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Programmed Cell Death of Endothelial Cells in Myocardial Infarction and Its Potential Therapeutic Strategy 心肌梗死中内皮细胞的程序性死亡及其潜在的治疗策略
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-05-11 DOI: 10.1155/2022/6558060
Mingyue Wu, Zixia Huang, Lijin Zeng, Chunfei Wang, Deming Wang
Cardiovascular disease, especially coronary artery disease and stroke, kills around one-third of the world's population, and myocardial infarction, a primary symptom of coronary heart disease, is a major worldwide health problem. Cardiovascular disease research has historically focused on promoting angiogenesis following myocardial damage. Myocardial vascular repair is crucial for improving myocardial infarction prognosis. Endothelial cells, the largest population of nonmyocytes within myocardial tissue, play an important role in angiogenesis. In recent years, different types of programmed cell death such as apoptosis, necroptosis, pyroptosis, ferroptosis, and autophagy have been described and found to be linked with cardiovascular diseases such as myocardial infarction, heart failure, and myocarditis. This will have important implications for reforming the treatment strategy of cardiovascular diseases. Different types of cell death of endothelial cells in myocardial infarction have been proposed, the roles and mechanisms of endothelial cell death in myocardial infarction are summarized in this review, and endothelial cell death inhibition as a therapeutic technique for treating myocardial infarction might be advantageous to human health.
心血管疾病,特别是冠状动脉疾病和中风,导致世界上约三分之一的人口死亡,而心肌梗死是冠心病的主要症状,是一个全球性的主要健康问题。心血管疾病的研究历来侧重于促进心肌损伤后的血管生成。心肌血管修复是改善心肌梗死预后的关键。内皮细胞是心肌组织中最大的非肌细胞群,在血管生成中起着重要作用。近年来,不同类型的程序性细胞死亡,如凋亡、坏死坏死、焦亡、铁亡和自噬,已被描述并发现与心血管疾病如心肌梗死、心力衰竭和心肌炎有关。这将对改革心血管疾病的治疗策略具有重要意义。本文综述了心肌梗死中内皮细胞死亡的不同类型,并对其在心肌梗死中的作用和机制进行了综述,认为内皮细胞死亡抑制作为一种治疗心肌梗死的治疗技术可能有利于人类健康。
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引用次数: 2
Quality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses. 支持太极拳运动对基本型高血压影响的证据质量:系统综述和元分析概述》。
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-30 eCollection Date: 2022-01-01 DOI: 10.1155/2022/4891729
Hongshuo Shi, Zixuan Wu, Dan Wang, Chengda Dong, Pulin Liu, Guomin Si, Ting Liu

Objectives: Tai Chi (TC) is a potential complementary treatment for essential hypertension (EH). This overview systematically summarizes and evaluates the existing evidence of TC in the therapy of EH.

Methods: Systematic reviews (SRs)/meta-analyses (MAs) on TC interventions for EH were comprehensively searched in seven databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed by means of the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), as well as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Results: Twelve published SRs/MAs were included in our study. According to the results of the AMSTAR-2, ROBIS, PRISMA, and GRADE assessment, only 1 SR/MA was assessed as high quality and only 1 SR/MA was assessed as low risk of bias. Only 2 SRs/MAs have been fully reported on the checklist. In addition to that, the quality of evidence was assessed for a total of 69 outcome indicators extracted from the SRs/MAs included in this overview, and only 3 items were assessed as high quality.

Conclusions: TC may be an effective and safe complementary treatment for EH. However, this conclusion must be approached with caution, as the quality of the evidence provided by the SRs/MAs is usually low.

目的:太极拳(TC)是治疗原发性高血压(EH)的一种潜在辅助疗法。本综述系统地总结和评估了太极拳治疗本质性高血压的现有证据:方法:在七个数据库中全面检索了有关TC干预EH的系统综述(SR)/计量分析(MA)。方法:在 7 个数据库中全面检索了有关 TC 对 EH 的干预措施的系统综述 (SR) /meta 分析 (MA),并通过多重系统综述评估 2 (AMSTAR-2)、系统偏倚风险 (ROBIS) 量表、系统综述和 Meta 分析首选报告项目列表 (PRISMA) 以及建议评估、发展和评价分级 (GRADE) 系统对方法学质量、偏倚风险、报告质量和证据质量进行了评估:我们的研究共纳入了 12 篇已发表的 SR/MA。根据AMSTAR-2、ROBIS、PRISMA和GRADE评估结果,只有1份SR/MA被评为高质量,只有1份SR/MA被评为低偏倚风险。只有 2 项 SR/MA 在核对表中进行了完整报告。除此之外,还对本综述所包含的SR/MA中提取的共69项结果指标进行了证据质量评估,只有3项被评为高质量:TC可能是一种有效、安全的EH辅助治疗方法。然而,由于SR/MA提供的证据质量通常较低,因此必须谨慎对待这一结论。
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引用次数: 0
Pattern Changes in the Heart Rate Variability of Patients Undergoing Coronary Artery Bypass Grafting Surgery 冠状动脉搭桥术患者心率变异性的模式变化
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-30 DOI: 10.1155/2022/1455025
Ngo Van Thanh, Nguyen Sinh Hien, P. N. Son, Pham Truong Son
Introduction Coronary artery bypass grafting (CABG) with extracorporeal circulation is a key therapy for coronary artery disease (CAD). However, cardiovascular events and cardiac arrhythmias may still occur in these patients following surgery. Many studies have demonstrated a correlation between cardiac arrhythmias and heart rate variability (HRV). This study aimed to establish the temporal change pattern of HRV observed following CABG. Methods A prospective method was used to study 119 consecutive patients with stable CAD who were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months after the surgery at Hanoi Heart Hospital from June 2016 to August 2018. Main results: All the time-domain and frequency-domain parameters of HRV decreased precipitately after CABG and were mostly recovered 3 months postoperatively. The percentage of decreased HRV before surgery was 28.6% and 51.8% after 7 days, 19.6% after 3 months, and 12.7% after 6 months. ASDNN and SDNN before and after surgery had the highest rates of change. Conclusion The early decrease in HRV observed 7 days after CABG may be related to the acute effects of the surgery. The recovery of HRV at 3 months after surgery, regardless of the preoperative state of the patients, implies that the autonomic nervous system (ANS) disorder may be improved at this time. At 6 months after surgery, the autonomic nervous injury was recovered in combination with improvement of reperfusion, resulting in improvement in almost all HRV indices compared with those indices preoperatively.
体外循环冠状动脉旁路移植术(CABG)是治疗冠状动脉疾病(CAD)的重要手段。然而,这些患者在手术后仍可能发生心血管事件和心律失常。许多研究表明心律失常与心率变异性(HRV)之间存在相关性。本研究旨在建立冠脉搭桥后HRV的时间变化规律。方法采用前瞻性方法,对2016年6月至2018年8月在河内心脏医院连续就诊的119例稳定期冠心病患者在冠脉搭桥前2天、术后1周、3个月和6个月的24小时动态心电图进行评估。主要结果:冠脉搭桥后HRV各时域、频域参数均急剧下降,术后3个月基本恢复。术前HRV下降比例分别为28.6%、51.8%,术后7天、3个月、6个月分别为19.6%、12.7%。手术前后ASDNN和SDNN的变化率最高。结论冠脉搭桥术后7天HRV早期下降可能与手术的急性效应有关。无论患者术前状态如何,术后3个月HRV的恢复表明此时自主神经系统(ANS)紊乱可能得到改善。术后6个月自主神经损伤恢复,再灌注改善,几乎所有HRV指标均较术前改善。
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引用次数: 1
Analysis of a Family with Brugada Syndrome and Sudden Cardiac Death Caused by a Novel Mutation of SCN5A SCN5A基因突变致Brugada综合征和心源性猝死1家系分析
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-28 DOI: 10.1155/2022/9716045
Yao-Bin Zhu, Jian-Hui Zhang, Yuanling Ji, Ya-Nan Hu, Han-Lu Wang, Dan-dan Ruan, Xiao-Rong Meng, Xin-fu Lin, Jie-wei Luo, W. Chen
Background Brugada syndrome is a hereditary cardiac disease associated with mutations in ion channel genes. The clinical features include ventricular fibrillation, syncope, and sudden cardiac death. A family with Brugada syndrome with sudden cardiac death was analyzed to locate the associated mutation in the SCN5A gene. Methods and Results Three generations of a Han Chinese family with Brugada syndrome were recruited in the study; their clinical phenotype data were collected and DNA samples extracted from the peripheral blood. Next-generation sequencing was carried out in the proband, and candidate genes and mutations were screened using the full exon capture technique. The family members who participated in the survey were tested for possible mutations using Sanger sequencing. Six family members were diagnosed with Brugada syndrome, including four asymptomatic patients. A newly discovered heterozygous mutation in the proband was located in exon 25 of SCN5A (NM_000335.5) at c.4313dup(p.Trp1439ValfsTer32). Among the surviving family members, only those with a Brugada wave on their electrocardiogram carried the c.4313dup(p.Trp1439ValfsTer32) variant. Bioinformatics prediction revealed that the frameshift of the c.4313dup (p.Trp1439ValfsTer32) mutant led to a coding change of 32 amino acids, followed by a stop codon, resulting in a truncated protein product. Conclusion The newly discovered mutation site c.4313dup(p.Trp1439ValfsTer32) in exon 25 of SCN5A may be the molecular genetic basis of the family with Brugada syndrome.
Brugada综合征是一种与离子通道基因突变相关的遗传性心脏病。临床特征包括心室颤动、晕厥和心源性猝死。我们分析了一例Brugada综合征合并心源性猝死的家族,以定位SCN5A基因的相关突变。方法与结果选取一个汉族Brugada综合征家族三代为研究对象;收集他们的临床表型数据并从外周血中提取DNA样本。先证者进行下一代测序,利用全外显子捕获技术筛选候选基因和突变。参与调查的家庭成员使用桑格测序检测可能的突变。6名家庭成员被诊断为Brugada综合征,包括4名无症状患者。新发现的先证者杂合突变位于SCN5A (NM_000335.5)的第25外显子c.4313dup(p.Trp1439ValfsTer32)。在幸存的家庭成员中,只有那些心电图上有Brugada波的人携带c.4313dup(p.Trp1439ValfsTer32)变体。生物信息学预测表明,c.4313dup (p.Trp1439ValfsTer32)突变体的移码导致32个氨基酸的编码改变,随后是一个终止密码子,导致蛋白产物的截断。结论新发现的SCN5A外显子25突变位点c.4313dup(p.Trp1439ValfsTer32)可能是Brugada综合征家族的分子遗传基础。
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引用次数: 3
Association of Low Expression of NUMB in Peripheral Blood with Acute Myocardial Infarction 外周血NUMB低表达与急性心肌梗死的关系
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-26 DOI: 10.1155/2022/7981637
Heyu Meng, Lihong Li, Jianjun Ruan, Yanqiu Chen, Zhaohan Yan, Jinsha Liu, Xiangdong Li, Cuiying Mao, Ping Yang
Objective Our study's goal was to find out acute myocardial infarction (AMI) patients' NUMB gene expression patterns and to evaluate its role as a diagnostic marker for AMI detection. Methods Peripheral blood was drawn from 124 individuals who had an AMI and 115 patients who had stable coronary artery disease (SCAD). The real-time quantitative polymerase chain reaction was used to measure the mRNA expression level of the NUMB gene in peripheral blood. Results The AMI group's NUMB gene expression was 0.906 (0.181–0.954), whereas the SCAD group's expression was 1.024 (0.207–1.127). However, the AMI group had 0.885 times lower NUMB mRNA expression than the SCAD group (P < 0.05). Conclusion Multivariate logistic regression evaluation found that lower NUMB expression was correlated with an increased risk of coronary artery disease. However, age and fasting plasma glucose levels were not associated with decreased NUMB expression.
目的了解急性心肌梗死(AMI)患者的NUMB基因表达模式,并评价其作为AMI诊断标志物的作用。方法选取124例急性心肌梗死患者和115例稳定型冠状动脉疾病(SCAD)患者的外周血。采用实时定量聚合酶链反应法检测小鼠外周血NUMB基因mRNA表达水平。结果AMI组NUMB基因表达量为0.906 (0.181 ~ 0.954),SCAD组NUMB基因表达量为1.024(0.207 ~ 1.127)。AMI组的NUMB mRNA表达量比SCAD组低0.885倍(P < 0.05)。结论多因素logistic回归评价发现,低NUMB表达与冠状动脉疾病风险增加相关。然而,年龄和空腹血糖水平与NUMB表达降低无关。
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引用次数: 2
Effect of PCSK9 Inhibitor on Blood Lipid Levels in Patients with High and Very-High CVD Risk: A Systematic Review and Meta-Analysis PCSK9抑制剂对心血管疾病高风险和极高风险患者血脂水平的影响:一项系统综述和荟萃分析
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-26 DOI: 10.1155/2022/8729003
Yue Zhang, Yanrong Suo, Lin-Po Yang, Xiaolu Zhang, Qun Yu, M. Zeng, Wenlan Zhang, Xijuan Jiang, Yijing Wang
Objectives We aimed to investigate the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design 14 trials (n = 52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality, and changes in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), lipoprotein (a) (LP (a)), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein A1 (ApoA1) from baseline were analyzed using Rev Man 5.1.0 software. Results Compared with treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD = −46.86, 95% CI (−54.99 to −38.72), P < 0.00001], TC [MD = −31.92, 95% CI (−39.47 to −24.38), P < 0.00001], TG [MD = −8.13, 95% CI (−10.48 to −5.79), P < 0.00001], LP(a) [MD = −26.69, 95% CI (-27.93 to −25.44), P < 0.00001], non-HDL-C [MD = −42.86, 95% CI (−45.81 to −39.92), P < 0.00001], and ApoB [MD = −38.44, 95% CI (−42.23 to -34.65), P < 0.00001] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36), P < 0.00001] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13), P < 0.00001] from baseline were significantly more in high cardiovascular disease risk patients who received PCSK9 inhibitors treatment. Conclusion Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels compared with therapies that did not include them.
目的:探讨枯草杆菌蛋白转化酶(protein conversion ase subtilisin/ keexin type 9, PCSK9)抑制剂对心血管高危和极高危患者血脂水平的影响。设计从PubMed和Embase检索到更新至2021年6月1日的14项试验(n = 52,586例患者),比较使用或不使用PCSK9抑制剂的治疗。纳入研究的数据质量由两名独立研究人员使用Cochrane系统评价方法进行评估。采用Rev Man 5.1.0软件分析全因死亡率、心血管死亡率以及基线时血清低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、载脂蛋白B (ApoB)、脂蛋白(a) (LP (a))、非高密度脂蛋白胆固醇(non-HDL-C)、高密度脂蛋白胆固醇(HDL-C)和载脂蛋白A1 (ApoA1)的变化。结果与治疗没有PCSK9抑制剂相比,添加PCSK9抑制剂(evolocumab和alirocumab)有明显的减少影响低密度脂蛋白的水平(MD =−46.86,95%可信区间(54.99−−38.72),P < 0.00001), TC (MD =−31.92,95%可信区间(39.47−−24.38),P < 0.00001), TG (MD =−8.13,95%可信区间(10.48−−5.79),P < 0.00001), LP (a) (MD =−26.69,95%可信区间(-27.93−25.44),P < 0.00001), non-HDL-C (MD =−42.86,95%可信区间(45.81−−39.92),P < 0.00001),和飞机观测(MD =−38.44,CVD高危患者95% CI (- 42.23 ~ -34.65), P < 0.00001。相反,在接受PCSK9抑制剂治疗的心血管疾病高危患者中,HDL-C [MD = 6.27, CI (5.17 ~ 7.36), P < 0.00001]和ApoA1 [MD = 4.33, 95% CI (3.53 ~ 5.13), P < 0.00001]较基线的变化更为显著。结论:与不含PCSK9抑制剂的治疗相比,在标准治疗中添加PCSK9抑制剂可明显改善血脂水平。
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引用次数: 7
Impact of MMP-9 Genetic Polymorphism and Concentration on the Development of Coronary Artery Disease in Ukrainian Population MMP-9基因多态性和浓度对乌克兰人群冠状动脉疾病发展的影响
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-11 DOI: 10.1155/2022/2067632
O. Pogorielova, V. Korniienko, Yaroslav D Chumachenko, O. Obukhova, I. Martsovenko, V. Harbuzova
Coronary artery disease (CAD) is one of the leading causes of death in Europe. It is known that atherosclerosis is the primary risk factor of CAD development. MMP-9 is involved in all stages of atherosclerosis and thus may contribute to CAD emergence. To investigate the influence of MMP-9 on the (CAD) development 25 patients with intact coronary arteries (CA), 40 patients with acute coronary syndrome (ACS), and 63 patients with chronic coronary syndrome (CCS) were enrolled in the study. Real-time PCR was carried out for genotyping on the rs17567-polymorphic locus, and ELISA study was performed to measure the MMP-9 plasma concentration. It was found the lower risk of MI occurrence for AG-carriers (Pa=0.023; ORa = 0.299, 95% CI = 0.106–0.848) in Ukrainian population.
冠状动脉疾病(CAD)是欧洲主要的死亡原因之一。众所周知,动脉粥样硬化是冠心病发生的主要危险因素。MMP-9参与动脉粥样硬化的所有阶段,因此可能有助于CAD的出现。为探讨MMP-9对冠心病发展的影响,本研究纳入25例完整冠状动脉(CA)患者、40例急性冠状动脉综合征(ACS)患者和63例慢性冠状动脉综合征(CCS)患者。采用Real-time PCR对rs17567多态性位点进行基因分型,ELISA检测MMP-9血药浓度。ag -携带者发生心肌梗死的风险较低(Pa=0.023;ORa = 0.299, 95% CI = 0.106-0.848)。
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引用次数: 4
Characteristics of Patent Foramen Ovale: Analysis from a Single Center 卵圆孔未闭的特征:单中心分析
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-04-06 DOI: 10.1155/2022/5430598
Bin Zhang, Dong Li, Anjian Song, Q. Ren, Shangan Cai, Peng Wang, Wenfeng Tan, Gaoxing Zhang, Jun Guo
Objective To collect and analyze data of patent foramen ovale (PFO). Methods This study included a total of 260 patients diagnosed with PFO. We analyzed basic clinical data such as sex, age, transesophageal echocardiography as well as other symptoms. Results Our data showed that females accounted for the highest proportion of PFO (166 females, 64%), with the highest number of patients (65 patients) having between 45 and 55 years. Transesophageal echocardiography examination demonstrated frequent occurrence of tunnel-like anatomical structures. In addition, PFO was associated with symptoms such as migraine, stroke or TIA, syncope, chest tightness, and palpitations, with dizziness being the most common symptom in the patients with PFO. Conclusion Our data demonstrated that females accounted for the highest proportion of PFO patients, with those aged between 45 and 55 years being most affected. The most frequently encountered clinical symptom was dizziness. Taken together, these findings may help doctors to better understand and screen for PFO patients.
目的收集和分析卵圆孔未闭(PFO)的临床资料。方法本研究共纳入260例诊断为PFO的患者。我们分析了基本的临床资料,如性别、年龄、经食管超声心动图以及其他症状。结果我们的数据显示,PFO患者中女性所占比例最高(166例,占64%),年龄在45 ~ 55岁之间的患者最多(65例)。经食管超声心动图检查显示常出现隧道样解剖结构。此外,PFO还伴有偏头痛、中风或TIA、晕厥、胸闷和心悸等症状,其中头晕是PFO患者最常见的症状。结论我们的数据表明,女性在PFO患者中所占比例最高,年龄在45 - 55岁之间的患者受影响最大。最常见的临床症状是头晕。综上所述,这些发现可能有助于医生更好地了解和筛查PFO患者。
{"title":"Characteristics of Patent Foramen Ovale: Analysis from a Single Center","authors":"Bin Zhang, Dong Li, Anjian Song, Q. Ren, Shangan Cai, Peng Wang, Wenfeng Tan, Gaoxing Zhang, Jun Guo","doi":"10.1155/2022/5430598","DOIUrl":"https://doi.org/10.1155/2022/5430598","url":null,"abstract":"Objective To collect and analyze data of patent foramen ovale (PFO). Methods This study included a total of 260 patients diagnosed with PFO. We analyzed basic clinical data such as sex, age, transesophageal echocardiography as well as other symptoms. Results Our data showed that females accounted for the highest proportion of PFO (166 females, 64%), with the highest number of patients (65 patients) having between 45 and 55 years. Transesophageal echocardiography examination demonstrated frequent occurrence of tunnel-like anatomical structures. In addition, PFO was associated with symptoms such as migraine, stroke or TIA, syncope, chest tightness, and palpitations, with dizziness being the most common symptom in the patients with PFO. Conclusion Our data demonstrated that females accounted for the highest proportion of PFO patients, with those aged between 45 and 55 years being most affected. The most frequently encountered clinical symptom was dizziness. Taken together, these findings may help doctors to better understand and screen for PFO patients.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87160669","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: 3
The Effect of Antihypertensive Drugs on NADH in Newly Diagnosed Primary Hypertension 降压药对初诊原发性高血压患者NADH的影响
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-03-31 DOI: 10.1155/2022/6159883
Regina Pawlak-Chomicka, T. Krauze, P. Uruski, J. Piskorski, A. Wykrętowicz, A. Tykarski, P. Guzik
Background Some antihypertensive medications alter cellular energy production, presumably by modification of the mitochondrial function. In vivo studies of such effects are challenging in humans. We applied a noninvasive forearm skin measurement of the 460-nm fluorescence specific for the reduced form of nicotinamide adenine dinucleotide (NADH) to study the 6-week effects of four different antihypertensive medications on mitochondrial function using the Flow-Mediated Skin Fluorescence (FMSF). Methods In a prospective open-label study, we compared the long-term effects of a 6-week treatment with either amlodipine (5 mg), perindopril (5 mg), nebivolol (5 mg), or metoprolol (50 mg) on the dynamic flow-mediated changes in the skin NADH content in 76 patients (29 women) with untreated primary arterial hypertension (HA). Patients underwent 24-hour ambulatory blood pressure monitoring. To study mitochondrial function, the FMSF was measured at rest, during 100-second ischemia and postischemic reperfusion. The control group consisted of 18 healthy people (7 women). Results There were no significant differences in the FMSF parameters between the control and the study group before medication. After the 6-week treatment, all drugs similarly reduced blood pressure. Neither amlodipine, perindopril, nor nebivolol changed the flow-mediated 460-nm skin fluorescence significantly. However, metoprolol raised this fluorescence at rest, during ischemia and reperfusion (P at most <0.05), indicating an increase in the total NADH skin content. Conclusion Amlodipine, perindopril, and nebivolol appear neutral for the skin NADH content during the 6-week antihypertensive treatment. Similar treatment with metoprolol increased skin NADH at rest, during ischemia and reperfusion, probably due to an effect on microcirculation and altered mitochondrial function. Explanation of the potential mechanisms behind metoprolol influence on the skin NADH metabolism requires further investigation.
背景:一些抗高血压药物可能通过改变线粒体功能改变细胞能量的产生。在人体中进行此类效应的体内研究具有挑战性。我们采用无创前臂皮肤测量法,对烟酰胺腺嘌呤二核苷酸(NADH)的还原型进行460纳米特异性荧光检测,利用流动介导的皮肤荧光(FMSF)研究四种不同降压药物对线粒体功能的6周影响。方法:在一项前瞻性开放标签研究中,我们比较了76例未经治疗的原发性动脉高血压(HA)患者(29名女性)接受6周氨氯地平(5mg)、培哚普利(5mg)、奈比洛尔(5mg)或美托洛尔(50mg)治疗后皮肤NADH含量动态血流调节变化的长期影响。患者接受24小时动态血压监测。为了研究线粒体功能,在静息、100秒缺血和缺血后再灌注时测量FMSF。对照组为18名健康人(女性7名)。结果对照组与研究组用药前FMSF参数差异无统计学意义。在6周的治疗后,所有的药物都同样降低了血压。氨氯地平、培哚普利和奈比洛尔均未显著改变血流介导的460 nm皮肤荧光。然而,美托洛尔在静息、缺血和再灌注时提高了这种荧光(P值最多<0.05),表明皮肤总NADH含量增加。结论氨氯地平、培哚普利和奈比洛尔在抗高血压治疗6周期间对皮肤NADH含量呈中性。在缺血和再灌注期间,美托洛尔的类似治疗增加了静息时皮肤NADH,可能是由于对微循环的影响和线粒体功能的改变。美托洛尔影响皮肤NADH代谢的潜在机制有待进一步研究。
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引用次数: 3
Sildenafil for Primary Prevention of Anthracycline-Induced Cardiac Toxicity: A Phase I/II Randomized Clinical Trial, SILDAT-TAHA6 Trial 西地那非用于一级预防蒽环类药物引起的心脏毒性:一项I/II期随机临床试验,SILDAT-TAHA6试验
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2022-03-27 DOI: 10.1155/2022/5681510
A. Attar, Masoumeh Heydari, F. Abtahi, A. Rezvani, Shirin Haghighat, R. Vojdani, M. Ramzi, M. Dehghani, M. Karimi, Mohammad Kasaei, S. Khosropanah, M. Tabandeh
Background Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibitors on cancer therapeutics-related cardiac dysfunction (CTRCD) of anthracyclines. Aim The aim of this study was to evaluate the clinical effect of sildenafil on the primary prevention of CTRCD in human. Materials and Methods In this randomized double-blind clinical trial, the primary end point was efficacy in preventing the reduction of left ventricular ejection fraction (LVEF). The intervention group patients received sildenafil at a dose of 25 milligrams twice a day before starting the chemotherapeutic regimen, and the control group received placebo. All the patients at baseline and after the 6-month follow-up underwent 4D and speckle-tracking echocardiography and cardiac MRI, accompanied by hs-troponin I and NT-Pro-BNP measurement. Results Sixty patients were enrolled in this study, and data from 52 patients (24 patients in the intervention group and 28 patients in the control group) were used in the final analysis. Our findings showed that in the intervention and control groups, LVEF was dropped from 61.28 ± 7.36 to 51.57 ± 7.67 (difference (D) = −9.71 ± 11.95, p=0.003) and from 57.9 ± 7.29 to 50.2 ± 7.02% (D = −7.7 ± 5.93; p=0.001), respectively (between-group difference = −2.01%, p=0.26). CTRCD was detected in 11 patients in the control group (42.8%) and 10 in the intervention group (41.6%, p=0.51). Conclusion Consumption of sildenafil for primary prevention of anthracycline-induced cardiac toxicity seems to be unbeneficial. This trial is registered with IRCT20180506039554N1.
先前的动物研究表明,5-磷酸二酯酶抑制剂对蒽环类药物的癌症治疗相关性心功能障碍(CTRCD)具有保护作用。目的评价西地那非对人CTRCD一级预防的临床效果。材料和方法在这项随机双盲临床试验中,主要终点是预防左心室射血分数(LVEF)降低的有效性。干预组患者在开始化疗方案前每天两次服用剂量为25毫克的西地那非,对照组服用安慰剂。所有患者在基线和随访6个月后均行4D、斑点追踪超声心动图和心脏MRI检查,并测量hs-肌钙蛋白I和NT-Pro-BNP。结果本研究共纳入60例患者,其中干预组24例,对照组28例,共52例患者的数据用于最终分析。结果显示,干预组和对照组的LVEF由61.28±7.36下降至51.57±7.67(差异D = - 9.71±11.95,p=0.003),由57.9±7.29下降至50.2±7.02%(差异D = - 7.7±5.93;P =0.001)(组间差异= - 2.01%,P =0.26)。对照组11例(42.8%),干预组10例(41.6%,p=0.51)。结论服用西地那非对蒽环类药物引起的心脏毒性一级预防似乎是不利的。本试验注册号为IRCT20180506039554N1。
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Cardiology Research and Practice
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