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World Journal of Clinical Cases 2020年第6期8卷 1129-1136页

作者： Yuan-Yuan Chen Hui Yan Jian-Hua Zhu Department of Cardiology The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Systemic sclerosis is a rare connective tissue disease characterized by localized ordiffuse skin thickening and fibrosis,which usually accumulates in various organsthroughout the body.Tachyarrhythmia is a common clinical manifestation ofcardiovascular damage in systemic sclerosis patients.However,few studies havereported the use of catheter ablation and an implantable cardioverter defibrillatorin patients with systemic sclerosis complicated by ventricular tachycardia.CASE SUMMARY A 39-year woman with an 11-year history of systemic sclerosis was referred toour hospital due to three syncopal episodes in the past 6 mo.The results of anelectrocardiogram and a transthoracic echocardiogram revealed ventriculartachycardia and left ventricular systolic and ventricular septum segmentalmotion abnormalities,respectively.The results of an electrocardiogram showed asinus rhythm with complete blockage of the left bundle branch.In light of theprogressive nature of systemic sclerosis,the presence of a left bundle branchblock,and the decreased ejection fraction,a cardiac resynchronization therapydefibrillatorwas implanted.The patient’s clinical conditions improved,and at the3-mo follow-up,the patient was free of ventricular tachycardia and all cardiacsymptoms.CONCLUSION We report the first case of systemic sclerosis complicated by ventriculartachycardia that was successfully treated with a cardiac resynchronizationtherapy-defibrillator.

关键词： Systemic sclerosis Ventricular tachycardia cardiac resynchronization therapy-defibrillator Case report

cardiac papillary fibroelastoma:The need for a timely diagnosis

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World Journal of Clinical Cases 2017年第1期5卷 9-13页

作者： Srikanth Yandrapalli Bella Mehta Pratik Mondal Tanush Gupta Pallavi Khattar John Fallon Randy Goldberg Sachin Sule Wilbert S Aronow Department of Internal Medicine New York Medical College at Westchester Medical Center Department of Pathology New York Medical College at Westchester Medical Center Department of Cardiology New York Medical College at Westchester Medical Center

cardiac papillary fibroelastomas(CPFs) are the second most common primary cardiac tumors and the most common cardiac valvular tumors. Although they are histologically benign and usually asymptomatic, CPFs can lead to serious and life-threatening complications like myocardial infarction, stroke, pulmonary embolus, cardiac arrest etc. CPFs represent a rare entity in clinical medicine and literature regarding their management is limited. We report two cases which illustrate such complications arising from undiagnosed CPFs on the aortic valve. We further stress on the importance of identifying CPFs early so that they can be managed appropriately based on recommendations from the available literature.

关键词： Lambl’s excrescences Aortic valve cardiac tumors cardiac papillary fibroelastoma Sudden cardiac death

ALDH2 contributes to melatonin-induced protection against APP/PS1 mutation-prompted cardiac anomalies through cGAS-STING-TBK1-mediated regulation of mitophagy

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Signal Transduction and Targeted Therapy 2020年第1期5卷 1335-1347页

作者： Shuyi Wang Lin Wang Xing Qin Subat Turdi Dongdong Sun Bruce Culver Russel JReiter Xiaoming Wang Hao Zhou Jun Ren Department of Emergency Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200072China Center for Cardiovascular Research and Alternative Medicine University of Wyoming College of Health SciencesLaramieWY 82071USA Department of Cardiology and Shanghai Institute of Cardiovascular Diseases Zhongshan Hospital Fudan UniversityShanghai 200032China Department of Geriatrics Xijing HospitalThe Air Force Military Medical UniversityXi’anChina Department of Cardiology Xijing HospitalThe Air Force Military Medical UniversityXi’an 710032China Department of Cellular and Structural Biology UT Health San AntonioSan AntonioTXUSA Chinese PLA General Hospital Medical School of Chinese PLABeijing 100853China

Ample clinical evidence suggests a high incidence of cardiovascular events in Alzheimer’s disease(AD),although neither precise etiology nor effective treatment is available.This study was designed to evaluate cardiac function in AD patients and APP/PS1 mutant mice,along with circulating levels of melatonin,mitochondrial aldehyde dehydrogenase(ALDH2)and autophagy.AD patients and APP/PS1 mice displayed cognitive and myocardial deficits,low levels of circulating melatonin,ALDH2 activity,and autophagy,ultrastructural,geometric(cardiac atrophy and interstitial fibrosis)and functional(reduced fractional shortening and cardiomyocyte contraction)anomalies,mitochondrial injury,cytosolic mtDNA buildup,apoptosis,and suppressed autophagy and mitophagy.APP/PS1 mutation downregulated cyclic GMP-AMP synthase(cGAS)and stimulator of interferon genes(STING)levels and TBK1 phosphorylation,while promoting Aβaccumulation.Treatment with melatonin overtly ameliorated unfavorable APP/PS1-induced changes in cardiac geometry and function,apoptosis,mitochondrial integrity,cytosolic mtDNA accumulation(using both immunocytochemistry and qPCR),mitophagy,and cGAS-STING-TBK1 signaling,although these benefits were absent in APP/PS1/ALDH2−/−mice.In vitro evidence indicated that melatonin attenuated APP/PS1-induced suppression of mitophagy and cardiomyocyte function,and the effect was negated by the nonselective melatonin receptor blocker luzindole,inhibitors or RNA interference of cGAS,STING,TBK1,and autophagy.Our data collectively established a correlation among cardiac dysfunction,low levels of melatonin,ALDH2 activity,and autophagy in AD patients,with compelling support in APP/PS1 mice,in which melatonin rescued myopathic changes by promoting cGAS-STING-TBK1 signaling and mitophagy via an ALDH2-dependent mechanism.

关键词： APP/PS1 cardiac ALDH2

Effects of permanent left bundle branch area pacing on QRS duration and short-term cardiac function in pacing-indicated patients with left bundle branch block

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Chinese Medical Journal 2021年第9期134卷 1101-1103页

作者： Qi-Jun Shan Hai Xu Xiu-Juan Zhou Qing Chang Ling Ji Chun Chen Zhi-Xin Jiang Decarnment of caroiology.The First Aifiated Hosptal of Nanjing Medcal University(Jiangsu Province Hospital) NanjingJiangsu 210029China

In 1986,Burkhoff and Sagawa[1]observed that left ventricular pressure decreased linearly as the QRS duration(QRSd)increased in a pacing experiment.Subsequently,it became recognized that either left bundle branch block(LBBB)or right ventricular pacing could result in prolonged QRSd,with potential deleterious effects on cardiac function and increased risk of atrial fibrillation(AF),heart failure,and mortality.[2]Although previous clinical trials have demonstrated that patients with LBBB and heart failure could benefit from biventricular pacing(ie,biventricular cardiac resynchronization therapy[BiV-CRT]),30%to 40%of such patients do not respond to BiV-CRT and approximately an additional 10%of patients remain untreated owing to an unsuitable coronary sinus vein.With the development of appropriate implant tools,His bundle pacing(HBP)has become increasingly important to enhance pacing as an adjunctive therapy in heart failure treatment.Various studies have demonstrated that CRT utilizing HBP(His-CRT)may be valuable in patients with no response or failure to place a BiV-CRT.However,HBP has higher pacing threshold and lower R-wave amplitude shortcomings and cannot correct LBBB in patients with distal conduction system disease.

关键词： patients cardiac bundle

Successful multidisciplinary clinical approach and molecular characterization by whole transcriptome sequencing of a cardiac myxofibrosarcoma: A case report

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World Journal of Clinical Cases 2019年第19期7卷 3018-3026页

作者： Maristella Saponara Valentina Indio Carmine Pizzi Elena-Daniela Serban Milena Urbini Annalisa Astolfi Pasquale Paolisso Sofia Martin Suarez Margherita Nannini Davide Pacini Valentina Agostini Ornella Leone Valentina Ambrosini Giuseppe Tarantino Stefano Fanti Fabio Niro Francesco Buia Domenico Attinà Maria Abbondanza Pantaleo Department of Specialized Experimental and Diagnostic MedicineMedical Oncology UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy “Giorgio Prodi”Cancer Research Center University of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineCardiology and Transplantation UnitSant’Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Pathology Cardiovascular Pathology UnitSant’Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Departments of Cardiovascular Surgery and Transplantation Sant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineNuclear Medicine UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy Department of Specialized Experimental and Diagnostic MedicineRadiology UnitSant'Orsola-Malpighi HospitalUniversity of BolognaBologna 40138Italy

BACKGROUND cardiac tumors are rare and complex entities.Surgery represents the cornerstone of therapy,while the role of adjuvant treatment remains unclear and,in case of relapse or metastatic disease,the prognosis is very poor.Lack of prospective,randomized clinical trials hinders the generation of high level evidence for the optimal diagnostic workup and multimodal treatment of cardiac sarcomas.Herein,we describe the multidisciplinary clinical management and molecular characterization of a rare case of cardiac myxofibrosarcoma in an elderly woman.CASE SUMMARY A 73-year-old woman presented signs and symptoms of acute left-sided heart failure.Imaging examination revealed a large,left atrial mass.With suspicion of a myxoma,she underwent surgery,and symptoms were promptly relieved.Histology showed a cardiac myxofibrosarcoma,a rare histotype of cardiac sarcoma.Eight months later,disease unfortunately relapsed,and after a multidisciplinary discussion,a chemotherapy with doxorubicin and then gemcitabine was started,achieving partial radiologic and complete metabolic response,which was maintained up to 2 years and is still present.This report is focused on the entire clinical path of our patient from diagnosis to follow-up,through surgery and strategies adopted at relapse.Moreover,due to their rarity,very little is known about the molecular landscape of myxofibrosarcomas.Thus,we also performed and described preliminary genome analysis of the tumor tissue to get further insight on mechanisms involved in tumor growth,and to possibly unveil new clinically actionable targets.CONCLUSION We report a case of cardiac myxofibrosarcoma that achieved a very good prognosis due to an integrated surgical,cardiac and oncologic treatment strategy.

关键词： cardiac sarcoma Myxofibrosarcoma Whole transcriptome sequencing Doxorubicin Gemcitabine Case report

Depression and myocardial injury in ST-segment elevation myocardial infarction:A cardiac magnetic resonance imaging study

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World Journal of Clinical Cases 2020年第7期8卷 1232-1240页

作者： Zhao-Qing Sun Tong-Tong Yu Yue Ma Quan-Mei Ma Yun-Di Jiao Dong-Xu He Jia-KeWu Zong-Yu Wen Xiao-Nan Wang Yang Hou Zhi-Jun Sun Department of Cardiology Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina Department of Radiology Shenyang 110004Liaoning ProvinceChina

BACKGROUND Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes.However,the association between depression and myocardial injury on cardiac magnetic resonance(CMR)in patients with ST-segment elevation myocardial infarction(STEMI)has still not been assessed.AIM To assess the association between depression and myocardial injury on CMR in patients with STEMI.METHODS A total of 107 STEMI patients undergoing primary percutaneous coronary intervention(P-PCI)were analyzed in this prospectivecohort study.Each subject completed the Patient Health Questionnaire-9(PHQ-9)to assess the presence and severity of depressive symptoms.CMR was performed at a median of 3 d after PPCI for quantifying post-MI myocardial injury.Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.RESULTS In this study,19 patients(17.8%)were diagnosed with major depression identified by the PHQ-9≥10.PHQ-9 was analyzed both as a continuous variable and dichotomous variable.After multivariable adjustment,the proportion of patients with large infarction size was significantly higher in the major depression group(PHQ-9≥10)(OR:4.840,95%CI:1.122–20.868,P=0.034).When the PHQ-9 was evaluated as a continuous variable,after multivariable adjustment,an increased PHQ-9 score was associated with an increased risk of large infarction size(OR:1.226,95%CI:1.073–1.401,P=0.003).CONCLUSION In patients with STEMI undergoing PCI,depression was independently associated with a large infarction size.

关键词： Depression Patient Health Questionnaire-9 Myocardial injury ST-segment elevation myocardial infarction cardiac magnetic resonance

Single-cell transcriptomics of cardiac progenitors reveals functional subpopulations and their cooperative crosstalk in cardiac repair

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Protein & Cell 2021年第2期12卷 152-157页

作者： Lei Gao Hongjie Zhang Jingyi Cui Lijuan Pei Shiqi Huang Yaning Mao Zhongmin Liu Ke Wei Hongming Zhu Translational Medical Center for Stem Cell Therapy Institute for Regenerative MedicineShanghai East HospitalTongji University School of MedicineShanghai 200120China Institute for Regenerative Medicine Shanghai East HospitalShanghai Institute of Stem Cell Research and Clinical TranslationShanghai Key Laboratory of Signaling and Disease ResearchFrontier Science Center for Stem Cell ResearchSchool of Life Sciences and TechnologyTongji UniversityShanghai 200092China

Dear Editor,Myocardial infarction is one of the leading causes of morbidity and mortality.Stem/progenitor cells therapy has emerged as a promising strategy for the cardiac repair,especially those derived from cardiac tissue,have attracted worldwide attention(Tompkins et al.,2018).However,challenges and controversies remain in characterizing functional progenitors and explaining their mechanisms of action.

关键词： progenitor cardiac al.

SIRT3-mediated inhibition of FOS through histone H3 deacetylation prevents cardiac fibrosis and inflammation

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Signal Transduction and Targeted Therapy 2020年第1期5卷 2322-2331页

作者： Xavier Palomer MSilvia Román-Azcona Javier Pizarro-Delgado Ana Planavila Francesc Villarroya Brenda Valenzuela-Alcaraz Fátima Crispi Álvaro Sepúlveda-Martínez Irene Miguel-Escalada Jorge Ferrer JFrancisco Nistal Raquel García Mercy MDavidson Emma Barroso Manuel Vázquez-Carrera Department of Pharmacology Toxicology and Therapeutic ChemistryIBUB(Institut de Biomedicina de la Universitat de Barcelona)Research Institute-Pediatric Research InstituteHospital Sant Joan de Déuand CIBER de Diabetes y Enfermedades Metabólicas Asociadas(CIBERDEM)Faculty of Pharmacy and Food SciencesUniversity of BarcelonaBarcelonaSpain Department of Biochemistry and Molecular Biomedicine IBUB and CIBER Fisiopatología de la Obesidad y Nutrición(CIBEROBN)Faculty of BiologyUniversity of BarcelonaBarcelonaSpain aBCNatal-Barcelona Center for Maternal–Fetal and Neonatal Medicine(Hospital Clínic and Hospital Sant Joan de Deu) Institut d’Investigacions Biomèdiques August Pi i SunyerUniversitat de Barcelonaand Center for Biomedical Research on Rare Diseases(CIBER-ER)BarcelonaSpain Genomic Programming of Betacells Laboratory Institut d’Investigacions August Pi i Sunyer(IDIBAPS)and CIBERDEMBarcelonaSpain Section of Epigenomics and Disease Department of Medicineand National Institute for Health Research(NIHR)Imperial Biomedical Research CentreImperial College LondonLondonUK Servicio de Cirugía Cardiovascular Hospital Universitario Marqués de ValdecillaDepartamento de Ciencias Médicas y QuirúrgicasFacultad de MedicinaUniversidad de CantabriaInstituto de Investigación Marqués de Valdecilla(IDIVAL)Centro de Investigación Biomédica en Red Cardiovascular(CIBERCV)Instituto de Salud Carlos IIISantanderSpain Departamento de Fisiología y Farmacología Facultad de MedicinaUniversidad de CantabriaInstituto de Investigación Marqués de Valdecilla(IDIVAL)SantanderSpain Department of Radiation Oncology Columbia UniversityNew YorkNYUSA

Sirtuin 3(SIRT3)is a deacetylase that modulates proteins that control metabolism and protects against oxidative stress.Modulation of SIRT3 activity has been proposed as a promising therapeutic target for ameliorating metabolic diseases and associated cardiac disturbances.In this study,we investigated the role of SIRT3 in inflammation and fibrosis in the heart using male mice with constitutive and systemic deletion of SIRT3 and human cardiac AC16 cells.SIRT3 knockout mice showed cardiac fibrosis and inflammation that was characterized by augmented transcriptional activity of AP-1.Consistent with this,SIRT3 overexpression in human and neonatal rat cardiomyocytes partially prevented the inflammatory and profibrotic response induced by TNF-α.Notably,these effects were associated with a decrease in the mRNA and protein levels of FOS and the DNA-binding activity of AP-1.Finally,we demonstrated that SIRT3 inhibits FOS transcription through specific histone H3 lysine K27 deacetylation at its promoter.These findings highlight an important function of SIRT3 in mediating the often intricate profibrotic and proinflammatory responses of cardiac cells through the modulation of the FOS/AP-1 pathway.Since fibrosis and inflammation are crucial in the progression of cardiac hypertrophy,heart failure,and diabetic cardiomyopathy,our results point to SIRT3 as a potential target for treating these diseases.

关键词： SIRT3 inflammation cardiac

From biomimicry to bioelectronics:Smart materials for cardiac tissue engineering

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Nano Research 2020年第5期13卷 1253-1267页

作者： Olurotimi A.Bolonduro Breanna M.Duffy Akshita A.Rao Lauren D.Black Brian P.Timko Department of Biomedical Engineering Tufts UniversityMedfordMassachusetts 02155USA Department of Cell Molecular&Developmental BiologySchool of Graduate Biomedical SciencesTufts UniversityMassachusetts 02111USA

Effective strategies in cardiac tissue engineering require matrices that recapitulate the mechanical,topographic and electrical cues present in the native extracellular matrix.In this review,we discuss recent efforts in materials science and nanotechnology to achieve functional three-dimensional(3D)scaffolds that modulate and monitor cardiac tissue function.We consider key design considerations,including choice of biopolymer matrix,cell sources,and delivery methods for eventual therapies.We then discuss how solid-state nanomaterials may be integrated within these systems to provide unique electrical and nanotopographic cues that improve electromechanical synchrony.We describe how these approaches may be extended to complex,spatially heterogeneous constructs using 3D bioprinting techniques.Finally,we describe how scaffold materials may be augmented with bioelectronic components to achieve hybrid myocardium that monitors or controls electrophysiological activity.Collectively,these approaches provide a framework for achieving cardiac tissues with tunable,rationally-designed functionalities.We discuss future prospects and remaining challenges for clinical translation.

关键词： cardiac tissue engineering extracellular matrix nanomaterial bioelectronics cyborg

Diagnostic detection with cardiac tomography and resonance of extremely rare coronary anomaly:A case report and review of literature

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World Journal of Clinical Cases 2019年第5期7卷 628-635页

作者： Nicolò Schicchi Marco Fogante Gian Marco Giuseppetti Andrea Giovagnoni Department of Radiology Azienda Ospedaliero-Universitaria Ospedali Riuniti Department of Radiology Università Politecnica delle Marche

BACKGROUND The association of two congenital coronary artery anomalies(CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography(CX-A) is still widely used in childhood, cardiac magnetic resonance(C-MRI) and cardiac computed tomography(C-CT) have recently taken on an increasing diagnostic role in early detection of CAAs and concomitant congenital cardiac malformations.CASE SUMMARY A healthy 10-year-old male patient was referred to the Radiological Department of our Institution due to no evidence of left coronary artery in echocardiographic examination. With C-MRI was detected marked myocardial trabeculation and was suspected anomalous origin and course of left circumflex(LCx) artery and of left anterior descending(LAD) artery. With third generation Dual Source C-CT192x2-sections(SOMATOM Force, Siemens, Germany) was confirmed anomalous origin of LCx artery from right pulmonary artery associated with anomalous origin of LAD artery from right coronary artery with course in front of right ventricular outflow tract. The patient underwent surgical treatment with reimplantation of the anomalous LCX and LAD arteries into the wall of ascending aorta, with no postoperative complications. The patient remained asymptomatic and follow-up C-MRI scan four months after operation showed complete success of surgery treatment.CONCLUSION This case highlights the diagnostic potential of C-CT and C-MRI in evaluation of CAAs and of cardiac morphology and functionality, with very low radiation dose and without the risks related to invasive procedure.

关键词： Coronary anomalies cardiac computed tomography cardiac magnetic resonance Case report Coronary artery anomalies