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Journal of Systematics and Evolution 2011年第5期49卷 379-385页

作者： Bing han xiao-fan WANG Shuang-Quan HUANG(College of Life Sciences,Wuhan University,Wuhan 430072,China) (College of Life Sciences Wuhan University Wuhan 430072 China)

It has been proposed that relative allocation to female function increases with plant size in animalpollinated *** investigations in several monoecious Sagittaria species seem to run contrary to the prediction of size-dependent sex allocation(SDS),throwing doubt on the generalization of *** size,phenotypic gender,and flower production were measured in experimental populations of an aquatic,insect-pollinated herb Sagittaria trifolia(Alismataceae) under highly different *** comparison of ramets produced clonally can reduce confounding effects from genetic and environmental *** the high-density population,48% of ramets were male without female flowers,but in the low-density population all ramets were *** observed allometric growth in reproductive allocation with ramet size,as evident in biomass of reproductive structures and number of ?***,within both populations female and male flower production were isometric with ramet size,in contrast to an allometric growth in femaleness as predicted by *** gender was not related to ramet size in either *** results indicated that large plants may increase both female and male function even in animal-pollinated plants,pointing towards further studies to test the hypothesis of size-dependent sex allocation using different allocation currencies.

关键词： Alismataceae clonal reproduction ?ower production insect-pollinated monoecious Sagittaria trifolia size-dependent sex allocation.

Plasma big endothelin-1 is an effective predictor for ventricular arrythmias and end-stage events in primary prevention implantable cardioverter-defibrillator indication patients

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Journal of Geriatric Cardiology 2020年第7期17卷 427-433页

作者： xiao-Yao LI Shuang ZHAO xiao-han fan Ke-Ping CHEN Wei HUA Zhi-Min LIU xiao-Di XUE Bin ZHOU Shu ZhanG Arrhythmia Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods In total, 207 patients fulfilling the inclusion criteria from Fuwai Hospital between January 2013 and December 2015 were retrospectively analyzed. The cohort was divided into three groups according to baseline plasma big ET-1 tertiles: tertile 1( 0.7 pmol/L, n = 70). The primary endpoints were VAs. The secondary endpoints were end-stage events comprising all-cause mortality and heart transplantation. Results During a mean follow-up period of 25.6 ± 13.9 months, 38(18.4%) VAs and 78(37.7%) end-stage events occurred. Big ET-1 was positively correlated with NYHA class(r = 0.165, P = 0.018), serum creatinine concentration(Scr;r = 0.147, P = 0.034), high-sensitivity C-reactive protein(hs-CRP;r = 0.217, P = 0.002), Lg NT-pro BNP(r = 0.463, P < 0.001), left ventricular end diastolic diameter(LVEDD;r = 0.234, P = 0.039) and negatively correlated with left ventricular ejection fraction(LVEF;r =-0.181, P = 0.032). Kaplan-Meier analysis showed that elevated big ET-1 was associated with increased risk of VAs and end-stage events(P < 0.05). In multivariate Cox regression models, big ET-1 was an independent risk factor for VAs(hazard ratio(HR) = 3.477, 95% confidence interval(CI): 1.352–8.940, P = 0.010, tertile 2 vs. tertile 1;HR = 4.112, 95% CI: 1.604–10.540, P = 0.003, tertile 3 vs. tertile 1) and end-stage events(HR = 2.804, 95% CI: 1.354–5.806, P = 0.005, tertile 2 vs. tertile 1;HR = 4.652, 95% CI: 2.288–9.459, P < 0.001, tertile 3 vs. tertile 1). Conclusions In primary prevention ICD indication patients, plasma big ET-1 levels can predict VAs and end-stage events and may facilitate ICD-implantation risk stratification.

关键词： Big endothelin-1 End-stage events Implantable cardioverter-defibrillator implantation Primary prevention Ventricular arrythmias

Predictors of super-response to cardiac resynchronization therapy： the significance of heart failure medication, pre-implant left ventricular geometry and high percentage of biventricular pacing

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Journal of Geriatric Cardiology 2017年第12期14卷 737-742页

作者： han JIN Min GU Wei HUA xiao-han fan Hong-Xia NIU Li-Gang DING Jing WANG Cong XUE Shu ZhanG The Cardiac Arrhythmia Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

Background Super-responders （SRs） are defined as patients who show crucial cardiac function improvement after cardiac resynchro- nization therapy （CRT）. The purpose of this study is to identify and validate predictors of SRs after CRT. Methods This study enrolled 201 patients who underwent CRT during the period from 2010 to 2014. Clinical and echocardiographic evaluations were conducted before CRT and 6 months after. Patients with a decrease in New York Heart Association （NYHA） fimctional class 〉 1, a decrease in left ventricular end-systolic volume （LVESV） ≥ 15%, and a final left ventricular ejection fraction （LVEF） ≥ 45% were classified as SRs. Results 29% of the 201 patients who underwent CRT were identified as SRs. At baseline, SRs had significantly smaller left atrial diameter （LAD）, LVESV, left ventricular end-diastolic volume （LVEDV） and higher LVEF than the non-super-responders （non-SRs）. The percentage of patients using angiotensin-converting enzyme inhibitors or angiotensin receptor blockers （ACEI/ARB） was higher in SRs than non-SRs. Most SRs had Biventricular （BiV） pacing percentage greater than 98% six months after CRT. In the multivariate logistic regression analysis, the independ- ent predictors of SRs were lower LVEDV [odd ratios （OR）： 0.93; confidence intervals （CI）： 0.90-0.97], use of ACEI/ARB （OR： 0.33; CI： 0.13~3.82） and BiV pacing percentage greater than 98% （OR： 0.29; CI： 0.16~.87）. Conclusion Patients with a better compliance of ACEI/ARB and a less ectatic ventricular geometry before CRT tends to have a greater probability of becoming SRs. Higher percentage of BiV pacing is essential for becoming SRs.

关键词： Biventricular pacing Cardiac resynchronization therapy Heart failure Super-responders

Does ‘super-responder’ patients to cardiac resynchronization therapy still have indications for neuro-hormonal antagonists? Evidence from long-term follow-up in a single center

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Journal of Geriatric Cardiology 2019年第3期16卷 251-258页

作者： Yi-Ran HU Wei HUA han JIN Min GU xiao-han fan Hong-Xia NIU Li-gang DING Jing WANG Shu ZhanG Cardiac Arrhythmia Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Whether cardiac resynchronization therapy super-responders (CRT-SRs) still have indications for neuro-hormonal antagonists or not remains *** We reviewed clinical data from 376 patients who underwent CRT implantation in Fuwai Hospital from 2009 to 2015 and followed up to ***-SRs were defined by an improvement of the New York Heart Association functional class and left ventricular ejection fraction to ≥ 50% in absolute values at 6-month *** CRT-SRs were assigned into two groups on the basis of whether persistently receiving neuro-hormonal antagonists (NHA)(defined as angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers and β-blockers) after 6-month follow-up and then we compared long-term *** A total of 60 patients met criteria for *** of thirteen (7.7%) CRT-SRs without NHA had all-cause death,which also occurred in 2 of 47 (4.3%) in CRT-SRs with NHA (P = 0.526).However,3 of 13 (23.1%) CRT-SRs without NHA had heart failure (HF) hospitalization,1 of 47 (2.1%) CRT-SRs with NHA had this endpoint (P = 0.040).Besides,subgroup analysis indicated that,for ischemic etiology group,CRT-SRs receiving NHA had considerably lower incidence of HF hospitalization than those without NHA (0 vs.75%,P = 0.014),which was not observed in non-ischemic etiology group (2.6% vs.0,P = 1.000) during long-term *** Our study found that for ischemic etiology,compared with CRT-SRs with NHA,CRT-SRs without NHA were associated with a higher risk of HF ***,for non-ischemic etiology,we found that CRT-SRs with NHA or without NHA at follow-up were associated with similar outcomes,which needed further investigation by prospective trials.

关键词： Cardiac resynchronization therapy Heart failure Super-responder Optimal medical therapy

Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy

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Journal of Geriatric Cardiology 2017年第4期14卷 238-244页

作者： Min GU han JIN Wei HUA xiao-han fan Hong-Xia NIU Tao TIAN Li-Gang DING Jing WANG Cong XUE Shu ZhanG Cardiac Arrhythmia Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

Backgrounds Clinical trials have demonstrated that cardiac resynchronization therapy （CRT） is effective in patients with ＂non-is- chemic cardiomyopathy＂. However, patients with dilated-phase hypertrophic cardiomyopathy （DHCM） have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy （IDCM）, or ischemic cardiomyopathy （ICM）. Methods A total of 312 consecutive patients （DHCM： n = 16; IDCM： n = 231; ICM： n = 65） undergoing CRT in Fuwai hospital were studied respectively. Response to CRT was defmed as reduction in left ventricular end-systolic volume （LVESV） _〉 15% at 6-month follow-up. Results Compared with DHCM, IDCM was associated with a lower total mortality （HR： 0.35, 95% CI： 0.13-0.90）, cardiac mortality （HR： 0.29; 95% CI： 0.11-0.77）, and total mortality or heart failure （HF） hospitalizations （HR： 0.34, 95% CI： 0.17-0.69）, independent of known confounders. Compared with DHCM, the total mortality, cardiac mortality and total mortality or HF hospitalizations favored ICM but were not statistically significant （HR： 0.59, 95% CI： 0.22-1.61; HR： 0.59, 95% CI： 0.21-1.63; HR： 0.54, 95% CI： 0.26-1.15; respectively）. Response rate to CRT was lower in the DHCM group than the other two groups although the differences didn＇t reach statistical significance. Conclusions Compared with IDCM, DHCM was associated with a worse outcome after CRT. The clinical outcome of DHCM patients receiving CRT was similar to or even worse than that of ICM patients. These indicate that DHCM behaves very differently after CRT.

关键词： Cardiac resynchronization therapy Dilated-phase hypertrophic cardiomyopathy Idiopathic dilated cardiomyopathy Ischemic cardiomyopathy

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

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Journal of Geriatric Cardiology 2017年第1期14卷 49-56页

作者： Zhao-Ran CHEN Bi HUANG Hai-Song LU Zhen-Hua ZHAO Ru-Tai HUI Yan-Min YANG xiao-han fan State Key Laboratory of Cardiovascular Disease Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Stale Key Laboratory of Cardiovascular Disease Department of Cardiovascular Anesthesiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China State Key Laboratory of Cardiovascular Disease Department of Cardiovascular Surgery Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

Objectives Inflammation has been shown to be related with acute aortic dissection （AAD）. The present study aimed to evaluate the association of white blood cell counts （WI3Cc） on admission with both in-hospital and long-term all-cause mortality in patients with uncom- plicated Stanford type B AAD. Methods From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. Results The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L （all P 〈 0.05）. After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio （HR）： 1.052, 95% CI： 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L （HR： 2.056, 95% CI： 1.673-5.253, P = 0.034）. No relationship was observed between WBCc on admission and long-term all-cause death. Conclusions Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.

关键词： Acute aortic dissection In-hospital mortality Stanford type B Survival White blood cell

Differential expression of microRNAs in aortic tissue and plasma in patients with acute aortic dissection

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Journal of Geriatric Cardiology 2015年第6期12卷 655-661页

作者： xiao-Jian WANG Bi HUANG Yan-Min YANG Liang ZhanG Wen-Jun SU Li TIAN Tian-Yi LU Shu ZhanG xiao-han fan Ru-Tai HUI State Key Laboratory of Cardiovascular Disease Sino-German Laboratory for Molecular Medicine Fuwai Hospital National Center for CardiovascularDiseases Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China State Key Laboratory of Cardiovascular Disease Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Acad-emy of Medical Sciences & Peking Union Medical College Beijing China State Key Laboratory of Cardiovascular Disease Department of Cardiovascular Surgery Fuwai Hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College Beijing China

Background Biomarker-assisted diagnosis of acute aortic dissection （AAD） is important for diagnosis and treatment. However, identification of biomarkers for AAD in blood is a challenging task. The aim of this study is to search for new potentially microRNA （miRNAs） biomarkers in AAD. Methods The miRNAs expression profiles in ascending aortic tissue and plasma were examined by microarray analysis in two sets or groups. The tissue group was composed of four patients with AAD and four controls of healthy male organ donors. The plasma group included 20 patients with AAD and 20 controls without cardiovascular disease. Bioinformatics was used to analyze the poten- tial targets of the differentially expressed miRNAs. Results Our study revealed that in AAD patients, the aortic tissue had 30 differentially expressed miRNAs with 13 up-regulated and 17 down-regulated, and plasma had 93 differentially expressed miRNAs, of which 33 were up-regulated and 60 were down-regulated. Four miRNAs were found to be up-regulated in both aortic tissue and plasma in AAD patients. The predicted miRNA targets indicated the four dysregulated miRNAs mainly targeted genes that were associated with cell-cell adhesion, extracellular matrix metabolism, cytoskeleton organization, inflammation, and multiple signaling pathways related to cellular cycles. Con- clusions Four miRNAs, which are up-regulated both in aortic tissue and in plasma in AAD patients, have been identified in this study. These miRNAs might be potential diagnostic biomarkers for AAD. Larger sample investigations are needed for further verification.

关键词： Acute aortic dissection Biomarker Diagnosis MicroRNAs

Predictors of non-response to cardiac resynchronization therapy implantation in patients with class Ⅰ indications: the markedly dilated left ventricular end-diastolic dimension and the presence of fragmented QRS

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Journal of Geriatric Cardiology 2019年第7期16卷 514-521页

作者： Yi-Ran HU Wei HUA Sheng-Wen YANG Min GU Hong-Xia NIU Li-Gang DING Jing WANG Ran JING xiao-han fan Shu ZhanG State Key Laboratory of Cardiovascular Disease Arrhythmia CenterFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background Cardiac resynchronization therapy(CRT)is a highly effective treatment in patients with a class I ***,a small proportion of the strictly selected patients still fail to *** study was designed to identify predictors of non-response in patients with class I indications for CRT and determine the non-response probability of the *** A total of 296 consecutive patients with a class I recommendation received CRT from January 2009 to January 2017 were retrospectively *** logistic regression analysis was performed to identify predictors for non-response(defined as cardiac death,heart transplantation,or HF hospitalization during 1-year follow-up).Results Among 296 patients,30(10.1%)met *** analysis demonstrated that non-response to CRT was associated with a fragmented QRS(odd ratio(OR)=2.86,95%CI:1.14–7.12;P=0.025)and left ventricular end-diastolic dimension(LVEDD)≥77 mm(OR=3.02,95%CI:1.17–7.82;P=0.022).Patients with both of the predictors had a non-response probability of 46.2%(95%CI:19.1%–73.3%).Conclusion In patients with left bundle branch block and wider QRS duration,the proportion of non-response to CRT is not low in real *** presence of the dilated LVEDD or fragmented QRS is a strong predictor of non-response to *** probability of non-response in the patients with the two predictors was 46.2%.

关键词： Cardiac resynchronization therapy Class I indication Non-response Predictors

Heart rate-adjusted PR as a prognostic marker of long-term ventricular arrhythmias and cardiac death in ICD/CRT-D recipients

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Journal of Geriatric Cardiology 2019年第3期16卷 259-264页

作者： Yu-Qiu LI Shuang ZHAO Ke-Ping CHEN Yang-Gang SU Wei HUA Si-Lin CHEN Zhao-Guang LIANG Wei XU Yan DAI xiao-han fan Shu ZhanG State Key Laboratory of Cardiovascular Disease Arrhythmia CenterFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Shanghai Institute of Cardiovascular DiseasesZhongshan HospitalFudan UniversityShanghaiChina Department of Cardiology Guangdong Cardiovascular InstituteGuangdong General HospitalGuangzhouChina Department of Cardiology First Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of Cardiology Nanjing Drum Tower HospitalNanjingChina

Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-D).Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home *** PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph,and the PR/RR was *** primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias (VAs),and the secondary endpoint was cardiac *** During a mean follow-up period of 38.8 ± 10.6 months,197 patients (46%) experienced VAs,and 47 patients (11%) experienced cardiac *** overall PR interval was 160 ± 40 ms,and the RR interval was 866 ± 124 *** on the receiver operating characteristic curve,a cut-off value of 18.5% for the PR/RR was identified to predict VAs.A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio (HR)= 2.243,95% confidence interval (CI)= 1.665–3.022,P < 0.001) and cardiac death (HR = 2.358,95%CI = 1.240–4.483,P = 0.009) in an unadjusted *** adjustment in a multivariate Cox model,the relationship remained significant among PR/RR ≥ 18.5%,VAs (HR = 2.230,95%CI = 1.555–2.825,P < 0.001) and cardiac death (HR = 2.105,95%CI = 1.101–4.025,P = *** A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.

关键词： Implantable cardioverter defibrillator PR interval RR interval Ventricular arrhythmias

Association of time-varying changes in physical activity with cardiac death and all-cause mortality after ICD or CRT-D implantation

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Journal of Geriatric Cardiology 2022年第3期19卷 177-188页

作者： Xue-Rong SUN Chen-Di CHENG Bin ZHOU Shuang ZHAO Ke-Ping CHEN Wei HUA Yan-Gang SU Wei XU fang WANG xiao-han fan Yan DAI Zhi-Min LIU Shu ZhanG Arrhythmia Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Laboratory of Heart CenterZhujiang HospitalSouthern Medical UniversityGuangzhouChina Department of Cardiology Shanghai Institute of Cardiovascular DiseasesZhongshan HospitalFudan UniversityShanghaiChina Department of Cardiology Nanjing Drum Tower HospitalNanjingChina Department of Cardiology Shanghai First People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

OBJECTIVE To evaluate the association of longitudinal changes in physical activity(PA)with long-term outcomes after im-plantable cardioverter-defibrillator(ICD)or cardiac resynchronization therapy defibrillator(CRT-D)*** Patients with ICD/CRT-D implantation from SUMMIT registry were retrospectively ***-de-rived PA changes over 12 months post implantation were obtained from the archived home monitoring *** primary end-points were cardiac death and all-cause *** secondary endpoints were the first ventricular arrthymia(VA)and first ap-propriate ICD *** In 705 patients,446(63.3%)patients showed improved PA over 12 months after *** a mean 61.5-month follow-up duration,99 cardiac deaths(14.0%)and 153 all-cause deaths(21.7%)*** to reduced/un-changed PA,improved PA over 12 months could result in significantly reduced risks of cardiac death(improved PA≤30 min:hazard ratio(HR)=0.494,95%CI:0.288−0.848;>30 min:HR=0.390,95%CI:0.235−0.648)and all-cause mortality(improved PA≤30 min:HR=0.467,95%CI:0.299−0.728;>30 min:HR=0.451,95%CI:0.304−0.669).No differences in the VAs or ICD shocks were observed across different groups of PA *** changes can predict the risks of cardiac death only in the low baseline PA group,but improved PA was associated with 56.7%,57.4%,and 62.3%reduced risks of all-cause mortality in the low,moderate,and high baseline PA groups,respectively,than reduced/unchanged *** Improved PA could protect aganist cardiac death and all-cause mortality,probably reflecting better clinical efficacy after ICD/CRT-D ***-intensity exercise training might be encouraged among patients with different baseline PA levels.

关键词： cardiac mortality implantation