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Independent prognostic value of the congestion and renal index in patients with acute heart failure

Journal of Geriatric Cardiology 2023年第7期20卷 516-526页

作者： Run-Qing JI Bin WANG Jin-Guo ZHANG Shu-Hong SU Li LI Qin YU Xian-YanJIANG Xin FU Xue-Hua FANG Xiao-Wen MA Ao-Xi TIAN Jing LI National Clinical Research center for cardiovascular Diseases NHC Key Laboratory of Clinical Research for Cardiovascular MedicationsState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNational Center for Cardiovascular DiseasesBeijingChina Fuwai hospital Chinese Academy of Medical SciencesShenzhenChina Department of Cardiology Affiliated Hospital of Jining Medical UniversityJiningChina Department of Cardiology Xinxiang Central HospitalXinxiangChina Department of Cardiology Shanxi Fenyang HospitalFenyangChina Department of Cardiology Affiliated Zhongshan Hospital of Dalian UniversityDalianChina Heart center Qingdao Fuwai Cardiovascular HospitalQingdaoChina Department of Cardiology the First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Department of Cardiology Beijing Liangxiang HospitalBeijingChina Department of Cardiology Qinyang People’s HospitalQinyangChina

BACKGROUND Clinical outcomes are poor if patients with acute heart failure(AHF)are discharged with residual congestion in the presence of renal ***,there is no single indication to reflect the combined effects of the two related pathophysiological ***,therefore,proposed an indicator,congestion and renal index(CRI),and examined the associations between the CRI and one-year outcomes and the incremental prognostic value of CRI compared with the established scoring systems in a multicenter prospective cohort of *** We enrolled AHF patients and calculated the ratio of thoracic fluid content index divided by estimated glomerular filtration rate before discharge,as *** we examined the associations between CRI and one-year *** A total of 944 patients were included in the analysis(mean age 63.3±13.8 years,39.3%women).Compared with patients with CRI≤0.59 mL/min per kΩ,those with CRI>0.59 mL/min per kΩhad higher risks of cardiovascular death or HF hospitalization(HR=1.56[1.13-2.15])and all-cause death or all-cause hospitalization(HR=1.33[1.01-1.74]).CRI had an incremental prognostic value compared with the established scoring *** In patients with AHF,CRI is independently associated with the risk of death or hospitalization within one year,and improves the risk stratification of the established risk models.

关键词： patients acute index

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The value of serum metabolomics analysis in predicting the response to cardiac resynchronization therapy

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Journal of Geriatric Cardiology 2019年第7期16卷 529-539,I0001-I0004页

作者： Meng-Ruo ZHU Zibire Fulati Yang LIU Wen-Shuo WANG Qian WU Yan-Gang SU Hai-Yan CHEN Xian-Hong SHU Department of Echocardiography Zhongshan HospitalFudan UniversityShanghai Institute of Cardiovascular DiseasesShanghaiChina Department of Cardiology Zhongshan HospitalFudan UniversityShanghai Institute of Cardiovascular DiseasesShanghaiChina Department of Cardiac Surgery Zhongshan HospitalFudan UniversityShanghai Institute of Cardiovascular DiseasesShanghaiChina Shanghai center for Bioinformation Technology ShanghaiChina

Objective To construct a prediction model based on metabolic profiling for predicting the response to cardiac resynchronization therapy(CRT).Methods Peripheral venous(PV)and coronary sinus(CS)blood samples were collected from 25 patients with heart failure(HF)at the time of CRT implantation,and PV blood samples were obtained from ten healthy *** serum samples were analyzed by liquid chromatography-mass spectrometry(LC-MS).As per the clinical and echocardiographic assessment at the 6-month follow-up,the HF patients were categorized as CRT responders and *** HF patients had altered serum metabolomic profiles that were significantly different from those of the healthy *** metabolites were also observed between CRT responders and non-responders.A prediction model for CRT response(CRT-Re)was constructed using the concentration levels of the differential metabolites,L-arginine and *** optimal cutoff value of the CRT-Re model was found to be 0.343 by ROC analysis(sensitivity,88.2%;specificity,87.5%;Area under curve(AUC)=0.897,P=0.002).The concentration levels of the differential metabolites,L-arginine and lysyl-gamma-glutamate,in PV serum were significantly correlated with that in CS serum(r=0.945 and 0.680,respectively,all P<0.001).Conclusions Our results suggest that serum-based metabolic profiling may be a potential complementary screening tool for predicting the outcome of CRT.

关键词： Biomarker Cardiac resynchronization therapy Heart failure Metabolomics Serum

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Community-based prevention and treatment of cardiovascular diseases

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Journal of Geriatric Cardiology 2024年第3期21卷 315-322页

作者： Sheng-Shou HU The Writing Committee of the Report on cardiovascular Health and Diseases in China Fuwai hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

The Annual Report on cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in *** is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic *** 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and *** report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in *** the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among *** reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among ***,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion ***,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated ***,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.

关键词： prevention district treatment

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Epidemiology and current management of cardiovascular disease in China

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Journal of Geriatric Cardiology 2024年第4期21卷 387-406页

作者： Sheng-Shou HU the Writing Committee of the Report on cardiovascular Health and Dis-eases in China Fuwai hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

The Annual Report on cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patien

关键词： epidemiology landscape deaths

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Tuberculosis in Takayasu arteritis: a retrospective study in 1105 Chinese patients

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Journal of Geriatric Cardiology 2019年第8期16卷 648-655页

作者： Ying ZHANG Peng FAN Fang LUO Hui-Min ZHANG Lei SONG Wen-Jun MA Hai-Ying WU Jun CAI Lin-Ping WANG Xian-Liang ZHOU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Tuberculosis (TB) infection has been reported to have a possible relationship with the occurrence and clinical course of Takayasu arteritis (TA). We aimed to describe the characteristics of TB in a large population of TA patients. Methods We included a total of 1105 patients with TA, who were hospitalized between January 1992 and December 2017. Comparisons of clinical features were made according to the presence of TB. Results Among the 1105 patients, 109 (9.9%) had TB, including 53 patients (48.6%) diagnosed with TB before the onset of TA, 23 (21.1%) with a concurrent diagnosis of TB and TA, and 24 patients (22.0%) who developed TB after TA. Pulmonary TB was the most frequently identified (97 patients, 89.0%). Patients with TB had more frequent involvement of the pulmonary artery and experienced more chest discomfort and constitutional symptoms but had less interventional treatment. Demographic characteristics, comorbid diseases, and use of steroids were similar between patients with and without TB. Conclusions The proportion of Chinese TA patients with TB was not low, and about half of the patients had TB before TA. Pulmonary TB was the most common. Pulmonary artery involvement and pulmonary hypertension was more frequent in TA patients with TB.

关键词： Immunosuppressive agents Mycobacterium tuberculosis Pulmonary artery Takayasu arteritis

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Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents:A Meta-analysis and Systematic Review

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Chinese Medical Sciences Journal 2017年第1期32卷 1-12页

作者： Peisen Huang Yuan Yu Xikun Han Yuejin Yang State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular Diseases Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100037 China National Clinical Research center of cardiovascular Diseases Fuwai HospitalNational Center for Cardiovascular Diseases Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100037 China

Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration *** less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.

关键词： meta-analysis drug-eluting stents dual antiplatelet therapy percutaneous coronary intervention efficacy

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Anemia in patients with Takayasu arteritis: prevalence, clinical features, and treatment

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Journal of Geriatric Cardiology 2019年第9期16卷 689-694页

作者： Ying ZHANG Di ZHANG Yi QU Peng FAN Ya-Xin LIU Hui-Min ZHANG Lei SONG Wen-Jun MA Hai-Ying WU Jun CAI Fang LUO Xian-Liang ZHOU De-Yu ZHENG Li-Sheng LIU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Anemia is a common comorbidity of patients with Takayasu arteritis(TA). This study evaluated the prevalence, clinical characteristics, and treatment in Chinese TA patients with anemia. Methods This retrospective study included 533 consecutive patients hospitalized for TA from January 2009 to April 2018. Anemia was diagnosed on the basis of hemoglobin level, according to World Health Organization criteria. Results A total of 194 patients(36.4%) were diagnosed with anemia. Most had mild anemia(177, 91.2%). Female patients were predominant(92.8% of anemic patients). Normocytic anemia(62.9%) was the most common pattern. Anemic patients were more likely than non-anemic patients to have dizziness(29.4% vs. 21.2%), low body mass index(22.0 ± 3.6 vs. 22.9 ± 3.4 kg/m2), and active disease stage(64.9% vs. 50.1%);pulmonary involvement(12.4% vs. 26.8%), pulmonary hypertension(12.9% vs. 20.1%) and pulmonary hypertensive-target drugs(2.8% vs. 11.6%) were less common among anemic than non-anemic patients(all P < 0.05). Larger left ventricular end-diastolic diameter and lower left ventricular ejection fraction were observed in anemic patients. Over a median follow-up of four months, the increase of hemoglobin in anemic patients was associated with the use of iron supplementation. Conclusions Anemia is a very common concurrent condition in TA, especially in young, female patients. Patients with anemia are more likely to be in the active disease stage. Iron supplementation helps increase hemoglobin.

关键词： Anemia Disease activity Oral iron supplementation Takayasu arteritis

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Invasive versus conservative strategy in consecutive patients aged 80 years or older with non-ST-segment elevation myocardial infarction: a retrospective study in China

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Journal of Geriatric Cardiology 2019年第10期16卷 741-748页

作者： Yong-Gang SUI Si-Yong TENG Jie QIAN Yuan WU Ke-Fei DOU Yi-Da TANG Shu-Bin QIAO Yong-Jian WU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.

关键词： Conservative strategy Death Invasive strategy Non-ST-segment elevation myocardial infarction

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Transcatheter aortic valve implantation in a patient with anomalous right coronary artery originating from the left aortic sinus with interarterial course

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Journal of Geriatric Cardiology 2023年第8期20卷 612-614页

作者： Lu-Chen WANG Yan-Xiang LIU Xiao-Gang SUN Wei WANG Department of cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Recently,the utilization of transcatheter aortic valve implantation(TAVI)has gained increasing prevalence due to its expanding range of applications in managing symptomatic severe aortic stenosis(AS).Coronary obstruction,a life-threatening complication,has been reported to occur during and after TAVI at an incidence rate of 0.5%-1%.^([1])In addition to shallow sinus of Valsalva(less than 30 mm),low coronary take-off(below 12 mm from annulus plane),and calcification of native valve leaflets over the coronary ostium,anomalous origins of coronary arteries and compression from expanded transcatheter heart valve have been shown to cause TAVI-associated coronary occlusion.

关键词： coronary aortic implantation

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A New Perspective for Chinese Medicine Intervention for Coronary Artery Disease: Targeting Inflammation

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Chinese Journal of Integrative Medicine 2019年第1期25卷 3-8页

作者： LI Si-ming LI Jin-gen XU Hao cardiovascular Diseases center Xiyuan Hospital China Academy of Chinese Medical Sciences Graduate School Beijing University of Chinese Medicine

Inflammation, which plays a critical role in atherosclerosis and the occurrence of acute cardiovascular events, may be a new target for treatment of coronary artery disease(CAD) to reduce residual cardiovascular risk. Recently, Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease(CANTOS), the largest scale clinical trial that targeted inflammation but not lipids, has affirmed for the first time the inflammatory hypothesis of artherosclerosis and marked the advent of an exciting era of targeting inflammation for the prevention and treatment of cardiovascular diseases. Chinese medicine(CM) is a promising adjuvant therapy for CAD in light of its safety and pleiotropic effect of anti-inflammation, anti-platelet, lipid-regulating, endothelium-protection, microcirculation-improving, etc. In recent years, exploration of anti-inflammatory treatment of CAD with CM has been going on from theory to practice. Taking CANTOS as an example, the design strategy to combine CM and Western medicine to inhibit inflammation were discussed in this paper, which might provide a new perspective for CM intervention on CAD.

关键词： coronary artery disease inflammation Chinese medicine

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