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The potential of herbal drugs to treat heart failure:The roles of Sirt1/AMPK

Journal of Pharmaceutical Analysis 2024年第2期14卷 157-176页

作者： Tao Zhang Lei Xu Xiaowei Guo Honglin Tao Yue Liu Xianfeng Liu Yi Zhang Xianli Meng State Key Laboratory of Southwestern Chinese Medicine Resources Innovative Institute of Chinese Medicine and PharmacyChengdu University of Traditional Chinese MedicineChengdu611137China College of Pharmacy Chengdu University of Traditional Chinese MedicineChengdu611137China School of Ethnic Medicine Chengdu University of Traditional Chinese MedicineChengdu611137China Meishan Hospital of Chengdu University of Traditional Chinese Medicine MeishanSichuan620032China

heart failure(HF)is a highly morbid syndrome that seriously affects the physical and mental health of patients and generates an enormous socio-economic *** addition to cardiac myocyte oxidative stress and apoptosis,which are considered mechanisms for the development of HF,alterations in cardiac energy metabolism and pathological autophagy also contribute to cardiac abnormalities and ultimately *** information regulator 1(Sirt1)and adenosine monophosphate-activated protein kinase(AMPK)are nicotinamide adenine dinucleotide(NAD+)-dependent deacetylases and phosphorylated kinases,*** play similar roles in regulating some pathological processes of the heart through regulating targets such as peroxisome proliferator-activated receptorγcoactivator 1α(PGC-1α),protein 38 mitogen-activated protein kinase(p38 MAPK),peroxisome proliferator-activated receptors(PPARs),and mammalian target of rapamycin(mTOR).We summarized the synergistic effects of Sirt1 and AMPK in the heart,and listed the traditional Chinese medicine(TCM)that exhibit cardioprotective properties by modulating the Sirt1/AMPK pathway,to provide a basis for the development of Sirt1/AMPK activators or inhibitors for the treatment of HF and other cardiovascular diseases(CVDs).

关键词： heart failure Silent information regulator 1 Adenosine monophosphate-activated protein kinase Traditional Chinese medicine

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Mechanism of Qili Qiangxin Capsule for heart failure Based on miR133a-Endoplasmic Reticulum Stress

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Chinese Journal of Integrative Medicine 2024年第5期30卷 398-407页

作者： JI Xiao-di YANG Ding CUI Xi-yuan LOU Li-xia NIE Bo ZHAO Jiu-li ZHAO Ming-jing WU Ai-ming Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine Key Laboratory of Chinese Internal Medicine of Ministry of Education and BeijingBeijing 100700China Department of Traditional Chinese Medicine Fuwai HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Objective:To investigate the pharmacological mechanism of Qili Qiangxin Capsule(QLQX)improvement of heart failure(HF)based on miR133a-endoplasmic reticulum stress(ERS)***:A left coronary artery ligation-induced HF after myocardial infarction model was used in this *** were randomly assigned to the sham group,the model group,the QLQX group[0.32 g/(kg·d)],and the captopril group[2.25 mg/(kg·d)],15 rats per group,followed by 4 weeks of *** function such as left ventricular ejection fraction(EF),fractional shortening(FS),left ventricular systolic pressure(LVSP),left ventricular end diastolic pressure(LVEDP),the maximal rate of increase of left ventricular pressure(+dp/dt max),and the maximal rate of decrease of left ventricular pressure(–dp/dt max)were monitored by echocardiography and *** and eosin(HE)and Masson stainings were used to visualize pathological changes in myocardial *** m RNA expression of mi R133a,glucose-regulated protein78(GRP78),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6),X-box binding protein1(XBP1),C/EBP homologous protein(CHOP)and Caspase 12 were detected by *** protein expression of GRP78,p-IRE1/IRE1ratio,cleaved-ATF6,XBP1-s(the spliced form of XBP1),CHOP and Caspase 12 were detected by Western *** T-mediated d UTP nick-end labeling(TUNEL)staining was used to detect the rate of ***:QLQX significantly improved cardiac function as evidenced by increased EF,FS,LVSP,+dp/dt max,-dp/dt max,and decreased LVEDP(P<0.05,P<0.01).HE staining showed that QLQX ameliorated cardiac pathologic damage to some *** staining indicated that QLQX significantly reduced collagen volume fraction in myocardial tissue(P<0.01).Results from RT-PCR and Western blot showed that QLQX significantly increased the expression of mi R133a and inhibited the m RNA expressions of GRP78,IRE1,ATF6 and XBP1,as well as decreased the protein expressions of GRP78,cleave

关键词： heart failure Qili Qiangxin Capsule miR133a endoplasmic reticulum stress apoptosis

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A Robust N-Terminal Pro-Brain Natriuretic Peptide Assay for Clinical Diagnosis of heart failure in Elderly Patients

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Journal of Analysis and Testing 2024年第1期8卷 74-82页

作者： Xue Gong Jiangling Wu Jiajia Zhang Zhongwei Jiang Yi Wang Pu Zhang Engineering Research Center for Biotechnology of Active Substances(Ministry of Education) Chongqing Key Laboratory of Green Synthesis and ApplicationsCollege of ChemistryChongqing Normal UniversityChongqing 401331China Chongqing Research Center for Pharmaceutical Engineering College of PharmacyChongqing Medical UniversityChongqing 400016China Department of Clinical Laboratory University Town Hospital of Chongqing Medical UniversityChongqing 401331China

heart failure(HF)is a clinical hallmark of cardiovascular syndrome leading to substantial morbidity,repeated hospitalization,and enormous healthcare *** elderly populations continue to increase,biomarker-guided diagnosis and treatment for age-related cardiac decline have become *** evidence demonstrates that N-terminal proBNP(NT-proBNP)can provide a unique window into the diagnosis and risk stratification with ***,a simple yet robust aptasensor is developed for on-site recognizing the NT-proBNP by its targeting aptamer,thus achieving the accurate diagnosis of *** aptasensing system is prepared by absorbing the fluorophore-labeled aptamer strand onto the graphene oxide(GO),leading to efficient quenching without possible off-site signal *** aptamer strand can specifically identify target NT-proBNP molecules via a versatile conformational transformation,resulting in the desorption of the aptamer-NTproBNP complexes from GO and re-generation fluorescence signal,thus allowing sensitive detection of NT-proBNP in 37 clinical blood *** advantage of the high specificity of aptamer-guaranteed recognitions of NT-proBNP,this aptasensor system readily achieves better diagnostic performance for HF than commercially adopted chemiluminescence immunoassay(Siemens,CLIA)in hospitals in terms of accuracy(89.2%vs 83.8%),specificity(89.5%vs 84.2%),and positive predictive value(88.9%vs 83.3%).This work provides a stable option for the diagnosis and treatment of elderly HF-related diseases inclinics.

关键词： NT-proBNP Graphene oxide Aptamer heart failure Clinical diagnosis

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Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

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World Journal of Clinical Cases 2024年第8期12卷 1382-1387页

作者： Christos Kourek Alexandros Briasoulis Dimitrios E Magouliotis John Skoularigis Andrew Xanthopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Surgery University Hospital of LarissaLarissa 41110Greece of Cardiology University Hospital of LarissaLarissa 41110Greece

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality *** rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF *** activity,lifestyle,and psychological support are core components of a successful CR *** has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of *** individualized exercise prescription should be developed on the basis of a baseline evaluation in all *** main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and *** is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR *** are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or *** the present editorial,we present all the updated knowledge and recommendations in CR programs.

关键词： Cardiac rehabilitation heart failure Outcomes Exercise protocols Prescription Future perspectives Limitations

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Network Pharmacology-Based Dissection of the Bioactive Compounds and Pharmacological Mechanisms of Yiqi Fumai Lyophilized Injection for the Treatment of heart failure

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World Journal of Traditional Chinese Medicine 2024年第1期10卷 75-82页

作者： Yu-Xi Huang Jing-Jing Fan Lu-Lu Xu Rong Yu Yi Kuang Yue Chai Rui Zheng Xiao-Yu Zhang Hong-Cai Shang Xue Qiao Min Ye State Key Laboratory of Natural and Biomimetic Drugs School of Pharmaceutical SciencesPeking UniversityBeijingChina Key Laboratory of Chinese Internal Medicine of Ministry of Education Dongzhimen HospitalBeijing University of Chinese MedicineBeijingChina Yunnan Baiyao International Medical Research Center Peking UniversityBeijingChina Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education Peking UniversityBeijingChina

Objective:Yiqi Fumai Lyophilized Injection(YQFM),a Chinese medicine injection,has been widely used for the treatment of cardiovascular diseases,especially heart failure(HF).However,bioactive compounds and underlying mechanisms of YQFM in treating HF remain poorly *** and Methods:Network pharmacology was employed to investigate the bioactive compounds and mechanisms of YQFM.A compound-target network was constructed to screen bioactive compounds based on contribution index ***,an adriamycin-induced HF rat model was established to evaluate the cardio-protective effects of YQFM by hematoxylin and eosin staining and enzyme-linked immunosorbent ***:Network pharmacology indicated that YQFM may alleviate HF through 36 compounds and 109 ***,ginsenosides Rb1,Rg1,Re,Rf,Rb2,Rh1,schisandrin,and ginsenoside Rc were indicated as the top contributors of YQFM in treating *** was predicted to act on multiple targets such as vascular endothelial growth factor A,interleukin-2(IL-2),IL-6,and IL-1β,as well as to regulate signaling pathways such as hypoxia-inducible factor 1,tumor necrosis factor,VEGF,and *** pharmacological study suggested that YQFM could attenuate cardiac injury and up-regulate plasma concentrations of VEGFR-1 and NO in HF *** Rb1,as the major contributor from network pharmacology analysis,also showed a cardioprotective effect and up-regulation of VEGFR-1 in ***:Ginsenosides and schisandrin were predicted as the most important contributors to the cardioprotective effect of *** Rb1 was proved to alleviate HF and increase the plasma concentration of VEGFR-1.

关键词： Contribution index heart failure network pharmacology traditional Chinese medicine yiqi fumai lyophilized injection

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Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure

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World Journal of Diabetes 2024年第6期15卷 1226-1233页

作者： Jie Pang Lin-Yan Qian Ping Lv Xiao-Ru Che heart Center Department of Cardiovascular MedicineZhejiang Provincial People’s Hospital(The Affiliated People’s Hospital)Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina

BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular *** To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December *** NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were *** receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of *** correlation between NLR and RDW with the presence or absence of cardiac events was also *** Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of ***,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac *** NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic ***,NLR and RDW values were directly proportional to patient outcomes.

关键词： Neutrophil-lymphocyte ratio Red blood cell distribution width Type 2 diabetes heart failure Early diagnosis

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Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

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World Journal of Clinical Cases 2024年第4期12卷 766-776页

作者： Li-Li Xia Shu-Yun Yang Jun-Yao Xu Han-Qing Chen Zhu-Yuan Fang Hypertension Research Institute Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210004Jiangsu ProvinceChina Department of General Practice Southeast University Affiliated Zhongda HospitalNanjing 210009Jiangsu ProvinceChina

BACKGROUND heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and *** traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are *** study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF *** encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established *** results offer crucial insights into the potential advantages and constraints of TCM in HF *** on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and *** quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 ***,the quality of evidence was rated according to the GRADE *** A total of 1098 RCTs were initially *** screening,16 RCTs were finally included in our study,which were published between 2020 and *** RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 *** syndrome differentiation was analyzed in 11 of the included *** all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP *** meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0

关键词： Traditional Chinese medicine heart failure Comprehensive clinical outcomes Traditional Chinese medicine syndrome score B-type natriuretic peptide level Meta-analysis©The Author(s)2024.Published by Baishideng Publishing Group Inc.

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A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and heart failure

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Chinese Medical Sciences Journal 2024年第2期39卷 79-90页

作者： Ming-Hui Zhao Wei Chen Hong Cheng Bi-Cheng Liu Zhi-Guo Mao Zhuang Tian Gang Xu Jing-Min Zhou Renal Division Peking University First HospitalBeijing 100034China Department of Nephrology The First Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510080China Department of Nephrology Capital Medical UniversityBeijing 100029China Department of Nephrology Southeast University Zhongda HospitalNanjing 210009China Department of Nephrology Shanghai Changzheng HospitalShanghai 200003China Department of Cardiology Peking Union Medical College HospitalBeijing 100730China Renal Division Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430030China Department of Cardiology Zhongshan HospitalFudan UniversityShanghai 200032China

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and *** A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group *** group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across *** was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent *** A total of 150 responses from 21 provinces across China were recruited in the *** were comprised of an even split(n=75,50%)between cardiologists and *** 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

关键词： Sardiorenal syndrome chronic kidney failure heart failure hyperkalemia multidisciplinary communication RAASi

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Cardioprotective effects of glucagon-like peptide 1 receptor agonists in heart failure: Myth or truth?

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World Journal of Diabetes 2024年第5期15卷 818-822页

作者： Lorenzo Nesti Domenico Trico Department of Clinical and Experimental Medicine University of PisaPisa 56126Italy Laboratory of Metabolism Nutritionand AtherosclerosisUniversity of PisaPisa 56126Italy

Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related ***,while evidence about atherosclerosis consistently suggests a cardioprotective potential with class effect,controversies remain on its impact on heart ***1 receptor agonists appear to prevent hospitalization for new-onset heart failure and reduce symptoms in heart failure with preserved ejection fraction(as demonstrated by the recent STEP-HFpEF Trial).Still,GLP1 agonism has resulted in neutral or even harmful effects in patients with established heart failure with reduced ejection fraction(the LIVE trial).GLP1 receptor agonists benefit the cardiovascular system indirectly through their marked metabolic effects(improved weight management,glycemic control,blood pressure,systemic and tissue inflammation),while direct effects on the heart have been ***,weight loss alone achieved through GLP1 receptor agonists has failed in improving left ventricular *** is a dual agonist of GLP1 and glucose-dependent insulinotropic polypeptide,representing an innovative treatment option in diabetes with a major impact on weight loss and promising cardiovascular *** this class of therapies is going to change the history of heart failure is an ongoing debate.

关键词： Atherosclerosis Cardiovascular system Glucagon-like peptide-1 heart failure Tirzepatide Type 2 diabetes Ventricular function Left

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Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第1期16卷 40-48页

作者： Farah Yasmin Abdul Moeed Rohan Kumar Ochani Hamna Raheel Malik Ali Ehtsham Awan Ayesha Liaquat Arisha Saleem Muhammad Aamir Nael Hawwa Salim Surani Department of Internal Medicine Yale University School of MedicineNew HavenCT 06511United States Department of Medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of Medicine SUNNY Upstate Medical UniversitySyracuseNY 13210United States Department of Cardiovascular Medicine Lehigh Valley Heart and Vascular InstituteAllentownPA 18105United States Department of Medicine Cleveland ClinicClevelandOH 44195United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of *** Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology *** In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with *** A significant reduction in New York heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT ***,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

关键词： Left bundle branch pacing Biventricular pacing QRS duration Left ventricular ejection fraction heart failure

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