Cardiovascular Therapeutics最新文献_第3页

Association Between Blood Cadmium Levels and Heart Failure Risk: Insights From NHANES 2009–2014 血镉水平与心力衰竭风险之间的关系：来自NHANES 2009-2014的见解

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-30 DOI: 10.1155/cdr/3656561

Yong He, Hongkun Wu, Yongjin Luo, Xin Wen, Hao Chen

Background

Heart failure (HF) is a major global public health problem, and identifying modifiable environmental risk factors is important for prevention. We evaluated the association between blood cadmium levels and the risk of HF in US adults.

Methods

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. A total of 10,542 adults with complete information on blood cadmium and HF status were included. Weighted multivariable logistic regression models were used to assess the relationship between blood cadmium and self-reported HF. Restricted cubic spline (RCS) regression and two-piecewise linear models were applied to explore potential dose–response relationships.

Results

A cohort of 10,542 US adults from the NHANES 2009–2014 dataset was analyzed, including 321 individuals diagnosed with HF. In fully adjusted, weighted logistic regression models, elevated blood cadmium levels were significantly correlated with an increased prevalence of HF. Specifically, each 1 μg/L increment in blood cadmium was associated with a 42% higher likelihood of HF (odds ratio [OR] = 1.42; 95% confidence interval [CI]: 1.18–1.72; p < 0.001). Participants in the highest quartile of blood cadmium levels exhibited more than a threefold increase in the odds of HF compared to those in the lowest quartile (OR = 3.15; 95% CI: 1.81–5.50; p < 0.001), with a significant linear trend observed across quartiles (p < 0.001). RCS analysis demonstrated a monotonic positive relationship, with an apparent inflection point at approximately 0.13 μg/L, beyond which the risk continued to escalate. This association was generally consistent across various subgroups but was notably stronger among smokers (p for interaction < 0.05).

Conclusions

Elevated blood cadmium is an independent risk factor for HF in the United States. These findings suggest that reducing cadmium exposure may be a novel strategy for HF prevention. Prospective studies are warranted to clarify causal relationships and underlying mechanisms.

心衰（HF）是一个重大的全球公共卫生问题，确定可改变的环境风险因素对于预防心衰非常重要。我们评估了美国成人血镉水平与HF风险之间的关系。方法分析2009-2014年美国国家健康与营养调查（NHANES）的数据。总共纳入了10542名具有完整血镉和HF信息的成年人。采用加权多变量logistic回归模型评估血镉与自报HF之间的关系。采用限制三次样条（RCS）回归和两分段线性模型探讨潜在的剂量-反应关系。结果分析了来自NHANES 2009-2014数据集的10,542名美国成年人的队列，其中包括321名诊断为HF的个体。在完全调整的加权logistic回归模型中，血镉水平升高与心衰患病率增加显著相关。具体来说，血镉浓度每增加1 μg/L，发生HF的可能性增加42%（优势比[OR] = 1.42； 95%可信区间[CI]: 1.18-1.72; p < 0.001）。血液中镉含量最高的四分位数的参与者与最低四分位数的参与者相比，HF的几率增加了三倍以上（OR = 3.15; 95% CI: 1.81-5.50; p < 0.001），在四分位数之间观察到显著的线性趋势（p < 0.001）。RCS分析显示两者呈单调正相关，在0.13 μg/L附近有明显的拐点，超过该拐点后风险继续升高。这种关联在各个亚组中普遍一致，但在吸烟者中尤为明显（p为相互作用<； 0.05）。结论在美国，血镉升高是心衰的独立危险因素。这些发现表明减少镉暴露可能是一种预防HF的新策略。有必要进行前瞻性研究，以阐明因果关系和潜在机制。

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引用次数: 0

Antiatherogenic and Cardioprotective Effects of a Xanthine Derivative KMUP-1 in ApoE Knockout Mice 黄嘌呤衍生物KMUP-1对ApoE基因敲除小鼠的抗动脉粥样硬化和心脏保护作用

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-29 DOI: 10.1155/cdr/8419343

Erna Sulistyowati, Shang-En Huang, Chih-Chieh Hsu, Yi-Chia Wu, Yu-Ying Chao, Jong-Hau Hsu, Bin-Nan Wu, Zen-Kong Dai, Ming-Chung Lin, Jwu-Lai Yeh

It is essential to manage cardiovascular disease related to atherosclerosis through understanding its disease progression mechanism. The effects of the xanthine derivative KMUP-1 on alleviating atherosclerosis and cardiac remodeling, as well as its underlying mechanisms, were examined. In this study, atherosclerosis and cardiac damage were induced in ApoE knockout (KO) mice by feeding them a high-fat diet (HFD) for 12 weeks. The co- and posttreatment of KMUP-1 was evaluated. Our results showed that KMUP-1 treatment significantly reduced body weight gain in HFD-induced mice. The Oil Red O and hematoxylin–eosin staining showed that KMUP-1 reduced the aortic plaque area, intima–media thickness, and intima–lumen thickness. KMUP-1 reduced inflammatory cytokines IL-1β, TNF-α, IL-6, and MCP-1 in the serum of mice through an ELISA assay. Moreover, echocardiography evaluation indicated that KMUP-1 attenuated left ventricular cardiac hypertrophy and restored cardiac function. Further, KMUP-1 treatment suppressed proapoptotic protein Bax and reversed Bcl-2 level by promoting autophagy-related Gene 7 and autophagosome marker LC3-II activation in the vascular through immunofluorescence and western blotting assay. KMUP-1 improved the serum lipidomic profile. Both co- and posttreatment of KMUP-1 stimulated autophagy and reduced inflammation and apoptosis, against atherosclerosis and cardiac remodeling in an ApoE-KO mouse model. It suggests its potential as a therapeutic agent for cardiovascular diseases.

了解动脉粥样硬化相关心血管疾病的发病机制，对动脉粥样硬化相关心血管疾病的管理具有重要意义。研究了黄嘌呤衍生物KMUP-1在缓解动脉粥样硬化和心脏重构中的作用及其潜在机制。在本研究中，通过给ApoE敲除（KO）小鼠喂食高脂肪饮食（HFD） 12周，诱导其动脉粥样硬化和心脏损伤。评价KMUP-1的共处理和后处理。我们的研究结果表明，KMUP-1治疗显著降低了手足口病诱导小鼠的体重增加。油红O和苏木精-伊红染色显示KMUP-1减少了主动脉斑块面积、内膜-中膜厚度和内膜-管腔厚度。通过ELISA检测，KMUP-1可降低小鼠血清中的炎症因子IL-1β、TNF-α、IL-6和MCP-1。超声心动图评价显示KMUP-1减轻左心室肥厚，恢复心功能。此外，通过免疫荧光和western blotting检测，KMUP-1处理通过促进血管中自噬相关基因7和自噬体标志物LC3-II的激活，抑制了促凋亡蛋白Bax并逆转了Bcl-2水平。KMUP-1改善了血清脂质组学特征。在ApoE-KO小鼠模型中，KMUP-1共处理和后处理均可刺激自噬，减少炎症和细胞凋亡，对抗动脉粥样硬化和心脏重塑。这表明其作为心血管疾病治疗剂的潜力。

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引用次数: 0

Is Carvedilol Effective in Preventing and Modulating Concentric Cardiac Remodelling? A Comprehensive Systematic Review and Meta-Analyses 卡维地洛对预防和调节同心心脏重构有效吗？综合系统评价和荟萃分析

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-28 DOI: 10.1155/cdr/9108324

Alice Valeria Wiyono, Azizah Puspitasari Ardinal

Background

Carvedilol, commonly used to treat hypertension and known for its vasodilatory and pleiotropic effects, has been studied in various patient populations. However, its specific impact on diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF) remains unclear.

Aim

The aim of the study is to evaluate carvedilol′s efficacy in preventing concentric cardiac remodelling in at-risk individuals and modulating it in patients with HFpEF.

Methods

In adherence to PRISMA guidelines, we searched PubMed and ScienceDirect up to March 2024 using terms related to carvedilol and HFpEF. We included randomised controlled trials and prospective cohort studies published in English. Outcomes include changes in natriuretic peptides and echocardiography parameters of diastolic function. Exclusion criteria encompassed non-English studies, nonhuman studies and studies not using carvedilol or exclusively involving HFrEF patients. Risk of bias was assessed using the revised Cochrane tool and Newcastle–Ottawa Scale. Data synthesis was performed using a random-effects meta-analysis with sensitivity analyses and a leave-one-out procedure to explore heterogeneity.

Results

Eighteen studies involving 2233 participants were included. Various populations were included: those with HFpEF or undergoing cardiotoxic chemotherapy. Meta-analysis did not reveal significant effects of carvedilol on echocardiography parameters such as E/A ratio (mean difference 0.04, 95% CI −0.01 to 0.08), E/e ^′ ratio (mean difference −0.50, 95% CI −1.39 to 0.39) and LVMI (mean difference 0.21, 95% CI −3.13 to 3.55), with substantial heterogeneity observed in LVEF, LVMI and BNP.

Conclusion

Carvedilol does not significantly impact diastolic dysfunction across various populations. However, the diversity of study populations and outcomes contributes to the heterogeneity of results.

卡维地洛通常用于治疗高血压，并以其血管扩张和多效作用而闻名，已在各种患者群体中进行了研究。然而，其对保留射血分数（HFpEF）的舒张功能障碍和心力衰竭的具体影响尚不清楚。目的本研究的目的是评估卡维地洛在高危人群中预防同心心重构和调节HFpEF患者的疗效。方法根据PRISMA指南，检索PubMed和ScienceDirect到2024年3月，使用卡维地洛和HFpEF相关术语。我们纳入了用英文发表的随机对照试验和前瞻性队列研究。结果包括利钠肽和舒张功能超声心动图参数的变化。排除标准包括非英语研究、非人类研究和不使用卡维地洛或仅涉及HFrEF患者的研究。使用修订后的Cochrane工具和Newcastle-Ottawa量表评估偏倚风险。数据综合采用随机效应荟萃分析和敏感性分析，并采用留一程序来探索异质性。结果纳入18项研究，2233名受试者。包括不同的人群：HFpEF患者或接受心脏毒性化疗的患者。meta分析未显示卡维地洛对超声心动图参数的显著影响，如E/A比（平均差异0.04,95% CI−0.01至0.08）、E/ E比（平均差异−0.50,95% CI−1.39至0.39）和LVMI（平均差异0.21,95% CI−3.13至3.55），且在LVEF、LVMI和BNP方面存在显著异质性。结论卡维地洛对不同人群舒张功能障碍无显著影响。然而，研究人群和结果的多样性导致了结果的异质性。

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引用次数: 0

CXCL1 Promotes Fibrotic Remodeling in Atrial Fibrillation via Activation of TXNDC5 and Endoplasmic Reticulum Stress CXCL1通过激活TXNDC5和内质网应激促进心房颤动纤维化重塑

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-28 DOI: 10.1155/cdr/7892499

Ran Yin, Cheng-Long Wu, Si-Yang Yu, Kun Huang, Yuan Wen, Jun-Gang Nie, Ru Ying

Background

Atrial fibrosis is a key structural substrate in atrial fibrillation (AF). This work was conducted to investigate the profibrotic effects of chemokine C-X-C motif Ligand 1 (CXCL1) and elucidate the actions of endoplasmic reticulum stress (ERS) and ER-resident protein thioredoxin domain-containing Protein 5 (TXNDC5) in this process.

Methods

Serum CXCL1 concentrations were measured in patients with AF and healthy controls. The effects of CXCL1 on atrial fibrosis were evaluated using ex vivo rat atrial tissue culture. Additionally, the influence of CXCL1 on collagen synthesis, ERS activation, and TXNDC5 expression was assessed in primary rat cardiac fibroblasts. Pharmacological inhibition of ERS and gene silencing of TXNDC5 were employed to decipher underlying mechanisms.

Results

CXCL1 levels were elevated in patients with AF compared to controls. In ex vivo rat atrial tissue, CXCL1 treatment induced marked fibrosis and upregulated the expression of ERS markers GRP78 and ATF6, as well as TXNDC5. In cardiac fibroblasts, CXCL1 promoted the secretion of Collagen I, Collagen III, and TGF-β1. Notably, both ERS inhibition and TXNDC5 knockdown effectively attenuated CXCL1-induced fibroblast activation and extracellular matrix protein expression.

Conclusion

CXCL1 promotes atrial fibrosis through the activation of ERS and upregulation of TXNDC5, potentially contributing to atrial remodeling and the pathogenesis of AF. Targeting the CXCL1–ERS–TXNDC5 axis may offer a novel therapeutic approach for preventing and treating AF-related atrial fibrosis.

心房纤维化是心房颤动（AF）的关键结构底物。本研究旨在探讨趋化因子C-X-C motif Ligand 1 （CXCL1）的促纤维化作用，并阐明内质网应激（ERS）和ER-resident protein thioredoxin domain containing protein 5 （TXNDC5）在这一过程中的作用。方法测定房颤患者和健康对照者血清CXCL1浓度。采用离体大鼠心房组织培养法评价CXCL1对心房纤维化的影响。此外，在原代大鼠心脏成纤维细胞中评估CXCL1对胶原合成、ERS激活和TXNDC5表达的影响。利用ERS的药理抑制和TXNDC5的基因沉默来解释其潜在的机制。结果与对照组相比，AF患者的CXCL1水平升高。在离体大鼠心房组织中，CXCL1处理诱导显著纤维化，上调ERS标记物GRP78和ATF6以及TXNDC5的表达。在心脏成纤维细胞中，CXCL1促进胶原I、胶原III和TGF-β1的分泌。值得注意的是，ERS抑制和TXNDC5敲低均能有效减弱cxcl1诱导的成纤维细胞活化和细胞外基质蛋白表达。结论CXCL1通过激活ERS和上调TXNDC5促进心房纤维化，可能参与心房重构和房颤发病机制，靶向CXCL1 - ERS - TXNDC5轴可能为预防和治疗房颤相关心房纤维化提供新的治疗途径。

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引用次数: 0

Hemodynamic Variability in Aortic Stenosis and Regurgitation During Transcatheter Aortic Valve Replacement With Self-Expanding Valves 经导管主动脉瓣置换术中主动脉瓣狭窄和返流的血流动力学变异性

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-23 DOI: 10.1155/cdr/8821435

Mingfei Li, Jianing Fan, Shasha Chen, Dawei Lin, Xiaochun Zhang, Wenzhi Pan, Daxin Zhou, Junbo Ge

Objective

This study investigated the impact of pathological differences between aortic stenosis (AS) and aortic regurgitation (AR) on hemodynamic outcomes following transcatheter aortic valve replacement (TAVR), with a focus on the performance of self-expanding valves relative to annular anatomy.

Methods

In this single-center, retrospective study, patients undergoing TAVR for AS or AR were stratified by annulus area into smaller (< 430 cm²) and larger (≥ 430 cm²) subgroups. Valve sizing was based on annular dimensions (≥ 27 mm for AR/smaller annulus; < 27 mm for AS subgroups). Hemodynamic parameters (aortic valve area [AVA], pressure gradients, and velocity) and prosthesis characteristics (sheath size and compression ratio) were evaluated pre- and postoperatively, with 1-year follow-up.

Results

The AR group required larger sheaths (p = 0.006) and demonstrated superior hemodynamics compared to the AS group: larger postoperative AVA (3.0 ± 0.4 vs. 2.2 ± 0.5 and 2.1 ± 0.6 cm² in larger and smaller annuli, respectively, p < 0.001); lower maximum (9.7 ± 4.3 vs. 15.8 ± 9.2 and 18.8 ± 10.8 mmHg in larger and smaller annuli, respectively, p < 0.001) and mean gradients (7.8 ± 4.4 mmHg vs. others, p < 0.001); and reduced aortic velocity (1.60 ± 0.43 vs. others, p = 0.038). Smaller annuli exhibited higher prosthesis compression (0.88 ± 0.04 vs. 0.84 ± 0.04 in AR and 0.8 ± 0.06 in larger annulus, p < 0.001), with 20% (n = 8) developing elevated transvalvular gradients (> 20 mmHg) at follow-up.

Conclusions

One-year outcomes revealed distinct hemodynamic profiles post-TAVR between AR and AS groups based on annular size. Patients with AR exhibited more favorable valve performance, supporting TAVR in younger, low-risk patients with AR who have suitable annular anatomy.

目的探讨经导管主动脉瓣置换术（TAVR）后主动脉瓣狭窄（AS）和主动脉瓣反流（AR）的病理差异对血流动力学结果的影响，重点研究自膨胀瓣膜相对于环形解剖的性能。方法在这项单中心回顾性研究中，根据环面积将接受TAVR治疗的AS或AR患者分为较小（< 430 cm2）和较大（≥430 cm2）亚组。阀门尺寸基于环空尺寸（AR≥27mm /较小环空；AS亚组≥27mm）。术前和术后评估血流动力学参数（主动脉瓣面积[AVA]、压力梯度和速度）和假体特征（鞘大小和压缩比），随访1年。结果与AS组相比，AR组需要更大的鞘（p = 0.006），并表现出更好的血流动力学：术后AVA更大(3.0±0.4 vs。较大和较小环空分别为2.2±0.5和2.1±0.6 cm2, p < 0.001)；最大（9.7±4.3 vs. 15.8±9.2和18.8±10.8 mmHg）和平均梯度（7.8±4.4 mmHg vs.其他，p < 0.001）较低；主动脉流速降低（1.60±0.43,p = 0.038）。较小的环空表现出较高的假体压迫（AR为0.88±0.04，AR为0.84±0.04，较大的环空为0.8±0.06,p < 0.001），随访时20% （n = 8）出现跨瓣梯度升高（> 20mmhg）。结论：基于血管环的大小，AR组和AS组在tavr后的血流动力学特征不同。AR患者表现出更良好的瓣膜功能，支持年轻、低风险、具有合适环解剖结构的AR患者进行TAVR。

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引用次数: 0

The Impact of SGLT2 Inhibitors on Pulmonary Artery Pressures and Pulmonary Hemodynamics in Patients With Heart Failure: A Systematic Review SGLT2抑制剂对心力衰竭患者肺动脉压和肺血流动力学的影响：一项系统综述

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-21 DOI: 10.1155/cdr/6649731

Kritick Bhandari, Maria Qadri, Rochak Dhakal, Sagun Ghimire, Gyanendra Jora, Santosh Basyal, Sanjit Kumar Shah

<div> <section> <h3> Background</h3> <p>Heart failure is a major global health burden associated with high morbidity and mortality. Elevated pulmonary artery pressures (PAP) are linked to worse outcomes in heart failure patients. Sodium–glucose cotransporter 2 (SGLT2) inhibitors, initially developed for diabetes, have demonstrated cardiovascular benefits, but their specific effects on pulmonary hemodynamics remain unclear.</p> </section> <section> <h3> Methods</h3> <p>This systematic review analyzed randomized controlled trials and observational cohort studies evaluating the effects of SGLT2 inhibitors on mean pulmonary artery pressure (mPAP) and pulmonary artery systolic pressure (PASP) in heart failure patients. A comprehensive search of PubMed, Embase, Cochrane Library, and Scopus databases was conducted until August 2024. Studies were appraised using PRISMA and AMSTAR guidelines, the Cochrane bias tool, and the Newcastle–Ottawa Scale.</p> </section> <section> <h3> Hypothesis</h3> <p>SGLT2 inhibitors reduce PAPs in heart failure patients, leading to beneficial pulmonary hemodynamic effects.</p> </section> <section> <h3> Results</h3> <p>Six studies (four RCTs and two observational; <i>n</i> = 346) were included. At rest, pooled analysis of three trials showed a significant reduction in mPAP (MD −1.41 mmHg; 95% CI −2.80 to −0.01; <i>p</i> = 0.05; <i>I</i><sup>2</sup> = 12<i>%</i>). During exercise, two studies demonstrated a nonsignificant reduction in mPAP (MD −3.12 mmHg; 95% CI −7.60 to 1.36; <i>p</i> = 0.17; <i>I</i><sup>2</sup> = 54<i>%</i>). For PASP, pooled analysis of four studies suggested a nonsignificant reduction (MD −6.72 mmHg; 95% CI −14.98 to 1.54; <i>p</i> = 0.11; <i>I</i><sup>2</sup> = 96<i>%</i>), but sensitivity analysis excluding one outlier yielded a significant effect (MD −2.76 mmHg; 95% CI −4.99 to −0.53; <i>p</i> = 0.02; <i>I</i><sup>2</sup> = 0<i>%</i>). Secondary outcomes included significant reductions in PCWP, PADP, and NT-proBNP.</p> </section> <section> <h3> Conclusion</h3> <p>SGLT2 inhibitors demonstrate beneficial effects on pulmonary pressures and hemodynamics in patients with heart failure, with consistent trends toward lower mPAP, PASP, and PCWP. Although results are influenced by study heterogeneity, the overall evidence suggests meaningful hemodynamic improvements. Larger, long-term randomized trials are warranted to clarify subgroup effects (HFrEF vs. HFpEF and dapagliflozin vs. empagliflozin) and establish clinical implica

背景：心力衰竭是与高发病率和高死亡率相关的主要全球健康负担。肺动脉压（PAP）升高与心力衰竭患者预后较差有关。钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂最初是为糖尿病开发的，已经证明对心血管有益，但它们对肺血流动力学的具体影响尚不清楚。方法本系统综述分析了随机对照试验和观察性队列研究，评估SGLT2抑制剂对心力衰竭患者平均肺动脉压（mPAP）和肺动脉收缩压（PASP）的影响。对PubMed、Embase、Cochrane Library和Scopus数据库进行了全面的检索，直到2024年8月。采用PRISMA和AMSTAR指南、Cochrane偏倚工具和Newcastle-Ottawa量表对研究进行评价。假设SGLT2抑制剂降低心力衰竭患者的pap，导致有益的肺血流动力学作用。结果共纳入6项研究（4项rct和2项观察性研究，n = 346）。其余，三个试验的合并分析显示mPAP显著降低（MD - 1.41 mmHg; 95% CI - 2.80至- 0.01;p = 0.05; I2 = 12%）。在运动期间，两项研究显示mPAP无显著降低（MD - 3.12 mmHg; 95% CI - 7.60 ~ 1.36; p = 0.17; I2 = 54%）。对于PASP，四项研究的汇总分析显示无显著降低（MD - 6.72 mmHg; 95% CI - 14.98至1.54;p = 0.11; I2 = 96%），但排除一个异常值的敏感性分析显示有显著效果（MD - 2.76 mmHg; 95% CI - 4.99至- 0.53;p = 0.02; I2 = 0%）。次要结局包括PCWP、PADP和NT-proBNP显著降低。结论SGLT2抑制剂对心力衰竭患者的肺动脉压和血流动力学有有益的影响，并具有降低mPAP、PASP和PCWP的趋势。虽然结果受到研究异质性的影响，但总体证据表明有意义的血流动力学改善。需要更大规模的长期随机试验来澄清亚组效应（HFrEF vs. HFpEF，达格列净vs.恩格列净）并确定临床意义。

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引用次数: 0

Endovenous Laser Ablation of Insufficient Superficial Veins in Patients After Deep Vein Thrombosis Recanalisation 深静脉血栓再通后浅静脉不足患者的静脉内激光消融

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-14 DOI: 10.1155/cdr/8458282

Srdjan Babic, Jovan Petrovic, Masa Petrovic, Slobodan Pesic, Slobodan Tanaskovic, Ana Cvetkovic, Predrag Gajin, Nenad Ilijevski

Introduction

This study is aimed at investigating the safety of endovenous laser ablation treatment in the superficial venous system and perforator venous system in patients with previous deep vein thrombosis.

Methods

From February 2017 to January 2023, 28 patients (20 women) with an average age of 41.5 ± 8.6 years, insufficient great saphenous vein and previous deep vein thrombosis were treated. All patients were diagnosed based on previous ultrasound examinations. In this retrospective study, patients were indeed included if they met specific criteria. Preoperative evaluations and thrombophilia assessments were conducted.

Results

Most patients had previous thrombosis in the popliteal vein (36.4%), while 31.8% had thrombosis in both the femoral and calf veins. Technical success was achieved in all patients, with concomitant procedures (closure of incompetent perforators and phlebectomies), and during follow-up (20 ± 16 months, range: 2–168 months), there were no signs of recanalisation of previously treated superficial veins. Patients were followed up at 1-month, 3-month, 6-month and 12-month intervals postprocedure. Recurrent deep vein thrombosis occurred in two (7%) patients after 26 and 31 months after treatment. Early complications included one (3.5%) case of endovenous heat-induced thrombosis Type II.

Conclusions

Endovenous laser ablation is safe and effective in patients with resolved deep vein thrombosis when combined with appropriate anticoagulant therapy.

本研究旨在探讨静脉内激光消融治疗既往深静脉血栓患者浅表静脉系统和穿支静脉系统的安全性。方法2017年2月至2023年1月对28例（女性20例）患者进行治疗，患者平均年龄41.5±8.6岁，大隐静脉不足，既往深静脉血栓形成。所有患者均根据既往超声检查进行诊断。在这项回顾性研究中，确实纳入了符合特定标准的患者。进行术前评估和血栓形成评估。结果既往腘静脉血栓发生率最高（36.4%），股静脉和小腿静脉合并血栓发生率最高（31.8%）。所有患者均获得了技术上的成功，同时进行了手术（关闭不合格穿支和静脉切除术），在随访期间（20±16个月，范围：2-168个月），未发现先前治疗过的浅静脉再通的迹象。术后随访时间分别为1个月、3个月、6个月和12个月。2例（7%）患者在治疗后26个月和31个月再次发生深静脉血栓。早期并发症包括1例（3.5%）静脉内热致血栓形成II型。结论静脉内激光消融联合适当的抗凝治疗治疗深静脉血栓是安全有效的。

{"title":"Endovenous Laser Ablation of Insufficient Superficial Veins in Patients After Deep Vein Thrombosis Recanalisation","authors":"Srdjan Babic, Jovan Petrovic, Masa Petrovic, Slobodan Pesic, Slobodan Tanaskovic, Ana Cvetkovic, Predrag Gajin, Nenad Ilijevski","doi":"10.1155/cdr/8458282","DOIUrl":"https://doi.org/10.1155/cdr/8458282","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study is aimed at investigating the safety of endovenous laser ablation treatment in the superficial venous system and perforator venous system in patients with previous deep vein thrombosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From February 2017 to January 2023, 28 patients (20 women) with an average age of 41.5 ± 8.6 years, insufficient great saphenous vein and previous deep vein thrombosis were treated. All patients were diagnosed based on previous ultrasound examinations. In this retrospective study, patients were indeed included if they met specific criteria. Preoperative evaluations and thrombophilia assessments were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most patients had previous thrombosis in the popliteal vein (36.4%), while 31.8% had thrombosis in both the femoral and calf veins. Technical success was achieved in all patients, with concomitant procedures (closure of incompetent perforators and phlebectomies), and during follow-up (20 ± 16 months, range: 2–168 months), there were no signs of recanalisation of previously treated superficial veins. Patients were followed up at 1-month, 3-month, 6-month and 12-month intervals postprocedure. Recurrent deep vein thrombosis occurred in two (7%) patients after 26 and 31 months after treatment. Early complications included one (3.5%) case of endovenous heat-induced thrombosis Type II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endovenous laser ablation is safe and effective in patients with resolved deep vein thrombosis when combined with appropriate anticoagulant therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/cdr/8458282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145316952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single Fluoroscopy Versus Transesophageal Echocardiogram: A Comparative Evaluation for Left Atrial Appendage Occlusion With LACbes Device 单透视与经食管超声心动图：LACbes装置对左心耳闭塞的比较评价

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-12 DOI: 10.1155/cdr/9933780

Mingfei Li, Dawei Lin, Lei Zhang, Jianing Fan, Wenzhi Pan, Xiaochun Zhang, Daxin Zhou, Junbo Ge

Objectives

This study was aimed at evaluating the effectiveness of fluoroscopy as an intraprocedural guidance method during left atrial appendage occlusion (LAAO) using the LACbes device.

Methods

The study included a cohort of 477 patients with nonvalvular atrial fibrillation (AF) who underwent LAAO. The cohort was divided into two groups: a retrospective group of 240 patients who underwent standard procedures involving both transesophageal echocardiogram (TEE) and fluoroscopy and a prospective group of 237 patients who only underwent fluoroscopy. The retrospective cohort was analyzed for device positioning, anchoring, compression, and peridevice leak (PDL) using both TEE and fluoroscopy to provide detailed insights for potential application in the prospective cohort. Clinical outcomes were compared between the two groups.

Results

There were no significant differences in left atrial appendage (LAA) characteristics and other echocardiographic parameters between the two groups. Although the prospective group had a higher prevalence of implantation failure and more deployment attempts per procedure, these differences did not reach statistical significance. Notable differences were observed in fluoroscopy and operation times. Specifically, the prospective group had longer fluoroscopy times and more deployment attempts per procedure but shorter overall operation times compared to the retrospective group. Additionally, patients in the prospective group had shorter hospital stays and lower hospitalization costs. Periprocedural and 2-year follow-up complications were comparable between both cohorts, with no statistically significant differences observed in pericardial effusion, peripheral vascular complications, survival, cardiac death, PDL, or device thrombus.

Conclusions

The use of fluoroscopy as the sole guidance modality for LAAO with the LACbes device demonstrated promising results in terms of efficacy and safety. It emerges as a viable and cost-effective alternative, offering a more efficient approach for LAAO.

目的本研究旨在评估使用LACbes装置的左心耳闭塞术中透视作为术中指导方法的有效性。方法本研究纳入477例接受LAAO治疗的非瓣膜性心房颤动（AF）患者。该队列被分为两组：回顾性组240名患者接受了包括经食管超声心动图（TEE）和透视检查在内的标准程序，前瞻性组237名患者只接受了透视检查。回顾性队列分析器械定位、锚定、压缩和器械周围泄漏（PDL），使用TEE和透视，为前瞻性队列的潜在应用提供详细的见解。比较两组患者的临床结果。结果两组患者左心耳（LAA）特征及其他超声心动图参数差异无统计学意义。虽然前瞻性组有更高的植入失败率和每次手术更多的部署尝试，但这些差异没有达到统计学意义。在透视和手术时间上观察到显著差异。具体来说，与回顾性组相比，前瞻性组每次手术有更长的透视时间和更多的部署尝试，但总手术时间更短。此外，前瞻性组患者住院时间较短，住院费用较低。围手术期和2年随访并发症在两个队列之间具有可比性，在心包积液、周围血管并发症、生存率、心源性死亡、PDL或装置血栓方面没有统计学上的显著差异。结论使用透视作为LAAO的唯一指导方式，结合LACbes装置在疗效和安全性方面具有良好的效果。它是一种可行的、具有成本效益的替代方案，为LAAO提供了一种更有效的方法。

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引用次数: 0

Metformin Attenuates Myocardial Ischemia–Reperfusion Injury in Rats by Modulating JNK Pathway and Inhibiting PANoptosis Mechanisms 二甲双胍通过调节JNK通路和抑制PANoptosis机制减轻大鼠心肌缺血再灌注损伤

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-07 DOI: 10.1155/cdr/4642838

Biao Hou, Xuejian Hou, Liyue Zhang, Tingting Liu, Yang Li, Ran Dong

Purpose

Myocardial ischemia–reperfusion injury (MIRI) is a condition in which the heart is aggravated when blood flow is restored after tissue damage caused by ischemia. Metformin (Met), a widely prescribed antidiabetic medication, has demonstrated promising cardioprotective properties, particularly through its anti-inflammatory, antiapoptotic, and metabolic regulatory mechanisms. This study investigates the cardioprotective effects of Met in a rat model of MIRI, focusing on its modulation of the c-Jun N-terminal kinase (JNK) pathway and inhibition of PANoptosis mechanisms.

Methods

The proportion of myocardial infarction was determined by triphenyl tetrazole chloride (TTC) staining. Wheat germ agglutinin (WGA) staining is used to determine whether myocardial cells are hypertrophic and other pathological conditions. Serum markers of myocardial injury along with inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence and Western blotting were employed to evaluate myocardial cell PANoptosis and the involvement of the JNK pathway.

Results

After MIRI, TTC staining revealed apparent myocardial infarction, and WGA staining showed significant myocardial cell hypertrophy. There was also a marked increase in myocardial injury markers, inflammatory factors, and reactive oxygen species (ROS). Met significantly reduced the myocardial injury area and notably lowered serum levels of c-TnI, CK-MB, LDH, IL-6, TNF-α, and ROS. Immunofluorescence and Western blot analyses demonstrated that Met attenuates myocardial cell PANoptosis by inhibiting JNK phosphorylation and reducing ROS generation. The cardioprotective effect of Met was reversed by the addition of anisomycin (ANI). The protective effect of JNK-specific inhibitors administered as monotherapy was found to be comparable to that of Met. The aforementioned results suggest that the regulation of the JNK pathway is a critical factor contributing to its protective effect.

Conclusion

The cardioprotective effect of Met in the rat model of MIRI is mediated through the regulation of the JNK pathway and PANoptosis. These findings suggest that Met may provide a potential therapeutic approach for treating MIRI.

心肌缺血再灌注损伤（心肌缺血再灌注损伤，心肌缺血再灌注损伤）是指心肌缺血组织损伤后，血流恢复后心脏功能加重的一种疾病。二甲双胍（Metformin, Met）是一种广泛使用的抗糖尿病药物，已被证明具有良好的心脏保护作用，特别是通过其抗炎、抗细胞凋亡和代谢调节机制。本研究探讨了Met在MIRI大鼠模型中的心脏保护作用，重点研究了其对c-Jun n -末端激酶（JNK）通路的调节和对PANoptosis的抑制机制。方法采用氯化三苯四唑（TTC）染色法测定心肌梗死比例。小麦胚芽凝集素（WGA）染色用于确定心肌细胞是否肥厚及其他病理状况。采用酶联免疫吸附法（ELISA）检测心肌损伤血清标志物及炎症因子水平。采用免疫荧光和Western blotting检测心肌细胞PANoptosis及JNK通路的参与情况。结果MIRI后，TTC染色显示明显心肌梗死，WGA染色显示心肌细胞明显肥大。心肌损伤标志物、炎症因子和活性氧（ROS）也明显增加。蛋氨酸显著减少心肌损伤面积，显著降低血清c-TnI、CK-MB、LDH、IL-6、TNF-α、ROS水平。免疫荧光和Western blot分析表明，Met通过抑制JNK磷酸化和减少ROS生成来减轻心肌细胞PANoptosis。加入大霉素（ANI）后，Met的心脏保护作用被逆转。jnk特异性抑制剂作为单药治疗的保护作用被发现与Met相当。上述结果提示，JNK通路的调控是其发挥保护作用的关键因素。结论Met在MIRI大鼠模型中的心脏保护作用是通过调控JNK通路和PANoptosis介导的。这些发现表明Met可能为治疗MIRI提供一种潜在的治疗方法。

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引用次数: 0

Optimization of Clinical Trial Design and Decision-Making for Heart Failure with Preserved Ejection Fraction (HFpEF): A Meta-Analysis Based on a Placebo Response Model 保留射血分数（HFpEF）心力衰竭临床试验设计和决策的优化：基于安慰剂反应模型的meta分析

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics

Pub Date : 2025-10-06 DOI: 10.1155/cdr/7087720

Xiaoya Chen, Juan Yang, Ling Xu, Fang Yin, Jihan Huang, Yinghua Lv, Qingshan Zheng, Lujin Li

Objective

The aim of this study was to establish a placebo response model for efficacy indicators in heart failure with preserved ejection fraction (HFpEF) clinical trials, facilitating sample size estimation and trial optimization.

Methods

PubMed, EMBASE, and Cochrane Library databases were searched systematically for placebo-controlled trials of HFpEF up to May 26, 2024. Using model-based meta-analysis (MBMA), we analyzed cardiovascular death or heart failure hospitalization, cardiovascular death, heart failure hospitalization, all causes of death, and changes from baseline in the 6-min walk distance (6MWD) of the placebo group. The final model simulated the placebo effect distribution for these indicators under varying scenarios.

Results

A total of 29 studies and 14,302 participants were analyzed. A log-normal risk function was developed to describe four event rate indicators, and typical event rates for the placebo group over 6 years were simulated. After 1 year, rates for cardiovascular death or heart failure hospitalization (composite event), heart failure hospitalization, all causes of death, and cardiovascular death were 11.1%, 10.5%, 2.91%, and 2.33%, respectively. We used a linear model to describe the time–effect relationship of the change value of change from baseline in 6MWD, revealing typical changes at 1, 3, and 6 months as 1.47, 4.76, and 9.57 m, respectively. These values indicated that using the composite event as criteria could reduce the sample size by 500–12,000 cases, while 548 cases were sufficient for changes in 6MWD. The placebo effect model was also used as an external control in evaluating Sacubitril/Valsartan and exercise training efficacy.

Conclusion

This placebo response model provides essential support for sample size estimation, trial optimization, and drug efficacy evaluation in future HFpEF clinical trials.

目的建立心力衰竭保留射血分数（HFpEF）临床试验疗效指标的安慰剂反应模型，便于样本量估计和试验优化。方法系统检索PubMed、EMBASE和Cochrane Library数据库，检索截至2024年5月26日的HFpEF安慰剂对照试验。使用基于模型的meta分析（MBMA），我们分析了心血管死亡或心力衰竭住院、心血管死亡、心力衰竭住院、所有死亡原因，以及安慰剂组6分钟步行距离（6MWD）与基线的变化。最后的模型模拟了这些指标在不同情景下的安慰剂效应分布。结果共分析29项研究和14302名参与者。建立了一个对数正态风险函数来描述四个事件率指标，并模拟了安慰剂组6年以上的典型事件率。1年后，心血管死亡或心力衰竭住院率（复合事件）、心力衰竭住院率、所有死因死亡率和心血管死亡率分别为11.1%、10.5%、2.91%和2.33%。我们使用线性模型描述了6MWD中变化值与基线的时间效应关系，揭示了1、3和6个月的典型变化分别为1.47、4.76和9.57 m。这些值表明，使用复合事件作为标准可以将样本量减少500-12,000例，而548例足以反映6MWD的变化。同时采用安慰剂效应模型作为外部对照，评价苏比里尔/缬沙坦与运动训练的疗效。结论该安慰剂反应模型为今后HFpEF临床试验的样本量估计、试验优化和疗效评价提供了重要支持。

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引用次数: 0