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Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention

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Journal of Geriatric cardiology 2013年第1期10卷 16-20页

作者： Wei Liu Kenji Wagatsuma Hideo Nii Mikihito Toda Hideo Amano Yasuto Uchida division of Interventional cardiology Cardiovascular Center Toho University 6-11-1 Omori-Nishi Ota-K Tokyo 143-8541 Japan Department of Cardiology Beijing An Zhen Hospital Capital Medical University Chao Yang District Beijing 100029 China division of Interventional cardiology Cardiovascular Center Toho University 6-11-1 Omori-Nishi Ota-K Tokyo 143-8541 Japan

Ba ckground The prognosis of elderly patients with chronic total occlusion (cTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PcI) is not known. Objective To investigate the effect of diabetes on long-term follow-up of cTO after PcI in elderly *** A total of 153 elderly patients (age > 65 years old) with cTO lesions which were successfully treated with PcI were enrolled. Fifty one patients with diabetes and 102 without diabetes were compared for long-term outcomes (mean follow up: 36 ±12 months). Major adverse cardiac events (MAcE) which include death, myocardial infarction or target lesion revascularization (TLR) were considered as a combined endpoint. Results The combined endpoint occurred in 29.4% of diabetes patients, and 11.3% of the patients without diabetes (P cox proportional hazards model identified: drug eluting stent (DES) or bare metal stent (BMS) (HR: 0.13, 95% confidence interval (95%cI): 0.03–0.62, P = 0.004), DM(HR: 6.69, 95% cI: 1.62–15.81, P = 0.01) and final minimal lumen diameter (MLD) (HR: 0.37, 95% cI: 0.13–0.90, P = 0.03 ) as independent predictors of MAcE, DM with renal impairment (HR: 6.64, 95% cI: 1.32–33.36, P = 0.02), HBA1c on admission (HR: 1.79, 95% cI: 1.09–2.94, P = 0.02), as independent predictors of MAcE at long term follow-up. conclusions The study demonstrates that DMis a predictive factor for MAcE in elderly cTOpatients treatedwith PcI, type of stent, final minimal lumen diameter and DMwith renal impairment, and HBA1c level on admission are predictors of MAcE.

关键词： chronic total occlusion Diabetes Drug eluting stent Elderly patient Percutaneous coronary intervention

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Five-year clinical outcomes of first-generation versus second-generation drug-eluting stents following coronary chronic total occlusion intervention

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Journal of Geriatric cardiology 2019年第8期16卷 639-647页

作者： Yong Hoon Kim Ae-Young Her Seung-Woon Rha Byoung Geol choi Se Yeon choi Jae Kyeong Byun Yoonjee Park Dong Oh Kang Won Young Jang Woohyeun Kim Ju Yeol Baek Woong Gil choi Tae Soo Kang Jihun Ahn Sang-Ho Park Ji Young Park Min-Ho Lee cheol Ung choi chang Gyu Park Hong Seog Seo division of cardiology Department of Internal MedicineKangwon National University School of MedicineChuncheonSouth Korea Department of cardiology Soonchunhyang University College of MedicineSeoulSouth Korea cardiovascular center Korea University Guro HospitalSeoulSouth Korea Department of Medicine Korea University Graduate SchoolSeoulSouth Korea cardiovascular center Seoul St. Mary’s Hospitalthe Catholic University of KoreaSeoulSouth Korea cardiology Department Konkuk University Chungju HospitalChungjuSouth Korea Department of Internal Medicine Cardiovascular DivisionDankook University HospitalCheonanSouth Korea Department of cardiology Soonchunhyang University Gumi HospitalGumiSouth Korea cardiology Department Soonchunhyang University Cheonan HospitalCheonanSouth Korea division of cardiology Department of Internal MedicineCardiovascular CenterNowon Eulji Medical CenterEulji UniversitySeoulSouth Korea

Background There are limited data comparing long-term clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DESs) in patients who underwent successful percutaneous coronary intervention (PcI) for coronary chronic total occlusion (cTO) lesion. Methods A total of 840 consecutive patients who underwent PcI with DESs for cTO lesion from January 2004 to November 2015 were enrolled. Finally, a total of 324 eligible cTO patients received 1G-DES (Paclitaxel-eluting stent or Sirolimus-eluting stent, n = 157) or 2G-DES (Zotarolimus-eluting stent or Everolimus-eluting stent, n = 167) were enrolled. The clinical endpoint was the occurrence of major adverse cardiac events (MAcE) defined as all-cause death, recurrent myocardial infarction (re-MI), total repeat revascularization [target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR]. We investigated the 5-year major clinical outcomes between 1G-DES and 2G-DES in patient who underwent successful cTO PcI. Results After propensity score matched (PSM) analysis, two well-balanced groups (111 pairs, n = 222, c-statistic = 0.718) were generated. Up to the 5-year follow-up period, the cumulative incidence of all-cause death, re-MI, TLR, TVR and non-TVR were not significantly different between the two groups. Finally, MAcE was also similar between the two groups (HR = 1.557, 95% cI: 0.820–2.959, P = 0.176) after PSM. conclusions In this study, 2G-DES was not associated with reduced long-term MAcE compared with 1G-DES following successful cTO revascularization up to five years.

关键词： chronic total occlusion Drug-eluting stent Outcomes

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changes in smoking behavior and adherence to preventive guidelines among smokers after a heart attack

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Journal of Geriatric cardiology 2013年第2期10卷 146-150页

作者： Yoon-Jung choi Jong-Seon Park Ung Kim Sang-Hee Lee Jang-Won Son Dong-Gu Shin Young-Jo Kim Myung-Ho Jeong Young-Keun Ahn Myeong-chan cho Jang-Whan Bae chong-Jin Kim Jin-Man cho Kyoo-Rok Han Jun-Hee Lee Divison of cardiology Department of Internal Medicine Yeungnam University Hospital 170 Hyeonchung-ro Nam-gu Daegu 705-717 South Korea division of cardiology Department of Internal Medicine Chonnam National University Hospital 42 Jebong-ro Dong-gu Kwangju 501-757 South Korea Divison of cardiology Department of Internal Medicine Chungbuk National University Hospital 410 Sungbong-ro Heungdeok-gu Cheongju Chungcheongbuk-do 361-711 South Korea division of cardiology Department of Internal Medicine Kyunghee University Hospital 892 Dongnam-ro Gandong-gu Seoul 134-727 South Korea division of cardiology Department of Internal Medicine Hanrim University Hospital 94-195 Yeongdeungpo-dong Yeongdeungpo-gu Seoul 150-030 South Korea

Objective Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among smoking patients. Methods The study was carried out in smokers admitted with myocardial infarction (MI). Atotal of 275 patients who had been regularly followed for over one year after MI were randomly selected and enrolled in this *** investigated changes in smoking behavior and the adherence rate to Acc/AHA Guidelines for secondary prevention in patients with coronary artery disease at the time of, and one year after, the index event. Results The study population consisted of 275 patients (97.1% males) with a mean age of 57.0 ±11.2 years. Achievement of target goals at one year was as follows: smoking cessation, 52.3%; blood pressure, 83.9%; HbA1c, 32.7%; lipid profile, 65.5%; and body mass index (BMI), 50.6%. Over one year, 80% of the patients attempted to quit smoking; 27% of them re-started smoking within one month after discharge while 65% succeeded in cessation of smoking. At one year, only 52% of the patients overall had stopped smoking. From the multivariate logistic analysis including smoking patterns and clinical characteristics, the severity of coronary artery disease was the only independent predictor for smoking cessation (Relative risk (RR): 1.230; P = 0.022). conclusions Only a small percentage of MI patients adhere to guidelines for secondary prevention and a sizable proportion fail to stop smoking. These findings underscore the need for an effective patient education system.

关键词： coronary artery disease Myocardial infarction Prevention Smoking

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Stem cells for cardiac repair: an introduction

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Journal of Geriatric cardiology 2013年第2期10卷 186-197页

作者： Bastiaan c du Pr(e) Pieter A Doevendans Linda W van Laake Departments of cardiology and Medical Physiology Division of Heart and Lungs University Medical Center Utrecht P.O. box 85500 3508 GA Utrecht the Netherlands Departments of cardiology and Medical Physiology Division of Heart and Lungs University Medical Center Utrecht P.O. box 85500 3508 GA Utrecht the Netherlands Inter university Cardiology Institute of the Netherlands P.O. box 19258 2501 DG Utrecht the Netherlands Departments of cardiology and Medical Physiology Division of Heart and Lungs University Medical Center Utrecht P.O. box 85500 3508 GA Utrecht the Netherlands Hubrecht Institute P.O box 85164 3508 AD Utrecht the Netherlands

cardiovascular disease is a major cause of morbidity and mortality throughout the world. Most cardiovascular diseases, such as ischemic heart disease and cardiomyopathy, are associated with loss of functional cardiomyocytes. Unfortunately, the heart has a limited regenerative capacity and is not able to replace these cardiomyocytes once lost. In recent years, stem cells have been put forward as a potential source for cardiac regeneration. Pre-clinical studies that use stem cell-derived cardiac cells show promising results. The mechanisms,though, are not well understood, results have been variable, sometimes transient in the long term, and often without a mechanistic *** are still severalmajor hurdles to be taken. Stem cell-derived cardiac cells should resemble original cardiac cell types and be able to integrate in the damaged heart. Integration requires administration of stem cell-derived cardiac cells at the right time using the right mode of delivery. Once delivered, transplanted cells need vascularization, electrophysiological coupling with the injured heart, and prevention of immunological rejection. Finally, stem cell therapy needs to be safe, reproducible, and affordable. In this review, we will give an introduction to the principles of stem cell based cardiac repair.

关键词： cardiomyocytes Heart Regeneration Stem cell

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A green synthesis of carbon nanoparticles from honey and their use in real-time photoacoustic imaging

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Nano Research 2013年第5期6卷 312-325页

作者： Lina Wu Xin cai Kate Nelson Wenxin Xing Jun Xia Ruiying Zhang Allen J. Stacy Micah Luderer Gregory M. Lanza Lihong V. Wang Baozhong Shen Dipanjan Pan c-train and division of cardiology Washington University School of Medicine 4320 Forest Park Avenue Saint Louis MO 63108 USA Key Laboratory of Molecular Imaging in college of Heilongjiang Province Department of Radiology the 4th Affiliated Hospital of Harbin Medical University Harbin 1S0001 China Optical Imaging Laboratory Department of Biomedical Engineering Washington University in St. Louis Campus Box 1097 One Brookings Drive St. Louis MO 63130 USA Nano Research Facility (NNIN-NSF) Washington University in St. Louis St. Louis MO 63130 USA

Imaging sentinel lymph nodes （SLN） could provide us with critical information about the progression of a cancerous disease. Real-time high-resolution intrao- perative photoacoustic imaging （PAI） in conjunction with a near-infrared （NIR） probe may offer opportunities for the immediate imaging for direct identification and resection of SLN or collecting tissue samples. In this work a commercially amenable synthetic methodology is revealed for fabricating luminescent carbon nanoparticles with rapid clearance properties. A one-pot ＂green＂ technique is pursued, which involved rapid surface passivation of carbon nanopartides with organic macromolecules （e.g., polysorbate, polyethyleneglycol） in solvent-free conditions. Interestingly, the naked carbon nanoparticles are derived for the first time, from commercial food grade honey. Surface coated particles are markedly smaller （-7 nm） than previously explored particles （gold, single-walled carbon nanotubes, copper） for SLN imaging. The results indicate an exceptionally rapid signal enhancement （-2 min） of the SLN. Owing to their strong optical absorption in the NIR region, tiny size and rapid lymphatic transport, this platform offers great potential for faster resection of SLN and may lower complications caused in axillary investigation by mismarking with dyes or low-resolution imaging techniques.

关键词： carbon nanoparticle honey,contrast agents photoacoustictomography real-time imaging

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Immunopathogenesis and immunomodulatory therapy for myocarditis

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中国科学:生命科学英文版 2023年第9期66卷 2112-2137页

作者： Wu He Ling Zhou Ke Xu Huihui Li James Jiqi Wang chen chen DaoWen Wang division of cardiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyHubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological DisordersWuhan 430030China

Myocarditis is an inflammatory cardiac disease characterized by the destruction of myocardial cells, infiltration of interstitial inflammatory cells, and fibrosis, and is becoming a major public health concern. The aetiology of myocarditis continues to broaden as new pathogens and drugs emerge. The relationship between immune checkpoint inhibitors, severe acute respiratory syndrome coronavirus 2, vaccines against coronavirus disease-2019, and myocarditis has attracted increased attention. Immunopathological processes play an important role in the different phases of myocarditis, affecting disease occurrence, development, and prognosis. Excessive immune activation can induce severe myocardial injury and lead to fulminant myocarditis,whereas chronic inflammation can lead to cardiac remodelling and inflammatory dilated cardiomyopathy. The use of immunosuppressive treatments, particularly cytotoxic agents, for myocarditis, remains controversial. While reasonable and effective immunomodulatory therapy is the general trend. This review focuses on the current understanding of the aetiology and immunopathogenesis of myocarditis and offers new perspectives on immunomodulatory therapies.

关键词： myocarditis etiology pathogen immunopathogenesis immunomodulatory

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Base editing:a brief review and a practical example

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The Journal of Biomedical Research 2021年第2期35卷 107-114页

作者： Dongwook c.choe Kiran Musunuru division of cardiology and cardiovascular Institute Department of MedicineDepartment of GeneticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA 19104USA

Genome editing has undergone rapid development in recent years,yielding new approaches to make precise changes in *** this review,we discuss the development of various adenine and cytosine base-editing technologies,which share the ability to make specific base changes at specific sites in the *** also describe multiple applications of base editing in vitro and in ***,as a practical example,we demonstrate the use of a cytosine base editor and an adenine base editor in human cells to introduce and then correct a prevalent mutation responsible for hereditary tyrosinemia type 1.

关键词： base editing cRISPR genetics genome editing mutation

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Iatrogenic atrial septal defects after transseptal puncture for percutaneous left atrial appendage occlusion and their hemodynamic effects

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Journal of Geriatric cardiology 2022年第9期19卷 675-684页

作者： Ioannis Drosos Roberta De Rosa Philipp c.Seppelt Sebastian cremer Silvia Mas-Peiro Katrin Hemmann Jana Oppermann Recha Blessing Mariuca Vasa-Nicotera Andreas M.Zeiher Zisis Dimitriadis division of cardiology Department of Medicine IIIUniversity Hospital FrankfurtGoethe University Frankfurt am MainFrankfurtGermany German center for cardiovascular Research(DZHK) BerlinGermany cardiopulmonary Institute(cPI) FrankfurtGermany center of cardiology University Medical Center MainzMainzGermany Di-vision of cardiology and Intensive care Department of Internal MedicineSt.Ansgar HospitalHöxterGermany

Background Percutaneous left atrial appendage occlusion(LAAO)requires puncture of the interatrial *** immediate hemodynamic effects of iatrogenic atrial septal defects(iASD)after LAAO have not been examined so *** aimed at evaluat-ing these effects through invasive measurements of pressure and oxygen ***,we assessed the incidence of per-sistent iASD at three *** Forty-eight patients scheduled for percutaneous LAAO were prospectively included in the *** and oxygen saturation were measured(1)in the right atrium(RA)before transseptal puncture,(2)in the left atrium(LA)through the transseptal sheath after transseptal puncture,(3)in the LA after removal of introducer sheath,and(4)in the RA after removal of introducer *** echocardiography was performed at three months to detect *** Pressure in the RA increased significantly after removing the introducer sheath(P=0.034),whereas no difference was found in oxygen saturation in the RA(P=0.623).Pressure measurement in the LA showed no significant difference after re-moving the introducer sheath(P=0.718).Oxygen saturation in the LA also showed no significant difference(P=0.129).Follow-up transesophageal echocardiogram at 3 months revealed a persistent iASD in 4 patients(8.5%).cONcLUSIONS Our study suggests that iASD after percutaneous LAAO does not result in significant shunts directly after the procedure,although a significant increase of mean right atrial pressure can be *** iASDs after percutaneous LAAO seem to be relatively rare at three months.

关键词： atrial septal puncture

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Exercise catheterization for Hemodynamic Evaluation of Adults with coarctation of the Aorta

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congenital Heart Disease 2022年第6期17卷 605-615页

作者： Irene Martin de Miguel c.charles Jain Alexander c.Egbe Jason H.Anderson Heidi M.connolly William R.Miranda Department of cardiovascular Medicine Mayo ClinicRochesterMinnesotaUSA Department of Pediatric and Adolescent Medicine Division of Pediatric CardiologyMayo ClinicRochesterMinnesotaUSA

Background: coarctation of the aorta (coA) is associated with a generalized arteriopathy and long-term complicationsdespite repair. Data on invasive exercise hemodynamics in this population are lacking. Accordingly, wereviewed adults with coA undergoing exercise catheterization to assess 1. hemodynamic profile;2. feasibilityfor assessment of coA severity. Methods: Twenty patients undergoing exercise cardiac catheterization (12 armadduction and 8 supine cycle ergometry) at a quaternary care center between 2004 and 2021 were identified. Restingand exercise hemodynamic data were abstracted from the procedure logs. Results: Mean age was 43.6 ±12.0 years. Eleven patients (55%) had resting pulmonary arterial wedge pressure (PAWP) >15 mmHg;amongthose undergoing arterial catheterization, left ventricular end-diastolic pressure was >15 mmHg in 63%. Elevenpatients (55%) had pulmonary hypertension: 7 (35%) combined and 4 (20%) isolated post-capillary. At peak exercise,ΔPAWP/Δcardiac output (cO) ≥2 and Δmean pulmonary artery pressure/ΔcO ≥3 mmHg/l/min were foundin 7 (78%) and 6 (67%) patients, respectively;the composite of exercise PAWP ≥25 mmHg or ΔPAWP/ΔcO>2 was seen in 12 (86%). coA peak-to-peak gradients at baseline (n = 14) and during exercise (n = 9) were 12(3–16) and 16 mmHg (9–28), respectively. Only 2 patients had an increase in coA gradient to >20 mmHg withexercise. conclusions: Diastolic dysfunction and pulmonary hypertension were highly prevalent, with exerciseunmasking abnormal diastolic and pulmonary vascular reserve in some individuals. Most patients failed to showsignificant increases in coA peak-to-peak gradients with exercise. Further studies are warranted to establish thebest diagnostic method for coA severity assessment.

关键词： coarctation of the aorta exercise heart catheterization diastolic dysfunction hypertension

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Epidemiology of liver diseases:global disease burden and forecasted research trends

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Science china Life Sciences 2024年

作者： Jia Xiao Fei Wang Yuan Yuan Jinhang Gao Lu Xiao chao Yan Feifei Guo Jiajun Zhong Zhaodi che Wei Li Tian Lan Frank Tacke Vijay H.Shah cui Li Hua Wang Erdan Dong division of Gastroenterology and Hepatology Mayo Clinic Department of Health Sciences National Natural Science Foundation of China Department of Oncology The First Affiliated Hospital Institute for Liver Diseases of Anhui Medical University Inflammation and Immune Mediated Diseases Laboratory of Anhui Province Anhui Medical University Research center for cardiopulmonary Rehabilitation University of Health and Rehabilitation Sciences Qingdao Hospital(Qingdao Municipal Hospital) School of Health and Life Sciences University of Health and Rehabilitation Sciences Department of cardiology and Institute of Vascular Medicine Peking University Third Hospital State Key Laboratory of Vascular Homeostasis and Remodeling Peking University Department of Gastroenterology Qingdao Central Hospital University of Health and Rehabilitation Sciences Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment Zhuhai Hospital Affiliated with Jinan University division of Gastroenterology Seventh Affiliated Hospital of Sun Yat-sen University School of Biological Sciences Jinan University Aier Institute of Ophthalmology Central South University Lab of Gastroenterology and Hepatology West China Hospital Sichuan University clinical Medicine Research Institute and Department of Metabolic and Bariatric Surgery the First Affiliated Hospital of Jinan University Faculty of Pharmaceutical Sciences Toho University Department of Hepatology and Gastroenterology Charité-Universit?tsmedizin Berlin Campus Virchow-Klinikum and Campus Charité Mitte

We assessed the global incidence, mortality, and disability-adjusted life years(DALYs) associated with various liver diseases, including alcohol-related liver disease(ALD), hepatitis B/c virus infections(HBV or HcV), liver cancer, metabolic dysfunction-associated steatotic liver disease(MASLD), and other chronic liver diseases, from the 2019 Global Burden of Disease study. Additionally, we analyzed the global trends in hepatology research and drug development. From 2000 to 2019, prevalence rates increased for ALD, MASLD and other liver diseases, while they decreased for HBV, HcV, and liver cancer. countries with a high socio-demographic index(SDI) exhibited the lowest mortality rates and DALYs. The burden of liver diseases varied due to factors like sex and region. In nine representative countries, MASLD,along with hepatobiliary cancer, showed highest increase in funding in hepatology research. Globally, the major research categories in hepatology papers from 2000 to 2019 were cancer, pathobiology, and MASLD. The United States(U.S.) was at the forefront of hepatology research, with china gradually increasing its influence over time. Hepatologists worldwide are increasingly focusing on studying the communication between the liver and other organs, while underestimating the research on ALD. cancer, HcV, and MASLD were the primary diseases targeted for therapeutic development in clinical trials. However, the proportion of new drugs approved for the treatment of liver diseases was relatively low among all newly approved drugs in the U.S., china, Japan, and the European Union. Notably, there were no approved drug for the treatment of ALD in the world.

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