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Astragaloside iv prevents lipopolysaccharide-induced injury in H9C2 cardiomyocytes

Chinese Journal of Natural Medicines 2015年第2期13卷 127-132页

作者： WANG Shi-Guang XU Yan XIE Hao WANG Wei CHEN Xiao-Hu Department of cardiology The First Affiliated Hospital of Anhui University of Chinese Medicine First Clinical Medical College Nanjing University of Chinese Medicine College of Basic Medical Science Nanjing University of Chinese Medicine Key Laboratory of Drug Metabolism and Pharmacokinetics China Pharmaceutical University Department of Life Science Hefei Normal University Department of cardiology Jiangsu Province Hospital of Traditional Chinese Medicine

This study aimed to investigate the protective effects of astragaloside iv(AS iv) on lipopolysaccharide(LPS)-induced injury in H9C2 cardiomyocytes. H9C2 Cardiomyocytes were cultured with LPS(10 μg·mL-1) for 4 h and treated with AS iv at 50, 100, and 150 μmol·L-1 for various durations. Cell viability was determined by MTT. The content of released TNF-α and IL-6 from cardiomyocytes were evaluated by enzyme-linked immunosorbent assay(ELISA). The levels of superoxidase dismutase(SOD), malondialdehyde(MDA), lactate dehydrogenase(LDH), and creatine phosphate kinase(CK) were measured by using commercial available kits. The mR NA and protein expression levels of NF-κB p65 were measured by RT-PCR and Western blotting, respectively. And the NF-κB p65 activity was measured by ELISA. Our results demonstrated that AS iv at 50, 100, and 150 μmol·L-1 markedly inhibited the release of TNF-α and IL-6 and decreased NF-κB expression, compared with the model group. Moreover, the improved SOD activity and decreased MDA, LDH and CK levels were detected after AS iv treatment. In summary, AS iv could increase the activities of antioxidant enzymes, inhibite lipid peroxidation, and down-regulate the inflammatory mediators involved in the inflammatory responses. These results demonstrated that AS iv could prevent LPS-induced injury in cardiomyocytes.

关键词： Astragaloside iv Lipopolysaccharide H9C2 Cardiomyocytes

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Anesthetic Technique for Transesophageal Electrophysiology Studies in Pediatric Patients with Wolff-Parkinson-White Syndrome

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Open Journal of Pediatrics 2015年第1期5卷 17-22页

作者： George M. Gilly Walter J. Hoyt Donald E. Harmon Eric H. Busch Bobby D. Nossaman David M. Broussard Christopher S. Snyder Department of Anesthesiology Ochsner Clinic Foundation New Orleans LA USA Division of Pediatric cardiology University of Virginia Charlottesville VA USA Department of Pediatrics Division of Pediatric Cardiology Rainbow Babies and Children’s Hospital Case Western Reserve School of Medicine Cleveland OH USA

Objective: Patients with Wolff-Parkinson-White (WPW) Syndrome require risk assessment to determine their potential for sudden cardiac death. Transesophageal electrophysiology studies (TEEPS) are an effective risk stratification tool. The purpose of this study is to describe a minimially invasive, effective anesthetic technique to employ during transesophageal electrophysiology studies. Methods: A retrospective review of anesthetic technique utilized during TEEPS. Inclusion criteria;WPW on ECG;age iv sedation was performed on 15%, MAC on 10% and GA in remainder. Airway management techniques included 13.3% LMA, 20% endotrachael tube (ETT) and 66% mask. iv sedation, the initial anesthetic, was found to be cumbersome and uncomfortable. Next was ETT and LMA but trouble pacing was encountered due to positional change of the esophagus relative to the left atrium during ventilation. Mask induction was then performed in remaining 10 patients with TEEPS probe inserted through a nare while anesthesiologist continued mask ventilation. All mask procedures were successful without complications. Conclusions: Induction of anesthesia to perform TEEPS procedures on pediatric patients with Wolff-Parkinson-White syndrome underwent numerous attempts to make the procedure easy, reliable and reproducible for anesthesia and electrophysiologist. The eventual technique that proved to meet these criteria during a transesopheagel electrophysiology procedure was utilization of mask induction with continuous iv sedation.

关键词： Wolff Parkinson White Transesophagel Electrophysiology Study

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Surgical Correction of Tetralogy of Fallot in Adulthood

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Open Journal of Thoracic Surgery 2012年第3期2卷 72-77页

作者： Ignacio Lugones Pablo D. Inguanzo Diego Antoni Marisa Di Santo Rubén O. García 2Department of Pediatric cardiology Hospital Universitario Fundación Favaloro Buenos Aires Argentina Department of Pediatric cardiology Hospital Universitario Fundación Favaloro Buenos Aires Argentina Pediatric Cardiovascular Surgery Unit Hospital Universitario Fundación Favaloro Buenos Aires Argentina

Background: The aim of this study is to evaluate the short-term results of surgical correction of Tetralogy of Fallot in adult patients. Methods: Between 1999 and 2007, surgical correction was performed in 16 adult patients (mean age: 34.6 years;range: 18 to 62). Five previous procedures had been performed in 4 patients. Thirteen patients were in NYHA functional classification III or iv (81%), and 12 were cyanotic. Echocardiography was performed in all patients and 14 of them were catheterized. The mean gradient in the right ventricular outflow tract was 82 mmHg. Four patients had bad anatomy, consisting in coronary fistulas (2) and small pulmonary artery branches (2). Results: Infundibular resection was performed in all patients, ventricular septal defect closure in 15, pulmonary valve commissurotomy in 8, right ventricular outflow tract patch enlargement in 9 and transannular patch placement in 4. Three patients died during the postoperative hospital stay, 2 of them with sepsis. All of them had bad anatomy and severe preoperative condition. No residual defects were found. The other 13 patients had a good recovery. Eleven had less than 24 hours of mechanical ventilation. Early hospital discharge was possible in all survivors. Conclusion: Surgical correction of Tetralogy of Fallot in adulthood is an infrequent procedure. The short-term results depend mostly on the anatomic substrate and the preoperative clinical condition of the patient.

关键词： Adult Congenital Heart Disease Congenital Heart Surgery Postoperative Care Pulmonary Arteries

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Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram:A comparison of shockable and non-shockable initial rhythms

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World Journal of cardiology 2017年第8期9卷 702-709页

作者： Pedro Martínez-Losas Pablo Salinas Carlos Ferrera María Teresa Nogales-Romo Francisco Noriega María Del Trigo iván Javier Núnez-Gil Luis Nombela-Franco Nieves Gonzalo Pilar Jiménez-Quevedo Javier Escaned Antonio Fernández-Ortiz Carlos Macaya Ana Viana-Tejedor Interventional cardiology and Coronary Care Unit Cardiovascular InstituteHospital Universitario Clínico San Carlos28040 MadridSpain

AIM To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic *** From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnostic post-resuscitation electrocardiogram(defined as ST segment elevation or pre-sumably new left bundle branch block) whounderwent invasive coronary angiogram during hospitalization were included. For purpose of analysis and comparison, patients were classified in two groups: Initial shockable rhythm(ventricular tachycardia or ventricular fibrillation; n = 148, 72.9%) and initial non-shockable rhythm(n = 55, 27.1%). Baseline characteristics, coronary angiogram findings including Syntax Score and long-term survival rates were compared. RESULTS Sudden cardiac arrest was witnessed in 95.2% of cases, 66.7% were out-of-hospital patients and 72.4% were male. There were no significant differences in baseline characteristics between groups except for higher mean age(68.1 years vs 61 years, P = 0.001) in the nonshockable rhythm group. Overall 5-year mortality of the resuscitated patients was 37.4%. Patients with non-shockable rhythms had higher mortality(60% vs 29.1%, P < 0.001) and a worst neurological status at hospital discharge based on cerebral performance category score(CPC 1-2: 32.7% vs 53.4%, P = 0.02). Although there were no significant differences in global burden of coronary artery disease defined by Syntax Score(mean Syntax Score: 10.2 vs 10.3, P = 0.96) there was a trend towards a higher incidence of acute coronary lesions in patients with shockable rhythm(29.7% vs 16.4%, P = 0.054). There was also a higher need for ad-hoc percutaneous coronary intervention in this group(21.9% vs 9.1%, P = 0.03). CONCLUSION Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs nonshockable

关键词： Sudden cardiac arrest Electrocardiogram Invasive coronary angiography Percutaneous coronary intervention Syntax score Coronary artery disease

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Myocardial disease,anemia and heart failure

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Journal of Geriatric cardiology 2005年第3期2卷 164-171页

作者： Donald S Silverberg Dov Wexler Adrian Iaina Doron Schwartz Department of Nephrology Tel Aviv Medical Center Weizman 6 Tel Aviv 64239Israel Department of cardiology and Heart Failure Clinic Tel Aviv Medical Center Weizman 6Tel Aviv 64239Israel

Many patients with congestive heart failure (CHF) fail to respond to maximal CHF therapy and progress to end stage CHF with many hospitalizations, very poor quality of life, end stage renal failure, or die of cardiovascular complications within a short time. One factor that has generally been ignored in many of these patients is the fact that they are often anemic. The anemia is due mainly to renal failure but also to the inhibitory effects of cytokines on the bone marrow. Anemia itself may further worsen the cardiac function and make the patients resistant to standard CHF therapies. Indeed anemia has been associated with increased severity of CHF, increased hospitalization, worse cardiac function and functional class, higher doses of diuretics, worsening of renal function and reduced quality of life. In both controlled and uncontrolled studies the correction of the anemia with erythropoietin (EPO) and oral or iv iron is associated with improvement in all these parameters. EPO itself may also play a direct role in improving the heart unrelated to the improvement of the anemia. Anemia may also play a role in the worsening of coronary heart disease even without CHF.

关键词： heart failure renal failure anemia erythropoietin iron

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Interferon Regulatory Factor 5 and Renin-Angiotensin-Aldosterone System Polymorphisms in Coronary Artery Disease: An Overview of Experimental and Clinical Studies

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World Journal of Cardiovascular Diseases 2021年第7期11卷 332-341页

作者： Jorge Luis Bermudez-Gonzalez Rodrigo Dagio-Cuellar Cristina Villarreal-Guerrero Ana Gilabert-Garcia Luis Angel Ferral-Barbabosa Joaquin Berarducci Jose Luis Siller-Nava Jose Antonio Luna-Alvarez-Amezquita Javier iván Armenta-Moreno Nilda Espínola-Zavaleta Erick Alexanderson-Rosas Juan Ignacio Straface National Institute of cardiology Ignacio Chavez Mexico City Mexico Medicine Faculty of National Autonomous University of Mexico Mexico City Mexico

Heart diseases are the main cause of mortality in Mexico, being coronary heart disease the most frequent in the country. Its high prevalence makes important the study of the pathophysiology and the search for prognostic factors. Different genes and polymorphisms promote atherogenesis and coronary artery disease, they affect inflammatory and vascular pathological processes. Interferon regulatory factor 5 (IRF5) is associated with coronary heart disease, it promotes chronic inflammation and cytokines release;it could trigger immune reactions and its activating receptors express in the vascular endothelium. Besides, polymorphisms in the renin-angiotensin-aldosterone system (RAAS) are implied with coronary disease, they are found in angiotensinogen (AGT), angiotensin II type 1 receptor (AT1R), angiotensin II type 2 receptor (AT2R), and angiotensin-converting enzyme (ACE) genes. These genetic polymorphisms are associated with a prothrombotic state, endothelial dysfunction, and immune activation. Multiple experimental studies showed that chronic activation of RAAS and chronic expression of IRF5 generates an environment prone to the development of atherosclerosis, and autoimmune and cardiovascular diseases. Studying these specific genes and their relationship with coronary heart disease will allow a better understanding of the pathological process and possibly the quest for new treatments.

关键词： Interferon Regulatory Factor 5 (IRF5) Angiotensin-Converting Enzyme (ACE) Angiotensinogen (AGT) Angiotensin II Type 1 Receptor (AT1R) Angiotensin II Type 2 Receptor (AT2R) Polymorphisms

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Searching for a treatment for Alport syndrome using mouse models

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World Journal of Nephrology 2014年第4期3卷 230-236页

作者： Kan Katayama Shinsuke Nomura Karl Tryggvason Masaaki Ito Departmenof cardiology and Nephrology Mie University Graduate Schoo of Medicine Division of Matrix Biology Department of Medical Biochemistry and Biophysics Karolinska Institute

Alport syndrome （AS） is a hereditary nephritis caused by mutations in COL4A3, COL4A4 or COL4A5 encod-ing the type iv collagen α3, α4, and α5 chains, which are major components of the glomerular basement membrane. About 20 years have passed since COL4A3, COL4A4, and COL4A5 were identifed and the frst Al-port mouse model was developed using a knockout ap-proach. The phenotype of Alport mice is similar to that of Alport patients, including characteristic thickening and splitting of the glomerular basement membrane. Alport mice have been widely used to study the patho-genesis of AS and to develop effective therapies. In this review, the newer therapies for AS, such as pharma-cological interventions, genetic approaches and stem cell therapies, are discussed. Although some stem cell therapies have been demonstrated to slow the renal disease progression in Alport mice, these therapies demand continual refnement as research advances. In terms of the pharmacological drugs, angiotensin-con-verting enzyme inhibitors have been shown to be effec-tive in Alport mice. Novel therapies that can provide a better outcome or lead to a cure are still awaited.

关键词： Alport syndrome Angiotensin-converting enzyme Genetic Hereditary nephritis Pharmacologi-cal Renal injury Stem cell therapy

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Quality of life, physical performance and nutritional status in older patients hospitalized in a cardiology department

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Journal of Geriatric cardiology 2020年第7期17卷 410-416页

作者： Matthieu Lilamand Mariannick Saintout Marie Vigan Astrid Bichon Laure Tourame Aurélie Brembilla Diet Bernard Iung Dominique Himbert Cédric Laouenan Agathe Raynaud-Simon Assistance Publique Hôpitaux de Paris Nord Department of GeriatricsBichat University HospitalFrance University of Paris France Assistance Publique Hôpitaux de Paris Nord Department of EpidemiologyBiostatistics and Clinical ResearchBichat University HospitalFrance Assistance Publique Hôpitaux de Paris Nord Department of CardiologyBichat University HospitalFrance

Objectives Quality of life(QoL) is a priority outcome in older adults suffering from cardiovascular diseases. Frailty and poor nutritional status may affect the QoL through mobility disorders and exhaustion. The objective of this study was to determine if physical frailty and nutritional status were associated with QoL, in older cardiology patients. Methods Cross sectional, observational study conducted in a cardiology department from a university hospital. Participants(n = 100) were aged 70 and older. Collected data included age, sex, cardiac diseases, New York Heart Association(NYHA) classification, comorbidities(Charlson Index) and disability. A Short Physical Performance Battery(SPPB), including walking speed assessment was performed;handgrip strength were measured as well as Fried’s frailty phenotype. Nutritional status was assessed using the Mini Nutritional Assessment(MNA) and Body Mass Index(BMI), inflammation by C-reactive protein(CRP). QoL was assessed using the EORTC–QLQ questionnaire. Univariate and multivariate analyses were performed to study the associations between all recorded parameters and QoL. Results In participants(mean age: 79.3 ± 6.7 years;male: 59%), Charlson index, arrhythmia, heart failure, NYHA class III-iv, MNA, disability, walking speed, SPPB score, frailty and CRP were significantly associated with QoL in univariate analysis. Multivariate analysis showed that NYHA class III-iv(P < 0.001), lower MNA score(P = 0.03), frailty(P < 0.0001), and higher CRP(P < 0.001) were independently associated with decreased QoL. Conclusions Frailty, nutritional status and inflammation were independently associated with poor QoL. Further studies are needed to assess the efficacy of nutritional and physical interventions on QoL in this population.

关键词： Cardiovascular diseases Frailty Muscle strength Nutrition Older adults Quality of life

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Impact of Left Bundle Branch Block on Left Ventricular Mechanics in Patients with Idiopathic Dilated Cardiomyopathy

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World Journal of Cardiovascular Diseases 2019年第2期9卷 132-148页

作者： Ahmed Emara Hala Mahfouz Badran Waleed Abdou Naglaa Fahim Mohamed Fathi Magdi H. Yacoub cardiology Department Menoufiya University Menoufia Governorate Egypt The BAHCM National Program Menoufia Governorate Egypt Imperial College London UK

Objectives: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence and impact of LBBB on left ventricular mechanics using 2D strain imaging in patients with idiopathic dilated cardiomyopathy (IDCM). Methods: We included 101 patients with IDCM with mean age 38 ± 18 years: 74% were males and 13.9% of them were in NYHA Class III-iv. LBBB was present in 26 (37%) of included patients. Myocardial mechanics including longitudinal, circumferential strain and rotation and LV synchronization were assessed using two-dimensional strain imaging. Results: LBBB group had higher LV volumes, and PAP compared with non LBBB. Peak LV longitudinal systolic strain (εsys) of the septum and global LV SRsys were significantly lower in LBBB compared to non LBBB group (P 0.01, 0.03). TTP-d was greater in LBBB in comparison to non LBBB group (274.5 ± 116 versus 209.4 ± 139, P 0.02). The electromechanical delay between septal segments was 35 ± 18 ms and between lateral wall segments: 48 ± 24 ms, between anterior wall segments: 21 ± 11 and between inferior wall segments: 41 ± 12. Consequently, LV mechanical dyssynchrony was more evident in IDCM patients with LBBB. QRS width was correlated inversely with LV longitudinal strain and strain rate and electromechanical delay (P 0.0001) in non LBBB group. In LBBB QRS width was not related to cardiac mechanics. Using univariate analysis and after a multiple covariate adjustment, the baseline LBBB was associated with a significantly increased LV dysfunction. Conclusion:After correcting for potential confounders, LBBB was found to be associated with more deterioration of LV mechanics and exaggerated LV dyssynchrony in patients with IDCM.

关键词： Idiopathic Dilated Cardiomyopathy LBBB 2D Strain Imaging

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Clinical Characteristics and Prognosis of End-stage Hypertrophic Cardiomyopathy

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Chinese Medical Journal 2015年第11期128卷 1483-1489页

作者： Yan Xiao Kun-Qi Yang Yan-Kun Yang Ya-Xin Liu Tao Tian Lei Song Xiong-Jing Jiang Xian-Liang Zhou Department of cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Disease Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background： End-stage hypertrophic cardiomyopathy （HCM） is complicated by substantial adverse events. However, few studies have focused on electrocardiographic features and their prognostic values in HCM. This study aimed to evaluate the clinical manifestations and prognostic value of electrocardiography in patients with end-stage HCM. Methods： End-stage HCM patients were enrolled from a total of 1844 consecutive HCM patients from April 2002 to November 2013 at Fuwai Hospital. Clinical data, including medical history, electrocardiography, and echocardiography, were analyzed. Cox hazards regression analysis was used to assess the risk factors for cardiovascular mortality. Results： End-stage HCM was identified in 99 （5.4%） patients, averaged at 52 ± 16 years old at entry. Atrial fibrillation was observed in 53 patients and mural thrombus in 19 patients. During 3.9 ±3.0 years of follow-up, embolic stroke, refractory heart failure, and death or transplantation were observed in 20, 39, and 51 patients, respectively. The incidence of annual mortality was 13.2%. Multivariate Cox hazards regression analysis identified New York Heart Association Class （NYHA） Ill/iv at entry （hazard ratio [HR]： 1.99; 95% confidence interval [C/I： 1.05-3.80; P = 0.036）, left bundle branch block （LBBB）（HR： 2.80; 95% CI： 1.47-5.31; P = 0.002）, and an abnormal Q wave （HR： 2.21; 95% CI： 1.16-4.23; P = 0.016） as independent predictors of cardiovascular death, in accordance with all-cause death and heart failure-related death. Conclusions： LBBB and an abnormal Q wave are risk factors of cardiovascular mortality in end-stage HCM and provide new evidence for early intervention. Susceptibility of end-stage HCM patients to mural thrombus and embolic events warrants further attention.

关键词： End-stage Hypertrophic Cardiomyopathy Left Bundle Branch Block Prognosis Q wave

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