Coronary Atherosclerotic Heart Disease Research Articles

Research on Coronary Heart Disease Indicators——Based on Machine Learning Model

Coronary atherosclerotic heart disease is a common and high-risk disease in clinical cardiology. The leading factor of this kind of heart disease is the atherosclerotic lesion of arteria coronary, which can lead to narrow or choke of the vascellum cavity and musculus cardiacus ischemia, anoxia or thanatosis. In this research, a clinical prediction model through artificial intelligence neural network is built, for instance, K-Nearest Neighbor Classifier, Nonlinear SVM, Random Forest, Gradient Boost, XG Boost, Ridge and so on to analyze the influence of each prediction variable on Coronary atherosclerotic heart. It can be observed that using the K-Nearest Neighbor Classifier algorithm the prediction accuracy of breast cancer reaches 90.16%.

Mechanism of Yiqi Huoxue Huatan recipe in the treatment of coronary atherosclerotic disease through network pharmacology and experiments.

In recent years, with population aging and economic development, morbidity and mortality of atherosclerotic cardiovascular disease associated with atherosclerosis (AS) have gradually increased. In this study, a combination of network pharmacology and experimental verification was used to systematically explore the action mechanism of Yiqi Huoxue Huatan Recipe (YHHR) in the treatment of coronary atherosclerotic heart disease (CAD). We searched and screened the active ingredients of Coptis chinensis, Astragalus membranaceus, Salvia miltiorrhiza, and Hirudo. We also searched multiple databases for related target genes corresponding to the compounds and CAD. STRING was used to construct the protein-protein interaction (PPI) network of genes. Metascape was used to perform gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis for common targets to analyze the main pathways, and finally, the molecular docking and main possible pathways were verified by experimental studies. Firstly, a total of 1480 predicted target points were obtained through the Swiss Target Prediction database. After screening, merging, and deleting duplicate values, a total of 768 targets were obtained. Secondly, "Coronary atherosclerotic heart disease" was searched in databases such as the OMIM, GeneCards, and TTD. 1844 disease-related targets were obtained. Among PPI network diagram of YHHR-CAD, SRC had the highest degree value, followed by AKT1, TP53, hsp90aa1 and mapk3. The KEGG pathway bubble diagram was drawn using Chiplot, the Signal pathways such as NF kappa B signaling pathway, Lipid and AS, and Apelin signaling pathway are closely related to the occurrence of CAD. The PCR and Western blot methods were used to detect the expression of NF-κB p65. When compared with that in the model group, the expression of NF-κB p65mRNA decreased in the low-concentration YHHR group, with P < .05, while the expression of NF-κB p65mRNA decreased significantly in the high-concentration YHHR group, with P < .01. On the other hand, when compared with that in the model group, the expression of NF-κB p65 decreased in the low-concentration YHHR group, but was not statistically significant, while the expression of NF-κB p65 was significant in the high-concentration YHHR group, and has statistical significance with P < .05. YHHR has been shown to resist inflammation and AS through the SRC/NF-κB signaling pathway.

156-OR: Apolipoprotein C-II Posttranslational Truncation Is Associated with Reduced Incident Cardiovascular Risk in Multiethnic Study of Atherosclerosis (MESA)

Higher truncated-to-native proteoform ratios of apolipoproteins (apo) C-I (C-I’/C-I) and C-II (C-II’/C-II) are associated with lower triglycerides (TG) and higher HDL levels. Here we examined the relationships of C-I’/C-II and C-II’/C-II, and total apo C-I and C-II concentrations with atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD). Apo C-I and C-II proteoforms were measured by mass spectrometry immunoassay at baseline in 5,765 MESA participants followed for CHD (definite myocardial infarction, resuscitated cardiac arrest or fatal CHD) and ASCVD (CHD or stroke) for up to 17 years. Baseline total apo C-I and C-II levels were measured in a subgroup of 3,848 participants. After adjusting for age, gender, and race/ethnicity, lower C-II’/C-II was associated with both ASCVD and CHD (Figure). The association of C-II’/C-II with CHD remained significant after further adjusting for BMI, diabetes, systolic BP, eGFR, use of tobacco, statins, antihypertensive medications, total apoC-II, and plasma TG, but was abolished after adjusting for HDL. Neither ASCVD nor CHD were related to total apo C-I and C-II or CI’/CI. In conclusion, increased posttranslational apoC-II truncation (but not total apo C-I or C-II) is associated with reduced cardiovascular risk, possibly explained by differences in HDL cholesterol metabolism. Disclosure J.Koska: None. J.Furtado: Employee; Biogen. Y.Hu: None. D.Nedelkov: None. D.Billheimer: Advisory Panel; AstraZeneca. M.Budoff: Research Support; Novo Nordisk, Novartis, Boehringer Ingelheim Inc., Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance. M.Allison: None. R.Mcclelland: None. P.Reaven: Research Support; Dexcom, Inc. Funding National Heart, Lung, and Blood Institute (R01HL138969, 75N92020D00001, HHSN268201500003I, N01HC95159, 75N92020D00005, N01HC95160, 75N92020D00002, N01HC95161, 75N92020D00003, N01HC95162, 75N92020D00006, N01HC95163, 75N92020D00004, N01HC95164, 75N92020D00007, N01HC95165, N01HC95166, N01HC95167, N01HC95168, N01HC95169); National Center for Advancing Translational Sciences (UL1TR000040, UL1TR001079, UL1TR001420)

Lipoprotein (a) and myocardial infarction: impact on long-term mortality

Background and aimsLipoprotein (a) [Lp(a)] is a genetically regulated lipoprotein particle that is an independent risk factor for coronary atherosclerotic heart disease. However, the correlation between Lp(a) and left ventricular ejection fraction (LVEF) in patients with myocardial infarction (MI) has been poorly studied. The present study investigated the correlation between Lp(a) and LVEF, as well as the impact of Lp(a) on long-term mortality in patients with MI.MethodsPatients who underwent coronary angiography resulting in MI diagnosis between May 2018 and March 2020 at the First Affiliated Hospital of Anhui Medical University were included in this study. The patients were divided into groups based on the Lp(a) concentration and LVEF (reduced ejection fraction group: < 50%; normal ejection fraction group: ≥ 50%). Then, correlations between the Lp(a) level and LVEF, as well as the impact of Lp(a) on mortality, were assessed.ResultsThis study included 436 patients with MI. The Lp(a) level and LVEF were significantly and negatively correlated (r = -0.407, β = -0.349, P < 0.001). The area under the receiver operating characteristic curve (ROC) indicated that an Lp(a) concentration > 455 mg/L was the best predictive value for reduced ejection fraction (AUC: 0.7694, P < 0.0001). The clinical endpoints did not differ based on the Lp(a) concentration. However, all-cause mortality and cardiac mortality differed based on LVEF.ConclusionsThese results suggest that an elevated Lp(a) concentration predicts reduced ejection fraction and that LVEF predicts all-cause mortality and cardiac mortality in patients with MI.

Sensitive Electrochemical Immunosensor Based on MXene-Nafion/Polyaniline (PANI) for the Sensitive Determination of the Novel Biomarker sST2 for Atherosclerotic Coronary Heart Disease by Differential Pulse Voltammetry (DPV)

Atherosclerotic coronary heart disease (CHD) is ischemic and a worldwide health issue. The soluble suppression of tumorigenicity 2 (sST2) is a novel biomarker for atherosclerotic coronary heart disease. This work develops an immunosensor with a nanocomposite consisting of polyaniline (PANI) and MXene-Nafion for the specific and sensitive determination of sST2. PANI was first electropolymerized on a glassy carbon electrode (GCE) to enhance electron transfer. Subsequently, MXene-Nafion dispersion was drop cast on the PANI/GCE substrate to further increase the electrical conductivity and immobilize anti-sST2 which captures sST2 for detection. The current response as a function of sST2 concentration was measured by differential pulse voltammetry (DPV). Under the optimal conditions, this immunosensor demonstrates a linear range from 1 pg mL−1 to 1 μg mL−1 and a detection limit of 0.149 pg mL−1. The device offers high sensitivity, excellent specificity, satisfactory reproducibility, good stability, and has significant potential for detecting clinical biomarkers. In addition, the immunosensor is able differentiate between serum of healthy people and CHD patients.

Analysis of Adherence to anti-PCSK9 Antibody Therapy among Patients from Italy.

Hypercholesterolemia is one of the main risk factors associated with atherosclerotic cardiovascular disease and coronary heart disease. Statins are the standard cholesterollowering treatment; however, they have shown, in clinical practice, a reduced adherence to therapy (<50%) and a modest achievement of the expected outcomes for treatment. This condition prompt scientific research to develop drugs with different mechanisms of action. In this regard, excellent results have been achieved with therapeutic use of monoclonal antibodies against PCSK9, enzyme involved in recycling of Low density lipoprotein receptors (LDLR) on the hepatocytes surface. Indeed, the reduction in receptor density caused by PCSK9 is associated with increased serum LDL levels. After the data extraction of all Local Health Authority (ASL) of Foggia patients (302) who received, in 2021, at least one administration of Alirocumab or Evolocumab, the therapeutic adherence was calculated, for each individual patient, by indirect method (calculation of the Medication Possession Ratio - MPR). According to scientific literature, patients were classified into: adherents (MPR>80%), average adherents (MPR between 40% and 80%) and non-adherents (MPR<40%). Patients were then stratified by gender and age groups (0-18, 19-49, 50-64, >65). The results show that, for both drugs (Alirocumab and Evolocumab), women are more adherent than men and the group of young adults (19-49 years old) is the one with the lowest adherence to therapy, 69% for Alirocumab and 56% for Evolocumab. According to Italian Drug Agency (AIFA), poor therapeutic adherence is the main cause of ineffectiveness of drug therapies, and it is associated with increased hospitalizations, morbidity and mortality. Data obtained from this study allow to detect the categories of patients who need specific programs about the correct use of drugs, in order to increase therapeutic adherence and facilitate the achievement of the expected outcomes for treatment.

Application of Nanoliposome Alprostadil in the Perioperative Period of Percutaneous Coronary Intervention to Reduce In-Stent Restenosis: A Systematic Review and Meta-Analysis.

In-stent restenosis (ISR) is a common complication after percutaneous coronary intervention (PCI) surgery for patients with coronary atherosclerotic heart disease (CHD). Reports indicate alprostadil may reduce ISR, and this study aimed at reviewing and summarizing the effect of nanoliposome alprostadil on ISR by meta-analysis. Articles were searched from databases, and meta-analysis was performed in Review Manager software. Funnel plots were performed to evaluate the publication bias, and sensitivity analysis was performed to determine the robustness of the overall treatment effects. Initially, 113 articles were identified, and 5 studies of 463 subjects were included for analysis eventually. The primary endpoint, i.e., the occurrence of ISR after PCI, occurred in 11.91% of the alprostadil treatment group (28 from 235 patients) vs. 21.49% of the conventional treatment group (49 from 228 patients) and showed a statistical significance in our pooled data (χ2 = 7.654, P=0.006), while there was no statistically significant difference in all of the separate studies. We observed no statistical methodological heterogeneity among the studies (P=0.64, I2 ≈ 0%). The pooled odds ratio (OR) of the occurrence of ISR was 49% in a fixed-effect model, and the 95% confidence boundary (95% CI) was 29% to 81%. The funnel plot did not show serious publication bias, and sensitivity analysis showed well robustness of the overall treatment effect. Discussion. In conclusion, the early application of nanoliposome alprostadil after PCI could effectively reduce the occurrence of ISR, and the overall effect of alprostadil treatment in reducing ISR after PCI was relatively stable.

Factors influencing recurrence after an ischemic stroke vary by sex

ABSTRACT Objectives To determine the factors that affect recurrent stroke after acute ischemic stroke, specifically between male and female groups. Methods We examined relative factors associated with recurrent stroke in Chinese patients with first-ever ischemic stroke. LASSO (least absolute shrinkage and selection operator) Cox regression were used to determine the predictors of recurrent stroke in the male and female groups. Next, We used Kaplan-Meier survival curves and interactions among these predictors to assess the association between relapse-related factors and recurrent stroke. Results During one year of follow-up, we documented 42 incidents of recurrent stroke in males and 15 in females. There was no significant difference in the overall recurrence rate between men and women. We finally identified three variables in males and one variable in females associated considerably with recurrent stroke by LASSO Cox regression. In females, good sleep appeared to be the most significant protective factor against recurrent stroke(hazard ratio [HR], 0.21; 95% CI, 0.08–0.57). In the male group, we found two risk factors: atherosclerotic burden (HR, 2.42; 95% CI, 1.30–4.51) and coronary heart disease (HR, 2.98; 95% CI, 1.16–7.66); and one protective factor: domestic/physical activities (HR, 0.45; 95% CI, 0.24–0.83). We also found an interaction between good sleep and domestic/physical activities in males (P interaction = 0.016). Discussion Our data indicate that the factors for recurrent stroke may differ by sex. Engaging in domestic/physical activities may substantially lower recurrent strokes in Chinese adult males. And good sleep in females appears to be more important in preventing stroke recurrence.

Diagnostic efficacy of the optical flow ratio in patients with coronary heart disease: A meta-analysis.

Coronary atherosclerotic heart disease (CAD) remains one of the most serious diseases threatening human health and life. PCI (Percutaneous Coronary Intervention) is the most common treatment for patients with CAD. A rigorous and comprehensive assessment of coronary artery lesions is now needed before PCI, however, there is no consensus on how best evaluate the combination of various intracavitary imaging techniques. By merging the benefits of physiological assessment and high-definition imaging, the optical flow ratio (OFR) has emerged as a novel technology with promising prospects for application. A systematic review of the literature was conducted. Studies that met the criteria of the meta-analysis were considered to assess OFR and FFR (fractional flow reserve). And the summary values of sensitivity and specificity of diagnostic tests and summary receiver operating curves (SROC) were calculated. A total of 5 studies were included. The sensitivity and specificity of OFR in the diagnosis of coronary artery lesions were 0.83 (95% CI: 0.75-0.88) and 0.94 (95% CI: 0.91-0.96), respectively; the positive likelihood ratio and the negative likelihood ratio were 14 (95% CI: 9.3, 21.3) and 0.18 (95% CI:0.13, 0.27), respectively. OFR showed good correlation and consistency with FFR. The new OFR technique achieve an encouraging diagnostic performance, which also showed good correlation and consistency with FFR.

A case report of chylous ascites after cardiac surgery

Abstract Background Chylous ascites (CA), an emulsion rich in triglycerides, is a rare type of ascites, especially after cardiac surgery. Also, there are few reports of the occurrence of CA after mitral valve replacement, aortic valve replacement, tricuspid valvuloplasty, and coronary artery bypass grafting. Case presentation We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence, aortic incompetence, tricuspid incompetence, and coronary atherosclerotic heart disease. Fifteen days after surgery, 3000 mL of milky-yellow ascites appeared in the abdominal cavity, diagnosed as CA by laboratory examination. The ascites gradually disappeared after being drained, and the patients improved. The curative was objective, but the exact cause is not clear. Conclusion Although CA is rare, it may occur during the surgical intervention in cardiac surgery.

LncRNA PVT1 inhibits endothelial cells apoptosis in coronary heart disease through regulating MAPK1 expression via miR-532-3p

Background: Coronary atherosclerotic heart disease (CAD) is an inflammatory vascular disease caused by atherosclerosis. Long non-coding RNAs are involved in the pathophysiological process of coronary heart disease. Here we investigated the regulatory effects of lncRNA PVT1 (PVT1) in human coronary artery endothelial cells (HCAECs). Methods: qRT-PCR and western blot were performed to detect gene and protein expressions. CCK-8, flow cytometry and wound healing assays were used to determine cell viability, apoptosis and migration of HCAECs. The binding relationship among miR-532-3p, PVT1 and MAPK1 was verified by dual luciferase reporter assay. Results: Overexpression of PVT1 markedly reduced cell apoptosis and increased cell proliferation and migration. However, miR-532-3p upregulation suppressed cell proliferation and migration and promoted apoptosis of HCAECs. PVT1 suppressed the expression of miR-532-3p via directly targeting miR-532-3p. And miR-532-3p overexpression abolished the effect of PVT1 upregulation on proliferation and apoptosis in HCAECs. Furthermore, MAPK1 acted as a target gene of miR-532-3p and miR-532-3p inhibited MAPK1 expression. Conclusion: PVT1 promoted MAPK1 expression by targeting miR-532-3p, thus inhibiting HCAECs apoptosis and promoting cell proliferation, suggesting PVT1 might have great potential as a therapeutic target for CAD.

Predicting coronary atherosclerosis heart disease with pericoronary adipose tissue attenuation parameters based on dual-layer spectral detector computed tomography: a preliminary exploration.

Coronary atherosclerosis is a chronic inflammatory condition. Pericoronary adipose tissue (PCAT) attenuation is closely related to coronary inflammation. This study aimed to investigate the relationship between PCAT attenuation parameters and coronary atherosclerotic heart disease (CAD) using dual-layer spectral detector computed tomography (SDCT). This cross-sectional study included eligible patients who underwent coronary computed tomography angiography using SDCT at the First Affiliated Hospital of Harbin Medical University between April 2021 and September 2021. Patients were classified as CAD (with coronary artery atherosclerotic plaque) or non-CAD (without coronary artery atherosclerotic plaque). Propensity score matching was used to match the two groups. The fat attenuation index (FAI) was used to quantify PCAT attenuation. The FAI was measured on conventional images (120 kVp) and virtual monoenergetic images (VMI) by semiautomatic software. The slope of the spectral attenuation curve (λ) was calculated. Regression models were established to evaluate the predictive value of PCAT attenuation parameters for CAD. A total of 45 patients with CAD and 45 patients without CAD were enrolled. The PCAT attenuation parameters in the CAD group were significantly higher than those in the non-CAD group (all P values <0.05). The PCAT attenuation parameters of vessels with or without plaques in the CAD group were higher than those of vessels without plaques in the non-CAD group (all P values <0.05). In the CAD group, the PCAT attenuation parameters of vessels with plaques were slightly higher than those of vessels without plaques (all P values >0.05). In receiver operating characteristic curve analysis, the FAIVMI model achieved an area under the curve (AUC) of 0.8123 for discriminating between patients with and without CAD, which was higher than those of the FAI120 kVp model (AUC =0.7444) and the λ model (AUC =0.7230). However, the combined model of FAIVMI, FAI120 kVp, and λ obtained the best performance (AUC =0.8296) of all the models. PCAT attenuation parameters obtained using dual-layer SDCT can aid in distinguishing patients with and without CAD. By detecting increases in PCAT attenuation parameters, it might be possible to predict the formation of atherosclerotic plaques before they appear.

Efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with coronary atherosclerotic heart disease and gastrointestinal disease undergoing percutaneous coronary intervention: study protocol for a non-inferiority randomized controlled trial

BackgroundDual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is recommended for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) to antithrombosis, meanwhile, increasing the risks of gastrointestinal bleeding. Rivaroxaban, a novel oral anticoagulant, combined with a P2Y12 receptor inhibitor reduces adverse events in patients with CHD and atrial fibrillation who underwent PCI. The effect of rivaroxaban plus P2Y12 inhibitor on reducing bleeding events in patients with CHD and gastrointestinal disease (GID) undergoing PCI remains unclear.MethodThe study is a prospective, single-center, randomized controlled trial. A total of 1020 patients with CHD and GID undergoing PCI will be enrolled. Patients are randomized (1:1) to receive either rivaroxaban 10 mg plus clopidogrel 75 mg daily or aspirin 100 mg plus clopidogrel 75 mg daily; both treatments will last 6 months. The primary endpoint is Bleeding Academic Research Consortium (BARC) type 2–5 bleeding requiring medical intervention. The secondary endpoint is a composite of major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemia-driven target vessel revascularization, and stroke.DiscussionThe objective of this study is to evaluate the efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with CHD and GID undergoing PCI. We aim to explore an optimized antithrombotic strategy, which achieves the same anti-ischemic effect as standard DAPT without increasing the risk of GIB, for patients with CHD and GID undergoing PCI.Trial registrationThis protocol is registered at the Chinese Clinical Trial Registry under the number ChiCTR2100044319. And this publication is based on version 1.4 of the trial protocol dated Sep 6, 2021.

Association of Neutrophil-to-Lymphocyte Ratio with Nutrition in Patients with Various Types of Malignant Tumors: A Multicenter Cross-Sectional Study.

Neutrophil-to-lymphocyte ratio (NLR) is an index of systemic inflammation. This study is to clarify the role of NLR in body functional status, nutritional risk and nutritional status in the course of tumor. A multi-center cross-sectional study of patients with various types of malignant tumors was accrued from the whole country. There were 21,457 patients with completed clinical data, biochemical indicators, physical examination, the Patient-Generated Subjective Global Assessment (PG-SGA) and Nutrition Risk Screening 2002 (NRS2002) survey. Logistic regression analysis was used to figure out the influencing factors of NLR, and four models were established to evaluate the influence of NLR on body functions, nutritional risks and nutritional status. Male patients, TNM stage IV, total bilirubin, hypertension and coronary atherosclerotic heart disease (CAHD) were independent predictors of NLR >2.5. BMI, digestive systemic tumors and triglyceride negatively affect NLR in multivariable logistic regression. NLR was an independent predictor of Karnofsky Performance Scale (KPS), fat store deficit in all degrees, moderate and severe muscle deficit, mild fluid retention and PG-SGA grade. Male patients and those with hypertension and CAHD are prone to systemic inflammation. Systemic inflammation significantly degrades body function status and nutritional status, increases nutritional risk and influences fat and muscle metabolism in patients with malignant tumor. Improving the intervenable indicators such as elevating albumin and pre-albumin, decreasing total bilirubin and enhancing nutrition support are imperative. Obesity and triglyceride behave like anti-systemic inflammation, which is misleading due to reverse causation in the course of malignancy.

Active substances and molecular mechanisms of the anti-myocardial ischemia effects of Carthami flos by network pharmacology and in vitro experiments

Myocardial ischemia is a predominant cardiovascular disorder that can result in a series of life-threatening cardiovascular diseases. Carthami flos (CF), the flower of Carthamus tinctorius L., is a commonly used herbal medicine in Chinese medicine for treating coronary atherosclerotic heart diseases based on its anti-myocardial ischemia (MI) effects. This paper aimed to investigate the active substances and mechanisms of the anti-MI effects of CF by network pharmacology and in vitro experiments. The results indicated that 9 constituents showed high degree of association with multiple targets of MI, including quercetin, kaempferol, β-sitosterol, luteolin, baicalein, safflomin A, safflomin C, safflower-yellow-B and hydroxysafflor yellow A. In addition, AKT1, EGFR, CASP3, MYC, JUN, ALB, CTNNB1, VEGFA, ESR1, and IL1B were screened as the leading targets with a degree number ≥50. Bioinformatic annotation of GO-MF and KEGG showed that the anti-MI effects of CF are related to apoptosis and response to antioxidative stress pathways. The in vitro results showed that CF reduced LDH and CK levels, alleviated cell cycle arrest, and decreased ROS levels in H2O2-treated H9c2 cells. In addition, CF also promoted the nuclear shift of Nrf2 and the mRNA expressions of Akt, Nrf2 and Bcl-2 but decreased the expression of caspase-3 in H2O2-treated H9c2 cells. Collectively, the anti-MI effects of CF involve inhibiting apoptosis and antioxidative stress in cardiomyoblasts by regulating Akt/Nrf2/Caspase-3/Bcl-2, and the possible active substances of CF are quercetin, kaempferol, β-sitosterol, luteolin, baicalein, safflomin C, safflower-yellow-B, and hydroxysafflor yellow A. The results of this study will be helpful for further drug development of CF and its active monomers.

Effects of 1,25-(OH)2-D3 on Oxidative Stress and Inflammation of Contrast

Contrast-induced nephropathy (CIN) is a common complication of clinical diagnosis and treatment of coronary atherosclerotic heart disease. This study focused on the role of 1,25-(OH)2-D3 (D3) in contrast-induced renal tissue inflammation and oxidative stress. Thirty C57BL/6 mouse underwent unilateral renal pedicle ligation. One week after surgery, they were randomly divided into three groups, 10 mice in control group (CON group), 10 mice injected with iodixanol in contrast-induced nephropathy model group (CM group), 10 mice injected with contrast agent +in 1,25-(OH)2-D3 group (D3 group). The effects of 1,25-(OH)2-D3 on contrast nephropathy were studied by Hematoxylin-Eosin (HE) observation of kidney structure, detection of serum creatinine, urea nitrogen observation of kidney function, and Western blotting and quantitative reverse-transcription polymerase chain reaction (RT-PCR). Under the light microscope, the renal tissue structure of the CM group was disordered, hypertrophic glomeruli, renal tubular cells were significantly edematous, and the interstitial fibrosis area was significantly increased. The serum creatinine (SCr) and blood urea nitrogen (BUN) in CM group were significantly increased compared with CON group, the antioxidant proteins GPX1 and GPX3 were significantly decreased, while the apoptosis proteins Bax and Caspase-3 were significantly increased, and the anti-apoptotic protein Bcl-2 was significantly decreased. The expression of inflammatory factors IL-1β, IL-6 and TNF-α was significantly increased. However, the D3 can effectively inhibit apoptosis through inhibiting oxidative stress and inflammatory response. In addition, the expression levels of Toll Like Receptor 4 (TLR4) and /NF-κB-P65 in the D3 group were lower than those in the CM group. It is indicated that 1,25-(OH)2-D3 has an inhibitory effect on TLR4/NF-κB signaling pathway. 1,25-(OH)2-D3 can reduce contrast-induced SCr and BUN and alleviate renal structural damage by inhibiting the TLR4/NF-κB pathway, which has an effect of reducing inflammation, increasing tissue antioxidant levels, and delaying cellular senescence.

An open, retrospective study on the duration of virus shedding for Shanghai patients infected with SARS-CoV-2 omicron variants.

An open, retrospective study on the duration of virus shedding for Shanghai patients infected with SARS-CoV-2 omicron variants.

Diagnostic value of parameters derived from planar MUGA for detecting HFpEF in coronary artery disease patients

BackgroundIn recent years, heart failure with preserved ejection fraction (HFpEF) has received increasing clinical attention. To investigate the diagnostic value of diastolic function parameters derived from planar gated blood-pool imaging (MUGA) for detecting HFpEF in coronary atherosclerotic heart disease (coronary artery disease, CAD) patients.MethodsNinety-seven CAD patients with left ventricular ejection fraction ≥ 50% were included in the study. Based on the left ventricular end-diastolic pressure (LVEDP), the patients were divided into the HFpEF group (LVEDP ≥ 16 mmHg, 47 cases) and the normal LV diastolic function group (LVEDP < 16 mmHg, 50 cases). Diastolic function parameters obtained by planar MUGA include peak filling rate (PFR), filling fraction during the first third of diastole (1/3FF), filling rate during the first third of diastole (1/3FR), mean filling rate during diastole (MFR), and peak filling time (TPF). Echocardiographic parameters include left atrial volume index (LAVI), peak tricuspid regurgitation velocity (peak TR velocity), transmitral diastolic early peak inflow velocity (E), average early diastolic velocities of mitral annulars (average e′), average E/e′ ratio. The diastolic function parameters obtained by planar MUGA were compared with those obtained by echocardiography to explore the clinical value of planar MUGA for detecting HFpEF.ResultsThe Receiver-operating characteristic curve analysis of diastolic function parameters obtained from planar MUGA and echocardiography to detect HFpEF showed that: among the parameters examined by planar MUGA, the area under the curve (AUC) of PFR, 1/3FF, 1/3FR, MFR and TPF were 0.827, 0.662, 0.653, 0.663 and 0.809, respectively. Among the echocardiographic parameters, the AUCs for average e′, average E/e′ ratio, peak TR velocity, and LAVI values were 0.747, 0.706, 0.735, and 0.633. The combination of PFR and TPF showed an AUC of 0.856. PFR combined with TPF value demonstrated better predictive value than average e′ (Z = 2.020, P = 0.043).ConclusionDiastolic function parameters obtained by planar MUGA can be used to diagnose HFpEF in CAD patients. PFR combined with TPF was superior to the parameters obtained by echocardiography and showed good sensitivity and predictive power for detecting HFpEF.

Application of decellularized vascular matrix in small-diameter vascular grafts.

Coronary artery bypass grafting (CABG) remains the most common procedure used in cardiovascular surgery for the treatment of severe coronary atherosclerotic heart disease. In coronary artery bypass grafting, small-diameter vascular grafts can potentially replace the vessels of the patient. The complete retention of the extracellular matrix, superior biocompatibility, and non-immunogenicity of the decellularized vascular matrix are unique advantages of small-diameter tissue-engineered vascular grafts. However, after vascular implantation, the decellularized vascular matrix is also subject to thrombosis and neoplastic endothelial hyperplasia, the two major problems that hinder its clinical application. The keys to improving the long-term patency of the decellularized matrix as vascular grafts include facilitating early endothelialization and avoiding intravascular thrombosis. This review article sequentially introduces six aspects of the decellularized vascular matrix as follows: design criteria of vascular grafts, components of the decellularized vascular matrix, the changing sources of the decellularized vascular matrix, the advantages and shortcomings of decellularization technologies, modification methods and the commercialization progress as well as the application prospects in small-diameter vascular grafts.

Research progress of CHD combined with anxiety and depression in Chinese and Western medicine

Coronary atherosclerotic heart disease (CHD) is one of the common diseases of the cardiovascular system, and it is also a common disease that seriously endangers human health. Patients with CHD are usually combined with anxiety and depression. In recent years, a large number of studies have shown that the incidence of CHD combined with anxiety and depression is gradually increasing, which seriously affects the prognosis of the disease and the quality of life of patients. This article reviews the epidemiology, pathogenesis and treatment of traditional Chinese and Western medicine, and provides reference for clinical practice.