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Science China(Life Sciences) 2023年第3期66卷 649-652页

作者： Juejin Wang Zhaoyang Chen Hongchang Guo Rui Wang Ruijuan Sun Key Laboratory of Targeted Intervention of cardiovascular Disease Department of PhysiologyNanjing Medical UniversityNanjing 211166China Department of Cardiology Union HospitalFujian Medical UniversityBeijing 100029China Department of cardiovascular Surgery Center Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100085China Department of Health Sciences National Natural Science Foundation of ChinaFuzhou 350001China

cardiovascular diseases(CVDs)are the major threats to global human health and the leading causes of mortality and morbidity in China(Liu et al.,2019).Although various strategies have been developed,the prevalence of CVDs is still increasing in China,and many CVDs cannot be managed well(Liu et al.,2019)because of the lack of full elucidation on many basic issues.

关键词： threat Natural strategies

Exercise training attenuates angiotensinⅡ-induced cardiac fibrosis by reducing POU2F1 expression

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Journal of Sport and Health Science 2023年第4期12卷 464-476页

作者： Na Feng Haiyi Yu Yueshen Wang Youyi Zhang Han Xiao Wei Gao Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesKey Laboratory of Molecular Cardiovascular ScienceMinistry of EducationBeijing Key Laboratory of Cardiovascular Receptors ResearchBeijing 100191China research Unit of Medical Science research Management/Basic and Clinical research of Metabolic cardiovascular Diseases Chinese Academy of Medical SciencesBeijing 100191China

Background:Exercise training protects against heart failure.However,the mechanism underlying the protective effect of exercise training on angiotensinⅡ(AngⅡ)-induced cardiac fibrosis remains unclear.Methods:An exercise model involving C57BL/6N mice and 6 weeks of treadmill training was used.AngⅡ(1.44 mg/kg/day)was administered to induce cardiac fibrosis.RNA sequencing and bioinformatic analysis were used to identify the key factors mediating the effects of exercise training on cardiac fibrosis.Primary adult mouse cardiac fibroblasts(CFs)were used in vitro.Adeno-associated virus serotype 9 was used to overexpress POU domain,class 2,transcription factor 1(POU2F1)in vivo.Results:Exercise training attenuated AngⅡ-induced cardiac fibrosis and reversed 39 gene expression changes.The transcription factor regulating the largest number of these genes was POU2F1.Compared to controls,POU2F1 was shown to be signififcantly upregulated by AngⅡ,which is itself reduced by exercise training.In vivo,POU2F1 overexpression nullified the benefits of exercise training on cardiac fibrosis.In CFs,POU2F1 promoted cardiac fibrosis.CCAAT enhancer-binding proteinβ(C/EBPβ)was predicted to be the transcription factor of POU2F1and verified using a dual-luciferase reporter assay.In vivo,exercise training activated AMP-activated protein kinase(AMPK)and alleviated the increase in C/EBPβinduced by AngⅡ.In CFs,AMPK agonist inhibited the increase in C/EBPβand POU2F1 induced by Ang II,whereas AMPK inhibitor reversed this effect.Conclusion:Exercise training attenuates AngⅡ-induced cardiac fibrosis by reducing POU2F1.Exercise training inhibits POU2F1 by activating AMPK,which is followed by the downregulation of C/EBPβ,the transcription factor of POU2F1.

关键词： AMPK C/EBPβ Cardiac fibrosis Exercise POU2F1

新型完全生物可吸收封堵器经导管封堵膜周部室间隔缺损:一项多中心前瞻性随机对照研究

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Science Bulletin 2023年第10期68卷 1051-1059,M0004页

作者：王首正李泽夫王云兵赵天力莫绪明范太兵李建华尤涛邓润迪欧阳文斌王伟伟张闯年 Gianfranco Butera Ziyad MHijazi 逄坤静朱达蒋世良张戈军胡晓鹏谢涌泉张凤文房芳孙静平李萍陈娟骆志玲潘湘斌 Department of Structural Heart Disease Fuwai Hospital&National Center for Cardiovascular DiseaseKey Laboratory of Innovative Cardiovascular DevicesChinese Academy of Medical Sciences&Peking Union Medical CollegeNational Health Commission Key Laboratory of Cardiovascular Regeneration MedicineNational Clinical Research Center for Cardiovascular DiseasesBeijing 100037China National Engineering research Center for Biomaterials Sichuan UniversityChengdu 610064China Department of cardiovascular Surgery The Second Xiangya HospitalCentral South UniversityChangsha 410011China Department of cardiovascular Surgery Children’s Hospital of Nanjing Medical UniversityNanjing 210008China Department of cardiovascular Surgery Fuwai Central China Cardiovascular HospitalZhengzhou 451464China Department of cardiovascular Surgery The Children’s HospitalZhejiang University School of MedicineHangzhou 310052China Department of cardiovascular Surgery Gansu Province HospitalLanzhou 730000China Tianjin Key Laboratory of Biomaterial research Institute of Biomedical EngineeringChinese Academy of Medical Science&Peking Union Medical CollegeTianjin 300192China Department of Pediatric and Adult Congenital Heart Disease Evelina London Children’s HospitalGuy’s and St Thomas’NHS Foundation TrustLondon SE19RTUK Department of Pediatrics Sidra Heart CenterSidra Medical&Research CenterDoha 999043Qatar Department of Echocardiography Fuwai Hospital&National Center for Cardiovascular DiseaseChinese Academy of Medical Sciences&Peking Union Medical CollegeNational Health Commission Key Laboratory of Cardiovascular Regeneration MedicineNational Clinical Research Center for Cardiovascular DiseasesBeijing 100037China Department of Structural Heart Disease Fuwai Yunnan Cardiovascular HospitalKunming 650102China Cardiology Department The Clinic Cleveland FoundationCleveland 44195USA Cardiology Department Fuwai Hospital&National Center for Cardiovascular DiseaseChinese Academy of Medical Sciences&Peking Union Medical College

生物可吸收封堵器的应用有望降低传统金属封堵器并发症的风险.之前研制的生物可吸收封堵器存在不完全降解的局限性并导致新的并发症,因此目前尚未有相关产品获批上市.本研究使用了一种新型完全可吸收封堵器,旨在探索完全可吸收封堵器治... 详细信息

生物可吸收封堵器的应用有望降低传统金属封堵器并发症的风险.之前研制的生物可吸收封堵器存在不完全降解的局限性并导致新的并发症,因此目前尚未有相关产品获批上市.本研究使用了一种新型完全可吸收封堵器,旨在探索完全可吸收封堵器治疗室间隔缺损的疗效和安全性.从2019年4月到2020年1月,本研究在七个医学中心入组125名膜周部室间隔缺损患者,经筛查后108名患者被纳入研究并随机分为植入生物可吸收封堵器实验组和金属封堵器组.所有受试者均成功植入封堵器并完成24个月的随访.生物可吸收封堵器组患者经胸超声心动图显示高亮回声在24个月内逐渐消失,说明可吸收封堵器在体内实现完全降解.对比金属封堵器,实验组器械相关心律失常发生率(5.56%vs.14.81%,P=0.112)和持续传导阻滞发生率(0/54 vs.6/54,P=0.036)显著降低.本研究提示新型完全可吸收封堵器可以在单纯超声引导下实现成功植入,同时降低术后永久性心律失常的发生率.

关键词： Ventricular septal defect Transcatheter closure Bioabsorbable Degradation Echocardiography

Renal denervation as an option for the management of hypertension

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The Journal of Biomedical research 2014年第1期28卷 18-24页

作者： Georgina Radhini Santiapillai Albert Ferro Department of Clinical Pharmacology Cardiovascular DivisionBritish Heart Foundation Centre of Research ExcellenceKing's College London

Hypertension is a multifactorial condition which makes the development of treatment approaches difficult.The vast majority of patients are treated with lifestyle measures either alone or in combination with antihypertensive drugs,and this approach is largely successful in controlling blood pressure.However,for a subgroup of patients,control of blood pressure remains resistant to this approach and therefore the development of new strategies is imperative.The sympathetic nervous system has been known to be implicated in hypertension for many decades,and evidence from studies in the past has revealed the benefit of reducing sympathetic nerve activity in the control of blood pressure albeit with severe side effects.Recent technological advances have allowed for specific targeting of the renal sympathetic nerves by catheter ablation.The Symplicity HTN-1 and HTN-2 trials have provided strong evidence for renal denervation giving rise to considerable blood pressure reductions in treatment-resistant hypertensives and,due to the high incidence of hypertension worldwide,this carries the promise of further reducing the global burden of hypertension and its attendant complications.Here we review the evidence for renal denervation in the management of hypertension.

关键词：神经支配高血压肾脏管理选项交感神经系统肾交感神经生活方式

Five-year outcomes of biodegradable versus second-generation durable polymer drug-eluting stents used in complex percutaneous coronary intervention

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Chinese Medical Journal 2023年第3期136卷 322-330页

作者： Na Xu Lin Jiang Yi Yao Jingjing Xu Ru Liu Huanhuan Wang Ying Song Lijian Gao Zhan Gao Xueyan Zhao Bo Xu Yaling Han Jinqing Yuan Department of Cardiology Fuwai HospitalNational Clinical Research Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiology Cardiovascular Research InstituteGeneral Hospital of Northern Theatre CommandShenyangLiaoning 110016China

Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-eluting stents(DP-DES).The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.Methods:Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence.CPCI included at least one of the following features:unprotected left main lesion,≥2 lesions treated,≥2 stents implanted,total stent length>40 mm,moderate-to-severe calcified lesion,chronic total occlusion,or bifurcated target lesion.The primary endpoint was major adverse cardiac events(MACE)including all-cause death,recurrent myocardial infarction,and total coronary revascularization(target lesion revascularization,target vessel revascularization[TVR],and non-TVR)during the 5-year follow-up.The secondary endpoint was total coronary revascularization.Results:Among the 7712 patients included,4882(63.3%)underwent CPCI.Compared with non-CPCI patients,CPCI patients had higher 2-and 5-year incidences of MACE and total coronary revascularization.Following multivariable adjustment including stent type,CPCI was an independent predictor of MACE(adjusted hazard ratio[aHR]:1.151;95%confidence interval[CI]:1.017–1.303,P=0.026)and total coronary revascularization(aHR:1.199;95%CI:1.037–1.388,P=0.014)at 5 years.The results were consistent at the 2-year endpoints.In patients with CPCI,BP-DES use was associated with significantly higher MACE rates at 5 years(aHR:1.256;95%CI:1.078–1.462,P=0.003)and total coronary revascularization(aHR:1.257;95%CI:1.052–1.502,P=0.012)compared with that of DP-DES,but there was a similar risk at 2 years.However,BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization c

关键词： Complex percutaneous coronary intervention Durable polymer drug-eluting stents Biodegradable polymer drug-eluting stents

Galectin-3-centered paracrine network mediates cardiac inflammation and fibrosis upon β-adrenergic insult

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Science China(Life Sciences) 2023年第5期66卷 1067-1078页

作者： Guomin Hu Jimin Wu Huijun Gu Xiangning Deng Wenli Xu Shan Feng Shuaixing Wang Yao Song Zhengda Pang Xiuling Deng Aleksandr E.Vendrov Nageswara R.Madamanchi Marschall S.Runge Xinyu Wang Youyi Zhang Han Xiao Erdan Dong Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalNHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesKey Laboratory of Molecular Cardiovascular ScienceMinistry of EducationBeijing Key Laboratory of Cardiovascular Receptors ResearchResearch Unit of Medical Science Research Management/Basic and Clinical Research of Metabolic Cardiovascular DiseasesChinese Academy of Medical SciencesBeijing 100191China Department of Physiology and Pathophysiology Cardiovascular Research CenterSchool of Basic Medical SciencesXi’an Jiaotong University Health Science CenterXi’an 710061China Department of Internal Medicine Frankel Cardiovascular CenterUniversity of MichiganAnn ArborMI48109USA Academy for Advanced Interdisciplinary Studies Peking UniversityBeijing 100087China

Rapid over-activation of β-adrenergic receptors (β-AR) following acute stress initiates cardiac inflammation and injury by activating interleukin-18 (IL-18),however,the process of inflammation cascades has not been fully illustrated.The present study aimed to determine the mechanisms of cardiac inflammatory amplification following acute sympathetic activation.With bioinformatics analysis,galectin-3 was identified as a potential key downstream effector of β-AR and IL-18 activation.The serum level of galectin-3 was positively correlated with norepinephrine or IL-18 in patients with chest pain.In the heart of mice treated with β-AR agonist isoproterenol (ISO,5 mg kg^(-1)),galectin-3 expression was upregulated markedly later than IL-18 activation,and Nlrp3^(-/-)and Il18^(-/-)mice did not show ISO-induced galectin-3 upregulation.It was further revealed that cardiomyocyte-derived IL-18 induced galectin-3 expression in macrophages following ISO treatment.Moreover,galectin-3deficiency suppressed ISO-induced cardiac inflammation and fibrosis without blocking ISO-induced IL-18 increase.Treatment with a galectin-3 inhibitor,but not a β-blocker,one day after ISO treatment effectively attenuated cardiac inflammation and injury.In conclusion,galectin-3 is upregulated to exaggerate cardiac inflammation and injury following acute β-AR activation,a galectin-3 inhibitor effectively blocks cardiac injury one day after β-AR insult.

关键词： galectin-3 interleukin-18 β-adrenergic receptor macrophage inflammation fibrosis

Perspectives on the rational integration of intravascular imaging and physiology into the current cath lab environment

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Chinese Medical Journal 2013年第6期126卷 1013-1018页

作者： Gary S. Mintz Chief Medical Officer Cardiovascular Research Foundation 111 East 59th Street-llth Floor New York NY 10022 USA

It is now more than two decades since Nico Pijls and Bernard DeBruyne introduced fractional flow reserve (FFR) as a way to assess stenosis severity in the catheterization laboratory and since Paul Yock invented grayscale intravascular ultrasound (IVUS) that then spawned many second-generation intravascular imaging techniques such as (1) Virtual histology-IVUS (VH-IVUS) that uses both amplitude and radiofrequency ultrasound information to classify plaque as necrotic core,

关键词：成像技术实验室环境导管整合生理血管超声信息严重程度

Long-term outcome of percutaneous or surgical revascularization with and without prior stroke in patients with threevessel disease

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Journal of Geriatric Cardiology 2022年第8期19卷 583-593页

作者： Na XU Ce ZHANG Lin JIANG Jing-Jing XU Ru LIU Ying SONG Xue-Yan ZHAO Lian-Jun XU Run-Lin GAO Bo XU Jin-Qing YUAN Lei SONG Center for Coronary Heart Disease National Clinical Research Center for Cardiovascular DiseasesNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

OBJECTIVE To determine whether high-risk patients with three-vessel disease(TVD)with and without prior stroke preferen-tially benefit from three strategies[percutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG)and medical therapy(MT)].METHODS A total of 8943 patients with TVD were included in the study.Patients enrolled were stratified into two categories according to the presence or absence of prior stroke history.The primary endpoint was all-cause death.Secondary endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and stroke.RESULTS Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of comorbidities.Du-ring a median follow-up of 7.5 years,patients with prior stroke were strongly associated with increased risks of all-cause death,cardiac death,stroke and MACCE,even after adjusting for confounding variables and results been consistent across either treat-ment subgroup(PCI,CABG and MT)(all adjusted P<0.01).Notably,there was a significant interaction between prior stroke his-tory and treatment strategies.Revascularization strategy(PCI or CABG)was associated with a lower incidence of all-cause death and MACCE compared with MT alone,and favorable rates of MACCE,MI and unplanned revascularization in the CABG group compared with the PCI group,but with similar rate of all-cause death regardless of prior stroke history.The prevalence of stroke was significantly higher after CABG when compared with PCI or MT in no prior stroke patients[hazard ratio(HR)=1.429,95%CI:1.132-1.805 for CABG vs.MT;HR=1.703,95%CI:1.371-2.116 for CABG vs.PCI].CONCLUSIONS Patients with TVD and prior stroke have poor clinical outcomes.It is essential to balance benefit and risk when determining the optimal treatment strategy for TVD with and without prior stroke.

关键词： patients prior founding

Undiscovered pathology of transient scaffolding remains a driver of failures in clinical trials

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World Journal of Cardiology 2018年第10期10卷 165-186页

作者： Alexander N Kharlamov Department of Interventional cardiovascular Biomedicine De Haar Research FoundationAmsterdam 1069CDThe Netherlands.

AIM To statistically examine the released clinical trials and meta-analyses of polymeric bioresorbable scaffolds resuming the main accomplishments in the field with a translation to the routine clinical practice. METHODS The statistical power in clinical trials such as ABSORB Japan, ABSORB China, EVERBIO II, AIDA, and few meta-analyses by the post hoc odds ratio-based sample size calculation, and the patterns of artery remodeling published in papers from ABSORB A and B trials were evaluated. RESULTS The phenomenal admiration from the first ABSORB studies in 2006-2013 was replaced by the tremendous disappointment in 2014-2017 due to reported relatively higher rates of target lesion failure(a mean prevalence of 9.16%) and device thrombosis(2.38%) in randomized controlled trials. Otherwise, bioresorbable vascular scaffold(BVS) performs as well as the metallic drugeluting stent(DES) with a trend toward some benefits for cardiac mortality [risk ratio(RR), 0.58-0.94, P > 0.05]. The underpowered design was confirmed for some studies such as ABSORB Japan, ABSORB China, EVERBIO Ⅱ, AIDA trials, and meta-analyses of Polimeni, Collet, and Mahmoud with some unintentional bias(judged by the asymmetrical Funnel plot). Scaffold thrombosis rates with Absorb BRS were comparable with DES performed with a so-called strategy of the BVS implantation with optimized pre-dilation(P), sizing(S) and post-dilation(P)(PSP) implantation(RR, PSP vs no PSP 0.37) achieving 0.35 per 100 patient-years, which is comparable to the RR 0.49 with bare-metal stents and the RR 1.06 with everolimus DES. Both ABSORB Ⅱ and ABSORB Ⅲ trials were powered enough for a five-year follow-up, but the results were not entirely conclusive due to the mostly non-significant fashion of data. The powered metaanalyses were built mostly on statistically poor findings. CONCLUSION The misunderstanding of the pathology of transient scaffolding drives the failures of the clinical trials. More bench studies of the vascular response are required. Several next-generation BVS incl

关键词： Bioresorbable scaffold Device thrombosis Clinical outcomes Statistics Intravascular imaging Arterial remodeling Transient scaffolding

BME2.1: The Need for a Systems Approach to Addressing Race-Based Disparities in Health and Health Care

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Biomedical Engineering Frontiers 2023年第1期4卷 100-102页

作者： Naomi C.Chesler Gilda A.Barabino Edwards Lifesciences foundation cardiovascular Innovation and research Center and Department of Biomedical Engineering Samueli School of EngineeringUniversity of CaliforniaIrvineCAUSA Olin College of Engineering NeedhamMAUSA

The recent article by Miller et al.[1]in BMEF on reimagining the Biomedical Engineering(BME)curriculum of the future proposes several exciting and transformative core principles.These include(a)incorporating modern molecular biology and analytical/computational modeling,(b)providing instruction in data science fundamentals,(c)integrating clinical needs for innovation and translation,(d)fostering an educational culture of inclusive excellence,and(e)ensuring that new research discoveries inform the core curriculum.

关键词： integrating translation culture