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The Novel long QT Syndrome Type 2-associated F129I Mutation in the KCNH2 Gene Significantly Affects IKr Through the hERG1 Homomeric and Heteromeric Potassium Channels

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Cardiology Discovery 2024年第2期4卷 174-182页

作者： Li Feng Kejuan Ma Xin Li Nian Liu deyong long Changsheng Ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Center for Cardiovascular DiseasesBeijing 100029China Community Health Service Center of Beijing Nomal University Beijing 100875China.

Objective:The long QT syndrome type 2 is caused by the loss-of-function mutations in the KCNH2 gene,which encodes hERG1,the voltage-gated potassium channel.The hERG1 channels conduct rapid delayed rectifier K+currents(k)in the human cardiac tissue.KCNH2 encodes 2 main isoforms-hERG1a and hERG1b,which assemble to form the homomeric or heteromeric hERG1 channels.However,the functional characteristics of the heteromeric hERG1 channels in long QT syndrome type 2 are not clear.In this study,a novel mutation in the N-terminus of hERG1a(F129l)was identified in a proband of long QT syndrome type 2.The purpose of this study was to identify the electrophysiological change of homomeric and heteromeric hERG1 channels with theF129l-hERG1a.Methods:Candidate genes were screened by direct sequencing.F129l-hERG1a was cloned in the pcDNA3.1 vector by site-directed mutagenesis.Then,the wild-type(WT)hERG1a and/or F129l-hERG1a were transiently expressed in the HEK293 cells with or without hERG1b co-expression.The expression levels of the transgenes,cellular distribution of hERG1a and hERG1b,and the electrophysiological features of the homomeric and the heteromeric hERG1 channels with the WT-hERG1a or F129l-hERG1a were analyzed using whole-cell patch-clamp electrophysiology,western blotting,and immunofluorescence techniques.Results:The proband was clinically diagnosed with long QT syndrome type 2 and carried a heterozygous mutation c.385T>A(F1291)in the KCNH2 gene.Electrophysiology study proved that the F129l substitution in hERG1a significantly decreased/kr in both the homomeric and heteromeric hERG1channels by 86%and 70%,respectively(WT-hERG1a(54.88±18.74)pA/pF vs.F129l-hERG1a(7.34±1.90)pA/pF,P<0.001;WT-hERG1a/hERG1b(89.92±24.51)pA/pF vs.F129l-hERG1a/hERG1b(26.54±9.83)pA/pF,P<0.001).The voltage dependence of Ik,activation(Vy and k)was not affected by the mutation in both the homomeric and heteromeric hERG1 channels.The peak current densities and the kinetic characteristics of Ik,were comparable for both WT/F129l-hERG1a and WT-hERG1a

关键词： long QT syndrome Arrhythmia lon channels hERG

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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin deyong long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA Department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.Methods:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was assessed.Results:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low risk.On admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking OAC.The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;P70%of AF patients were at a high risk of stroke.Although poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov,NCT02309398.

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention Contraindication

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ABC-AF-Stroke score predicts thromboembolism in nonanticoagulated patients following successful atrial fibrillation ablation: a report from the Chinese Atrial Fibrillation Registry

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Chinese Medical Journal 2023年第20期136卷 2451-2458页

作者： Yufeng Wang Chao Jiang Liu He Xin Du Xueyuan Guo Ribo Tang Caihua Sang deyong long Jianzeng Dong Ziad Hijazi Gregory YHLip Changsheng Ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijing 100029China Heart Health Research Center Beijing 100029China The George Institute for Global Health Faculty of MedicineUniversity of New South WalesSydneyNSWAustralia Department of Cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan 450052China Department of Medical Sciences CardiologyUppsala UniversityUppsalaSweden Uppsala Clinical Research Center Uppsala UniversityUppsalaSweden Liverpool Centre for Cardiovascular Science Liverpool Heart and Chest HospitalUniversity of LiverpoolLiverpoolUK

Background:The age,biomarkers,and clinical history(ABC)-atrial fibrillation(AF)-Stroke score have been proposed to refine stroke risk stratification,beyond what clinical risk scores such as the CHA2DS2-VASc score can offer.This study aimed to identify risk factors associated with thromboembolism and evaluate the performance of the ABC-AF-Stroke score in predicting thromboembolism in non-anticoagulated AF patients following successful ablations.Methods:A total of 2692 patients who underwent successful ablations with discontinued anticoagulation after a 3-month blanking period in the Chinese Atrial Fibrillation Registry(CAFR)between 2013 and 2019 were included.Cox regression analysis was conducted to present the association of risk factors with thromboembolism risk.The ABC-AF-Stroke score was evaluated in terms of discrimination,including concordance index(C-index),net reclassification improvement(NRI)and integrated discrimination improvement(IDI),clinical utilization by decision curve analysis(DCA),and calibration by comparing the predicted risk with the observed annualized event rate.Results:After a median follow-up of 3.5 years,64 patients experienced thromboembolism events.Age,prior history of stroke/transient ischemic attack(TIA),high-sensitivity cardiac troponin T(cTnT-hs),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were independently associated with thromboembolism risk.The ABC-AF-Stroke score performed statistically significantly better than the CHA2DS2-VASc score in terms of C-index(0.67,95%confidence interval[CI]:0.59-0.74 vs.0.60,95%CI:0.52-0.67,P=0.030)and reclassification capacity.The DCA implied that the ABC-AF-Stroke score could identify more thromboembolism events without increasing the false positive rate compared to the CHA2DS2-VASc score.The calibration curve showed that the ABC-AF-Stroke score was well calibrated in this population.Conclusions:In this real-world study enrolling non-anticoagulated AF patients following successful ablations,age,prior history of stroke/TIA,level of NT-p

关键词： Atrial fibrillation ABC-AF-Stroke score CHAS2DS2-VASc Thromboembolism Catheter ablation

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特发性室性期前收缩评估和管理的研究进展

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中国医药 2024年第4期19卷 610-613页

作者：杨扬李梦梦韩康宁龙德勇首都医科大学附属北京安贞医院心内科、国家心血管疾病临床医学研究中心北京100029

特发性室性期前收缩是临床常见的心律失常类型,既往观点认为此类疾病多数预后良好。但近年来人们发现这一过去被普遍认为是良性、无需过多干预的心脏节律异常,与部分患者左心室功能可逆性减退,甚至发生心力衰竭相关,并由此引出室性期前... 详细信息

特发性室性期前收缩是临床常见的心律失常类型,既往观点认为此类疾病多数预后良好。但近年来人们发现这一过去被普遍认为是良性、无需过多干预的心脏节律异常,与部分患者左心室功能可逆性减退,甚至发生心力衰竭相关,并由此引出室性期前收缩诱发性心肌病这一概念。并非所有室性期前收缩最终都会进展为心肌病,这一过程受室性期前收缩负荷、起源部位、QRS波群时程、伴随症状等多因素的共同影响。成功的导管消融术和抗心律失常药物治疗能够有效减少患者室性期前收缩负荷,改善甚至逆转已经受损的心功能。

关键词：特发性室性期前收缩室性期前收缩诱发性心肌病室性期前收缩负荷

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UNITROL 5000励磁整流桥冷却系统电源回路优化

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云南水力发电 2024年第6期40卷 9-10,16页

作者：何开正丁姣谭佑文朱琳龙德勇云南华电镇雄发电有限公司云南镇雄657204

励磁系统是发电厂的重要组成部分,对电力系统的安全稳定运行有着重要作用。针对镇雄电厂采用的ABB UNITROL 5000励磁整流桥冷却系统风机电源存在的缺陷进行了分析。提出了优化方案,有效解决了该缺陷,提高了励磁系统运行的稳定性和可靠性... 详细信息

励磁系统是发电厂的重要组成部分,对电力系统的安全稳定运行有着重要作用。针对镇雄电厂采用的ABB UNITROL 5000励磁整流桥冷却系统风机电源存在的缺陷进行了分析。提出了优化方案,有效解决了该缺陷,提高了励磁系统运行的稳定性和可靠性,消除了机组的安全隐患,为机组长周期安全稳定运行提供了有力保障。

关键词：发电厂励磁整流桥冷却系统风机电源优化

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500 kV断路器本体三相不一致防误动回路优化与运用

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云南水力发电 2024年第6期40卷 7-8,13页

作者：龙德勇丁姣谭佑文朱琳何开正云南华电镇雄发电有限公司云南镇雄657204

镇雄公司在用西开生产的LW13A-550/Y型500 kV分相操作断路器本体三相不一致保护回路存在多方面的安全隐患。断路器处于合闸状态,当三相不一致跳闸出口继电器故障或因人为误碰、误动将会使断路器误跳闸。介绍了在原有回路的基础上以精简... 详细信息

镇雄公司在用西开生产的LW13A-550/Y型500 kV分相操作断路器本体三相不一致保护回路存在多方面的安全隐患。断路器处于合闸状态,当三相不一致跳闸出口继电器故障或因人为误碰、误动将会使断路器误跳闸。介绍了在原有回路的基础上以精简的优化方式高效地解决了上述存在的问题,有效防止运行中的断路器误跳闸,进一步提高涉网设备安全性、稳定性、可靠性。

关键词：分相操作断路器三相不一致保护回路防误动优化

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Mild Renal Dysfunction and Risk of Thromboembolism and Bleeding in Patients with Atrial Fibrillation:The Chinese Atrial Fibrillation Registry Study

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Cardiology Discovery 2021年第1期1卷 29-36页

作者： Jingye Li Sitong Li Chao Jiang Jing Du Xueyuan Guo Songnan Li Chenxi Jiang Ribo Tang Caihua Sang deyong long Xin Du Jianzeng Dong Changsheng Ma Department of Cardiology Beijing Anzhen HospitalCapital Medical University and National Clinical Research Center for Cardiovascular DiseasesBeijing 100029China Department of Cardiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Beijing Center for Disease Prevention and Control Beijing 100013China Heart Health Research Centre Beijing 100029China

Objective:Previous studies indicated that patients with atrial fibrillation(AF)and moderate-to-severe chronic kidney disease(CKD)are at a higher risk of thromboembolism and bleeding during anticoagulation.Whether mild CKD is associated with an increased risk of thromboembolism and bleeding in AF patients remains unknown.This study aimed to evaluate the impact of mild CKD on thromboembolism and major bleeding among patients with AF.Methods:Baseline serum creatinine was available in 17,559 of 25,512 patients enrolled in the China-AF study between August 2011 and December 2018.After excluding those who underwent AF ablation or with moderate-to-severe CKD,7191 non-valvular AF patients(2059 with mild CKD and 5132 with normal renal function)with regular follow-up for at least 6 months were included.Primary outcomes were the time to the first occurrence of thromboembolic and major bleeding events.Results:Over a mean follow-up of(44.4±23.4)months,639 thromboembolism and 231 major bleeding events occurred.The crude incidence rates of thromboembolism were higher in the mild CKD group than that of the normal renal function group(3.0/100 person-years vs.2.2/100 person-years,P<0.0001),while the crude incidence rates of major bleeding were comparable between the two groups(1.0/100 person-years vs.0.8/100 person-years,P=0.076).After multivariate analyses,mild CKD was not associated with an increased risk of thromboembolism(HR=1.05,95%CI:0.89-1.25,P=0.547)or major bleeding(HR=1.11,95%CI:0.84–1.47,P=0.476).Conclusions:Mild CKD was not an independent risk factor of thromboembolism or major bleeding in patients with AF.

关键词： Atrial fibrillation Chronic kidney disease Major bleeding Thromboembolism

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Postablation neutrophil/lymphocyte ratio correlates with arrhythmiarecurrence after catheter ablation of lone atrial fibrillation

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Chinese Medical Journal 2014年第6期127卷 1033-1038页

作者： Guo Xueyuan Zhang Sen Yan Xianliang Chen Yingwei Yu Ronghui long deyong Sang Caihua Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background Neutrophil/lymphocyte ratio(NLR) has been proposed as a novel marker of systemic inflammation and oxidative stress. The objective of this study was to ascertain the relationship between levels of NLR and recurrence of lone atrial fibrillation(AF) after catheter ablation.Methods A total of 379 lone AF patients who underwent catheter ablation were enrolled in the study. The NLR before and after catheter ablation was determined. Cox regression analyses were used to estimate the relationship between NLR and the recurrence of lone AF.Results After a mean follow-up of(30.5±5.3) months, 124(32.7%) patients had AF recurrences. The patients who developed AF recurrence had a higher postablation NLR(post-NLR) than patients with no recurrence(5.74±1.55 vs. 4.66±1.27, P <0.001). Multivariate Cox regression analysis revealed that post-NLR(hazard ratio(HR) 1.514, 95% confidence interval(CI) 1.364–1.680, P <0.001), left atrium diameter(HR 1.035, 95% CI 1.001–1.071, P=0.04) and body mass index(HR 1.028, 95% CI 1.002–1.054, P=0.03) were independent predictors of AF recurrence. Using a cut-off level of 5.15, post-NLR predicted AF recurrence with a sensitivity of 73% and specificity of 67%.Conclusions Our results indicate that an elevated post-NLR is associated with a high rate of lone AF recurrence. A simple measurement of NLR may help us to identify high-risk patients who need pharmacologic intervention to prevent recurrence.

关键词： atrial fibrillation catheter ablation neutrophil lymphocyte ratio

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Rationale and Study Design for Evaluating the Efficacy and Safety of Intracardiac Echocardiography-Guided Minimal-Fluoroscopy Ablation in Patients with Paroxysmal Atrial Fibrillation:A Non-Inferior,Multi-Center,Prospective Randomized Controlled Trial(PAF-ICE Trial)

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Cardiology Discovery 2021年第4期1卷 228-232页

作者： Ruhong Jiang Xingpeng Liu Jidong Zhang Yu Chen Rui Wang Mengzuo Wu deyong long Jia Li Haixiong Wang Jie Fan Weizhu Ju Weili Ge Xu Liu Hai Deng Weijian Wang Pingzhen Yang Ding Li Xiaobo Huang Xiongtao Liu Hailong Tao Paul CZei Roderick Tung Xunzhang Wang Chenyang Jiang Department of Cardiology Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310016China Cardiac Center Beijing Chaoyang Hospital Affiliated to Capital Medical UniversityBeijing 100043China Department of Sixth Cardiovascular Medicine The Second Hospital of Hebei Medical UniversityShijiazhuangHebei 050004China Department of Cardiology Sichuan Provincial People’s HospitalChengduSichuan 610072China Department of Cardiology First Hospital of Shanxi Medical UniversityTaiyuanShanxi 030001China Department of Cardiology The First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui 230022China Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China Department of Cardiology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325027China Department of Cardiology Shanxi Cardiovascular HospitalTaiyuanShanxi 030024China Division of Cardiology The First Peoples’Hospital of Yunnan ProvinceKunmingYunnan 650034China Division of Cardiology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Cardiology Taizhou Hospital of Zhejiang ProvinceTaizhouZhejiang 317000China Department of Cardiology Shanghai Chest HospitalShanghai 200030China Department of Cardiology Guangdong Provincial People’s HospitalGuangzhouGuangdong 510180China Department of Cardiology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325035China Department of Cardiology Zhujiang HospitalSouthern Medical UniversityGuangzhouGuangdong 510260China Department of Cardiology Peking University People’s HospitalBeijing 100044China Department of Cardiology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China Department of Cardiology Tangdu Hospital of Air Force Military Medical UniversityXi’anShaanxi 710038China Department of Cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHena

The feasibility and safety of intracardiac echocardiography(ICE)-guided catheter ablation for atrial fibrillation(AF)using a minimal/zero-fluoroscopy approach have recently been reported.This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons.The objectives of this planned prospective,multicenter randomized controlled trial(RCT)(paroxysmal AF(PAF)-ICE trial;ChiCTR2000033624)are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.Patients will be randomized in a 1:1 ratio to 2 groups:minimal fluoroscopy group(n=216)and traditional approach group(n=216).In the minimal fluoroscopy group,an ICE catheter will be used for geometry/anatomic construction,transseptal puncture,catheter tracking,and effusion monitoring.Pulmonary vein isolation(PVI)will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter(Biosense Webster,Diamond Bar,California,USA),and confirmed by a multipolar Lasso or PentaRay catheter(Biosense Webster).In the traditional approach group,an ICE catheter will not be used.Transseptal puncture will be performed under fluoroscopic guidance,with all geometries constructed by mapping the catheters.The primary efficacy endpoint is freedom from AF recurrence(without antiarrhythmic medications)at 12months after ablation.Other endpoints include duration of lead apron use,measures of intra-procedural efficiency,and peri-procedural complications.This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF,also evaluate the benefits to lab staff(regarding reducing occupational hazards)related to this“minimal/zero-fluoroscopy”and“leadless”mode.

关键词： Atrial fibrillation Catheter ablation Intracardiac echocardiography Radiofrequency ablation

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Emergency pericardiocentensis with two-pigtail technique in a patientwith cardiac tamponade during atrial fibrillation ablation

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Chinese Medical Journal 2014年第6期127卷 1185-1186页

作者： Guo Lizhu Jiang Chenxi Bai Rong long deyong Yu Ronghui Dong Jianzeng Ma Changsheng Department of Cardiology Center for Atrial Fibrillation Beijing Anzhen Hospital Capital Medical University

Acute cardiac tamponade is a life threateningcomplication of interventional procedures usuallyrequiring immediate management.Open-chest surgeryis needed occasionally when emergency percutaneous

关键词： atrial fibHllation pericardial tamponade ablation

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