Cardiology Research and Practice最新文献

Objective: To investigate the relationship between methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and coronary heart disease (CHD) in the elderly patients living in the coastal area of eastern Zhejiang Province in China. Methods: From September 2021 to May 2022, 163 elderly patients (male ≥ 55 years old, female ≥ 65 years old) admitted to the cardiology department in the Ningbo Lihuili Hospital were collected. Among these patients, 90 patients were diagnosed with CHD (CHD group) and 79 patients did not have CHD (control group). The homocysteine (Hcy) level was measured by the blood biochemical test, and the MTHFR genotype was detected by the PCR fluorescence probe method. Results: Compared with the control group, the CHD group showed a significantly higher distribution frequency of TT genotype (X ² = 5.137, p < 0.05) and a lower frequency of CC genotype (X ² = 6.560, p < 0.05), indicating that elderly people with MTHFR677 TT genotype are more likely to have CHD. In addition, the Hcy level of TT genotype in the CHD group and the control group were both obviously higher than that of CT genotype and CC genotype (p < 0.05). Finally, the univariate and multivariate logistic regression analyses showed that gender, hypertension, diabetes, and MTHFR677 TT genotype were independent risk factors for CHD (p < 0.05). Conclusion: MTHFR C677T mutation is significantly associated with the serum Hcy, and is an important genetic risk for CHD development in the elderly people living in the coastal area of eastern Zhejiang province, China.

Objective: Recurrence of pericardial effusion is possible despite the successful completion of pericardiocentesis and initiation of treatment. Predicting recurrence is important for determining treatment strategies. This study aimed to examine the factors that influence the recurrence of effusion in patients who had undergone pericardiocentesis. Method: A total of 113 patients with the evidence of tamponade or pericardial effusion over 10 mm were included in the study. The mean follow-up period was 49 months. Patients with and without recurrent effusion were divided into two groups. PNI calculation (PNI = 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (mm³) formula was used. Results: Recurrent pericardial effusion was observed in 30 patients during the follow-up period. There was no difference in age, gender, hypertension, LVEF%, hypertension, and appearance of fluid when the two groups were compared. There was a difference in PNI score and presence of malignancy between the two groups (p: 0.031 and 0.042, respectively). Multivariate logistic regression showed that malignancy and PNI score were independent predictors of recurrence in patients undergoing pericardiocentesis (p: 0.015 and p: 0.014, respectively). In the ROC analysis, PNI < 40.75 predicts recurrent pericardial effusion with 75% sensitivity and 58% specificity (AUC: 0.626, 95% CI: 0.509-0.742, and p=0.042). Conclusion: Predictors of recurrence in patients undergoing pericardiocentesis are important for patient follow-up. PNI is a simple and useful score that can be used to predict recurrent pericardial effusion.

This study probes the relationship between serum matrix metalloproteinase-9 (MMP-9) levels, the genetic variant rs17576 in the MMP-9 gene, and the extent of coronary atherosclerosis among Ukrainian patients diagnosed with coronary artery disease (CAD). A cohort of 128 patients was assessed, comprising 25 with angiographically intact (normal) coronary arteries, 40 with acute coronary syndrome (ACS), and 63 with chronic coronary syndrome (CCS). Utilizing clinical, anthropometric, and biochemical analyses, alongside ELISA immunoassays, genotyping, electrocardiography, and coronary angiography, we conducted a comprehensive evaluation. Our findings indicate that MMP-9 levels peaked in ACS patients, particularly those with single and triple-vessel coronary lesions, while the lowest levels were observed in individuals with unaltered coronary arteries. Notably, the glomerular filtration rate (GFR) was highest in patients with angiographically normal coronary arteries, averaging 79.91 ± 27.8 mL/min. In the context of ACS, individuals carrying the GG allele exhibited the highest GFR, whereas AA allele carriers had the lowest. Conversely, in the CCS cohort, GG carriers demonstrated the lowest GFR and heterozygotes the highest, although these differences did not reach statistical significance. A significant disparity in serum MMP-9 levels was observed between ACS patients, CCS patients, and individuals with unimpaired coronary arteries. Moreover, a substantial correlation was established between the degree of coronary artery lesions and GFR in the CCS group, providing a predictive measure for GFR in patients with triple-vessel involvement. However, no significant association was detected between serum MMP-9 levels, the rs17576 genetic variant in the MMP-9 gene, and the number of affected vessels or GFR in both ACS and CCS patients.

Background: Total thoracoscopic mitral valve surgery (TT-MVS) is a minimally invasive technique for mitral regurgitation (MR), but its impact on left ventricular (LV) function and remodeling in patients with reduced LV ejection fraction (LVEF) is unclear. Methods: We retrospectively compared 94 patients who underwent total thoracoscopic mitral valve repair (TT-MVr) or total thoracoscopic mitral valve replacement (TT-MVR) for MR and reduced LVEF at our center from January 1, 2017, to December 31, 2022. We assessed LV functional recovery and remodeling by echocardiography at baseline, 1 week, 3 months, and 6 months after surgery. Results: A total of 43 patients underwent TT-MVr and 51 patients underwent TT-MVR. Both groups had similar early outcomes, hospital mortality, and postoperative complications. The TT-MVr group had higher LVEF and lower left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) than the TT-MVR group at 3 and 6 months after surgery (p < 0.05 for all comparisons). Both groups improved in New York Heart Association (NYHA) functional class from baseline to 6 months after surgery (p < 0.05 for all comparisons). Conclusion: TT-MVr and TT-MVR are feasible and safe for patients with MR and reduced LVEF, but TT-MVr is associated with better LV functional recovery and remodeling within 6 months after surgery. TT-MVr should be preferred over TT-MVR whenever possible in this high-risk population. Further studies are needed to evaluate the long-term outcomes of TT-MVS in this population.

Left ventricular global longitudinal strain (LVGLS) is a highly sensitive echocardiographic biomarker that detects signs of myocardial dysfunction. It has been proven that exercise-based cardiac rehabilitation (CR) improves LV-GLS but whether high-intensity interval training (HIIT) is more efficient than moderate-intensity interval training (MIIT) to improve LV-GLS as cardiac deformation index in cardiovascular patients is debatable. In the current systematic review and meta-analysis, different digital databases including PubMed, Scopus, Web of Science (ISI), and Google Scholar were searched systematically with no time restriction to answer the abovementioned question. Studies were included that reported GLS as the outcome in CVD subjects before and after enrolling in HIIT and/or MITT. A random effects model was used for meta-analysis. Eleven sets of results from nine articles-two of which had two sets of results-were included. The result of the sensitivity test to check the publication bias was not significant either for MIIT (p=0.211) or for HIIT (p=0.238). Our findings showed that GLS was improved significantly after both MIIT (-1.72. [-2.68, -0.77]) and HIIT (-1.86 [-3.01, -0.71]) in CVD patients; however, the effect of HIIT was greater than MIIT. Subgroup analysis results showed that baseline disease and duration of exercises do not influence the effect of training on GLS. More studies are needed to confirm the conclusion.

Background: Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly associated with symptomatic aortic regurgitation (AR) or aortic stenosis (AS). Transcatheter aortic valve replacement (TAVR) for QAV remains uncertain. Methods: We retrospectively reviewed prospectively collected data from patients with QAV undergoing TAVR in our center and conducted a systematic literature review for further investigation. Results: Five patients with QAV were treated with TAVR between April 2016 and December 2023. The median age was 67 years (range: 59-86), and the median Society of Thoracic Surgeons score (STS-score) was 3.750% (range: 0.916%-11.823%). Procedural success was achieved in all cases. The median follow-up period was 3 years (from 30 days to 7 years). Four of the patients exhibited no serious complications, while one experienced delayed coronary obstruction. Our systematic review included 31 cases from 21 publications and our center. The median age of patients was 79 years (range: 57-90), including 18 males. The median STS score was 7.835%. Severe AS was present in 64.5% of the patients and severe AR in 41.9%. The most common QAV subtype was type B (48.4%). Technical success was achieved in 100% of the cases, with two cases reporting coronary obstruction and one required a permanent pacemaker implantation. During a median follow-up period of 1 year (from 30 days to 7 years), one case experienced serious complications of delayed coronary obstruction. Conclusion: The TAVR may be an alternative treatment for patients with QAV, preliminarily demonstrating feasible early and long-term results from current experience. However, extra precautions regarding coronary artery obstruction complications are necessary due to the rarity and anatomical complexity of QAV.

Introduction: Nondilated left ventricular cardiomyopathy (NDLVC) is a newly defined category of cardiomyopathy. We sought to evaluate and compare the phenotype of NDLVC with DCM using cardiac magnetic resonance (CMR) imaging and to investigate the prognostic significance of these conditions. Methods: One hundred and fifty patients suspected of having cardiomyopathy referred for CMR were recruited. We considered 3 groups; Group 1: NDLVC-reduced EF, (NDLVC-REF), LVEF ≤ 40%, Group 2: NDLVC-mildly reduced EF(NDLVC-MREF), 40 < LVEF < 50, Group 3: Dilated cardiomyopathy (DCM). All selected patients were followed up for a median of 24 months to determine the composite cardiac endpoint consisting of mortality and/or hospitalization for cardiovascular reasons (composite cardiac event (CCE)) as the primary endpoint. Results: The mean age (SD) was 42.6 (13.7) years (range: 18-77 years). There was no association between the presence of myocardial LGE and the development of atrial and/or ventricular arrhythmias. Atrial fibrillation was most common in the NDLVC groups during the follow-up period. Myocardial late gadolinium enhancement (LGE) was also more pronounced in the DCM group. Most patients in the NDLVC groups had no LGE. LGE in the midwall was the most common LGE pattern in all three groups and the septal wall was the most commonly affected area of the LV. There was no significant difference between the CMR findings of patients with and without CCE in each subgroup. However, the presence of myocardial replacement fibrosis was higher in patients with a CCE in total study population, (n = 144, 68% versus 32%, p=0.03), but the difference was not significant in subgroup analyzes. Conclusion: NDLVC has a relatively good prognosis in recent times. The consideration of NDLVC in a spectrum with DCM can be reasonable. However, the prognostic risk factors need to be investigated in more detail.

Objective: Arterial stiffness, as determined by pulse wave velocity (PWV), is a recognized marker of cardiovascular risk. Noninvasive technologies have enabled easier and more accessible assessments of PWV. The current gold standard for measuring carotid-femoral PWV (cfPWV)-a reliable indicator of arterial stiffness-utilizes applanation tonometry devices, as recommended by the Artery Society Guidelines. The objective of this study was to compare the performance of various noninvasive arterial stiffness measurement methods, specifically the Mobil-O-Graph and SphygmoCor/SphygmoCor XCEL, and evaluate their alignment with the Artery Society Guidelines for accuracy and reliability. Methods: A comprehensive search was conducted in the PubMed and Scopus databases to identify studies that compared and validated noninvasive PWV measurements, focusing on their repeatability. The search covered studies from inception through March 31, 2024. A total of 2092 papers were identified. Following the selection process, 21 studies met the inclusion criteria. Additionally, 2 more studies, not retrieved by the initial search but deemed relevant from other databases, were included. The included studies focused on populations with chronic diseases who were hemodynamically stable. Studies involving participants in specific conditions, such as pregnancy, hemodynamic shock, or undergoing stress tests, were excluded from the analysis. Results: Several devices have been developed and validated for the noninvasive measurement of arterial stiffness, utilizing applanation tonometry (e.g., SphygmoCor, SphygmoCor XCEL) and cuff-based oscillometry (e.g., Arteriograph, Mobil-O-Graph). The analyses reviewed included studies using both invasive and noninvasive devices. A notable finding was the relative heterogeneity of study populations across different research, with variations in sample size, BMI, sex proportions, and age groups often falling short of guideline recommendations. In most of the included validation studies, the sample sizes were smaller than the minimum recommended by guidelines. Moreover, factors such as BMI, sex distribution, and age group sizes were inconsistent with established standards. Despite these limitations, validation studies comparing invasive and noninvasive methods consistently highlighted the superiority of cfPWV assessment devices. Applanation tonometry devices demonstrated smaller discrepancies in PWV measurements and better overall agreement with invasive methods than oscillometry-based devices. Three studies comparing the SphygmoCor XCEL with the standard SphygmoCor showed an excellent level of agreement, with one study confirming the SphygmoCor XCEL's superior adherence to validation criteria. Oscillometric devices showed a stronger reliance on algorithmic adjustments based on factors such as age and systolic blood pressure. This dependence likely contributes to the underestimation of PWV, particularly in populations w

Aim: This study aimed to investigate the impact of the NOD1/Rip2 signaling pathway on macrophage inflammatory activation and polarity switching in ox-LDL-induced THP-1-derived macrophages. Methods: THP-1-derived macrophages were stimulated with various concentrations (10, 25, or 50 mg/L) of ox-LDL for different durations (8, 16, or 24 h). Quantitative real-time PCR was used to measure the mRNA expression of NOD1, Rip2, IL-10, IL-12, iNOS, and Arg-1. Western blotting was used to determine the protein levels of NOD1 and Rip2. The secretion of TNF-α and MCP-1 in the cell culture supernatants was measured via ELISA. Rip2 siRNA was used to inhibit the NOD1/Rip2 signaling pathway. Oil Red O staining was employed to visualize foam cell formation. CD86, CD80, and CD163 membrane molecules were analyzed via FACS. Results: After exposure to ox-LDL, the expression levels of NOD1 and Rip2 mRNAs and proteins in THP-1-derived macrophages increased in a dose- and time-dependent manner. This upregulation was accompanied by increased concentrations of TNF-α and MCP-1 in the cell culture supernatants. The effects of NOD1 and Rip2 expression upregulation were mitigated by Rip2 siRNA, as evidenced by decreased concentrations of TNF-α and MCP-1. Furthermore, ox-LDL downregulated the expression of M2 macrophage markers CD163, IL-12, and Arg-1 and upregulated the expression of M1 macrophage markers CD86, CD80, IL-10, and iNOS. The inhibition of Rip2 by siRNA reversed these effects and prevented the formation of foam cells. Conclusion: Our data show that the NOD1/RIP2 signaling pathway regulates the inflammatory activation of macrophages induced by ox-LDL and controls the macrophage polarity switch.

Purpose: This study aimed to investigate the impacts of tanshinone IIA (Tan IIA) on ischemia/reperfusion (I/R)-induced cardiomyocyte injury in coronary heart disease (CHD), and to determine whether Tan IIA regulates myocardial cell injury induced by I/R through the Hyaluronan Synthase 2/fibroblast growth factor 9 (HAS2/FGF9) axis.

Methods: Weighted gene co-expression network analysis (WGCNA) of the GSE23561 microarray dataset determined gene modules linked to CHD. The key genes were further explored through differential expression and protein-protein interaction (PPI) network analyses. Human AC16 cardiomyocytes were treated with Tan IIA, HAS2 knockdown, and FGF9 overexpression and they were exposed to normoxic, hypoxic, and I/R environments. Cell viability, apoptosis, gene/protein expression, and markers of oxidative stress were evaluated in vitro.

Results: The turquoise module was significantly correlated with CHD and HAS2 was identified as a hub gene. Under hypoxic conditions, Tan IIA exhibited a dose-dependent cardioprotective effect. Tan IIA ameliorated I/R-induced cellular injury, as evidenced by increased cell viability, decreased apoptosis, and regulation of key proteins (PCNA, Bax). After I/R conditions, knockdown of HAS2 increased cell viability and reduced apoptosis, whereas overexpression of FGF9 reversed these effects. Notably, HAS2 knockdown also ameliorated I/R-induced increases in inflammatory cytokines and oxidative stress, and synergistic protection was provided by combined treatment with FGF9 and Tan IIA.

Conclusion: Taken together, our findings confirm that Tan IIA protects cardiomyocytes from I/R-induced injury by controlling the HAS2/FGF9 axis. These findings reveal the potential therapeutic significance of Tan IIA in alleviating CHD-related myocardial dysfunction.