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Stable ischemic heart disease in the older adults

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Journal of Geriatric Cardiology 2016年第2期13卷 109-114页

作者： xuming dai Jan Busby-Whitehead Daniel E Forman Karen P Alexander Division of Cardiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA Division of Geriatric Medicine Center for Aging and Health University of North Carolina at Chapel Hill North Carolina USA Section of Geriatric Cardiology University of Pittsburgh Medical Center Geriatrics Research Education and Clinical Center VA Pittsburgh Healthcare System Pittsburgh PA USA Division of Cardiology Duke University Medical Center Durham North Carolina USA

1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.

关键词： Aging Coronary artery disease Older adults Risk assessment Stable ischemic heart disease

Plaque herniation after stenting the culprit lesion with myocardial bridging in ST elevation myocardial infarction: A case report

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World Journal of Cardiology 2020年第2期12卷 91-96页

作者： Jeffrey Ma Gregory M Gustafson xuming dai Division of Cardiology Theresa and Eugene M.Lang Center for Research and Education New York Presbyterian–Queens Hospital

BACKGROUND Myocardial bridging(MB)is increasingly recognized to stimulate atherogenesis,which may contribute to an acute coronary *** the coronary segment with MB has been recognized to have an increased risk of in-stent restenosis,stent fracture and coronary *** safety and efficacy of stenting the culprit lesion with overlaying MB in ST elevation myocardial infarction(STEMI)as primary reperfusion therapy has not been *** SUMMARY We reported a patient who presented with inferior STEMI with a culprit lesion of an acute thrombotic occlusion in the right coronary artery and thrombolysis and thrombin inhibition in myocardial infarction 0 *** the stent placement during primary percutaneous coronary intervention,intravascular ultrasound revealed MB overlying the stented segment where heavy atherosclerotic plaque were *** due to the combination of plaque herniation or prolapse caused by MB,as well as local increased inflammation and thrombogenicity,acute stent thrombosis occurred at this region,which led to acute stent *** patient required an emergent repeated cardiac catheterization and placing a second layer of stent to enhance the radial strength and reduce the inter-strut *** Plaque herniation or prolapse after stenting a MB segment in STEMI is a potential etiology for acute stent failure.

关键词： Case report ST elevation myocardial infarction Myocardial bridging Plaque herniation Plaque prolapse Intravascular ultrasound Acute stent thrombosis

Cardiovascular physiology in the older adults

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Journal of Geriatric Cardiology 2015年第3期12卷 196-201页

作者： xuming dai Scott L Hummel Jorge B Salazar George E Taffet Susan Zieman Janice B Schwartz Division of Cardiology University of North Carolina at Chapel Hill Chapel Hill NC USA Division of Cardiovascular Medicine Department of Medicine University of Michigan Ann Arbor Ml Ann Arbor Veterans Affairs Health System Ann Arbor M1 USA Division of Cardiology Mayo Clinic Rochester MN USA Division of Geriatrics Geriatrics and Cardiovascular Sciences Houston Methodist Hospital Baylor College of'Medicine Houston TX USA Division of Geriatrics and Clinical Gerontology National Institute of Aging Bethesda ME) USA Divisions of Geriatrics and Clinical Pharmacology Department of Medicine University of California San Francisco CA USA

1 Introduction In an aging society with persistent high prevalence of cardiovascular disease （CVD） in the elderly population, the health care system is facing an increasing challenge to effectively care for these patients. However, due to the under-representation of CVD patients over 75 years of age in clinical trials, assessing safety and efficacy of diagnostic and therapeutic approaches, the evidence for managing elderly CVD patients is especially limited. Physiological changes of aging intertwined with pathophysiology of CVD, and comorbid conditions often complicate clinical management.

关键词： Aging Cardiovascular disease Left ventricular

Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

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World Journal of Cardiology 2020年第6期12卷 269-284页

作者： Fatima A Shaik David J Slotwiner Gregory M Gustafson xuming dai Division of Cardiology New York Presbyterian Queens HospitalFlushingNY 11355United States

BACKGROUND Cardiac catheterization is among the most performed medical procedures in the modern *** were sporadic reports indicating that cardiac arrhythmias are common during cardiac catheterization,and there are risks of developing serious and potentially life-threatening arrhythmias,such as sustained ventricular tachycardia(VT),ventricular fibrillation(VF)and high-grade conduction disturbances such as complete heart block(CHB),requiring immediate ***,there is lack of systematic overview of these *** To systematically review existing literature and gain better understanding of the incidence of cardiac arrhythmias during cardiac catheterization,and their impact on outcomes,as well as potential approaches to minimize this *** We applied a combination of terms potentially used in reports describing various cardiac arrhythmias during common cardiac catheterization procedures to systematically search PubMed,EMBASE and Cochrane databases,as well as references of full-length *** During right heart catheterization(RHC),the incidence of atrial arrhythmias(premature atrial complexes,atrial fibrillation and flutter)was low(<1%);these arrhythmias were usually transient and *** associated with the development of a new RBBB at a rate of 0.1%-0.3%in individuals with normal conduction system but up to 6.3%in individuals with pre-existing left bundle branch *** patients may require temporary pacing due to transient *** premature ventricular complexes or non-sustained VT are common during RHC(up to 20%of cases).Sustained ventricular arrhythmias(VT and/or VF)requiring either withdrawal of catheter or cardioversion occurred infrequently(1%-1.3%).During left heart catheterizations(LHC),the incidence of ventricular arrhythmias has declined significantly over the last few decades,from 1.1%historically to 0.1%*** overall reported rate of VT/VF in diagnostic LHC and coronary angiography is 0.8

关键词： Catheterization Coronary angiography Percutaneous coronary intervention Ventricular fibrillation Ventricular tachycardia

Cardiac implications of thrombotic thrombocytopenic purpura

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World Journal of Cardiology 2018年第12期10卷 254-266页

作者： Szymon L Wiernek Bo Jiang Gregory M Gustafson xuming dai Division of Cardiology McAllister Heart Institute University of North Carolina at Chapel Hill Division of Cardiology Lang Research Center New York Presbyterian Medical Group–Queens Hospital

Thrombotic thrombocytopenic purpura(TTP) is a multisystem disorder that essentially can affect any organ in the human body. The hallmark of the pathogenesis in TTP is the large von Willebrand factor multimers on plateletmediated micro-thrombi formation, leading to microvascular *** studies showed that cardiac arrest and myocardial infarction are the most common immediate causes of death in these patients. Clinical manifestations of cardiac involvement in TTP vary dramatically, from asymptomatic elevation of cardiac biomarkers, to heart failure, MI and sudden cardiac death. There is limited knowledge about optimal cardiac evaluation and management in patients with TTP. The absence of typical cardiac symptoms,combined with complicated multi-organ involvement in TTP, may contribute to the under-utilization of cardiac evaluation and treatment. Prompt diagnosis and timely initiation of effective therapy could be critically important in selected cases. Based on our experience and this review of the literature, we developed several recommendations for focused cardiac evaluation for patients with acute TTP:(1) patients with suspected or confirmed TTP should be screened for the potential presence of cardiac involvement with detailed history and physical,electrocardiogram and cardiac enzymes;(2) clinical deterioration of TTP patients warrants immediate cardiac reevaluation;(3) TTP patients with clinical evidence of cardiac involvement should be monitored for telemetry, cardiac biomarkers and evaluated with transthoracic echocardiography. These patients require urgent targeted TTP treatment as well as cardiac-specific treatment. Aspirin therapy is indicated for all TTP patients. Since epicardial coronary artery involvement is rare, cardiac catheterization is usually not required, given the high risk for hemorrhage and kidney injury;(4) we recommend evidence-based medical therapy for ischemic symptoms and heart failure. TTP patients with evidence of cardiac invol

关键词： Thrombotic thrombocytopenic purpura Acute myocardial infarction Coronary artery disease Anti-platelet therapy von Willebrand factor ADAMTS13

Genetics of coronary artery disease and myocardial infarction

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World Journal of Cardiology 2016年第1期8卷 1-23页

作者： xuming dai Szymon Wiernek James P Evans Marschall S Runge Division of Cardiology University of North Carolina at Chapel Hill Department of Genetics University of North Carolina at Chapel Hill

Atherosclerotic coronary artery disease(CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial infarction(MI) and sudden cardiac death. CAD continues to be the leading cause of death in industrialized society. The long-recognized familial clustering of CAD suggests that genetics plays a central role in its development, with the heritability of CAD and MI estimated at approximately 50% to 60%. Understanding the genetic architecture of CAD and MI has proven to be difficult and costly due to the heterogeneity of clinical CAD and the underlying multi-decade complex pathophysiological processes that involve both genetic and environmental interactions. This review describes the clinical heterogeneity of CAD and MI to clarify the disease spectrum in genetic studies, provides a brief overview of the historical understanding and estimation of the heritability of CAD and MI, recounts major gene discoveries of potential causal mutations in familial CAD and MI, summarizes CAD and MIassociated genetic variants identified using candidate gene approaches and genome-wide association studies(GWAS), and summarizes the current status of the construction and validations of genetic risk scores for lifetime risk prediction and guidance for preventive strategies. Potential protective genetic factors against the development of CAD and MI are also discussed. Finally, GWAS have identified multiple genetic factors associated with an increased risk of in-stent restenosis following stent placement for obstructive CAD. This review will also address genetic factors associated with in-stent restenosis, which may ultimately guide clinical decision-making regarding revascularization strategies for patients with CAD and MI.

关键词： Coronary artery disease Myocardial infarction In-stent restenosis Genetics Heritability Genome-wide association study Atherosclerosis

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转基因的分子生物学特性

生物化学与生物物理进展 1996年第2期23卷 137-141页

作者：戴旭明潘星华傅继梁第二军医大学生物学教研室

现代分子生物学研究中，转基因概念的出现越来越频繁，它渐渐被用来表示所有的用基因工程手段构建、导入高等真核生物细胞，并稳定地整合入受体基因组的外源ＤＮＡ．文章较系统地总结了已见报道的转基因的结构类型、它在受体细胞内的遗... 详细信息

现代分子生物学研究中，转基因概念的出现越来越频繁，它渐渐被用来表示所有的用基因工程手段构建、导入高等真核生物细胞，并稳定地整合入受体基因组的外源ＤＮＡ．文章较系统地总结了已见报道的转基因的结构类型、它在受体细胞内的遗传学行为、表达特性和影响因素及其相应的生物学效应；分析了转基因研究中尚待研究的问题。

关键词：转基因分子生物学转基因生物

Construction and application of gene targeting replacement vector formouse coagulation factor IX gene

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Journal of Medical Colleges of PLA(China) 1998年第2期13卷 106-110页

作者： dai xuming’ Xue Hong Yang Hual Hu Yiping’ Fu Jiliang (Open Laboratory of Medical Molecular Genetics, Department of Basic Medicine Science, Second MilitaryMedical University, Shanghai, 200433)(Department of Biochemistry, hong Kong University of Scienc

Objective: To construct and apply a replacement targeting vector for mouse coagulation factor IX(mFIX) gene in embryonic stem (ES) cells. Methods: Based on the cloning and structural analysis of the genomic DNA fragment of coagulation factor IX gene from 129Sv mouse genomic DNA A phage library, PMFIXDEL plasmid was designed with positive-negative-selection (PNS) strategy, and constructed with commonmolecular cloning techniques. Structure of PMFIXDEL was identified by PCR and restriction analysis. Afterelectroporation with the linearized PMFIXDEL DNA, transfected ES cells were cultured in G418/GANC drugselection medium. The recombination efficacy of this vector was tested. Results: The main components ofPMFIXDEL were two copies of negative selection gene (HSV-tk expression cassette), a positive selectiongene (Neo expression cassette), long and short homologous fragments and plasmid backbone. The introduction of negative selection gene (HSV-tk ) into the construct resulted in 24-fold increase of ***: An effective replacement vector for mFIX gene targeting was constructed and applied in ES cell.

关键词： gene targeting embryonic stem cells replacement vector hemophilia B coagulation factor IX gene

聚(N-异丙基丙烯酰胺)/海藻酸钠/黏土复合水凝胶的制备及其性能

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化工进展 2009年第4期28卷 661-664页

作者：代旭明刘鑫马敬红东华大学纤维材料改性国家重点实验室上海201620

以无机黏土为交联剂制备了聚(N-异丙基丙烯酰胺)/海藻酸钠/黏土(PINPA/SA/clay)复合水凝胶,通过红外光谱、X射线衍射和SEM对凝胶的结构和形态进行了表征,并研究了凝胶的溶胀动力学和力学性能。结果表明:黏土的结晶结构已被破坏,黏土规... 详细信息

以无机黏土为交联剂制备了聚(N-异丙基丙烯酰胺)/海藻酸钠/黏土(PINPA/SA/clay)复合水凝胶,通过红外光谱、X射线衍射和SEM对凝胶的结构和形态进行了表征,并研究了凝胶的溶胀动力学和力学性能。结果表明:黏土的结晶结构已被破坏,黏土规整的片层被剥离并在凝胶中无序分布,起到交联剂的作用;随黏土含量的增加,凝胶网络交联密度增加,孔洞的孔径减小,溶胀速度下降。另外,PINPA/SA/clay凝胶显示了良好的力学性能,断裂伸长率超过1000%。

关键词：聚(N-异丙基丙烯酰胺) 海藻酸钠黏土溶胀性能力学性能