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Cardiac autonomic nerve fiber regeneration in chronic heart failure Do Akt gene-transduced mesenchymal stem cells promote repair?

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Neural Regeneration Research 2010年第1期5卷 28-34页

作者： Hongliang Kong Zhanquan Li Shumei Zhao Li Zhu Yingjun Zhao Weiwei Zhang GuipingXu Wenjun Hao Huijun Li Guoxian Qi Department of Cardiology the First Affiliated Hospital of China Medical University Shenyang 110001 Liaoning Province China Department of Cardiology the People's Hospital of Liaoning Province Shenyang 110016 Liaoning Province China Shenyang Normal University Shenyang 110034 Liaoning Province China

BACKGROUND： Transplantation of Akt-over-expressing mesenchymal stem ceils （Akt-MSCs） has been shown to repair infarcted myocardium and improve cardiac function. However, little is known about the therapeutic effects of Akt-MSCs on cardiac autonomic neuropathy in chronic heart failure （CHF）. OBJECTIVE： The present study used adriamycin-induced CHF rat models to observe the effect of Akt-MSCs on cardiac autonomic nervous regeneration and the factors mediating this effect. DESIGN, TIME AND SETTING： A randomized, controlled animal experiment was performed at the Central Laboratory of Basic Medical College, China Medical University, between September 2008 and April 2009. MATERIALS： Rabbit anti-choline acetyltransferase （CHAT）, growth associated protein-43 （GAP-43） synaptophysin （SYN） polyclonal antibodies and the secondary antibody （goat anti-rabbit IgG） were purchased from Boster, China. Cat-A-Kit assay system was provided by Amersham, USA. METHODS：（1） Adult rat MSCs were isolated and cultured for the preparation of Akt-MSCs. （2） Forty male Wistar rats were intramyocardially administered adriamycin at 2 mg/kg over 3 days for a total of five times and once a week for additional five times thereafter to establish CHF models. At 2 weeks after final adriamycin treatment, 34 successful CHF rat models were randomized to three groups： Akt-MSCs （n = 11）, simple MSCs （s-MSCs, n =11）, and control （n = 12）. Each group was intravenously administered Akt-MSCs （2x106 cells in 100 IJL PBS）, s-MSCs （2×10^6 cells in 100 μL PBS） or equal volume of phosphate buffered saline, once a day for a total of three times. MAIN OUTCOME MEASURES： At 4 weeks after final adriamycin treatment, myocardial norepinephrine （NE） content was detected using a Cat-A-Kit assay system. Myocardial CHAT, SYN and GAP-43 were performed by immunohistochemistry and Western blot analysis. Prior to, 2 and 4 weeks after adriamycin treatment, echocardiographic examination was performed and left ventricular ejection fract

关键词： mesenchymal stem cells Akt gene transfection chronic heart failure neural regeneration autonomic nerve system

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Isoniazid-induced rhabdomyolysis in a patient with chronic heart failure： a case report

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Chinese Medical Journal 2010年第4期123卷 502-504页

作者： LIU Pin-ming ZHENG Hai-sheng YUAN Wo-liang NIE Ru-qiong WANG Jing-feng Department of Cardiology Sun Yat-sen Memorial Hospital Second Affiliated Hospital of Sun Yat-sen University Guangzhou Guangdong 510120 China

Rhabdomyolysis is one of the identified uncommon .but potentially lethal complications of isoniazidintoxication, which can be secondary to severe muscle exertion due to generalized seizures or can be caused by direct toxicity of either the drug or one of its metabolites on muscles.1＇2 ^However, as widely used anti-tuberculosis drug in China, isoniazid induced rhabdomyolysis appears to be very rare. To our knowledge, there is no report indicating association between rhabdomyolysis and isoniazid intoxication in Chinese population. We presented herein a case report of isoniazid-induced rhabdomyolysis in a Chinese man with chronic heart failure.

关键词： rhabdomyolysis myopathy chronic heart failure dilated cardiomyopathy isoniazid

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Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

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Journal of Geriatric Cardiology 2017年第2期14卷 127-134页

作者： Wei YAN Rui-Jun LI Qian JIA Yang MU Chun-Lei LIU Kun-Lun HE Department of Cardiology Chinese PLA General Hospital Beijing China School of Medicine Nankai University Tianjin China

Background The neutrophil-to-lymphocyte （N/L） ratio has been associated with poor prognosis in patients with heart failure, but it has not been compared with N-terminal pro-brain natriuretic peptide （NT-proBNP） in elderly patients with chronic heart failure （CHF）. We sought to make this comparison. Methods A total of 1355 elderly patients with CHF were analyzed. A multivariate logistic regression model was used to analyze the variables associated with atrial fibrillation （AF）. Cox regression analysis was used to assess the multivariable rela- tionship between the N/L ratio, NT-proBNP level, and subsequent major cardiovascular events （MCE）. Results In the multiple logistic regression analysis, the N/L ratio was demonstrated as a risk factor for AF in elderly patients with CHF [odds ratio （OR）： 1.079, 95% confi- dence interval （CI）： 1.027-1.134, P = 0.003]. The median follow-up period was 18 months. In a multivariable model using tertiles of both variables, the highest tertile of the N/L ratio was significantly associated with MCE [hazard ratio （HR）： 1.407, 95% CI： 1.098-1.802, P = 0.007] compared with the lowest tertile. Similarly, the highest NT-proBNP tertile was also significantly associated with MCE （HR： 1.461, 95% CI： 1.104-1.934, P- 0.008）. Conclusions In elderly patients with CHF, the N/L ratio is one of the important risk factors for AF and it is an inexpensive and readily available marker with similar independent prognostic power to NT-proBNP. The risk of MCE increases 1.407-fold when the N/L ratio is elevated to the highest tertile.

关键词： Atrial fibrillation chronic heart failure Elderly patients Neutrophil-to-lymphocyte ratio N-terminal pro-brain natriureticpeptide

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Impact of potentially lethal ventricular arrhythmias on long-term outcome in patients with chronic heart failure

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Chinese Medical Journal 2012年第4期000卷 563-568页

作者： Liu Ye-hong Su Jing-ying Wang Lin-jie Li Jin-ping Zhou Qing-fen Gan Qian Chai Xi-chen Dai Li-ying Zhang Feng-ru Shen Wei-feng Shanghai Jiao Tong Univ Sch Med Ruijin Hosp Dept Cardiol Shanghai 200025 Peoples R China Shanghai Jiao Tong Univ Sch Med Ruijin Hosp Dept Geriatr Shanghai 200025 Peoples R China Ctr Hosp Minhang Dist Dept Cardiol Shanghai 201100 Peoples R China

Background Potentially lethal ventricular arrhythmias （PLVAs） occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart *** study investigated the prevalence and prognostic significance of PLVAs in patients with chronic heart failure （CHF）.Methods Data concerning demographics,etiology of heart failure,NYHA functional class,biochemical variables,electrocardiographic and echocardiographic findings,and medical treatments were collected by reviewing hospital medical records from 1080 patients with NYHA Ⅱ-Ⅳ and a left ventricular （LV） ejection fraction ≤45%.PLVAs were defined as multi-focal ventricular ectopy （〉30 beats/h on Holter monitoring）,bursts of ventricular premature beats,and nonsustained ventricular ***-cause mortality,sudden death,and rehospitalization due to worsening heart failure,or cardiac transplantation during 5-year follow-up after discharge were *** The occurrence rate of PLVAs in CHF was 30.2%,and increased with age; 23.4% in patients 〈45 years old,27.8% in those between 45-65 years old,and 33.5% in patients 〉65 years old （P=0.033）.Patients with PLVAs had larger LV size and lower ejection fraction （both P 〈0.01） and higher all-cause mortality （P=0.014） during 5-year follow-up than those without *** （OR 1.041,95% Cl 1.004-1.079,P=0.03） and LV end-diastolic dimension （OR 1.068,95% Cl 1.013-1.126,P=0.015） independently predicted the occurrence of *** PLVA was an independent factor for all-cause mortality （RR 1.702,95% Cl 1.017-2.848,P=0.031） and sudden death （RR 1.937,95% CI 1.068-3.516,P=0.030） in patients with *** PLVAs are common and exert a negative impact on Iona-term clinical outcome in patients with CHF.

关键词： chronic heart failure arrhythmia outcome electrocardiography

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Febuxostat, a nonpurine selective inhibitor of xanthine oxidase： a promising medical therapy for chronic heart failure？

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Chinese Medical Journal 2010年第17期123卷 2471-2474页

作者： GAO Ling-gen YAO Xiu-ping ZHANG Lin WEN Dan LUO Fang ZHOU Xian-liang HUI Ru-tai Department of Cardiology Fu Wai Hospital and Cardiovascular Institute Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Sino-German Laboratory for Molecular Medicine Key Laboratory for Clinical Cardiovascular Genetics Ministry of Education Fu Wai Hospital and Cardiovascular Institute Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Very Important Person Health Care Department The General Hospital of Chinese People's Armed Police Forces Beijing 100039 China

heart failure is currently one of the most common and most cost-intensive of the chronic diseases The main cause of chronic heart failure （CHF） is the abnormalities of both cardiac contractile performance and myocardial energy metabolism. Elevated levels of reactive oxygen species （ROS） have been proposed to contribute to both of them. Xanthine oxidoreductase （XO） is a major source of ROS in the cardiovascular system. XO inhibitors （XOIs） have been the cornerstone of the clinical management of gout and conditions associated with hyperuricemia for several decades.

关键词： febuxostat reactive oxygen species xanthine oxidase inhibitors chronic heart failure signaling pathways

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Long-term prognostic value of analysis of sympathetic drive by myocardial 123I-metaiodobenzylganidine scintigraphy in chronic heart failure

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Chinese Medical Journal 2010年第15期123卷 2023-2027页

作者： CAO Ya-min Jourdain Patrick Funck Fran(c)ois Institute of Geriatric Cardiology General Hospital of Chinese People's Liberation Army Beijing 100853 China Department of Cardiology CHRDUBOS Pontoise France

Background The over increase of sympathetic drive in chronic heart failure （CHF） is with main responsibility for the deterioration and mortality of the *** 123I-metaiodobenzylganidine （MIBG） scintigraphy is a non-invasive convenient method to assess sympathetic dysfunction in patients with *** aim of the study was to detect if sympathetic antidrive analysed through myocardial MIBG scintigraphy plays a crucial role in long-term prognosis in *** Sixty-four enrolled patients underwent myocardial MIBG scintigraphy, and their plasma concentration of brain natriuretic peptide （BNP）, myocardial contractile reserve （MCR）, rest left ventricular ejection fraction （rest LVEF）and New York heart Association （NYHA） function class were *** were separated into groups according to median of above *** was cardiac death and it was recorded in each group during average 54 months＇ *** At the end of follow-up, group with lower ratio of heart/mediastinum （H/M） had more death events （P=0.001）,and its BNP level was higher and MCR level was lower （P=0.003 and 0.001, respectively）; but its rest LVEF and NYHA function class were not significantly different.H/M, MCR and BNP correlated closely with death （P=0.000, 0.000 and 0.001, respectively）.Among the three indicators the death risk ratio （RR） of H/M was 4.66, more than MCR and BNP （1.88 and 2.56, respectively）.However, rest LVEF and NYHA function class did not correlate with death （P=0.652 and 0.384, respectively）.The group with lower H/M and MCR, higher BNP had much more death than that with higher H/M and MCR, lower BNP, the RR being *** Myocardial MIBG scintigraphy is a long-term prognostic marker in ***, MCR are also excellent predictors of long-term prognosis in CHF, but not stronger than myocardial MIBG *** the three indicators were joined together, the prediction would become most *** LVEF and NYHA have no significance in long-ter

关键词： myocardial 123I-metaiodobenzylganidine scintigraphy chronic heart failure long term prognostic value

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Clinical significance of pain in patients with chronic heart failure

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Chinese Medical Journal 2012年第18期125卷 3223-3227页

作者： GAN Qian ZHANG Feng-ru ZHOU Qing-fen DAI Li-ying LIUYe-hong CHAI Xi-chen WU Fang SHEN Wei-feng Department of Cardiology Ruijin Hospital Shanghai Jiao Tong University School ofMedicine ShanghaiChina 200025 Department of Geriatrics Ruijin Hospital Shanghai Jiao Tong University School ofMedicine ShanghaiChina 200025

Background There is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure （CHF） patients. This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain. Methods Sociodemographics, serum levels of creatinine, NT-proBNP, high-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor （TNF）-α, interleukin （IL）-6 and IL-10, and two-dimensional echocardiographic left ventricular ejection fraction （LVEF） were determined in 305 patients with CHF. A questionnaire packet including the Brief Pain Inventory （BPI） and the Minnesota Living with heart failure Questionnaire （MLHFQ） was used to assess the degree of pain rated on a 0-10 scale and the quality of life （QOL）. A six-minute walking test was performed during routine clinic visits. Major adverse cardiac events （MACE） were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke at follow-up. Results Pain occurred in 25.6% of CHF patients, and was more common when the New York heart Association （NYHA） functional class was worse. More patients with pain were female in gender, and had more co-morbidities, lower LVEF, and shorter distance during the 6-minute walking test. Despite similar serum levels of creatinine, N-terminal prohormone of brain natriuretic peptide （NT-proBNP）, IL-6 and IL-10, the TNF-a levels were higher and MLHFQ scores were greater in CHF patients with pain. At follow-up, CHF patients with moderate to severe pain （≥4 scale） had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke. Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.

关键词： chronic heart failure pain quality of life clinical outcome

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Prevalence, clinical characteristics and outcome in patients with chronic heart failure and diabetes

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Chinese Medical Journal 2010年第6期123卷 646-650页

作者： SHI Chuan WANG Ling-jie HU Dan-feng LI Jin-ping ZHU Tian-qi SHAN Ying ZHAO Jian-rong ZHANG Feng-ru SHEN Wei-feng Department of Cardiology Ruiiin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Cardiology Huashan HospitalFudan University School of MedicineShanghai 200032China Department of Cardiology Luwan HospitalShanghai 200025China

Background chronic heart failure（CHF）and diabetes mellitus portend high morbidity and mortality because of an interrelated pathophysiologic *** large cohort study aimed to analyze the prevalence,clinicaI characteristics and long-term outcome of patients with CHF and *** A totaI of 1119 patients with NYHA functionaI class Ⅱ-Ⅳ and left ventricular ejection fraction（LVEF）〈45% between January 1995 and May 2009 were *** variables, biochemical and echocardiographic measurements were retrospectively reviewed,and composite major cardiac events （MCE） including death,headtransplantation, and refractory heart failure requiring multiple hospitalizations were *** The prevalence of CHF with diabetes was progressively increased with time （16.9% in 1995-1999;20.4% in 2000-2004,and 29.1% in 2005-2009）and age（1 8.5% in〈60 years,26.6% in 60-80 years,and 26.6% in〉80 years）.Compared with CHF patients without diabetes,those with diabetes had worse cardiac function,more abnormal biochemical *** higher *** with glucose-lowering agents significantly improved LVEF and decreased *** elevated serum HbA1c level was associated with large left ventricular end-systolic diameter （P〈0.05）,decreased LVEF（P〈0.01）and reduced survival（P〈0.05）.Multivariable Logistic regression analysis revealed that after adjustment for confounding factors,NYHA functional class（OR2.65,95%CI 1.14-6.16,P=0.024）and HbA1c level≥7%（OR2.78, 95%CI 1.00-7.68,P=0.049）were independent risk factors for adverse outcomes in CHF patients with *** Prevalence of CHF with diabetes was increasing during past decades,and patients with CHF and diabetes had worse clinical profiles and *** anti-CHF and diabetes therapies are needed to improve overall outcomes for these patients.

关键词： chronic heart failure diabetes mellitus prognosis medical treatment

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Short-term outcome of chronic heart failure with atrial fibrillation in two hospitals cohort study

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South China Journal of Cardiology 2010年第3期11卷 140-146页

作者：李智卢喜烈汪剑锋朱金秀 Department of Cardiology Chaozhou People's Hospital Department of Cardiology First Affiliated Hospital of Shantou University Medical College Department of Cardiology PLA General Hospital

Background The epidemiologic features and outcomes of chronic heart failure（CHF） patients with atrial fibrillation（AF） remain not clear in *** aim to evaluate the epidemiologic features and outcomes of CHF patients with AF,compared by those CHF patients with sinus rhythm（SR）,which is still not clear in *** From January 2005 to December 2008,1161 patients were admitted to the PLA general hospitals and First Affiliated Hospital of Shantou University Medical College with a discharge diagnosis of CHF were enrolled in the *** patients were divided into two groups according to the presence or absence of *** main outcomes were defined as death within one year and readmission to the hospital for heart *** The rate of CHF patients with AF was 36 %.During 1 year follow-up,the overall main outcomes was higher in AF patients than in those with SR（P = 0.02）.After adjusting for other covariables,including age,gender,left ventricular ejection fraction（LVEF）,NYHA classification,et al,AF was no longer related to increased the risk of main outcomes during 1 year follow-up（RR：1.052,CI：0.938 ± 1.165,P = 0.629）.A Cox model showed that risk of main outcomes were associated with NYHA Ⅳ（P 〈 0.001）,age（P = 0.022）,left atrial dimension（P = 0.020）.Conclusion The generally observed higher adverse outcome during 1-year follow-up in patients with AF thus seems to be related to other factors,such as NYHA Ⅳ,age,left atrial dimension,but not AF.

关键词： chronic heart failure atrial fibrillation prognosis

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Plasma metabolomics combined with personalized diagnosis guided by Chinese medicine reveals subtypes of chronic heart failure

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Journal of Traditional Chinese Medical Sciences 2015年第2期2卷 80-90页

作者： Juan Wang Shuzhen Guo Kuo Gao Qi Shi Bangze Fu Chan Chen Liangtao Luo Dong Deng Huihui Zhao Wei Wang Beijing University of Chinese Medicine Beijing 100029China China-Japan Friendship Hospital Beijing 100029China Hangzhou Xiaoshan TCM Hospital Zhejiang 311201China Capital Medical University Beijing 100069China

Background:chronic heart failure(CHF)is characterized by insufficient blood supply from heart to meet the body’s metabolic *** Western and traditional Chinese medicine to treat CHF has proved a validated therapeutic *** recent years,metabolomics has been regarded as a potential platform to provide biomarkers for ***:To examine 38 patients,combined NMR plasma metabolomics and traditional Chinese medicine diagnosis in order to identify diagnostic biomarkers for two CHF syndrome ***:After processing the spectra,orthogonal partial least square discriminant analysis was performed,and the contributing NMR signals were analyzed using Y-scrambling statistical validation with good ***:Plasma metabolic patterns of yin deficiency and yang deficiency patients were clearly *** yin-deficiency group had increased level of lactate,glycoprotein,lipoprotein and lower levels of glucose,valine and *** yang-deficiency group had higher levels of lactate,glycoprotein and pyruvic acid,and lower levels of glucose and *** biomarkers of CHF based on the two traditional Chinese medicine syndromes indicated alternative modes of metabolites and metabolic pathways in the disease,*** of energy utilization and disturbance in fatty acids,amino ***:This study suggests that combining metabolomics with traditional Chinese medicine diagnosis can reveal metabolic signatures for CHF syndrome *** plasma metabolites identified might be of special clinical relevance for subtypes of CHF,which could lead to further understanding of mechanisms involved and an improvement in personalized treatment for CHF.

关键词： Metabolomics Chinese medicine chronic heart failure

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