Accurate Impact of as an Independent Predictor of Fragmented QRS on Cardiovascular Events'. 回复致编辑的信:"作为心血管事件独立预测因子的 QRS 波形片段的更准确影响"。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4579
Şükrü Çetin
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引用次数: 0
Equation with Many Unknowns in a Young Patient with Massive Coronary Thrombus. 年轻冠状动脉血栓患者的未知方程式
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4017
Mert Doğan, Berkay Ceyhun Dinçer, Süleyman Cihan Kara, Ahmet Hakan Ateş, Uğur Canpolat
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引用次数: 0
More Accurate Impact of as an Independent Predictor of Fragmented QRS on Cardiovascular Events. 更准确地预测 QRS 波形片段对心血管事件的影响。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4577
Mehmet Erdoğan
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引用次数: 0
Causal Effect of Atrial Fibrillation on Heart Failure Risk in East Asian Ancestry: A Bidirectional Mendelian Randomization Study Using Genome-wide Association Data. 心房颤动对东亚血统心力衰竭风险的因果效应:利用全基因组关联数据的双向孟德尔随机化研究
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4369
Yibin Mei, Fang Ye, Xiaofen Yin, Xianjun Wu

Background: Atrial fibrillation (AF) and heart failure (HF) are prevalent cardiovascular conditions in East Asia, with a complex interrelationship. The directionality of the causal impact of AF on HF risk remains uncertain. This study employs Mendelian randomization (MR) to investigate the potential causal effect of AF on HF.

Methods: Utilizing summary data from genome-wide association studies (GWAS) within the Medical Research Council Integrative Epidemiology Unit open GWAS database, we analyzed 8180 AF cases and 28 612 controls, alongside 9413 HF cases and 203 040 controls, all of East Asian descent. We conducted MR analysis using the inverse variance weighted (IVW) method, complemented by various sensitivity analyses, including bidirectional MR to assess causality in the reverse direction.

Results: Genetically predicted AF was found to be causally associated with an increased risk of HF in East Asian populations (odds ratio = 1.14, 95% CI: 1.10-1.19, P <.001) as per the IVW method. These findings were consistent across multiple MR methods. Sensitivity analyses revealed no significant heterogeneity or pleiotropy. Notably, bidirectional MR analysis showed no causal effect of HF on the risk of developing AF.

Conclusions: The MR analysis supports a unidirectional causal relationship between AF and increased HF risk in East Asian individuals. The absence of a reverse causal effect reinforces the importance of maintaining sinus rhythm to mitigate HF risk. Further research is warranted to corroborate these findings and to explore their clinical implications in depth.

背景:心房颤动(AF)和心力衰竭(HF)是东亚地区普遍存在的心血管疾病,两者之间存在复杂的相互关系。心房颤动对心力衰竭风险的因果影响的方向性仍不确定。本研究采用孟德尔随机法(MR)研究心房颤动对高血压的潜在因果效应:利用医学研究委员会综合流行病学组开放式 GWAS 数据库中全基因组关联研究 (GWAS) 的汇总数据,我们分析了 8180 例心房颤动病例和 28 612 例对照,以及 9413 例心房颤动病例和 203 040 例对照(均为东亚后裔)。我们使用逆方差加权(IVW)方法进行了MR分析,并辅以各种敏感性分析,包括双向MR分析,以评估反向因果关系:结果:研究发现,遗传预测的房颤与东亚人群罹患心房颤动的风险增加存在因果关系(几率比=1.14,95% CI:1.10-1.19,P 结论:MR 分析支持单向的房颤与心房颤动之间的因果关系:磁共振分析支持东亚人心房颤动与心房颤动风险增加之间的单向因果关系。缺乏反向因果效应加强了保持窦性心律对降低高频风险的重要性。为证实这些发现并深入探讨其临床意义,还需要进一步的研究。
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引用次数: 0
Coronary Sinus Ostial Atresia with Coronary Sinus Thrombosis. 冠状动脉窦闭锁伴冠状动脉窦血栓形成
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4602
Furkan Ufuk
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引用次数: 0
Role of Cardiac Magnetic Resonance in the Assessment of Patients with Premature Ventricular Contractions: A Narrative Review. 心脏磁共振在评估室性早搏患者中的作用:叙述性综述。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-04 DOI: 10.14744/AnatolJCardiol.2024.4314
Stefan Ailoaei, Laurentiu Sorodoc, Carina Ureche, Gabriel Sandu, Nicolae Sitari, Alexandr Ceasovschih, Mihaela Grecu, Radu Andy Sascau, Cristian Statescu

Premature ventricular contractions (PVCs) are a common finding in clinical practice, requiring a full diagnostic work-up in order to exclude an underlying cardiomyopathy. Still, in a substantial proportion of patients, these investigations do not identify any substrate, and the PVCs are labelled as idiopathic. Cardiac magnetic resonance (CMR) has proven in the last decades as the method of choice for the exploration of patients with cardiomyopathies, since it can identify subtle changes in the myocardial tissue and help with risk stratification. In patients with idiopathic PVCs and a high PVC burden, several studies report the presence of late gadolinium enhancement (LGE) at CMR, which can offer additional diagnostic and prognostic benefits, as well as assistance in catheter ablation procedures, as the risk for adverse cardiac and risk for arrhythmic events events is higher compared to patients without scar. This paper focuses on the impact of the presence of LGE in patients with idiopathic PVCs, reviewing all the relevant studies published so far, including randomized controlled clinical trials, prospective or retrospective cohort studies, case series and case reports as well as systematic reviews.

室性早搏(PVC)是临床实践中的常见病,需要进行全面的诊断检查,以排除潜在的心肌病。然而,在相当一部分患者中,这些检查并不能确定任何基质,PVC 也就被贴上了特发性的标签。过去几十年来,心脏磁共振(CMR)已被证明是检查心肌病患者的首选方法,因为它能发现心肌组织的细微变化,有助于进行风险分层。在特发性 PVC 和 PVC 负荷较高的患者中,有几项研究报告称 CMR 存在晚期钆增强(LGE),这可以提供额外的诊断和预后益处,并有助于导管消融手术,因为与无瘢痕患者相比,患者发生不良心脏事件和心律失常事件的风险更高。本文重点讨论了特发性 PVC 患者出现 LGE 的影响,回顾了迄今为止发表的所有相关研究,包括随机对照临床试验、前瞻性或回顾性队列研究、病例系列和病例报告以及系统综述。
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引用次数: 0
期刊
Anatolian Journal of Cardiology
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