CHD Patients Research Articles

A Survey on the Sexual Health of Elderly Patients with Cardiovascular Disease and Their Spouses

Objective: To investigate the sexual relationship and sexual health of elderly patients with cardiovascular disease and their spouses, as well as to explore the relationship between sexual health and the quality of life. Methods: A total of 206 CHD patients and their spouses (N = 206) as well as 238 age- and gender-matched healthy people were recruited and investigated by using a self-designed sexual relationship and sexual health questionnaire and the SF-36 questionnaire; data analysis and comparison were carried out by using SPSS 22.0. Results: The scores of perceived health, marital satisfaction, sexual satisfaction, sexual function, and quality of life were all significantly different among elderly CVD patients, their spouses, and healthy people (F = 3.894, p < 0.05). There was a significant correlation between perceived health, marital satisfaction, sexual satisfaction, and sexual function with quality of life (p < 0.05). Conclusion: Sexual behavior is an important aspect of quality of life. The sexual relationship, sexual health, and quality of life of elderly patients with cardiovascular disease and their spouses were significantly lower than those of healthy people. It is recommended that more attention should be paid on the sexual relationship and sexual health of these patients and their spouses, with counselling offered when needed.

Comparative analysis of psychological distress factors on CHD and non-CHD patients

The study was undertaken to determine Comparative Analysis of Psychological Distress Factors on CHD and Non- CHD Patients During COVID-19 in Adults. Three different areas were taken to get the subjects of CHD patients viz. Delhi, Haryana, and Punjab from hospitals. One hundred subjects were taken (50 subjects from the CHD group, 50 subjects from the non-CHD group) randomly and were matched in age, sex, education, and occupation. Psychological well-being scale, Anxiety Depression Stress Scale was employed with each of these subjects in two sessions. Results reveal that the CHD patients showed grossed psychological well-being deterioration and anxiety, depression, and stress dimension. The CHD patients showed these results due to their preoccupation with CHD problems. It can directly change their psychological profile. It is also obviously felt that the COVID-19 pandemic has a more severe effect on their mental health thannon-CHD patients. This study aims to investigate a Comparative Analysis of Psychological Distress Factors on CHD and non- CHD patients during COVID-19 in adults.

Paediatric cardiologist adherence to American Heart Association neurodevelopmental recommendations for CHD patients.

A 2012 American Heart Association statement concluded that children with CHD are at an increased risk for neurodevelopmental delays. Routine surveillance and evaluation throughout childhood are recommended. To assess paediatric cardiologist compliance with American Heart Association guidelines and developmental referral practices, a survey was distributed to paediatric cardiologists nationwide (n = 129). The majority of participants (69%) stated they were somewhat familiar or not familiar with the American Heart Association statement and were concerned about patients not being properly referred to specialists for developmental evaluation. Forty paediatric cardiologists (31%) indicated that their institution did not have a neurodevelopmental cardiology programme. Of these, 25% indicated they generally did not refer CHD patients for neurodevelopmental evaluation, 45% performed surveillance and referred if warranted, and 30% generally referred all patients for surveillance. Lastly, 43% of paediatric cardiologists did not feel responsible for developmental surveillance, and 11% did not feel responsible for referrals. To ensure all children with CHD are appropriately screened and referred, paediatricians and cardiologists must work together to address differing impressions of accountability for surveillance and screening of children with CHD.

ENOS T786C (rs2070744) Gene Polymorphism and Its Underlying Mechanism Associated with Coronary Heart Disease

The study aims to examine plasma nitric oxide concentration and its relationship to T-786C gene polymorphism levels in the development of coronary heart disease in young people. Reduced nitric oxide (NO) bioavailability and endothelial nitric oxide synthase (eNOS) T786C gene polymorphism have been identified as risk factors for the development of coronary heart disease. This cross-sectional study was conducted in SRM Medical College Hospital and Research Centre on 200 angiographically proven CHD subjects attending the Department of Cardiology and medicine and 100 controls from MHC in the age group of ≤ 45 years. Overnight fasting plasma samples were obtained to evaluate lipid profile and nitric oxide by Griess reaction in UV spectrophotometry utilizing the ELISA technique. Polymerase Chain Reaction and Restricted fragment length polymerase amplify the eNOS gene T-786C. As a result, NO levels in plasma were significantly lower in CHD patients than in controls. In addition, C allele carriers of the eNOS T786C polymorphism showed significantly lower mean plasma NO levels than T allele carriers (P < 0.001). Our findings suggest that a lower plasma NO level is related to an increased risk of CHD. Furthermore, the eNOS T786C polymorphism is a significant risk factor for CHD development by lowering NO levels in the plasma. However, the eNOS T786C polymorphism influences the severity of CHD.

Quality of Life in Children with Acyanotic Congenital Heart Disease in Dr. Soetomo General Hospital, Surabaya, Indonesia

Abstract: Acyanotic congenital heart disease is a disease that affects the patient physically and psychologically result in the patient not being able to carry out his life normally. As a result, patients will feel lonely, rejected, and isolated from society which makes social integration more difficult. The picture of quality of life in acyanotic CHD patients can be used as a therapeutic evaluation material to improve quality of life. Material and Methods: This study used descriptive analytic method with total sampling. The variable studied was quality of life using Pedsql Inventory 3.0 Cardiac Module questionnaire to the patients aged 2-18 years who were treated at Dr. Soetomo General Hospital Surabaya in 2019—2020. Results: 74 Acyanotic CHD patients (left to right shunt) obtained an average quality of life of 73.89 ± 9.79 with low-value aspects, namely Heart Problems and Therapy I (72.92 ± 18.20), Cognitive (59.53 ± 18.40), and Communication (71.40 ± 24.21). There was a significant difference in the type of combination diagnosis compared with other types with a significance of 0.014 (p <0.05). Conclusion: Aspects that have a negative impact on the patient's quality of life are Heart Problems and Therapy I, Cognitive, and Communication. The Combination type is a diagnosis with the lowest quality of life compared to other types.

Ventricular Assist Device (VAD) Implantation in a Patient with Complex Congenital Heart Disease (CHD)

<h3>Introduction</h3> VAD implantation in complex CHD patients presents physiologic and anatomic challenges. Few such cases have been described. <h3>Case Report</h3> We report a 41-year-old man with a history of dextrocardia, unbalanced atrioventricular (A-V) septal defect, single ventricle, heterotaxy with right atrial isomerism and asplenia, bilateral superior vena cava, pulmonic stenosis, and systemic hypertension. He had undergone surgical palliation including bilateral BT shunts (age 3 months and 7 years) and central aortopulmonary shunt at age 13 years. At age 14 years, he underwent bilateral bidirectional Glenn and extracardiac Fontan repair, followed by mechanical A-V valve replacement at age 21 years and epicardial pacemaker placement for paroxysmal atrial tachycardia (AT). He had recurrent heart failure hospitalizations requiring inotropes. Echocardiography now demonstrated moderate aortic regurgitation. Cardiac catheterization on milrinone and dobutamine found elevated Fontan pressures to 21 mmHg (panel A), reduced cardiac index to 1.4 L/min/m², normal pulmonary vascular resistance and no transhepatic gradient. An intra-aortic balloon pump was placed with improvement of his Fontan pressures to 17 mmHg. However, he subsequently developed refractory AT and cardiogenic shock. Due to cardiac deterioration, he underwent urgent HeartMate3 implantation and aortic valve repair with Park stitch (B: pre-op; C: post-op image) as a bridge to transplant. Surgical approach was an upper hemisternotomy and an anterior right thoracotomy at the 6th intercostal space. His course was complicated by postoperative bleeding requiring re-exploration of the chest, as well as acute kidney injury requiring temporary hemodialysis with subsequent renal recovery. He was transferred to acute rehab 3 weeks after surgery and was discharged home on guideline-directed medical therapy. <h3>Summary</h3> We report an adult patient with dextrocardia, Fontan repair, and single ventricle who underwent successful VAD implantation.

The prevalence, operations, and outcomes of carcinoid heart disease

BackgroundCarcinoid heart disease (CHD) is a sequela of carcinoid liver metastases (LM). The true prevalence of CHD is unknown due to infrequent screening by transthoracic echocardiography (TTE). Octreotide is believed to protect against new and recurrent CHD, but supporting data are scant. This study determined CHD prevalence and outcomes in patients screened by TTE and treated with octreotide. MethodsRecords of carcinoid patients from 2001 to 2021 were reviewed. Survival was estimated by Kaplan-Meyer curves and compared by log-rank. ResultsAmong 282 patients screened by TTE, overall survival was lower in CHD (n = 40) versus non-CHD (n = 242) patients (p < 0.001). Despite octreotide therapy, 21 patients developed CHD. Among patients with inoperable LM, survival was lower in CHD patients without valve replacement (VR) (p < 0.001), but similar between CHD patients with VR and non-CHD patients. CHD patients with VR and hepatic cytoreduction had survival similar to CHD patients without VR. ConclusionVR improves survival in CHD patients with inoperable LM. Hepatic cytoreduction after VR should be reserved for carefully selected cases. Our data do not support a protective effect of octreotide.

EVALUASI INTERAKSI OBAT JANTUNG KORONER PADA PASIEN RAWAT INAP DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA MEDAN

Coronary heart disease is the most common cause of death globally. Deaths in patients with coronary heart disease are 7.8 million out of 11.11 million people in developing countries in 2020. One of the factors that can worsen heart disease is drug interactions caused by patients with heart disease not only having one disease but followed by other diseases. so that they use more than one kind of drug. The purpose of this study was to describe the treatment profile of CHD patients and drug interactions in coronary heart inpatients at Imelda General Hospital, Indonesian Workers. This research is an observational study designed with retrospective descriptive design. Data analysis was carried out by screening drug interactions using the Drug Interaction Checker. The results showed that the criteria for CHD patients mostly occurred in women (56.3%) at the age of 56-60 years (23.9%). The distribution of diagnoses in CHD patients had the most three diagnoses of disease and with the most comorbidities, namely dyspepsia (20.6%) and diabetes mellitus (19.0%). The most widely used coronary heart therapy in inpatients at Imelda Workers' Hospital in Indonesia was SDN (12.7%) while the combination therapy was Clopidogrel and Concor (4.2%). Drug interactions in CHD patients were mostly nifedipine and atorvastatin with moderate levels.

F2RL3 Methylation in the Peripheral Blood as a Potential Marker for the Detection of Coronary Heart Disease: A Case-Control Study

Background and Aims: Previous work has shown the association between blood-based methylation of coagulation factor II receptor-like 3 gene (F2RL3) and cardiovascular mortality in Caucasians. However, the diagnostic value of F2RL3 methylation for CHD is still unknown. The aim of our study was to evaluate the association between blood-based F2RL3 methylation and the risk of CHD in the Chinese population. Methods: The methylation level of F2RL3 was quantified by mass spectrometry in a case-control study with 180 CHD cases and 184 controls. The association between F2RL3 methylation intensity and CHD was assessed by logistic regression models, controlling confounding factors. Results: The hypomethylation in F2RL3_A amplicon was significantly associated with CHD (odds ratio (ORs) per -10% methylation: 1.22–1.42, p < 0.035 for six out of seven CpG loci). Specifically, this significant association was observed in elderly CHD patients (≥60 years), myocardial infarction (MI) patients, heart failure patients and the patients with minor to medium cardiac function impairment (NYHA Ⅰ&Ⅱ CHD cases) (ORs per -10% methylation: 1.35–1.58, 1.32–2.00, 1.29–1.43, 1.25–1.44; p < 0.024, 0.033, 0.035, 0.025, respectively). However, F2RL3_B CpG sites showed no or very weak association with CHD. The combination of F2RL3_A_CpG_1 and F2RL3_A_CpG_3 methylation levels could efficiently discriminate CHD, MI, heart failure, NYHA I&II CHD, and elderly CHD patients from controls (area under curve (AUC) = 0.75, 0.79, 0.75, 0.76, and 0.82, respectively). Conclusion: We propose blood-based F2RL3 methylation as a potential biomarker for CHD, especially for people with older age or with the status of MI. The combination of F2RL3 methylation and conventional risk factors might be an approach to evaluate CHD at early stage.

Association Between Thromboelastography and Coronary Heart Disease.

BackgroundThromboelastography (TEG) is a novel blood viscoelasticity detection method revealing blood coagulation status and has been reported to be helpful in predicting clinical outcomes in patients with cardiovascular diseases (CVD). In this study, we aimed to investigate the association between TEG and CVD.Material/MethodsA single-center case-control study was performed. Individuals who took TEG tests at Tongji Hospital in Wuhan, China from 2015 to 2019 were included. The nearest-neighbor Mahalanobis matching with replacement, within propensity score calipers of 0.25 was used to control the covariate imbalance between CVD patients and controls. Logistic regression analyses were conducted to assess the relationship between TEG and CVD. Subgroup and sensitivity analyses were performed to evaluate the robustness of the association between TEG and CVD.ResultsAfter matching, a total of 151 participants were included in this study, with 83 patients having CVD (49 patients having coronary heart disease [CHD] and 34 patients having an ischemic stroke). By comparison, CHD patients had a significantly higher maximum amplitude (MA) (P=0.02) than controls. After multivariable adjustment, MA (OR 1.11, 95% CI 1.01–1.24, P=0.04) was independently associated with CHD. The association between MA and CHD remained robust across subgroups and in sensitivity analyses.ConclusionsThe current study suggests that MA is significantly associated with CHD. Enhanced platelet reactivity as described by high MA might be associated with risk of CHD. The exact role of MA in the measurement of CHD risk needs to be further examined in large-scale prospective cohort studies.

Infective endocarditis in a cohort of adult CHD patients.

CHD increases the risk of infective endocarditis due to the substrate of prosthetic materials and residual lesions. However, lesion-specific and mortality risks data are lacking. We sought to analyse clinical course and mortality of infective endocarditis in a cohort of adult CHD. Retrospective analysis of all cases of proven and probable infective endocarditis (Duke's criteria) followed in our adult CHD clinic between 1970 and August, 2021. Epidemiological, clinical and imaging data were analysed. Predictors of surgical treatment and mortality were assessed using regression analysis. During a mean follow-up of 15.8 ± 10.9 years, 96 patients had 105 infective endocarditis episodes, half with previous cardiac surgery (corrective or palliative). The most frequent diagnoses were: ventricular septal defect, bicuspid aortic valve, Tetralogy of Fallot and pulmonary atresia. The site of infection was identified by echocardiography in 82 episodes (91%), most frequently in aortic (n = 27), tricuspid (n = 15), and mitral (n = 13) valves. Blood cultures were positive in 79% of cases, being streptococci (n = 29) and staphylococci (n = 23) the predominant pathogens. Surgery was necessary in 40% and the in-hospital mortality was 10.5%, associated with heart failure (p < 0.001; OR 13.5) and a non-surgical approach (p = 0.003; OR 5.06). In an adult CHD cohort, infective endocarditis was more frequent in patients with ventricular septal defect and bicuspid aortic valves, which contradicts the current guidelines that excludes them from prophylaxis. Surgical treatment is often required and mortality remains substantial. Prevention of this serious complication should be one of the major tasks in the care of adults with CHD.

Lead Extraction at a Pediatric/Congenital Heart Disease Center: The Importance of Patient Age at Implant.

This study sought to evaluate the safety and efficacy of transvenous lead extraction (TLE) at a single pediatric/congenital heart disease (CHD) center. Data on TLE in pediatric and CHD patients are limited. Retrospective cohort study evaluating TLE from 2008 to2019. A total of 113 patients underwent TLE with 162 leads removed (including 38 high-voltage leads). Median age at lead implantation was 13 years (range 0.6-61.8 years), with a median age at extraction of 21.6 years (6.4-64.3 years). Median lead age was 7.2 years (1.0-35.3 years). Successful extraction occurred in 110 (97%) patients, 159 (98%) leads. Complex extraction was needed for 120 leads; 52 (44%) using laser alone, 27 (23%) mechanical sheath alone, and 21 (18%) using both. Femoral extraction was used for 19 (16%) leads. Risk factors for complex extraction were≥2 leads extracted (odds ratio: 3.36; 95% confidence interval [CI]: 1.2-9.36; P=0.021), lead within the right ventricle (odds ratio: 2.8; 95%CI: 1.2-6.5; P=0.017), and a combination of younger patient age at implant and older lead age at extraction, with patients≤12 years of age at implant and leads≥7 years of age having an odds ratio: of 10.1 (95%CI: 2.21-45.9; P=0.003). Major complications occurred in 5 (4.4%) of patients, with no mortality, but a high incidence of tricuspid valve injury. TLE can be performed successfully and safely in a pediatric and CHD center. Patient age at lead implantation, not age at extraction, is an important predictor of needing a complex extraction, with younger patients at implant and older leads at extraction having the highest risk.

The study of expression levels of DNA methylation regulators in patients affected with congenital heart defects (CHDs).

Congenial heart defects (CHDs) have multifactorial etiology with complex interplay of genetic and environmental factors. Environmental impact can have epigenetic mechanism of CHD development. Many studies have reported the causal association between CHD and distinct DNA methylation profile which is one of the key epigenetic events, which has vital role in normal embryonic development. The products of DNMT1, DNMT3A, DNMT3B, and MBD2 are important regulators of DNA methylation process. Changes in the expression of these genes are implicated in congenital structural cardiac defects. Hence, in this proof-of-concept study, we have compared the expression levels of these genes in the blood samples of healthy controls and CHD cases while investigating the etiology of CHD. In this study with 48 CHD cases and 47 healthy controls, total RNA was isolated from the whole blood samples using TRI reagent. Quantitative RT PCR (qRT-PCR) was used to analyze the mRNA levels of DNMT1, DNMT3A, DNMT3B, and MBD2. The expression levels have been analyzed by relative quantification. We observed that DNMT3B (fold change=-2.563; p=.0018) and DNMT3A (fold change=-2.169; p=.05) were significantly downregulated in CHD patients, whereas the expression of DNMT1 and MBD2 was not significantly different between cases and controls. Lower expression of de novo methyltransferases, namely, DNMT3B and DNMT3A in CHD cases, may be an important contributor to the mechanism of CHD pathogenesis. Further studies with age-matched controls and analysis of global DNA methylation profile are required to investigate the proposed causal association.

Learning dynamic treatment strategies for coronary heart diseases by artificial intelligence: real-world data-driven study

BackgroundCoronary heart disease (CHD) has become the leading cause of death and one of the most serious epidemic diseases worldwide. CHD is characterized by urgency, danger and severity, and dynamic treatment strategies for CHD patients are needed. We aimed to build and validate an AI model for dynamic treatment recommendations for CHD patients with the goal of improving patient outcomes and learning best practices from clinicians to help clinical decision support for treating CHD patients.MethodsWe formed the treatment strategy as a sequential decision problem, and applied an AI supervised reinforcement learning-long short-term memory (SRL-LSTM) framework that combined supervised learning (SL) and reinforcement learning (RL) with an LSTM network to track patients’ states to learn a recommendation model that took a patient’s diagnosis and evolving health status as input and provided a treatment recommendation in the form of whether to take specific drugs. The experiments were conducted by leveraging a real-world intensive care unit (ICU) database with 13,762 admitted patients diagnosed with CHD. We compared the performance of the applied SRL-LSTM model and several state-of-the-art SL and RL models in reducing the estimated in-hospital mortality and the Jaccard similarity with clinicians’ decisions. We used a random forest algorithm to calculate the feature importance of both the clinician policy and the AI policy to illustrate the interpretability of the AI model.ResultsOur experimental study demonstrated that the AI model could help reduce the estimated in-hospital mortality through its RL function and learn the best practice from clinicians through its SL function. The similarity between the clinician policy and the AI policy regarding the surviving patients was high, while for the expired patients, it was much lower. The dynamic treatment strategies made by the AI model were clinically interpretable and relied on sensible clinical features extracted according to monitoring indexes and risk factors for CHD patients.ConclusionsWe proposed a pipeline for constructing an AI model to learn dynamic treatment strategies for CHD patients that could improve patient outcomes and mimic the best practices of clinicians. And a lot of further studies and efforts are needed to make it practical.

Evaluation of the prevalence, prenatal risk factors &amp; clinical profiles of Paediatric Patients with congenital heart disease

Introduction: Congenital Heart Diseases (CHD’s) are amongst the major congenital malformations contributing to infant mortality. Most CHDs are diagnosed in infancy. Later, in childhood or adolescence, CHD patients may present differently. Objectives: To evaluate the prevalence, maternal risk factors and clinical profile of all children with CHD at a tertiary care centre in Bhopal. Materials and Methods: This prospective, observational study was conducted at a tertiary care centre in Bhopal from Feb 2018 to Feb 2020. Approval from the ethical committee was obtained prior to the commencement of the study. Children up to 13 years of age, admitted with the features of CHD for the first time in out institution, were included in this study. A detailed history and clinical examination were carried out and a diagnosis of CHD was confirmed with 2D Echocardiography. Results: A total of 224 patients were admitted with the features of CHD for the first time during the study period. In our study, the commonest lesion was VSD (29.01%) followed by ASD (14.73%), PDA (12.5%), and TOF (9.37%). Among the clinical presentation, fast breathing (90.17%) was the most common symptom. Conclusion: In our study, VSD was found to be the most common acynaotic CHD and TOF was the most common cynotic CHD. The most common presenting feature was breathing difficulty. In order to improve prenatal detection of CHD’s, it is imperative to have a deep understanding of maternal risk factors.

Gender differences in cardiovascular risk factor awareness: Results from the ESC EORP EUROASPIRE V Registry

BackgroundPatients' risk factor awareness is essential to decrease the risk of recurrent coronary events. The aim of this study was to provide up-to-date evidence on existing gender differences in the patients' knowledge of risk factors and information provided by healthcare professionals. MethodsAnalyses were based on the cross-sectional ESC EORP EUROASPIRE V survey, including data on CHD patients across 27 European countries. Consecutive patients (18–80 years), hospitalized for a coronary event or surgical procedure, were retrospectively identified. Information on risk factor awareness was collected from medical records, medical examination, and structured questionnaires during the study visit (six months to two years after hospitalization). ResultsPatient information was available for 8261 patients, of which 25.8% were women. Although women with obesity were significantly less aware about their actual (OR = 0.66, CI = 0.52–0.85) and target weight levels (OR = 0.66, CI = 0.54–0.81), no significant gender differences in risk factor awareness were found in disfavour of women. Remarkably, women with hypertension and women with raised low-density lipoprotein cholesterol (LDL-C) levels were even more aware about their target blood pressure levels (OR = 1.21, CI = 1.01–1.46) and actual cholesterol levels (OR = 1.18, CI = 1.02–1.36), respectively. Moreover, there is some indication that women were more informed by a healthcare professional if they had raised CHD risk factor levels. ConclusionsOur study showed only few gender differences in disfavour of women in terms of risk factor awareness and information provided by a healthcare professional. Nevertheless, previous EUROASPIRE V findings demonstrated that women still have a poorer risk factor control in secondary CHD prevention.

Social Support and Self-Efficacy as Mediating Factors Affecting the Association Between Depression and Medication Adherence in Older Patients with Coronary Heart Disease: A Multiple Mediator Model with a Cross-Sectional Study.

PurposeMedication non-adherence is a major public health issue. Recent evidence suggests that depression, inadequate social support, and lower levels of self-efficacy are associated with poor medication adherence. However, the mechanism underlying the association among depression, social support, self-efficacy and medication adherence is unclear. This study aims to examine the mediating role of social support and self-efficacy between depression and medication adherence in older patients with coronary heart disease.Patients and MethodsData were collected from 238 hospitalized older patients with coronary heart disease. Depression, social support, self-efficacy, and medication adherence were assessed using structured questionnaires. A serial multiple mediation model was tested using the PROCESS macro for SPSS.ResultsA total of 238 older patients with CHD with a mean age of 70.5 years were involved in this cross-sectional study. Depression was negatively correlated with medication adherence in older patients with coronary heart disease. Social support and self-efficacy were positively associated with medication adherence, and fully mediated the relationship between depression and medication adherence. Three mediation paths were included in the model: (a) social support, (b) chain combination of social support and self-efficacy, and (c) self-efficacy.ConclusionSocial support and self-efficacy explain the association of depression and medication adherence in older CHD patients and may be the keys target for enhanced intervention to improve medication adherence in older CHD patients with depression.

POS-965 CHARACTERISTICS, PREDICTIVE FACTORS AND OUTCOMES OF HEMODIALYSIS PATIENTS WITH COVID 19 INFECTION IN THE INTENSIVE CARE UNIT AT A STATE COVID REFERRAL CENTRE

Patients with end-stage kidney disease (ESKD) on chronic haemodialysis (cHD) have been reported to have poorer outcome. There is currently lack of data on the predicive factors and outcomes of severe covid infection (Category 4 & 5) in cHD patients managed in the intensive care unit (ICU).

Potential Effects of Metformin on the Vitality, Invasion, and Migration of Human Vascular Smooth Muscle Cells via Downregulating lncRNA-ATB.

Objective To elucidate the role of metformin in influencing VSMCs via the involvement of lncRNA-ATB. Methods qRT-PCR was conducted to detect serum levels of lncRNA-ATB and p53 in CHD patients (n = 50) and healthy subjects (n = 50). Correlation in serum levels of lncRNA-ATB and p53 in CHD patients was assessed by Pearson correlation test. ROC curves were depicted for analyzing the predictive potential of lncRNA-ATB in the occurrence of CHD. After metformin induction in VSMCs overexpressing lncRNA-ATB, relative levels of lncRNA-ATB and p53 were detected. Meanwhile, proliferative, migratory, and invasive abilities in VSMCs were, respectively, examined by CCK-8 and transwell assay. The interaction between lncRNA-ATB and p53 was tested by RIP. In addition, the coregulation of lncRNA-ATB and p53 in cell functions of VSMCs was finally determined. Results Increased serum level of lncRNA-ATB and decreased p53 level were detected in CHD patients than those of healthy subjects. LncRNA-ATB could interact with p53 and negatively regulate its level. In addition, lncRNA-ATB could serve as a potential biomarker for predicting the occurrence of CHD. The overexpression of lncRNA-ATB triggered viability, migratory, and invasive abilities in VSMCs, and the above trends were abolished by metformin induction. The overexpression of p53 partially abolished the promotive effects of lncRNA-ATB on proliferative, migratory, and invasive abilities in VSMCs. Conclusions Metformin induction inhibits proliferative, migratory, and invasive abilities in VSMCs by downregulating lncRNA-ATB, which may be related to p53 activation.

Assessment of Reversibility in Pulmonary Hypertension Related to Congenital Heart Disease by Using Biomarkers and Clinical Features

Background: Reversibility of pulmonary hypertension (PH) is closely related to the treatment options for and prognosis of children with congenital heart disease. Objective: We combined patient-specific clinical features including diagnosis, age and echocardiographic results, and biomarkers of pulmonary vascular dysfunction to explore the noninvasive methods that can be used to accurately evaluate the reversibility of pulmonary hypertension in congenital heart disease (PH-CHD). Methods: Based on the preoperative systolic pulmonary arterial pressure (sPAP), 70 CHD patients were divided into normal, PH-CHD suspected, and confirmed groups. Additionally, biomarkers of circulating endothelial cells (CECs), endothelin-1 (ET-1), and endothelial nitric oxide synthase (eNOS) were detected. Patients were categorized into reversible (RPH) and irreversible (IRPH) groups according to the sPAP 6 months after surgery. Risk stratification was performed according to the clinical features and biomarkers. Results: CECs and ET-1 levels in the confirmed group were significantly higher. eNOS was higher in the confirmed and suspected groups than that in the normal group. CECs in the IRPH group were significantly higher compared to the RPH group. No such intergroup differences were observed with respect to ET-1 and eNOS levels. The ROC curve showed that the risk stratification was of high diagnostic value to evaluate reversibility. Conclusion: The CECs, eNOS, and ET-1 were closely related with PH-CHD. CECs and risk stratification have high practical value in assessing the reversibility of PH-CHD.