Left Ventricular Diameter Research Articles

RUNX1 facilitates heart failure progression through regulating TGF-β-induced cardiac remodeling.

Heart failure is caused by acute or chronic cardiovascular diseases with limited treatments and unclear pathogenesis. Therefore, it is urgent to explore new therapeutic targets and reveal new pathogenesis for heart failure. We carried out heart failure animal model by transverse aortic arch constriction (TAC) in mice. The left ventricular internal diameter diastole (LVIDd), left ventricular internal diameter systole (LVIDs), and ejection fraction (EF) value were detected using ultrasound and myocardial fibrosis was evaluated by Masson stain assay. Cell apoptosis in myocardial tissues were detected by TUNEL immunofluorescence stain. Signal pathway analysis was performed by dual-luciferase reporter assay and western blot. Our results showed that inhibition of RUNX1 led to remission of cardiac enlargement induced by TAC in mice. Inhibition of RUNX1 also caused raise of EF and FS value under TAC-induced condition. Besides, RUNX1 inhibition mice showed decreased myocardial fibrosis area under TAC-induced condition. RUNX1 inhibition caused decrease of apoptotic cell rate in myocardial tissues under TAC. Interestingly, we found that RUNX1 could promote the activation of TGF-β/Smads in dual-luciferase reporter assay. We illustrated that RUNX1 could be considered as a new regulator of myocardial remodeling by activating TGF-β/Smads signaling. Based on this, we concluded that RUNX1 may be developed as a new therapeutic target against heart failure in the future. In addition, this study also provide a new insight for the etiological study on heart failure.

Ceftazidime/Tazobactam Sodium Combined with Levofloxacin and Enteral Nutrition Nursing Intervention for Heart Failure Complicated with Pulmonary Infection

This study aimed to investigate the clinical efficacy of ceftazidime/tazobactam sodium combined with levofloxacin and enteral nutrition nursing interventions in treating older adults with heart failure complicated with pulmonary infection. Control group patients (59) received ceftazidime tazobactam sodium injection (3:1). Observation group patients (59) received ceftazidime/tazobactam sodium with levofloxacin hydrochloride injection and enteral nutrition. The observation group had a higher total effective rate (χ2 = 5.94) and lower levels of inflammatory factors (interleukin-4, interleukin-6, and tumor necrosis factor-alpha) than the control group. Left ventricular end-systolic diameter and end-diastolic diameter were lower in the observation group than in the control group, and the left ventricular ejection fraction and pathogenic bacteria clearance rate were higher in the observation group than in the control group. The observation group had fewer adverse reactions than the control group. The levels of serum transferrin, prealbumin, and albumin were higher in the observation group than in the control group. No significant difference in satisfaction rate was found between the groups (χ2 = 3.01). Ceftazidime/tazobactam sodium, combined with levofloxacin and enteral nutrition, can reduce inflammatory factor levels in older adults with heart failure complicated with pulmonary infection. It improves the bacterial clearance rate and treats body infections without increasing adverse reactions.

Dapagliflozin treatment and cardiovascular outcome in RBP4/TTRVal30Met (transthyretin cardiac amyloidosis) mice.

Whether sodium-glucose co-transporter 2 inhibitors are effective for heart failure caused by ATTR-CA (transthyretin cardiac amyloidosis) remains uncertain. The aim of this study is to investigate the cardiovascular prognosis in ATTR-CA mice model with dapagliflozin treatment. Humanized RBP4/TTRVal50Met and RBP4/TTR mice models were constructed with clustered regularly interspaced short palindromic repeats and associated Cas9 endonuclease (CRISPR-Cas9) techniques and multiple generations breeding. A total of 6 RBP4/TTR mice received placebo treatment, when 12 RBP4/TTRVal50Met received dapagliflozin (1mg/kg/day, 6 mice) and placebo (6 mice) treatment. Fasting glucose, intraperitoneal glucose tolerance test, and plasma brain natriuretic peptide (BNP) concentration were measured at Day 0, Week 2, and Week 4. BNP, transforming growth factor-beta (TGF-β), collagen type I alpha 1 (COL1A1) protein levels, and Cola1, TGFβ1, TNFα, IL-1β, BNP relative quantities in cardiac, along with cardiac pathology examination including right ventricular collagen percentage, ventricular septum thickness, left ventricular wall thickness, and left ventricular internal diameter were measured at Week 4 after treatment procedure. All 18 mice completed the experiment. The baseline characteristics were balanced among three treatment groups. In placebo-treated mice, the cardiac BNP relative quantity was significantly higher in RBP4/TTRVal50Met mice than RBP4/TTR mice (RBP4[KI/KI], TTR [KI/KI]: 0.72±0.46, RBP4[KI/KI], TTRVal50Met [KI/KI]: 1.44±0.60, P=0.043), indicating more significant heart failure progression in ATTR-CA mice than normal mice. In ATTR-CA mice, the cardiovascular prognosis measurements including heart failure (plasma BNP concentration and relative quantities of BNP), cardiac inflammation (relative quantities of Cola1, TGFβ1, TNFα, and IL-1β), and pathological changes (right ventricular collagen percentage, ventricular septum thickness, left ventricular wall thickness, and left ventricular internal diameter) were statistically comparable between those under dapagliflozin and placebo treatment. Dapagliflozin did not improve cardiovascular prognosis including the progression of heart failure, cardiac inflammation, and pathological changes in ATTR-CA mice compared with placebo. The results of this study were not in support of dapagliflozin's therapeutic effects for ATTR-CA. More pre-clinical and clinical researches to validate these findings and demonstrate the underlying mechanisms are still required.

Analysis of conventional echocardiographic features in apical hypertrophic cardiomyopathy patients complicated with left ventricular apical aneurysm

Objective: To explore the basic characteristics of conventional echocardiography of apical hypertrophic cardiomyopathy (ApHCM) patients complicating with left ventricular apical aneurysm (LVAA). Methods: This is a retrospective study. Patients who underwent echocardiography and cardiac magnetic resonance (CMR) and were diagnosed with ApHCM complicated with LVAA by CMR at Fuwai Hospital, Chinese Academy of Medical Sciences from August 2012 to July 2017 were enrolled. According to whether LVAA was detected by echocardiography, the enrolled patients were divided into two groups: LVAA detected by echocardiography group and LVAA not detected by echocardiography group. Clinical data of the two groups were compared to analyze the causes of missed diagnosis by echocardiography. Results: A total of 21 patients were included, of whom 67.0% (14/21) were males, aged (56.1±16.5) years. Patients with chest discomfort accounted for 81.0% (17/21), palpitation 38.1% (8/21), syncope 14.3% (3/21). ECG showed that 21 (100%) patients had ST-T changes and 18 (85.7%) had deep T-wave invertion. Echocardiography revealed ApHCM in 17 cases (81.0%) and LVAA in 7 cases (33.3%). The mean left ventricular apical aneurysm diameter was 33.0 (18.0, 37.0) mm, and left ventricular ejection fraction was (66.5±6.6) %, and left ventricular apex thickness was (21.0±6.3) mm. Left ventricular outflow tract obstruction was presented in 4 cases and middle left ventricular obstruction in 10 cases. The mean left ventricular apical aneurysm diameter of LVAA detected by echocardiography was greater than that of LVAA not detected by echocardiography (25.0 (18.0, 28.0) mm vs. 16.0 (12.3, 21.0) mm, P=0.006). Conclusions: Conventional echocardiography examination has certain limitations in the diagnosis of ApHCM. Smaller LVAA complicated with ApHCM is likely to be unrecognized by echocardiography. Clinicians should improve their understanding of this disease.

ET-1 receptor type B (ETBR) overexpression associated with ICAM-1 downregulation leads to inflammatory attenuation in experimental autoimmune myocarditis.

An experimental autoimmune myocarditis rat model was established by subcutaneous injection of porcine myocardial myosin (PCM). The effect of ET-1 receptor type B (ETBR) overexpression on autoimmune myocarditis was observed via tail vein injection of ETBR overexpression lentivirus in rats. We further investigated the mechanisms involved in the regulation of autoimmune myocarditis by ETBR overexpression. Six rats were randomly selected from 24 male Lewis rats as the NC group, and the remaining 18 rats were injected with PCM on Day 0 and Day 7, to establish the experimental autoimmune myocarditis (EAM) rat model. The 18 rats initially immunized were randomly divided into three groups: the EAM group, ETBR-oe group, and GFP group. On Day 21 after the initial immunization of rats, cardiac echocardiography and serum brain natriuretic peptide (BNP) analysis were performed to evaluate cardiac function, myocardial tissue HE staining was performed to assess myocardial tissue inflammatory infiltration and the myocarditis score, and mRNA expression of IFN-γ, IL-12, and IL-17 was detected by qRT-PCR. Subsequently, immunohistochemical analysis was performed to detect the localization and expression of the ETBR and ICAM-1 proteins, and the expression of ETBR and ICAM-1 was verified by qRT-PCR and western blotting methods. On Day 21 after initial immunization, left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), and serum BNP concentrations increased in the hearts of rats in the EAM group compared with the NC group (P < 0.01), and ejection fraction (EF) and fractional shortening (FS) decreased compared with those of the normal control (NC) group (P < 0.01). LVEDd, LVEDs, and serum BNP concentrations decreased in the ETBR-oe group compared with the EAM group, while EF and FS increased significantly (P < 0.01). HE staining showed that a large number of inflammatory cell infiltrates, mainly lymphocytes, were observed in the EAM group, and the myocarditis score was significantly higher than that of the NC group (P < 0.01). Compared with that of the EAM group, myocardial tissue inflammatory cell infiltration was significantly reduced in the ETBR-oe group, and the myocarditis scores were significantly lower (P < 0.01). The mRNAs of the inflammatory factors IFN-γ, IL-12 and IL-17 in myocardial tissue of rats in the EAM group exhibited elevated levels compared with those of the NC group (P < 0.01) while the mRNAs of IFN-γ, IL-12 and IL-17 were significantly decreased in the ETBR-oe group compared with the EAM group (P < 0.01). Immunohistochemistry showed that the staining depth of ETBR protein in myocardial tissue was greater in the EAM group than in the NC group, and significantly greater in the ETBR-oe group than in the EAM group, while the staining depth of ICAM-1 was significantly greater in the EAM group than in the NC group, and significantly lower in the ETBR-oe group than in the EAM group. The ICAM-1 expression level was significantly higher in the EAM group than in the NC group (P < 0.01), and was significantly lower in the ETBR-oe groupthan in the EAM group (P < 0.01).

Clinical Efficacy of Tongxinluo Capsule Combined with Nutritional Support on Coronary Heart Disease Angina Pectoris

This study aimed to explore the impact of the Tongxinluo capsule combined with nutritional support on the clinical efficacy and nutritional status of patients with coronary heart disease angina pectoris. A total of 118 patients admitted to our hospital between August 2022 and May 2023 were divided into a control group and an observation group. Patients in the control group underwent routine treatment and nutritional interventions. Patients in the observation group received Tongxinluo capsules and tailored nutritional treatments. The observation group had a higher total effective rate, left ventricular ejection fraction, and high-density lipoprotein cholesterol level than the control group. Conversely, it had lower left ventricular end-systolic diameter, left ventricular end-diastolic diameter, total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels compared to the control group. Interleukin-6, tumor necrosis factor α, hypersensitive C-reactive protein levels, plasma viscosity, hematocrit, high-cut whole blood viscosity, fibrinogen level, and body mass index of the observation group were also lower than the control group. The incidence of adverse reactions between the two groups was not significant (P &gt; 0.05). Tongxinluo capsule, combined with nutritional support effectively and safely treats coronary heart disease angina pectoris and can improve patients’ cardiac function index.

Characteristics of the left heart structure and function in 86 term neonates with intrauterine growth restriction

To study the left heart structure and functional characteristics of term neonates with intrauterine growth restriction (IUGR). This study included 86 term neonates with IUGR admitted to the Neonatal Ward of Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2022 as the IUGR group, as well as randomly selected 86 term neonates without IUGR born during the same period as the non-IUGR group. The clinical data and echocardiographic data were compared between the two groups. The analysis of left heart structure and function showed that compared with the non-IUGR group, the IUGR group had significantly lower left ventricular mass, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, end-diastolic interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic volume, left ventricular end-systolic volume, and stroke volume (P<0.05) and significantly higher ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness, proportion of neonates with a mitral peak E/A ratio of ≥1, and cardiac index (P<0.05). The Spearman correlation analysis suggested that stroke volume was positively correlated with birth weight and body surface area (rs=0.241 and 0.241 respectively; P<0.05) and that the ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness was negatively correlated with birth weight and body surface area (rs=-0.229 and -0.225 respectively; P<0.05). The left ventricular systolic function of neonates with IUGR is not significantly different from that of neonates without IUGR. However, the ventricular septum is thicker in neonates with IUGR. This change is negatively correlated with birth weight and body surface area. The left ventricular diastolic function may be impaired in neonates with IUGR.

Cardiovascular diseases across OSA phenotypes: A retrospective cohort study

BackgroundDespite the considerable knowledge of Obstructive Sleep Apnea (OSA) implications for cardiac diseases, the evidence regarding cardiovascular complications across OSA phenotypes including Rapid Eye Movement OSA (REM-OSA) and Positional OSA (POSA) is limited. In this study, we aimed to evaluate the risk of cardiovascular diseases development and progression among patients with REM-OSA and POSA. MethodsBased on a retrospective cohort analysis, we included polysomnography studies done in the sleep lab at the Jordan University Hospital. Regarding cardiovascular diseases, primary outcomes were Heart Failure, and 1-years Major Adverse Cardiac Events while secondary outcomes were atrial fibrillation, pulmonary hypertension, other arrhythmia, metabolic profile, and echocardiographic measurements of the heart. ResultsThe total number of the included patients was 1,026 patients. POSA group had significantly lower percentage of patients with hypertension (P-value = 0.004). Additionally, systolic blood pressure and HbA1c were significantly lower among patients with POSA compared to the NPOSA group (P-value<0.050). Left ventricular end diastolic dimension was significantly higher among patients with POSA while ejection fraction was significantly lower (P-value<0.050). Patients with diabetes and mean HbA1c were significantly lower among patients with REM-OSA compared to patients with NREM-OSA (P-value = 0.015, P-value = 0.046). Multivariate regression analysis revealed that after adjusting for age, gender and preexisting comorbidities, POSA was significantly associated with lower ejection fraction and higher left ventricular diastolic diameter. ConclusionIn conclusion, our findings indicate that POSA might be associated with huge and clinically significant heart strain and poor cardiac functions, yet it might not have a clinically significant atherogenic effect. This study should guide clinicians to identify OSA phenotypes to imply the best treatment plan to reduce its detrimental impact on cardiac muscle.

Deep learning for automated left ventricular outflow tract diameter measurements in 2D echocardiography

BackgroundMeasurement of the left ventricular outflow tract diameter (LVOTd) in echocardiography is a common source of error when used to calculate the stroke volume. The aim of this study is to assess whether a deep learning (DL) model, trained on a clinical echocardiographic dataset, can perform automatic LVOTd measurements on par with expert cardiologists.MethodsData consisted of 649 consecutive transthoracic echocardiographic examinations of patients with coronary artery disease admitted to a university hospital. 1304 LVOTd measurements in the parasternal long axis (PLAX) and zoomed parasternal long axis views (ZPLAX) were collected, with each patient having 1–6 measurements per examination. Data quality control was performed by an expert cardiologist, and spatial geometry data was preserved for each LVOTd measurement to convert DL predictions into metric units. A convolutional neural network based on the U-Net was used as the DL model.ResultsThe mean absolute LVOTd error was 1.04 (95% confidence interval [CI] 0.90–1.19) mm for DL predictions on the test set. The mean relative LVOTd errors across all data subgroups ranged from 3.8 to 5.1% for the test set. Generally, the DL model had superior performance on the ZPLAX view compared to the PLAX view. DL model precision for patients with repeated LVOTd measurements had a mean coefficient of variation of 2.2 (95% CI 1.6–2.7) %, which was comparable to the clinicians for the test set.ConclusionDL for automatic LVOTd measurements in PLAX and ZPLAX views is feasible when trained on a limited clinical dataset. While the DL predicted LVOTd measurements were within the expected range of clinical inter-observer variability, the robustness of the DL model requires validation on independent datasets. Future experiments using temporal information and anatomical constraints could improve valvular identification and reduce outliers, which are challenges that must be addressed before clinical utilization.Graphical

Impact of a combination of pimobendan, furosemide, and enalapril on heart rate variability in naturally occurring, symptomatic, myxomatous mitral valve degeneration dogs

BackgroundPimobendan, diuretics, and an angiotensin-converting enzyme inhibitor (ACEi) are widely used for the management of chronic valvular heart disease in dogs; however, the effects of that combination on heart rate variability (HRV) are unknown. The purpose of this study was to assess the HRV of symptomatic myxomatous mitral valve degeneration (MMVD) dogs in response to therapy with a combination of pimobendan, diuretics, and ACEi.ResultsMMVD stage C (n = 17) dogs were enrolled and a 1-hour Holter recording together with echocardiography, blood pressure measurement, and blood chemistry profiles were obtained before and 1, 3, and 6 months after oral treatment with pimobendan (0.25 mg/kg), enalapril (0.5 mg/kg), and furosemide (2 mg/kg) twice daily. The results revealed that MMVD stage C dogs at the baseline had lower values of time-domain indices, low frequency (LF), high frequency (HF), and total power, as well as higher value of LF/HF. Triple therapy significantly increases these parameters in MMVD stage C dogs (P < 0.05). A positive moderate correlation was observed between time domain parameters and a left ventricular internal diastole diameter normalized to body weight (P < 0.05).ConclusionsIt can be concluded that MMVD stage C dogs possess low HRV due to either the withdrawal of parasympathetic tone or enhanced sympathetic activation, and a combination therapy was shown to enhance cardiac autonomic modulation inferred from the increased heart rate variability. Therefore, a combination therapy may be useful for restoring normal autonomic nervous system activity in dogs with MMVD stage C.

Computational evaluation of heart failure and continuous flow left ventricular assist device support in anaemia.

Anaemia is common in end-stage heart failure patients supported with continuous flow left ventricular assist device (CF-LVAD) and is associated with adverse outcomes such as heart failure readmission. This study evaluates the haemodynamic effects of anaemia on cardiac function and cerebral blood flow in heart failure patients supported with CF-LVAD using computational simulations. A dynamic model simulating cardiac function, systemic, pulmonary and cerebral circulations, cerebral flow autoregulatory mechanisms and gas contents in blood was used to evaluate the effects of anaemia and iron deficiency in heart failure and during CF-LVAD support. CF-LVAD therapy was simulated by a model describing HeartMate 3. Anaemia and iron deficiency were simulated by reducing the haemoglobin level from 15 to 9 g/dL and modifying scaling coefficients in the models simulating heart chamber volumes. Reduced haemoglobin levels decreased the arterial O2 content, which increased cerebral blood flow rate by more than 50% in heart failure and during CF-LVAD assistance. Reduced haemoglobin levels simulating anaemia had minimal effect on the arterial and atrial blood pressures and ventricular volumes. In contrast, iron deficiency increased end-diastolic left and right ventricular diameters in heart failure from 6.6 cm to 7 cm and 2.9 cm to 3.1 cm and during CF-LVAD support from 6.1 to 6.4 cm and 3.1 to 3.3 cm. The developed numerical model simulates the effects of anaemia in failing heart and during CF-LVAD therapy. It is in good agreement with clinical data and can be utilised to assess CF-LVAD therapy.

Effect of amiodarone hydrochloride tablets combined with potassium magnesium aspartate on hemodynamics and cardiac function in patients with coronary heart disease and arrhythmia

Purpose: To investigate the effects of amiodarone hydrochloride tablets combined with potassium magnesium aspartate on hemodynamics and cardiac function in coronary heart disease (CHD) patients with arrhythmia.Methods: In this retrospective research, a total of 110 CHD and arrhythmia patients on admission at Jiaozhou Central Hospital of Qingdao from June 2020 to June 2022 were randomly but equally divided into control group (CG) treated with propafenone hydrochloride tablets, and study group (SG) treated with a combination of amiodarone hydrochloride tablets and potassium magnesium aspartate. Clinical efficacy of the treatment types as well as the number of premature ventricular contractions (PVC), QTc interval and heart rate (HR) of the patients were monitored to determine left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and cardiac index (CI). Fibrinogen levels, plasma viscosity and hematocrit of the patients were also assessed.Results: The total effectiveness/efficacy of treatment in SG was 92.73 %, which was significantly higher than the corresponding CG value of 76.36 % (p &lt; 0.05). Relative to CG, PVC and HR in SG were significantly lower, while QTc interval was significantly higher. The levels of LVESD and LVEDD were significantly lower in SG than in CG, while CI level was significantly higher. However, fibrinogen, plasma viscosity and hematocrit values were significantly lower in SG than in CG (p &lt; 0.05).Conclusion: When administered along with potassium magnesium aspartate in the treatment of CHD and arrhythmia, amiodarone hydrochloride tablets enhances clinical efficacy and improves electrocardiograph index, hemodynamics and cardiac function. Nonetheless, there is need for expanded clinical trials before the use of this treatment strategy in clinical practice.

Prospective evaluation of echocardiographic parameters and cardiac biomarkers in healthy dogs eating four custom-formulated diets

IntroductionDiet-associated dilated cardiomyopathy (DCM) has been suspected in breeds that have not been previously noted to have a predisposition to the DCM phenotype. This study hypothesized that over 210 days, dogs fed diets with varying amounts of animal-sourced protein and carbohydrate sources would not be negatively impacted in terms of their cardiac parameters and function.MethodsThirty-two purebred beagles and 33 mixed-breed hounds were randomized into four diet groups and studied for 210 days. The diet groups were as follows: the high-animal-protein grain-free (HAGF) group, the low-animal-protein grain-free (LAGF) group, the high-animal-protein grain-inclusive (HAGI), and the low-animal-protein grain-inclusive (LAGI) group. Cardiac-specific biomarkers, endomyocardial biopsies, and linear and volumetric echocardiographic parameters were evaluated.ResultsThere was a treatment-by-day-by-breed effect observed for the normalized left ventricular internal diameter at end-diastole (p = 0.0387) and for the normalized left ventricular internal diameter at end-systole (p = 0.0178). On day 210, mixed-breed hounds fed the LAGI diet had a smaller normalized left ventricular internal diameter at end-diastole than on day 90. On day 210, beagles fed the LAGF diet had a larger normalized left ventricular internal diameter at end-systole than those fed the LAGI diet. Fractional shortening for beagles in the LAGF group was significantly lower (p = 0.007) than for those in the HAGI and LAGI groups. Cardiac-specific biomarkers and endomyocardial biopsies were not significantly different between breeds, diets, and various time points.DiscussionThis study did not detect the development of cardiac dysfunction throughout the study period through the echocardiographic parameters measured, select cardiac biomarkers, or endomyocardial biopsies. There were noted interactions of treatment, breed, and time; therefore, isolating a diet association was not possible. Future research should further investigate the other factors that may help to identify the variable(s) and possible mechanisms underlying suspected diet-associated DCM in dogs.

The insufficiency of recreational exercises in improving cardiovascular fitness: an investigation of ventricular systolic and diastolic parameters and left atrial mechanical functions

AimThis study aimed to compare the left ventricular (LV) systolic and diastolic parameters and left atrial (LA) mechanical functions of individuals engaging in recreational sports and resistance exercises on a weekly basis.MethodsA total of 43 male amateur athletes were included in this study, of which 24 performed resistance exercises (REs) (29.70 ± 8.74 year, weight: 81.70 ± 12.64 kg, height: 176.05 ± 7.73 cm, BMI: 27.64 ± 4.97 kg/m2), and 19 participated in recreational football training and were included in the recreational sports group (31.73 ± 6.82 year, weight: 86.00 ± 18.52 kg, height: 178.62 ± 4.95 cm, BMI: 25.55 ± 3.42 kg/m2). The exercises were standardized according to the weekly exercise frequency and volume. After recording the participants’ demographic information, the LV systolic and diastolic parameters and LA mechanical functions were measured using echocardiography (ECHO) and Tissue Doppler Imaging.ResultsSignificant differences were observed in various cardiac parameters between the recreational sports group (REG) and resistance exercise Group (RSG). Specifically, the left ventricular (LV) diastolic diameter, LV end diastolic volume index (LVEDVi), and stroke volume index were notably higher in the REG compared to the RSG (t = 2.804, p = .010, effect size (ES) = 2.10; t = 3.174, p = .003, ES = 0.98; t = 3.36, p = .002, ES = 1.02, respectively). Notably, the RSG exhibited higher values for LV mass index (LVMi) and isovolumic relaxation time (IVRT) than the REG (t = 2.843, p = .007, ES = 0.87; t = 2.517, p = .016, ES = 0.76) in terms of LV systolic and diastolic parameters. Regarding left atrial (LA) mechanics, the REG demonstrated increased LA total emptying volume index, LA maximum volume index, LA volume before systole measured at the onset of the p-wave index, and conduit volume index compared to RSG (t = 2.419, p = .020, ES = 0.75; t = 2.669, p = .011, ES = 0.81; t = 2.111, p = .041, ES = 0.64; t = 2.757, p = .009, ES = 0.84, respectively).ConclusionOur study revealed significant variations in LV and LA functions between REG and RSG. Our data suggest that REs led to substantial cardiac remodeling, altering myocardial structure and function. In contrast, the effect of recreational exercise on cardiac adaptation was less pronounced than that of resistance exercise. Consequently, we propose that individuals engaging in recreational exercise should consider modalities that impose higher cardiovascular demand for more effective cardiac conditioning.

Efficacy and mechanism of Xuefu Zhuyu Decoction on model rats of coronary heart disease with heart blood stasis syndrome based on metabolomics

This study investigated the effects of Xuefu Zhuyu Decoction on myocardial metabolites in a rat model of coronary heart disease with heart blood stasis syndrome and explored the therapeutic mechanism of blood circulation-promoting and blood stasis-removing therapy. SD rats were randomly divided into a sham operation group, a model group, a Xuefu Zhuyu Decoction group(14.04 g·kg~(-1)), and a trimetazidine group(5.4 mg·kg~(-1)). The sham operation group underwent thread insertion without ligation, while the other groups underwent coronary artery left anterior descending branch ligation to induce a model of coronary heart disease with heart blood stasis syndrome. Three days after modeling, drug intervention was performed, and samples were taken after 14 days of intervention. General conditions were observed, and electrocardiogram and cardiac ultrasound indices were measured. Hematoxylin-eosin(HE) staining and Masson staining were used to observe tissue pathological morphology. The enzyme linked immunosorbent assay(ELISA) was used to measure the levels of triglyceride(TG) and total cholesterol(TC) in the serum. Ultra high performance liquid chromatography-quantitative exactive-mass spectrometry(UHPLC-QE-MS) technology was used to screen differential metabolites in myocardial tissue and conduct metabolic pathway enrichment analysis. The results showed that Xuefu Zhuyu Decoction significantly improved the general condition of the model rats, reduced heart rate and ST segment elevation in the electrocardiogram, increased left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS), and decreased left ventricular internal diameter in diastole(LVIDd) and left ventricular internal diameter in systole(LVIDs). HE staining and Masson staining showed that Xuefu Zhuyu Decoction effectively alleviated myocardial tissue structural disorders, inflammatory cell infiltration, and collagen fiber deposition in the model rats. ELISA results showed that Xuefu Zhuyu Decoction effectively regulated serum TG and TC levels in the model rats. There were significant differences in the metabolic phenotypes of myocardial samples in each group. Fourteen differential metabolites were identified in the Xuefu Zhuyu Decoction group, involving five metabolic pathways, including arginine and proline metabolism, glycerophospholipid metabolism, aminoacyl-tRNA biosynthesis, ether lipid metabolism, and alanine, aspartate, and glutamate metabolism. Xuefu Zhuyu Decoction improved cardiac function and myocardial structural damage in the rat model of coronary heart disease with heart blood stasis syndrome, and its biological mechanism involved the regulation of lipid metabolism, choline metabolism, amino acid metabolism, energy metabolism, and protein synthesis pathways.

The Anti-Inflammatory Mediator 17(R)-Resolvin D1 Attenuates Pressure Overload-Induced Cardiac Hypertrophy and Fibrosis.

Increased inflammation contributes to pressure overload-induced myocardial remodeling. 17(R)-Resolvin D1 (17(R)-RvD1), a potent lipid mediator derived from docosahexaenoic acid, possesses anti-inflammatory and pro-resolving properties. However, the association between 17(R)-RvD1 and pressure overload-induced cardiac hypertrophy remains unclear. Transverse aortic constriction (TAC) surgery was performed to establish a cardiac hypertrophy model. C57BL/6J mice were randomly assigned to the Sham, TAC and TAC+17(R)-RvD1 groups. 17(R)-RvD1 was injected (2 μg/kg, i.p.) before TAC surgery and once every other day after surgery for 4 weeks. The same volume of saline was injected into the mice in both Sham group and TAC group. Then, cardiac function was evaluated and heart tissues were collected for biological analysis. 17(R)-RvD1 treatment attenuated TAC-induced increase in left ventricular diameter and decrease in left ventricular contractility, mitigated increased cardiomyocyte cross-sectional area, and downregulated the expression of hypertrophic genes. Besides, 17(R)-RvD1 attenuated myocardial fibrosis, as indicated by the decreased LV collagen volume and expression of fibrotic genes. In addition, 17(R)-RvD1 ameliorated the inflammatory response in cardiac tissue, as illustrated by the decreased infiltration of CD68+ macrophages and reduced production of pro-inflammatory cytokines, including TNF-α, IL-1β, and IL-6. 17(R)-RvD1 treatment significantly suppressed the activation of NLRP3 inflammasome after TAC surgery, which might be responsible for the attenuation of inflammation in cardiac tissue. 17(R)-RvD1 attenuated pressure overload-induced cardiac hypertrophy and fibrosis, and the possible mechanism may be associated with the inhibition of NLRP3 inflammasome. 17(R)-RvD1 may serve as a potential drug for the treatment of cardiac hypertrophy.

Evaluation of cardiac biomarkers, electrocardiogram changes and echocardiography findings before and after exercise in paediatric athletes

Purpose: The aim of this study was to investigate the structural and electrical changes in the heart associated with exercise in young athletes under 18 years of age and to examine the relationship between these changes and biochemical markers.&#x0D; Materials and Methods: In this study, 32 male paediatric athletes (five rowers, five kayakers and 22 footballers) were prospectively evaluated. Dynamic exercise training for 75 minutes was applied to all athletes. An echocardiographic evaluation was performed on the athletes at rest. An electrocardiogram (ECG) was taken before and after the exercise. Blood samples were taken from all athletes before the exercise, during the first hour of exercise and after the fourth hour of the training session to analyse the serum levels of creatine kinase myocardial band, troponin T(cTnT) and pro-brain natriuretic peptide.&#x0D; Results: The mean age of all athletes was 15.3±0.9 years. In the echocardiography examination, end-diastolic thickness, left ventricular end-diastolic diameter, posterior wall end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass measurements (LVM) and left ventricular mass indices (LVMI) were higher among the rowers than in the remaining groups. In the post-exercise ECG, T-wave peaks were observed in 16 individuals, including all rowers, all kayakers, and six footballers. The cTnT values in the first hour and after the fourth were 0.31–0.71 ng/ml in football players, 0.10–0.27 ng/ml in rowers, and 0.04–0.15 ng/ml kayakers. An increase in cTnT levels was detected after the fourth hour of exercise in all groups. There was a correlation between T-wave peaks in the ECG taken after exercise and age, cTnT serum level and increased LVM. &#x0D; Conclusion: In this study, we found T-wave peaks in half of the athletes after exercise. The serum cTnT levels of young athletes may be elevated by exercise and that LVM and LVMI may be higher in athletes. Echocardiography and ECG evaluations should be performed in paediatric athletes.

The effects of prophylactic intravenous injection of rhBNP on prognosis in patients with STEMI undergoing PPCI.

This experiment was carried out to observe the application value of recombinant human brain natriuretic peptide (rhBNP) in patients with ST-segment elevation myocardial infarction (STEMI) by primary percutaneous coronary intervention (PPCI), to provide reference for the future treatment of STEMI. In this study, we selected STEMI patients who underwent PPCI treatment in our hospital from October 2019 to December 2021 were selected as the study subjects, of which 46 received intravenous injections of rhBNP (research group), and 36 STEMI patients underwent PPCI (control group). There was no difference in clinical efficacy between the two groups (P>0.05). After treatment, high-sensitivity cardiac troponin I (hs-cTnI), creatine kinase-MB (CK-MB) and plasma N-terminal pro-BNP (NT-proBNP) levels decreased in both groups, with the research group lower than the control group; cardiac output (CO), cardiac index (CI) and mean arterial pressure (MAP) of the research group were lower than the control group's (P<0.05). The left ventricular ejection fraction (LVEF) in the research group was higher than that in the control group at 1 week and 1 month after treatment, while left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were lower than those in the control group (P<0.05). There was also no difference in the rate of prognostic risk events between the two groups at 6 months of follow-up (P>0.05). Combining the results of these experiments above, we believe that the intravenous injection of rhBNP in STEMI patients undergoing PPCI treatment can improve cardiac function and promote the recovery of hemodynamics.

Mitochondrial aldehyde dehydrogenase rescues against diabetic cardiomyopathy through GSK3β-mediated preservation of mitochondrial integrity and Parkin-mediated mitophagy.

Mitochondrial aldehyde dehydrogenase (ALDH2) offers proven cardiovascular benefit, although its impact on diabetes remains elusive. This study examined the effects of ALDH2 overexpression and knockout on diabetic cardiomyopathy and the mechanism involved with a focus on mitochondrial integrity. Mice challenged with streptozotocin (STZ, 200mg/kg, via intraperitoneal injection) exhibited pathological alterations, including reduced respiratory exchange ratio, dampened fractional shortening and ejection fraction, increased left ventricular end-systolic and diastolic diameters, cardiac remodeling, cardiomyocyte contractile anomalies, intracellular Ca2+ defects, myocardial ultrastructural injury, oxidative stress, apoptosis, and mitochondrial damage, which were overtly attenuated or accentuated by ALDH2 overexpression or knockout, respectively. Diabetic patients also exhibited reduced plasma ALDH2 activity, cardiac remodeling, and diastolic dysfunction. In addition, STZ challenge altered expression levels of mitochondrial proteins (PGC-1α and UCP2) and Ca2+ regulatory proteins (SERCA, Na+-Ca2+ exchanger, and phospholamban), dampened autophagy and mitophagy (LC3B ratio, TOM20, Parkin, FUNDC1, and BNIP3), disrupted phosphorylation of Akt, GSK3β, and Foxo3a, and elevated PTEN phosphorylation, most of which were reversed or worsened by ALDH2 overexpression or knockout, respectively. Furthermore, the novel ALDH2 activator torezolid, as well as the classical ALDH2 activator Alda-1, protected against STZ- or high glucose-induced in vivo or in vitro cardiac anomalies, which was nullified by inhibition of Akt, GSK3β, Parkin, or mitochondrial coupling. Our data discerned a vital role for ALDH2 in diabetic cardiomyopathy possibly through regulation of Akt and GSK3β activation, Parkin mitophagy, and mitochondrial function.

HeartMate 3 Snoopy: Noninvasive cardiovascular diagnosis of patients with fully magnetically levitated blood pumps during echocardiographic speed ramp tests and Valsalva maneuvers

The HeartMate 3 (HM3) left ventricular assist device (LVAD) has demonstrated excellent clinical outcomes; however, pump speed optimization is challenging with the available HM3 monitoring. Therefore, this study reports on clinical HM3 parameters collected with a noninvasive HM3 monitoring system (HM3 Snoopy) during echocardiographic speed ramp tests and Valsalva maneuvers. In this prospective, single-center study, the HM3 data communication between the controller and pump was recorded with a novel data acquisition system. Twelve pump parameters sampled every second (1Hz) and clinical assessments (echocardiography, electrocardiogram (ECG), and blood pressure measurement) during speed ramp tests were analyzed using Pearson's correlation (r, median [IQR]). The cause for the occurrence of pulsatility index (PI)-events during ramp speed tests and valsalva maneuvers was investigated. In 24 patients (age: 58.9±8.8years, body mass index: 28.1±5.1kg/m2, female: 20.8%), 35 speed ramp tests were performed with speed changes in the range of ±1000rpm from a baseline speed of 5443±244rpm. Eight HM3 pump parameters from estimated flow, motor current, and LVAD speed together with blood pressure showed positive collinearities (r=0.9 [0.1]). Negative collinearities were observed for pump flow pulsatility, pulsatility index, rotor noise, and left ventricular diameters (r=-0.8 [0.1]), whereas rotor displacement and heartrate showed absence of collinearities (r=-0.1 [0.08]). In this study, the HM3 Snoopy was successfully used to acquire more parameters from the HM3 at a higher sampling rate. Analysis of HM3 per-second data provide additional clinical diagnostic information on heart-pump interactions and cause of PI-events.