BMC Cardiovascular Disorders最新文献

Background and aims: To explore the predictive value of the triglyceride-glucose(TyG)index combined with non-high-density lipoprotein cholesterol (Non-HDL-C) in coronary atherosclerotic heart disease (CHD).

Methods and results: We retrospectively collected patients who were suspected of CHD and underwent coronary angiography in Yiwu Central Hospital and collected medical history, other serum biochemical evaluation and echocardiography from the enrolled population, Non-HDL-C and TyG indices were calculated, and their correlation with Gensini score was analyzed. Logistic regression analysis was used to analyze the risk factors of coronary heart disease, and ROC curves were plotted to assess the predictive value of CHD in subjects with single or multiple indices. TyG index and Non-HDL-C were higher in patients with CHD than in patients without CHD (P < 0.05), and they were independent risk factors for the development of CHD after logistic regression analysis. Diabetes, Non-HDL-C, TyG index, and Gensini score were positively correlated. The areas under the ROC curves for TyG index and Non-HDL-C for the diagnosis of coronary heart disease were 0.719 (95% CI 0.675-0.763) and 0.652 (95% CI 0.605-0.700), respectively, and the area under the ROC curve plotted with the joint equation of the two was 0.724 (95% CI 0.681-0.768), which can better predict the occurrence of coronary heart disease.

Conclusion: TyG index and Non-HDL-C are independent risk factors for the occurrence of coronary heart disease, and the combination of the two can better predict the occurrence of coronary heart disease.

Background: Hypertension is a major cause of cardiac dysfunction. The earliest manifestation is left ventricular remodeling/hypertrophy. The occurrence of adverse cardiac remodeling and outcomes occurs irrespective of age in blacks. This necessitated an estimate of the prevalence of left ventricular hypertrophy (LVH) and an assessment of the roles of the mammalian target organ of rapamycin (mTOR) and angiotensin-II (Ang II) as possible pathogenic markers of LVH among young hypertensives.

Methods: This prospective case-control study involved 110 hypertensive and 60 normotensive (control) participants aged 18-45 across tertiary hospitals in Ekiti state. Ethical approval was obtained from all the various institutions. Participants were recruited consecutively after giving informed consent. Sociodemographic/clinical information, resting electrocardiogram and echocardiography were obtained. Venous blood was obtained to estimate mTOR, Ang II, Chemerin, lipids - triglyceride (TG), high-density lipoprotein (HDL), total cholesterol (TC), troponin-T, NF-Kβ, and Galectin-3 using enzyme-linked immunosorbent assay.

Results: The prevalence of LVH among the hypertensive group was 20.9%, 39%, 11.01%, and 15.74% using 2D-transthoracic echocardiography, Sokolow-Lyon, Cornell's and Cornell product ECG criteria. Also, hypertensives with LVH had a significantly increased blood pressure, body mass index, serum level of TG, TG/HDL, TC/HDL, chemerin, troponin T, Galectin-3 and total mTOR compared to normotensive and hypertensives without LVH. At the same time, serum NF-kβ and Ang II were only significant when compared with normotensive but not hypertensives without LVH. The total mTOR moderately correlated positively with ANG-II.

Conclusions: The results suggest an interaction between mTOR and Ang II in the development of LVH. In addition, it shows that LVH is associated with dyslipidemia, inflammation, and fibrosis.

Aim: This study aims to investigate the effects of combining a multifunctional pulse wave sphygmomanometer with constant temperature ice on patients with forearm hematoma following coronary intervention.

Methods: Patients who developed forearm hematoma after undergoing coronary intervention from March 2021 to March 2023 at our hospital were selected as the study cohort. Using a random number table, they were divided into two groups the control group and the research group. The control group received cuff compression treatment using a multifunctional pulse wave sphygmomanometer. The primary endpoint was the effective rate of one compression. Secondary endpoints included body surface temperature, pain, comfort, arm measurements, and swelling value.

Results: A total of 190 patients were included, with 95 in the control group and 95 in the research group. The research group showed a significantly higher effective rate of one compression compared to the control group (87.2% vs. 95.8%, p = 0.035). Additionally, the research group experienced significantly reduced pain (2.0 [2.0,3.0] vs. 1.0 [1.0,2.0], p < 0.001) and improved comfort levels. This approach also effectively reduced body surface temperature (32.91 ± 0.83℃ vs. 12.09 ± 1.09℃, p < 0.001), arm measurements (274.32 ± 9.56 mm vs. 271.15 ± 8.82 mm, p = 0.019), and swelling value (12.40 ± 1.95 vs. 11.07 ± 2.13, p < 0.001) after compression.

Conclusions: The combined use of a multifunctional pulse wave sphygmomanometer for cuff compression on forearm hematoma with simultaneous constant temperature ice application demonstrated more benefits. This approach effectively reduced pain, improved comfort levels, and enhanced compression-based hemostasis and reduction of swelling.

Trial registration: Ethics No.KY20210604-02-KS-01.

Objective: To establish the reference intervals of plasma Plasminogen, Factor XII activity, and Factor XIII Antigen in healthy adults in Guangzhou.

Methods: A total of 168 young people (75 males and 93 females, aged 18-65 years) who underwent physical examination in Zhujiang Hospital of Southern Medical University from 2020 to 2022 were recruited. Sysmex CS5100 automatic coagulation analyzer and matching reagents were used to detect Plasminogen. Factor XII activity and Factor XIII Antigen were detected using the ACL TOP 700 (Instrumentation Laboratory, Bedford, MA, USA) automatic coagulation analyzer and matching reagents; reference intervals were established.

Results: Plasma Plasminogen and Factor XIII Antigen were normally distributed, and plasma Factor XII activity showed a skewed distribution with no statistical significance in gender. The established reference intervals were as follows: Plasminogen: 71.6-123.0%; Factor XIII Antigen: 55.1-113.1%; Factor XII: 42.3-144.1%.

Conclusion: The reference intervals for special coagulation items of the laboratory population in a particular area should be established to provide results that align with the population characteristics for assessing the coagulation status of clinical patients.

Objective: The objective of this study is to examine the postoperative self-management experiences of patients with aortic dissection (AD) through qualitative interviews, providing a foundation for the standardized management of postoperative home care for these patients.

Methods: Semi-structured interviews were conducted with 18 patients with AD postoperatively, in the cardiac surgery department of a tertiary hospital in Fujian Province between March and May 2020. This qualitative study used phenomenological methods and purposive sampling, with data analyzed using Colaizzi's seven-step approach to extract themes.

Results: Based on the interviews, four primary themes related to postoperative self-management challenges were identified: limited disease-related knowledge, inadequate disease management behavior, insufficient communication with healthcare providers, and compromised psychological well-being.

Conclusion: Postoperative self-management among patients with AD presents several challenges. Healthcare professionals should provide targeted interventions tailored to the specific condition and individual differences of the patient in self-management. Such interventions are crucial for enhancing the postoperative self-management abilities of patients with AD, promoting rehabilitation, and enhancing the overall quality of life.

Background: Long-term endurance training is associated with structural, functional, and biochemical markers of cardiac dysfunction in highly trained athletes. Many studies have focused on structural changes in the right ventricle (RV) and few have examined functional adaptation of the right ventricle. This meta-analysis aims to compare the changes in right ventricular systolic function between endurance athletes and controls before and after exercise using speckle tracking echocardiography (STE).

Methods: A comprehensive search of relevant studies published before March 19, 2024 that examined RV systolic function using speckle tracking technology was conducted. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used as pooled statistics. Meta regression was employed to identify sources of heterogeneity and publication bias was evaluated by Egger's test and funnel plots. Sensitivity analysis was performed by removing sources of significant change from the results of a single publication to evaluate the stability of the results.

Results: Twenty studies were included with 1186 participants. A fixed effect meta-analysis revealed RV global longitudinal strain (GLS) WMD = 0.40, 95% CI (-0.08 ~ 0.89), p = 0.102 and free wall longitudinal strain (FWLS) WMD = 0.62, 95% CI (0.28 ~ 0.96), p < 0.001, random effect models of RV basal strain WMD = 2.94, 95% CI (2.00 ~ 3.88), p < 0.001 and RV apical strain WMD = -0.79, 95% CI (-1.95, 0.37), p = 0.245 between endurance athletes and controls. In addition, a random-effects meta-analysis revealed significant impairments in RV function when assessed by comparing RV GLS pre-endurance versus post endurance exercise WMD = 2.51, 95% CI (1.634 ~ 3.40), p < 0. 001.

Conclusion: The evidence obtained thus far suggests that reporting only global right ventricular strain data may obscure segment-specific adaptation changes, and the use of global and segmental strain analysis may help to identify potential functional changes in the right ventricle while differentiating between normal endurance athletes and non-active controls.

Background: The dried root of Inula helenium L., known as Inulae Radix in Mongolian medicine, is a widely used heat-clearing plant drug within the Asteraceae family. Alantolactone (ATL), a compound derived from Inulae Radix, is a sesquiterpene lactone with a range of biological activities. However, there is a lack of studies investigating its effectiveness in the treatment of hypertension. The aim of this study is to explore the regulatory effect of alantolactone on blood pressure and its underlying mechanism.

Methods and results: Network pharmacology analysis suggested that ATL had a potential therapeutic effect on hypertension induced by angiotensin II (Ang II). Subsequently, the results of animal experiments demonstrated that ATL could suppress the increase in blood pressure caused by Ang II. Vascular ring experiments indicated that ATL could inhibit the vascular contractions induced by Ang II, Phenylephrine, and Ca²⁺. Further experiments demonstrated that ATL could inhibit the calcium influx induced by Ang II and increase the expression of pMLC2. Molecular docking experiments showed that ATL had a high binding affinity with L-type Voltage-gated Calcium Channels (VGCC), and vascular ring experiments indicated that ATL could significantly inhibit the vascular contractions caused by the agonists of L-type VGCC. In addition, we also observed that ATL had an ameliorative effect on the vascular remodeling induced by Ang II.

Conclusions: ATL exerted an antihypertensive effect by inhibiting the activation of L-type VGCC and reducing calcium influx.

Background: Atrial fibrillation (AF) is the most prevalent form of sustained cardiac arrhythmia, with vascular endothelial growth factor (VEGF) increasingly recognized for its potential role in the pathogenesis of AF through mechanisms involving atrial remodeling, inflammation, and fibrosis. This systematic review aims to synthesize available evidence on the association between VEGF and AF, exploring the implications of VEGF as a biomarker and therapeutic target.

Methods: We conducted a comprehensive search across PubMed, Embase, and Web of Science until November 10 2024, selecting studies based on pre-defined criteria that involve adults with AF and measurements of VEGF levels. The selected studies included observational and experimental designs, excluding non-English and methodologically insufficient publications. Narrative synthesis was used for summarising the results.

Results: Eight studies met the inclusion criteria. The studies show a general trend of elevated VEGF levels in AF patients compared to controls, with significant heterogeneity in findings across studies. VEGF subtypes such as VEGF-A and VEGF-D demonstrated stronger associations with AF risk compared to VEGF-C. These variations point to the complex role of VEGF in AF, influencing factors like angiogenesis, endothelial function, and inflammatory responses.

Conclusion: VEGF is potentially a significant contributor to AF pathophysiology, with its levels reflecting disease activity. The variability observed across studies suggests a need for standardized measurement approaches and further investigation into VEGF subtypes. Future research should focus on longitudinal studies to better understand the causal relationships and the potential of VEGF as a therapeutic target and biomarker in AF management.

Clinical trial number: Not applicable.

Background: Left ventricular (LV) myocardial contraction patterns can be assessed using LV mechanical dispersion (LVMD), a parameter closely associated with electrical activation patterns. Despite its potential clinical significance, limited research has been conducted on LVMD following myocardial infarction (MI). This study aims to evaluate the predictive value of cardiac magnetic resonance (CMR)-derived LVMD for adverse clinical outcomes and to explore its correlation with myocardial scar heterogeneity.

Methods: We enrolled 181 post-MI patients (median age: 55.7 years; 76.8% male) who underwent CMR examinations. LVMD was calculated using the CMR-feature tracking (CMR-FT) technique, defined as the standard deviation (SD) of the time from the R-wave peak to the negative strain peak across 16 myocardial segments. Entropy was quantified using an algorithm implemented with a generic Python package. The primary composite endpoints included sudden cardiac death (SCD), sustained ventricular arrhythmias (VA), and new-onset heart failure (HF).

Results: Over a median follow-up of 31 months, LVMD and border zone (BZ) entropy demonstrated relatively high accuracy for predicting the primary composite endpoints, with area under the curve (AUC) values of 0.825 and 0.771, respectively. Patients with LVMD above the cut-off value (86.955 ms) were significantly more likely to experience the primary composite endpoints compared to those with lower LVMD values (p < 0.001). Multivariable analysis identified LVMD as an independent predictor of the primary composite endpoints after adjusting for entropy parameters, strain, and left ventricular ejection fraction (LVEF) (hazard ratio [HR]: 1.014; 95% confidence interval [CI]: 1.003-1.024; p = 0.010). A combined prediction model incorporating LVMD, BZ entropy, and LVEF achieved the highest predictive accuracy, with an AUC of 0.871 for the primary composite endpoints. Spearman rank correlation analysis revealed significant linear correlations between LVMD and entropy parameters (p < 0.001 for all).

Conclusions: Myocardial heterogeneity, as assessed by LVMD and BZ entropy, represents reliable and reproducible parameters reflecting cardiac remodeling following MI. LVMD has independent prognostic value, and the combination of LVMD and BZ entropy with the guideline-recommended LVEF as a unified model enhances the accuracy of forecasting the risk of primary combined endpoints in patients after MI.

Background: Systemic light chain amyloidosis is a rare and debilitating disease, especially for which initially presented with digestive tract involvement. Myocardial amyloidosis is highly aggressive with generally poor prognosis and often resulted in missed diagnosis or misdiagnosis with routine examination tools. Multimodality imaging play an important role in diagnosing the amyloidosis effect on multiple organs. Chemoradiotherapy is the mainstay of treatment.

Case presentation: This article presents a rare case of systemic light chain amyloidosis, initially with gastrointestinal symptoms, in a 68-year-old male. He was hospitalized with diarrhea for one year and a half, dysphagia for 4 months, but he had no dyspnea. The transthoracic echocardiogram revealed myocardial hypertrophy of the left ventricle, the hypertrophic heart muscle echoed like "ground glass". The left ventricular ejection fraction (LVEF) detected by Simpson method was 51% and global longitudinal strain (GLS) was -9.00%. But cardiac magnetic resonance showed the patient without gadolinium delayed enhancement. The urinary protein series quantification and the serum free light chain levels were all increased. While the ratio of free κ and free λ was decreased. Hence, the abdominal fat biopsy of the patient was amyloidosis by electronic and immunoelectron microscopy. Organs involved include heart, kidneys, gastrointestinal tract and nervous system, stage III of mayo 2012 model. The patient was treated with Dara-BCD chemotherapy. This case underscores the diagnostic complexity, emphasizing the need for early identification given the grim prognosis associated with systemic AL amyloidosis requiring clinical data, detailed imaging, and histopathological insights. After discharge, the patient became better and followed up in the outpatient.

Conclusions: Systemic light chain amyloidosis can easily be missed diagnosis or misdiagnosis in its early stages, losing the opportunity for initiating earlier treatments to improve potential patient outcomes. Despite advancements in diagnostic biomarkers, this case highlights the potential for missed diagnosis with standard CMR imaging when gadolinium enhancement is negative. The utility of echocardiographic features such as reduced GLS and abnormal ECG findings emerges as critical in early identification of myocardial amyloidosis. The correct diagnosis of this case relied on the comprehensive utilization of multimodal imaging techniques including biopsy.