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World Journal of cardiology 2021年第3期13卷 46-54页

作者： Kara Callum Claudia Graune Elizabeth Bowman Edward Molden Stephen J Leslie Department of cardiology NHS HighlandInverness IV23UJUnited Kingdom

BACKGROUND Implantable cardioverter defibrillators(ICDs)and cardiac resynchronisation therapy with defibrillators(CRT-D)reduce mortality in certain cardiac patient ***,inappropriate shocks pose a problem,having both adverse physical and psychological effects on the *** advances in device technology now allow remote monitoring(RM)of devices to replace clinic follow up *** allows real time data to be analysed and actioned and this may improve patient *** To determine if RM in patients with an ICD is associated with fewer inappropriate shocks and reduced time to medical *** This was a single centre,retrospective observational study,involving 156 patients implanted with an ICD or CRT-D,followed up for 2 years post *** appropriate and inappropriate shocks were recorded along with cause for inappropriate shocks and time to medical *** RM was associated with fewer inappropriate shocks(13.6%clinic vs 3.9%RM;P=0.030)and a reduced time to medical assessment(15.1±6.8 vs 1.0±0.0 d;P<0.001).CONCLUSION RM in patients with an ICD is associated with improved patient outcomes.

关键词： Implantable cardioverter defibrillator Inappropriate shocks Remote monitoring Cardiac patients Heart failure Arrythmia

Barriers and facilitators to participating in cardiac rehabilitation and physical activity:A cross-sectional survey

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World Journal of cardiology 2022年第2期14卷 83-95页

作者： Matthew James Fraser Stephen J Leslie Trish Gorely Emma Foster Ronie Walters Division of Biomedical Science University of the Highlands and IslandsInverness IV23JHUnited Kingdom Department of cardiology NHS HighlandInverness IV23UJUnited Kingdom Department of Nursing and Midwifery University of the Highlands and IslandsInverness IV23JHUnited Kingdom Cardiac Unit NHSH NHS HighlandInverness IV23JHUnited Kingdom

BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to *** is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardiac event to reduce mortality,improve recovery and positively influence behaviour around CVD risk *** the recognised benefits and international recommendations for exercisebased CR,uptake and attendance remain suboptimal.A greater understanding of CR barriers and facilitators is required,not least to inform service *** understanding current cardiac patients’attitudes and opinions around CR and physical activity(PA)could inform patient-led ***,through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the *** To investigate participants’attitudes and opinions around CR and *** This study employed a cross-sectional survey design on 567 cardiac *** patients who were referred for standard CR classes at a hospital in the Scottish Highlands,from May 2016 to May 2017 were *** part of a larger survey,the current study analysed the free-text responses to 5 open-ended questions included within the wider *** were related to the participants’experience of CR,reasons for non-attendance,ideas to increase attendance and their opinions on *** data were analysed using a 6-step,reflexive thematic *** Two main topic areas were explored:“Cardiac rehabilitation experience”and“physical activity”.Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment *** ranged from age and health to distance and starting times of the classes which increased travel time and ***,responses demonstrated a lack of information and communication around the *** h

关键词： Cardiovascular disease Cardiac rehabilitation Physical activity Barriers Facilitators Patient experience

Improvement of increased cQTd is associated with heart function in patients with ischemic heart failure

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Journal of Geriatric cardiology 2018年第1期15卷 41-49页

作者： Hui GUO Miao WANG Juan ZHAO Jing LIU Jie-Mei YANG Department of cardiology the First Affiliated Hospital of Harbin Medical University Harbin China Department of cardiology Ultrasound the First Affiliated Hospital of Harbin Medical University Harbin China

Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class （NYHA） III-iv with a left ventricular ejection fraction （LVEF）〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy （DCM） group （n = 120） and an ischemic cardiomyopathy （ICM） group （n = 120）. Then, based on the cQTd width, the ICM group was divided into two subgroups： a QS group （cQTd ≤60 ms, n = 70） and a QL group （cQTd 〉 60 ms, n = 50）. All patients were examined by echocardiography and 12-lead electrocardiography （ECG） at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.

关键词： Cardiac dyssynchrony Chronic heart failure Corrected QT dispersion Heart function Ischemic cardiomyopathy

Astragaloside Ⅳ for Heart Failure: Preclinical Evidence and Possible Mechanisms, A Systematic Review and Meta-Analysis

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Chinese Journal of Integrative Medicine 2023年第7期29卷 626-633页

作者： LI Xing-xing LI Dong CUI Xiao-yun ZHOU Kun LIU Jing LU Jin-jin WU Yang LIN Qian LI Yan Department of cardiology Dongfang HospitalBeijing University of Chinese MedicineBeijing100078China Department of cardiology Dongzhimen HospitalBeijing University of Chinese MedicineBeijing100700China

Objective:To explore the cardioprotective effects of astragaloside Ⅳ(AS-Ⅳ) in heart failure(HF).Methods:PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,Wanfang Database,Chinese Bio-medical Literature and Retrieval System(SinoMed),China Science and Technology Journal Database(VIP),and China National Knowledge Infrastructure(CNKI) were searched from inception to November 1,2021for animal experiments to explore AS-Ⅳ in treating HF in rats or mice. The left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-diastolic dimension(LVEDD),left ventricular endsystolic dimension(LVESD),left ventricular weight-to-body weight(LVW/BW) and B-type brain natriuretic peptide(BNP) were *** qualities of included studies were assessed by the risk of bias according to the Cochrane ***-analysis was performed using Stata ***:Twenty-one articles involving 558 animals were *** with the control group,AS-Ⅳ improved cardiac function,specifically by increasing LVEF(mean difference(MD)=6.97,95% confidence interval(CI)=5.92 to 8.03,P<0.05;fixed effects model) and LVFS(MD=7.01,95% CI=5.84 to 8.81,P<0.05;fixed effects model),and decreasing LVEDD(MD=-4.24,95% CI=-4.74to-3.76,P<0.05;random effects model) and LVESD(MD-4.18,95% CI=-5.26 to-3.10,P<0.05;fixed effects model).In addition,the BNP and LVW/BW levels were decreased in the AS-Ⅳ treatment group(MD=-9.18,95%CI=-14.13 to-4.22,P<0.05;random effects model;MD=-1.91,95% CI=-2.42 to-1.39,P<0.05;random effects model).Conclusions:AS-Ⅳ is a promising therapeutic agent for ***,this conclusion needs to be clinically validated in the future.

关键词： astragaloside iv heart failure pre-clinical evidence systematic review

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Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Journal of Geriatric cardiology 2021年第1期18卷 20-29页

作者： Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón Department of cardiology Hospital Universitario Fundación Jiménez Díaz-Quirónsalud Centro Nacional de Investigaciones Cardiovasculares MadridSpain Department of cardiology Hospital Central de Asturias Department of cardiology Hospital Universitario Ruber-Quirónsalud Department of cardiology Hospital Universitario Infanta Leonor Department of Endocrinology Hospital Clínico San Carlos Universidad Autónoma de Madrid CIBERCV MadridSpain

OBJECTivE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 *** AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^*** analyzed the relationship between treatment with BB and mortality or cardiovascular *** mean age of our population was 82.6±4.1 *** ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,andiving *** median follow-up was28.04(IR:19.41-36.67)*** the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;Piving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,Piv and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better *** of BB should be encouraged when possible.

关键词： CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Radial artery access site complications during cardiac procedures,clinical implications and potential solutions: The role of nitric oxide

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World Journal of cardiology 2020年第1期12卷 26-34页

作者： Emma M Coghill Timothy Johnson Russell E Morris Ian L Megson Stephen J Leslie Free Radical Research Facility Division of Biomedical SciencesUniversity of the Highlands and IslandsInverness IV23JHUnited Kingdom Johnson Matthey Technology Centre Blount’s CourtSonning CommonReading RG49NHUnited Kingdom School of Chemistry University of St.AndrewsSt Andrews KY169STUnited Kingdom Department of cardiology NHS HighlandInverness IV23UJUnited Kingdom

Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery,as this is considered to be safer than the femoral ***,despite improvements in technology and techniques,complications can *** most common complication,arterial spasm,can cause intense pain and,in some cases,procedural *** incidence of spasm is dependent on several variables,including operator experience,artery size,and equipment *** antispasmolytic cocktail can be applied to reduce spasm,which usually includes an exogenous nitric oxide(NO)donor(glyceryl trinitrate).NO is an endogenous local vasodilator and therefore is a potential target for anti-spasm ***,systemic administration can result in unwanted side-effects,such as hypotension.A method that adopts local delivery of NO might be *** review article describes the mechanisms involved in radial artery spasm,discusses the advantages and disadvantages of current strategies to reduce spasm,and highlight the potential of NO-loaded nanoporous materials for use in this setting.

关键词： Radial artery Cannulation Spasm Nitric oxide Vasodilation Nanoporous material

Homozygous factor Ⅴ Leiden mutation in type Ⅳ Ehlers-Danlos patient

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World Journal of Clinical Cases 2014年第3期2卷 75-77页

作者： Marwan Refaat Mostafa Hotait Brion Winston Department of cardiology American University Medical Center Capital cardiology Associates 7 Southwoods Blvd. Albany NY 12211 United States

Ehlers-Danlos syndrome(EDS) is a group of inherited connective tissue disorders caused by collagen synthesis defects. Several hemostatic abnormalities have been described in EDS patients that increase the bleeding tendencies of these patients. This case report illustrates a patient with an unusual presentation of a patient with type Ⅳ EDS, platelet δ-storage pool disease and factor Ⅴ Leiden mutation. Young woman having previous bilateral deep vein thrombosis and pulmonary emboli coexisting with ruptured splenic aneurysm and multiple other aneurysms now presented with myocardial infarction. Presence of factor Ⅴ Leiden mutation raises the possibility that the infarct was due to acute coronary thrombosis, although coronary artery aneurysm and dissection with myocardial infarction is known to occur in vascular type EDS. This is the first report in the medical literature of factor Ⅴ Leiden mutation in an EDS patient which made the management of our patient challenging with propensity to both bleeding and clotting.

关键词： Ehlers-Danlos syndrome Factor Ⅴ Leiden Platelets Coagulopathy

Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction

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Journal of Geriatric cardiology 2024年第10期21卷 954-961页

作者： Albert Ariza-Solé Juan Andrés Bermeo Francesc Formiga Héctor Bueno Gemma Miñana Oriol Alegre David Martí Manuel Martínez-Sellés Laura Domínguez-Pérez Pablo Díez-Villanueva JoséA Barrabés Francisco Marín Adolfo Villa Marcelo Sanmartín Cinta Llibre Alessandro Sionís Antoni Carol Sergio García-Blas María JoséMorales Gallardo Jaime Elízaga iván Gómez-Blázquez Fernando Alfonso Bruno García Del Blanco Julio Núñez Juan Sanchis cardiology Department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Internal Medicine Department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Centro Nacional de Investigaciones Cardiovasculares(CNIC) MadridSpain.Cardiology DepartmentHospital 12 de Octubreand Instituto de Investigación Sanitaria Hospital 12 de Octubre(imas12)MadridCIBERCVMadridSpain.Universidad ComplutenseMadridSpain cardiology Department Hospital Clínico Universitario de ValenciaINCLIVAUniversidad de ValenciaCIBERCVValenciaSpain cardiology Department Hospital Central de la DefensaMadridSpain cardiology Department Hospital Universitario Gregorio MarañónCIBERCVUniversidad ComplutenseUniversidad EuropeaMadridSpain cardiology Department Hospital Universitario La PrincesaIIS-IPCIBERCVMadridSpain cardiology Department Hospital Universitari Vall d’HebronCIBERCVBarcelonaSpain cardiology Department Hospital Virgen de la ArrixacaCIBERCVEl PalmarMurciaSpain cardiology Department Hospital Universitario del SuresteArganda del ReyMadridSpain cardiology Department Hospital Ramon y CajalCIBERCVMadridSpain cardiology Department Hospital Germans Trias i PujolCIBERCVBadalonaBarcelonaSpain cardiology Department Hospital Sant PauCIBERCVBarcelonaSpain cardiology Department Hospital Moisés BroggiSant Joan DespíBarcelonaSpain

Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical *** The MOSCA-FRAIL trial randomized 167 frail patients,defined by a Clinical Frailty Scale(CFS)≥4,with NSTEMI to an invasive or conservative *** primary endpoint was the number of days alive and out of hospital(DAOH)one year after *** this subanalysis,we compared the impact of an invasive strategy on the outcomes between vulnerable(CFS=4,n=43)and frail(CFS>4,n=124)*** Compared to vulnerable patients,frail patients presented lower values of DAOH(289.8 vs.320.6,P=0.146),more read-missions(1.03 vs.0.58,P=0.046)and higher number of days spent at the hospital during the first year(10.8 vs.3.8,P=0.014).The cau-ses of readmission were mostly non-cardiac(56%).Among vulnerable patients,DAOH were similar regardless of strategy(invasive ***:325.7 vs.314.7,P=0.684).Among frailest patients,the invasive group tended to have less DAOH(267.7 vs.311.1,P=0.117).Indeed,patients with CFS>4,invasively managed lived 29 days less than their conservative *** contrast,the-re were no differences in the subgroup with CFS=*** Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty.A routine in-vasive strategy does not improve outcomes and might be harmful to the frailest patients.

关键词： routine invasive infarction

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Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

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World Journal of Clinical Cases 2021年第36期9卷 11165-11172页

作者： Hai-Jian Guo Feng Jiang Chu Chen Jia-Yu Shi Ya-Wen Zhao Department of cardiology Affiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality *** occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious *** To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart *** From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the *** pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery *** BNP and platelet parameters were estimated and compared among each group and *** correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then *** In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P0.05).In the cardiac function grade I,II,III,and iv subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pul

关键词： Chronic obstructive pulmonary disease Pulmonary heart disease Plasma brain natriuretic peptide Platelet parameter Cardiac function Pulmonary hypertension Correlation analysis

Rspo2 promotes embryonic stem cells to differentiate towards smooth muscle cells through LGR5/β-catenin pathway

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中国病理生理杂志 2016年第8期32卷 1531-1532页

作者： WU Yu-tao YANG Mei WANG Jing YANG Feng DAI Bing WANG Wei-na CHEN Ting ZHOU Yi-jiang ZHANG Li Department of cardiology First Affiliated HospitalSchool of MedicineZhejiang University

AIM: R-spondin 2( Rspo2),one member of R-spondin family which contains four secreted proteins,plays an important role in skeletal muscle development. However,the impact of Rspo2 on vascular smooth muscle cell( SMC) differentiation is little *** study aims at revealing the role and mechanism of Rspo2 on SMC differentiation from embryonic stem cells( ESCs). METHODS:A well-established model for studying SMC differentiation from ESCs were used,in which mouse embryonic stem cells( ES-D3) were seeded on collagen iv-coated asks and cultured in differentiation medium( DM) for 2,4,6 and 8 days. Smooth muscle specific markers,including α-smooth muscle actin( α-SMA),SM22 and smooth muscle myosin heavy chain( SM-MHC),were detected to insure the successful model by q RT-PCR and Western blot. After 3-day pre-differentiation,ESCs were treated with recombinant Rspo2 protein,overexpression plasmid or sh RNA plasmid for 96 h,and the m RNA and protein expression of smooth muscle markers was detected. To explore the role of Rspo2 on SMC differentiation in vivo,3-day predifferentiated ESCs(106in 50 μLα-MEM) incubated with Rspo2-overexpression plasmid were mixed with 50 μL of Matrigel( Becton Dickinson Labware) and then subcutaneously injected into C57 BL /6J mice. After 12 days,mice were sacrificed and the implants were harvested for immunofluorescence staining,q RT-PCR and Western blot. Furthermore,electrophoretic mobility shift assay( EMSA),chromatin immunoprecipitation assay( Ch IP) and luciferase reporter assay were performed to investigate the transcriptional activity of SMC differentiation related transcription factors,including serum response factor( SRF),myocardin( MYO),myocyte-specific enhancer factor 2C( MEF-2C). Involvement of Rspo2 receptor,leucine-rich repeat-containing,G-protein-coupled receptors( Lgr) 4,5,6,and β-catenin pathway during Rspo2-induced MSC differentiation were also uncovered by overexpression or inhibition of the respective protein. RESULTS: Our resu

关键词： stem Rspo2 promotes embryonic stem cells to differentiate towards smooth muscle cells through LGR5 catenin pathway