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Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensinaldosterone system

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Journal of Geriatric Cardiology 2016年第4期13卷 333-343页

作者： ze-ning jin Yong-Xiang WEI Emergency Center Beijing Anzhen Hospital Capital Medical University Beijing China Department of Otolaryngology Beijing Anzhen Hospital Capital Medical University Beijing China

Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed the effects of OSA on plasma levels of RAAS components. Methods Full-text studies published on MEDL1NE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index 〉 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the 12 statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed. Results The meta-analysis included 13 studies, of which 10 reported results on renin （n = 470 cases and controls）, 7 on angiotensin II （AnglI, n = 384）, and 9 on aldosterone （n = 439）. AnglI levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI： 2.00-4.79, P 〈 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension （mean differences = 1.32 ng/dL, 95% CI： 0.58-2.07, P = 0.0005）. Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL （95% CI： 0.88-1.82, P 〈 0.00001） emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies. Conelusions OSA is associated with higher AnglI and aldosterone levels, espe- cially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.

关键词： Hypertension Obstructive sleep apnea Renin-angiotensin-aldosterone system

Guiding extension catheter facilitated percutaneous coronary intervention for a dextrocardia patient with acute left anterior descending artery occlusion:a case report

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Journal of Geriatric Cardiology 2020年第12期17卷 790-792页

作者： jing NAN Shuai MENG Ya-Li TIAN Tong ZHANG Rui WANG Shao-Bin WEI ze-ning jin Department of Cardiology and Macrovascular Disease Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Tiantan Neuroimaging Center of Excellence Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina

Dextrocardia refers to a right-sided location of the heart within the thoracic cavity which is the primary manifestation of the abnormal lateralisation of the embryonic leftright axis.[1]As a rare cardiac malformation,the prevalence rate of dextrocardia is between 1/6000 to 1/35000 live births.[2]It is reported that the incidence rate of coronary artery disease for dextrocardia patients is similar for patients without ***,the detailed information including electrocardiogram(ECG)manifestation and percutaneous coronary intervention(PCI)technique for dextrocardia patients is still limited.[3,4]Herein,we report a dextrocardia patient who was diagnosed by modified ECG and treated by trans-radial PCI facilitated with guiding extension catheter(GEC).

关键词： Dextrocardia Guiding extension catheter Percutaneous coronary intervention

Essen score in the prediction of cerebrovascular events compared with cardiovascular events after ischaemic stroke or transient ischaemic attack:a nationwide registry analysis

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Journal of Geriatric Cardiology 2022年第4期19卷 265-275页

作者： Long LI ze-ning jin Yue-Song PAN jing jinG Xia MENG Yong JIANG Hao LI Cai-Xia GUO Yong-Jun WANG Department of Cardiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Car-diology and Beijing Key Laboratory of Hypertension Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Department of Cardiology Beijing Tongren HospitalCapital Medical UniversityBeijingChina

BACKGROUND The Essen risk score improves stratification of patients with acute ischemic stroke by early stroke *** study showed it could also predict myocardial infarction(MI).This study aimed to compare the Essen score’s ability to predict cerebrovascular events with compared cardiovascular *** We included patients with acute ischaemic stroke or transient ischaemic attack within seven days from the Third China National Stroke ***-year cumulative event rates of combined vascular events(a composite of MI,stroke recurrence or vascular death)and cardiac events(a composite of MI,heart failure or cardiac death)was estimated using the Kaplan-Meier *** predictive value of the Essen score was assessed with *** multivariate Cox regression analyses,we assessed whether Essen score,etiological subtype and imaging parameters were associated with *** Of 13,012 patients were included,the cumulative one-year event rates were 10.03%for combined vascular events and 0.77%for cardiac events,*** with those with an Essen score<3,patients with an Essen score≥3 were more likely to have a subsequent combined vascular event[hazard ratio(HR)=1.39,95%CI:1.24−1.55]and cardiac events(HR=2.30,95%CI:1.53−3.44).The score tended to be more predictive of the risk of MI(C-statistic=0.63,95%CI:0.55−0.71)and cardiac events(C-statistic=0.62,95%CI:0.56−0.67)than stroke recurrence(C-statistic=0.55,95%CI:0.54−0.57)and combined vascular events(C-statistic=0.56,95%CI:0.54−0.57).In multivariable analysis after adjusted Essen score,patients with multiple acute in-farctions or single acute infarctions and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular *** the cardioembolism subtype was associated with an increased risk of cardiac *** The Essen score is potentially more suitable for risk stratification of cardiovascular events than cerebrovasc

关键词： transient score statistic

Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention

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Journal of Geriatric Cardiology 2020年第7期17卷 393-399页

作者： Ruo-Fei JIA Long LI Yong ZHU Cheng-Zhi YANG Shuai MENG Yang RUAN Xiao-jing CAO Hong-Yu HU Wei CHEN jing NAN Xiao-Wei XIONG jing-jin LI Jia-Yu WANG ze-ning jin Department of Cardiology and Macrovascular Disease Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina

Background Subintimal plaque modification(SPM) is often performed to restore antegrade flow and facilitate subsequent lesion recanalization. This study aimed to compare the safety and efficacy of modified SPM with traditional SPM. Methods A total of 1454 consecutive patients who failed a chronic total occlusion percutaneous coronary intervention(CTO PCI) attempt and underwent SPM from January 2015 to December 2019 at our hospital were reviewed retrospectively. Fifty-four patients who underwent SPM finally were included in this study. We analyzed the outcomes of all the patients, and the primary endpoint was recanalization rate, which was defined as Thrombolysis in Myocardial Infarction(TIMI) grades 2-3 flow on angiography 30 to 90 days post-procedure. Results The baseline characteristics were similar between the two groups. In the follow-up, the recanalization rate was noticeably higher in the modified SPM group compared with the traditional SPM group(90.9% vs. 62.5%, P ze(1.83 ± 0.30 vs. 2.48 ± 0.26 mm, P < 0.05) and longer subintimal angioplasty(0.59 ± 0.16 vs. 0.92 ± 0.12 mm, P < 0.05). Also, the common use of a Stingray balloon and guide catheter extension resulted in improvement of patients in the modified SMP group(12.5% vs. 100%, P < 0.05). Conclusion Modified SPM, which is associated with a high likelihood of successful recanalization, is an effective and safe CTO PCI bail out strategy.

关键词： Chronic total occlusion Recanalization Subintimal plaque modification

Comparison of the safety and efficacy of two types of drug-eluting balloons （RESTORE DEB and SeQuent Please） in the treatment of coronary in-stent restenosis： study protocol for a randomized controlled trial （RESTORE ISR China）

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Journal of Geriatric Cardiology 2018年第2期15卷 117-122页

作者： Lei GAO Qin QIN Shao-Liang CHEN Hui CHEN Le-Feng WANG ze-ning jin Hui LI Jun ZHANG Jian-An WANG Yang ZHENG Guo-Sheng FU Yun-Dai CHEN Department of Cardiology Chinese PLA General Hospital Beijing China Department of Cardiology Tianjin Chest Hospital Tianjin China Department of Cardiology Nanjing First Hospital Nanjing China Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing China Department of Cardiology Beijing Chao-yang Hospital Capital Medical University Beijing China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing China Department of Cardiology Daqing Oilfield General Hospital Daqing China Department of Cardiology Cangzhou Central Hospital Cangzhou China Department of Cardiology the Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou China Department of Cardiology the First Hospital of Jilin University Changchun China Department of Cardiology Sir Run Run Shaw Hospital Zhejiang University School of Medicine Hangzhou China

1 Introduction In-stent restenosis （ISR）, characterized by neointimal proliferation and/or neoatherosclerosis in the vessel of the stent, can cause a reduction in lumen diameter after stent implantation, which can directly induce the recurrence of angina symptoms or an acute coronary syndrome in patients and is usually life-threatening.

关键词： Drug-eluting balloons In-stent restenosis Percutaneous coronary interventions

Adiponectin receptor 1 and small ubiquitin-like modifier 4 polymorphisms are associated with risk of coronary artery disease without diabetes

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Journal of Geriatric Cardiology 2016年第9期13卷 776-782页

作者： Hong LI ze YANG Lian-Mei PU Xiang LI Yang RUAN Fan YANG Shuai MENG Duo YANG Wei YAO Hao FU Feng ZHANG ze-ning jin Department of Emergency Medicine Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessels Beijing China Key Laboratory of Geriatrics Beijing Hospital & Beijing Institute of Geriatrics Ministry of Health of China Beijing China Graduate School of Peking Union Medical College the Key Laboratory of Geriatrics Beijing Hospital & Beijing Institute of Geriatrics Chinese Ministry of Health Beijing China

Background The genes encoding adiponectin receptor 1 （ADIPOR1） and small ubiquitin-like modifier 4 （SUM04） have been linked to anti-atherogenic effects, but little is known about whether polymorphisms in the two genes, acting separately or interacting, affect risk of coronary artery disease （CAD） without diabetes. Methods We genotyped 200 CAD patients without diabetes and 200 controls without CAD or diabetes at three single-nucleotide polymorphisms （SNPs） in ADIPOR1 and one SNP in SUM04, which were chosen based on previous studies. Potential associations were also explored between these SNPs and clinical characteristics of CAD without diabetes. Results Risk alleles at three SNPs inADIPOR1 （rs7539542-G, rs7514221-C and rs3737884-G） and the G allele at SNP rs237025 in SUM04 significantly increased risk of CAD without diabetes, with ORs ranging from 1.79 to 4.44. Carriers of any of these four risk alleles showed similar adverse clinical characteristics. Compared with individuals with a CC or GC genotype, those with a GG genotype at rs3737884 were at significantly higher risk of CAD that affected the left anterior descending coronary artery （OR： 6.77, P = 0.009）, the right coronary artery （OR： 4.81, P = 0.028） or a relatively large number of vessels （P = 0.04）. Individuals carrying a risk allele at one or more of the three SNPs in ADIPOR1 as well as a risk allele at the SNP in SUM04 were at significantly higher risk of CAD without diabetes than individuals not carrying any risk alleles （OR： 5.82, 95% CI： 1.23-27.7, P= 0.013）. Conelusions SNPs in ADIPORl and SUMO4 are associated with elevated risk of CAD without diabetes, and SNPs in the two genes may interact to jointly affect disease risk.

关键词： Adiponectin receptor 1 Coronary artery disease Diabetes Polymorphism Small ubiquitin-like modifier 4

Short- and long-term effect of complete versus culprit-only revascularization in patients undergoing primary PCI for multivessel disease： a meta-analysis

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Journal of Geriatric Cardiology 2017年第6期14卷 416-422页

作者： Hong LI Shuai MENG Duo YANG Hua-Gang ZHU Xiang LI Lian-Mei PU Ruo-Fei JIA Wei-Guang CHEN Chao QU ze-ning jin The 33^rd Ward Department of Emergency Cardiology Beijing An Zhen Hospital Capital Medical University Beijing China

Objective The optimal strategy during primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction and multivessel disease is still controversial. Therefore, the aim of our study is to evaluate the short- and long-term effect of complete revas- cularization （CR） versus infarct-related artery revascularization （IR） following primary PCI. Methods We identified randomized controlled studies （RCTs） by systematic search of PubMed, EMBASE, Web of Science, *** Website, Cochrane Library and Google scholar Database. Primary outcome was major adverse cardiac events （MACE）. Result Nine RCTs （2198 patients） with mean follow-up of 21.1 months were retrieved. Overall, CR was associated with significantly lower risk of MACE compared with IR therapy when followed by long-term duration （≥ 12 months）（RR： 0.56; 95% Ch 0.47-0.68; I^2 = 58.5%）. Additionally, CR was associated with equivalent rates of all-cause mortality （RR： 0.76; 95% CI： 0.53-1.08; I^2= 0.0%） and myocardial infarction （RR： 0.81; 95% CI： 0.57-1.16; I^2= 26.4%） compared with control. Meanwhile, risk of stroke was similar between groups （RR： 0.73; 95% CI： 0.24-2.19; I^2= 0.0%）. However, rates of cardiac death and target vessel revascularization were significantly decreased in the CR group （RR： 0.41; 95% CI： 0.23-0.72; I^2 = 0.0% and RR： 0.46; 95% CI： 0.37-0.57; I^2= 47.4%）. Conclusion Complete revascularization appears to have long-term clinical benefit with regard to adverse cardiac events following primary PCI. However, more studies are needed to confirm these findings.

关键词： Adverse cardiac events Complete revascularization Culprit-related artery Meta-analysis Multivessel disease

The effectiveness and safety of the RESTORE R drug-eluting balloon versus a drug-eluting stent for small coronary vessel disease： study protocol for a multi-center, randomized, controlled trial

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Journal of Geriatric Cardiology 2018年第7期15卷 469-475页

作者： Yi-Da TANG Shu-Bin QIAO Xi SU Yun-Dai CHEN ze-ning jin Hui CHEN Biao XU Xiang-Qing KONG Wen-Yue PANG Yong LIU Zai-Xin YU Xue LI Hui LI Yan-Yan ZHAO Wei LI Jian TIAN Chang-Dong GUAN Bo XU Run-Lin GAO Department of Cardiology Fu Wai Hospital National Centerfor Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China Department of Cardiology Wuhan Asia Heart Hospital Wuhan Hubei China Department of Cardiology Chinese PLA General Hospital Beijing China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing China Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing China Department of Cardiology Affiliated Nanjing Drum Tower Hospital of Nanjing University School of Medicine Nanjing Jiangsu China Department of Cardiology Jiangsu Province Hospital the First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu China Department of Cardiology Shengjing Hospital of China Medical University Shenyang Liaoning China Department of Cardiology The Fourth Central Hospital of Tianjin Tianjin China Department of Cardiology Xiangya Hospital of Central South University Changsha Hunan China Department of Cardiology Tangdu Hospital of the Fourth Military Medical University Xi 'an Shannxi China Department of Cardiology Daqing Oilfield General Hospital Daqing Heilongjiang China Division of Biometrics National Center for Cardiovascular Diseases of China Beijing China Catheterization Laboratories Fu Wai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China

bjective Small coronary vessel disease （disease affecting coronary vessels with main branch diameters of 〈 2.75 mm） is a common and intractable problem in percutaneous coronary intervention （PCI）. This study was designed to test the theory that the effectiveness and safety of drug-eluting balloons for the treatment of de novo lesions in small coronary vessels are non-inferior to those of drug-eluting stents. Methods We designed a prospective, multicenter, randomized, controlled clinical trial aiming to assess the effectiveness and safety of the RESTORE R （Cardionovum, Bonn, Germany） drug-eluting balloon （DEB） versus the RESOLUTE R （Medtronic, USA） drug-eluting stent （DES） in the treatment of small coronary vessel disease. This trial started in August 2016. A total of 230 patients with a reference vessel diameter （RVD）〉 2.25 mm and 〈 2.75 mm were randomly assigned to treatment with a DEB or a DES at a 1：1 ratio. The study was also designed to enroll 30 patients with an RVD 〉 2.00 mm and 〈 2.25 mm in the tiny vessel cohort. Results The key baseline data include demographic characteristics, relative medical history, baseline angiographic values and baseline procedural characteristics. The primary endpoint is in-segment diameter stenosis at nine months after the index procedure. Secondary endpoints include acute success, all-cause death, myocardial infarction, target vessel revascularization, target lesion revascularization and stent thrombosis. Conclusions The study will evaluate the clinical efficacy, angiographic outcomes, and safety of DEBs compared to DESs in the treatment of de novo coronary artery lesions in small vessels.

关键词： Drag eluting balloon Percutaneous coronary intervention Small vessel disease

Enhanced solid-electrolyte interface efficiency for practically viable hydrogen-air fuel cell systems

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Journal of Energy Chemistry 2025年第1期100卷 356-368页

作者： Venkitesan Sakthivel Dong jin Yoo Graduate School Department of Energy Storage/Conversion Engineering (BK21 FOUR) Hydrogen and Fuel Cell Research Center Jeonbuk National University Jeonju Department of Life Science Jeonbuk National University

Proton exchange membrane fuel cells （PEMFCs） provide an appealing sustainable energy system,with the solid-electrolyte membrane playing a crucial role in its overall ***,sulfonated poly（1,4-phenylene ether-ether sulfone）(SPEES),an aromatic hydrocarbon polymer,has garnered considerable attention as an alternative to Nafion ***,the long-term durability and stability of SPEES present a significant *** this context,we introduce a potential solution in the form of an additive,specifically a core–shell-based amine-functionalized iron titanate （A–Fe2TiO5）,which holds promise for improving the lifetime,proton conductivity,and power density of SPEES in *** modified SPEES/A–Fe2TiO5composite membranes exhibited notable characteristics,including high water uptake,enhanced thermomechanical stability,and oxidative ***,the SPEES membrane loaded with 1.2 wt%of A–Fe2TiO5demonstrates a maximum proton conductivity of 155 mS cm-1,a twofold increase compared to the SPEES membrane,at 80°C under 100%relative humidity （RH）.Furthermore,the 1.2 wt%of A–Fe2TiO5/SPEES composite membranes exhibited a maximum power density of 397.37 mW cm-2and a current density of 1148 mA cm-2at 60°C under 100%RH,with an opencircuit voltage decay of 0.05 m V/h during 103 h of continuous *** study offers significant insights into the development and understanding of innovative SPEES nanocomposite membranes for PEMFC applications.

关键词： Composite membranes