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Vaccination against coronavirus disease 2019 in patients with pulmonary hypertension:A national prospective cohort study

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Chinese Medical Journal 2024年第6期137卷 669-675页

作者： Xiaohan Wu Jingyi Li Jieling Ma Qianqian Liu Lan Wang Yongjian Zhu Yue Cui Anyi Wang Cenjin Wen Luhong Qiu Yinjian Yang Dan Lu Xiqi Xu Xijie Zhu Chunyan Cheng Duolao Wang Zhicheng Jing department of cardiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China department of Echocardiography National Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China department of Pulmonary Circulation Shanghai Pulmonary HospitalTongji University School of MedicineShanghai 200433China department of cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China department of Clinical Sciences Liverpool School of Tropical MedicineLiverpoolUnited Kingdom

Background:Coronavirus disease 2019(COVID-19)has potential risks for both clinically worsening pulmonary hypertension(PH)and increasing mortality.However,the data regarding the protective role of vaccination in this population are still lacking.This study aimed to assess the safety of approved vaccination for patients with PH.Methods:In this national prospective cohort study,patients diagnosed with PH(World Health Organization[WHO]groups 1 and 4)were enrolled from October 2021 to April 2022.The primary outcome was the composite of PH-related major adverse events.We used an inverse probability weighting(IPW)approach to control for possible confounding factors in the baseline characteristics of patients.Results:In total,706 patients with PH participated in this study(mean age,40.3 years;mean duration after diagnosis of PH,8.2 years).All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China.Among them,278 patients did not receive vaccination,whereas 428 patients completed the vaccination series.None of the participants were infected with COVID-19 during our study period.Overall,398 patients received inactivated severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)vaccine,whereas 30 received recombinant protein subunit vaccine.After adjusting for baseline covariates using the IPW approach,the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase(27/428[6.3%]vs.24/278[8.6%],odds ratio=0.72,P=0.302).Approximately half of the vaccinated patients reported at least one post-vaccination side effects,most of which were mild,including pain at the injection site(159/428,37.1%),fever(11/428,2.6%),and fatigue(26/428,6.1%).Conclusions:COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH,although there were some tolerable side effects.A large-scale randomized controlled trial is warranted to confirm this finding.The final approval

关键词： Coronavirus disease COVID-19 Pulmonary hypertension Vaccination

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Managing end-stage carcinoid heart disease:A case report and literature review

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 1076-1083页

作者： Nikola Bulj Vedran Tomasic Maja Cigrovski Berkovic department of cardiology University Hospital Centre“Sestre Milosrdnice“Zagreb 10000Croatia Division of Gastroenterology Department of Internal MedicineUniversity Hospital Centre“Sestre Milosrdnice”Zagreb 10000Croatia department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of life.Cardiovascular complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic disease.CASE SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver metastases.During the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to follow-up.After 10 years,he presented to the emergency room with signs and symptoms of right-sided heart failure.Panneuroendocrine markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic metastases.Computed tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and pelvis.Furthermore,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart disease.The patient was not a candidate for valve replacement.He started octreotide acetate treatment,and the dose escalated to 80 mg IM monthly.Although biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart failure.Carcinoid heart disease and tumor burden are major prognostic factors of poor survival.Therefore,they must be actively sought by avai

关键词： Gastroenteropancreatic neuroendocrine neoplasms Carcinoid syndrome Carcinoid heart disease Diagnosis Treatment Case report

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Experimental Study on AT1-receptor-peptide-induced Myocardial Immune Damage in Rat

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2001年第3期21卷 198-201,208页

作者：罗余生廖玉华王敏魏宇淼董继华王金萍卢银平 department of cardiology Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan

In order to investigate the immunological damage in rat immunized with AT1-receptor peptide, 18 male Wistar rats were divided into two groups: immunized-group (n=12), each rat was immunized with 150 μg AT 1-receptor petide coupled to bovine serum albumin, together with Freund's adjuvant. Control group (n=6), sham-immunized, 'immunized liquid' was same as immunized-group except AT1-receptor peptide. Systolic blood pressure (SBP) was measured by using the tail-cuff technique, antibody against AT1-receptor peptide detected by using ELISA method, and left ventricular myocardium and renal cortex sections were observed under light and electron microscopy. There was no significant difference in SBP and light microscopic observation of the tissue sections between the immunized-group and control group. The O.D. value of anti-AT1-receptor peptide antiserum was significantly higher in the immunized-group than in the rats before immunization and control group (P<0.01). Positive rate in the immunized-group was 100 %, while 0 % in the control group. Ultramicroscopic morphology showed potential myocardial injury, including: increase in number of mitochondria, swelling of many mitochondria with reduction in number or absence of their cristae and cristolysis, disorder of the cardiac myofibrils, and myofibrillar disruption and myocytolysis. And lysosomes were increased in renal tubular epithelia. The AT1-receptor peptide could induce to generate the antibody against AT1-receptor peptide and lead to myocardial and renal damage in rats.

关键词： immunity AT1-receptor autoantibody peptide pathology

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Resilience provides mediating effect of resilience between fear of progression and sleep quality in patients with hematological malignancies

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World Journal of Psychiatry 2024年第4期14卷 541-552页

作者： Yuan Tian Ying-Li Wang department of Hematology The First Affiliated Hospital of Jinzhou Medical UniversityJinzhou 121000Liaoning ProvinceChina department of cardiology The First Affiliated Hospital of Jinzhou Medical UniversityJinzhou 121000Liaoning ProvinceChina

BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease,rapid progression,high recurrence rates,complex treatment methods,and treatment costs.AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies.METHODS A cross-sectional analysis of 100 patients with hematological malignancies,treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023,was conducted.Patients were assessed using a general data survey,a simplified scale for the fear of progression(FoP)of disease,a resilience scale,and the Pittsburgh Sleep Quality Index.Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP,resilience,and sleep quality.Spearman’s correlation analysis was used to examine the correlations between mental resilience,FoP,and sleep quality.RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09±5.16;the total resilience score mean value was 40.73±7.04;and the Pittsburgh Sleep Quality Index score mean value was 10.72±1.90.FoP,resilience,and sleep quality of the patients were associated with family per capita monthly income and patient education level(P<0.05).Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores(r=-0.560,-0.537,P<0.01),respectively,and resilience was significantly associated with sleep quality scores(r=0.688,P<0.01).Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was-0.100 and accounted for 50.51%of the total effect.This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience.CONCLUSION Resilience is an in

关键词： Resilience Blood tumor Fear of progression Sleep quality Mediating effect

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Therapeutic Angiogenesis:The Combination Point of Chinese and Western Medicine in Prevention and Treatment of Ischemic Heart Disease

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Chinese Journal of Integrative Medicine 2009年第5期15卷 323-324页

作者：吴宗贵 department of cardiology Changzheng HospitalSecond Military Medical University

At present, the conventional medicine and revascularization （including interventional treatment and coronary bypass surgery） in ischemic heart disease have limited the clinical efficacy on the progress of the left ventricular remodeling and heart failure after myocardial infarction, and the mortality accounts about 50% of cardiovascular diseases. With the potential role of repairing injured or necrotic myocardium and improving the blood supply in ischemic region, heart cell therapy and therapeutic angiogenesis have become new highlights in disease treatment and the field of cardiovascular new strategies for the prevention and treatment of complications of endstage ischemic heart diseases.

关键词： Therapeutic Angiogenesis

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Clinical Study on Chronopharmacokinetics of Digoxin in Patients with Congestive Heart Failure

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1998年第1期18卷 21-24页

作者：刘正湘方淑贤王琳朱同新杨汉荣余枢 department of cardiology Tongji Hospital Tongji Medical University Wuhan department of Pharmacy Tongji Hospital Tongji Medical University Wuhan

Fluorescence polarization immunoassay was used to study the chronopharmacokirietics of digoxin in 10 patients with congestive heart failure (CHF) who also served as self-controls. Our results showed that the serum digoxin concentration reached peak value 1h after taking digoxin at 7: 00 a. m.,but the serum digoxin concentration reached the peak value 2 h after taking digoxin at 4: 00 p. m.. The average serum digoxin concentration area under curve was greater and the best maintainable time of serum concentration within 24 h after taking digoxin at 4 p. m. longer than those at 7: 00 a. m.. The heart rates were obviously lower and the cardiac function was significantly improved in 4:00 p. m.group.

关键词： digoxin congestive heart failure chronopharmacokinetics

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Left bundle branch pacing set to outshine biventricular pacing for cardiac resynchronization therapy?

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World Journal of cardiology 2024年第4期16卷 186-190页

作者： Akash Batta Juniali Hatwal department of cardiology Dayanand Medical College and HospitalLudhiana 141001India department of Internal Medicine Advanced Cardiac CentrePost Graduate Institute of Medical Education&ResearchChandigarh 160012India

The deleterious effects of long-term right ventricular pacing necessitated the search for alternative pacing sites which could prevent or alleviate pacinginduced cardiomyopathy.Until recently,biventricular pacing(BiVP)was the only modality which could mitigate or prevent pacing induced dysfunction.Further,BiVP could resynchronize the baseline electromechanical dssynchrony in heart failure and improve outcomes.However,the high non-response rate of around 20%-30%remains a major limitation.This non-response has been largely attributable to the direct non-physiological stimulation of the left ventricular myocardium bypassing the conduction system.To overcome this limitation,the concept of conduction system pacing(CSP)came up.Despite initial success of the first CSP via His bundle pacing(HBP),certain drawbacks including lead instability and dislodgements,steep learning curve and rapid battery depletion on many occasions prevented its widespread use for cardiac resynchronization therapy(CRT).Subsequently,CSP via left bundle branch-area pacing(LBBP)was developed in 2018,which over the last few years has shown efficacy comparable to BiVP-CRT in small observational studies.Further,its safety has also been well established and is largely free of the pitfalls of the HBP-CRT.In the recent metanalysis by Yasmin et al,comprising of 6 studies with 389 participants,LBBPCRT was superior to BiVP-CRT in terms of QRS duration,left ventricular ejection fraction,cardiac chamber dimensions,lead thresholds,and functional status amongst heart failure patients with left bundle branch block.However,there are important limitations of the study including the small overall numbers,inclusion of only a single small randomized controlled trial(RCT)and a small follow-up duration.Further,the entire study population analyzed was from China which makes generalizability a concern.Despite the concerns,the meta-analysis adds to the growing body of evidence demonstrating the efficacy of LBBP-CRT.At this stage,one must acknowledge that the fact that stil

关键词： Biventricular pacing Cardiac resynchronization therapy Conduction system pacing Left bundle branch-area pacing Left bundle branch block Electromechanical dssynchrony

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Top Five Stories of the Cellular Landscape and Therapies of Atherosclerosis:Current Knowledge and Future Perspectives

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Current Medical Science 2024年第1期44卷 1-27页

作者： Qi PAN Cheng CHEN Yue-jin YANG State Key Laboratory of Cardiovascular Disease Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100037China

Atherosclerosis(AS)is characterized by impairment and apoptosis of endothelial cells,continuous systemic and focal inflammation and dysfunction of vascular smooth muscle cells,which is documented as the traditional cellular paradigm.However,the mechanisms appear much more complicated than we thought since a bulk of studies on efferocytosis,transdifferentiation and novel cell death forms such as ferroptosis,pyroptosis,and extracellular trap were reported.Discovery of novel pathological cellular landscapes provides a large number of therapeutic targets.On the other side,the unsatisfactory therapeutic effects of current treatment with lipid-lowering drugs as the cornerstone also restricts the efforts to reduce global AS burden.Stem cell-or nanoparticle-based strategies spurred a lot of attention due to the attractive therapeutic effects and minimized adverse effects.Given the complexity of pathological changes of AS,attempts to develop an almighty medicine based on single mechanisms could be theoretically challenging.In this review,the top stories in the cellular landscapes during the initiation and progression of AS and the therapies were summarized in an integrated perspective to facilitate efforts to develop a multi-targets strategy and fill the gap between mechanism research and clinical translation.The future challenges and improvements were also discussed.

关键词： atherosclerosis transdifferentiation extracellular traps efferocytosis stem cell nanoparticles

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Minimalistic approach to left atrial appendage occlusion guided by cardiac computed tomography angiography

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Journal of Geriatric cardiology 2024年第4期21卷 431-442页

作者： Xian-Sai MENG Qing-Song WANG Xin-Yan WANG Xu LU Yang MU Jing WANG Ting-Ting SONG Yun-Dai CHEN Tao CHEN Jun GUO Graduate School of Chinese PLA Medical College BeijingChina Senior department of cardiology the Sixth Med-ical CenterChinese PLA General HospitalBeijingChina

OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.

关键词： anesthesia matched approach

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Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure

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World Journal of Psychiatry 2024年第1期14卷 53-62页

作者： Li Zhang Qiang Wang Hong-Sheng Cui Yuan-Yuan Luo department of cardiology Jingzhou HospitalYangtze UniversityJingzhou 434020Hubei ProvinceChina department of Intensive Care Unit The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Patients with chronic heart failure(CHF)have a progressive disease that is associated with poor quality of life and high mortality.Many patients experience anxiety and depression(A&D)symptoms,which can further accelerate disease progression.We hypothesized that indicators of myocardial function and inflammatory stress may reflect the severity of A&D symptoms in patients with CHF.Changes in these biomarkers could potentially predict whether A&D symptoms will deteriorate further in these individuals.AIM To measure changes in cardiac and inflammatory markers in patients with CHF to determine A&D severity and predict outcomes.METHODS We retrospectively analyzed 233 patients with CHF treated at the Jingzhou Hospital,Yangtze University between 2018-2022 and grouped them according to Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores.We compared clinical data in the no-A&D,mild-A&D,moderate-A&D,and severe-A&D groups,the SAS and SDS scores with the New York Heart Association(NYHA)functional classification,and cardiac markers and inflammatory factors between the no/mild-A&D and moderate/severe-A&D groups.Regression analysis was performed on the markers with P0.05).In addition,we found that higher NYHA classes were associated with higher the SAS and SDS scores(P<0.05).Regression analysis showed that LVEF,NTproBNP,and IL-6 were independent risk factors for A&D severity(P<0.05).Among them,NT-proBNP had the best predictive ability as a single

关键词： Chronic heart failure Anxiety Depression Cardiac markers Inflammatory factors Prediction

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