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Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes

Congenital Heart Disease 2024年第1期19卷 69-83页

作者： Jae Hong Lee Sungkyu Cho Jae Gun Kwak Hye Won Kwon Woong-Han Kim Mi Kyoung Song Sang-Yun Lee Gi Beom Kim Eun Jung Bae Department of Thoracic and cardiovascular Surgery Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanKorea Department of Thoracic and cardiovascular Surgery Seoul National University Children’s HospitalSeoulKorea Department of Pediatrics Seoul National University Children’s HospitalSeoulKorea

Background:The optimal surgical timing and clinical outcomes of ventricular septal defect(VSD)closure in neo-nates remain unclear.We aimed to evaluate the clinical outcomes of VSD closure in neonates(age≤30 days).Methods:We retrospectively reviewed 50 consecutive neonates who underwent VSD closure for isolated VSDs between August 2003 and June 2021.Indications for the procedure included congestive heart failure/failure to thrive and pulmonary hypertension.Major adverse events(MAEs)were deﬁned as the composite of all-cause mortality,reoperation,persistent atrioventricular block,and signiﬁcant(≥grade 2)valvular dysfunction.Results:The median age and body weight at operation were 26.0 days(interquartile range[IQR],18.8–28.3)and 3.7 kg(IQR,3.3–4.2),respectively.The median follow-up duration was 110.4 months(IQR,56.8–165.0).Seven patients required preoperative respiratory support,andﬁve had signiﬁcant(≥grade 2)preoperative valvular dysfunction.One early mortality occurred due to irreversible cardiogenic shock;no late mortality was observed.One reopera-tion was due to hemodynamically signiﬁcant residual VSD at 103.8 months postoperatively.The overall survival,freedom from reoperation,and freedom from MAE at 15-years were 98.0%,96.3%,and 94.4%,respectively.Pre-operative mechanical ventilation was associated with a longer duration of postoperative mechanical ventilation(punit stay(p<0.001).Conclusions:VSD closure with favorable outcomes without morbidities is feasible even in neonates.However,neonates requiring preoperative respiratory support may require careful postoperative management considering the long-term postoperative risks.Overall,surgical VSD closure might be indicated earlier in neonates with respiratory compromise.

关键词： Ventricular septal defect neonate early surgery neonatal surgery

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Inflammation as a cause of acute myocardial infarction in patients with myeloproliferative neoplasm

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World Journal of Cardiology 2024年第2期16卷 58-63页

作者： Amedeo Tirandi Elisa Schiavetta Elia Maioli Fabrizio Montecucco Luca Liberale Department of Internal Medicine University of GenoaGenoa 16132Italy IRCCS Ospedale Policlinico San Martino Genoa–Italian Cardiovascular NetworkGenoa 16132Italy

Myeloproliferative neoplasms(MPN)are a group of diseases characterized by the clonal proliferation of hematopoietic progenitor or stem cells.They are clinically classifiable into four main diseases:chronic myeloid leukemia,essential thrombocythemia,polycythemia vera,and primary myelofibrosis.These pathologies are closely related to cardio-and cerebrovascular diseases due to the increased risk of arterial thrombosis,the most common underlying cause of acute myocardial infarction.Recent evidence shows that the classical Virchow triad(hypercoagulability,blood stasis,endothelial injury)might offer an explanation for such association.Indeed,patients with MPN might have a higher number and more reactive circulating platelets and leukocytes,a tendency toward blood stasis because of a high number of circulating red blood cells,endothelial injury or overactivation as a consequence of sustained inflammation caused by the neoplastic clonal cell.These abnormal cancer cells,especially when associated with the JAK2V617F mutation,tend to proliferate and secrete several inflammatory cytokines.This sustains a pro-inflammatory state throughout the body.The direct consequence is the induction of a pro-thrombotic state that acts as a determinant in favoring both venous and arterial thrombus formation.Clinically,MPN patients need to be carefully evaluated to be treated not only with cytoreductive treatments but also with cardiovascular protective strategies.

关键词： Inflammation Myeloproliferative neoplasm Acute coronary syndrome Myocardial infarction Thrombosis Cancer

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Current status and impact of the Young Scientist Foundation of the National Natural Science Foundation on Chinese young scholars in cardiovascular research

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Science China Life Sciences 2024年

作者： Fei Gao Zhenzhen Chen Wendong Li Hujun Jiang Rui Wang Department of Cardiology Beijing Anzhen HospitalCapital Medical University Hypertension Center Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeState Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular Diseases Department of Vascular Surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical School Department of Health Sciences National Natural Science Foundation of China

cardiovascular disease (CVD) remains the leading cause of disease burden globally,and continued efforts are required in identifying new targets for CVD prevention and treatment (Vaduganathan et al.,2022).Breakthroughs in basic research are urgently needed to fully understand the CVD mechanism and improve clinical treatment modality.

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Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope

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Journal of Geriatric Cardiology 2024年第6期21卷 651-657页

作者： Bin TU Zi-Hao LAI Ai-Yue CHEN Zhi-Yuan WENG Si-Min CAI Zhu-Xin ZHANG Li-Kun ZHOU Li-Hui ZHENG Yan YAO Arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesNational Key LaboratoryChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Cardiac Center Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina cardiovascular Department The First Affiliated HospitalFujian Medical UniversityFujian Institute of HypertensionFujianChina Department of cardiovascular The Second Affiliated Hospital of Zhejiang University School of MedicineZhejiangChina

BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.

关键词： syncope subtypes diagnosis

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LncR NA CCRR maintains Cahomeostasis against myocardial infarction through the FTO-SERCA2a pathway

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Science China Life Sciences 2024年

作者： Hua Yang Lina Xuan Shengjie Wang Huishan Luo Xiaomeng Duan Jianjun Guo Shijia Cui Jieru Xin Junwei Hao Xiufang Li Jun Chen Feihan Sun Xiaolin Hu Siyun Li Ying Zhang Lei Jiao Baofeng Yang Lihua Sun Department of Pharmacology Harbin Medical University (State Key Laboratory of Frigid Zone Cardiovascular DiseaseJoint International Research Laboratory of Cardiovascular Medicine Research Ministry of Education China) College of Pharmacy Harbin Medical University Department of Pharmacology Harbin Medical University (State Key Laboratory of Frigid Zone Cardiovascular Disease Joint International Research Laboratory of Cardiovascular Medicine Research Ministry of Education China) College of Pharmacy Harbin Medical University

Cardiac conduction regulatory RNA(CCRR) has been documented as an antiarrhythmic lncRNA in our earlier investigation. This study aimed to evaluate the effects of CCRR on SERCA2a and the associated Ca2+homeostasis in myocardial infarction(MI). Overexpression of CCRR via AAV9-mediated delivery not only partially reversed ischemia-induced contractile dysfunction but also alleviated abnormal Ca2+homeostasis and reduced the heightened methylation level of SERCA2a following MI. These effects were also observed in CCRR overexpressing transgenic mice. A conserved sequence domain of CCRR mimicked the protective function observed with the full length.Furthermore, silencing CCRR in healthy mice led to intracellular Ca2+overloading of cardiomyocytes. CCRR increased SERCA2a protein stability by upregulating FTO expression. The direct interaction between CCRR and FTO protein was characterized by RNA-binding protein immunoprecipitation(RIP) analysis and RNA pulldown experiments. Activation of NFATc3 was identified as an upstream mechanism responsible for CCRR downregulation in MI. This study demonstrates that CCRR is a protective lncRNA that acts by maintaining the function of FTO, thereby reducing the m6A RNA methylation level of SERCA2a, ultimately preserving calcium homeostasis for myocardial contractile function in MI. Therefore, CCRR may be considered a promising therapeutic strategy with a beneficial role in cardiac pathology.

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Role of T Cells in Viral and Immune-mediated Myocarditis

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Cardiology Discovery 2024年第1期4卷 43-54页

作者： Chunyan Cheng Anna Baritussio Andrea Silvio Giordani Renzo Marcolongo Alida L.P.Caforio Sabino Iliceto Department of cardiovascular Medicine Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesSouthern Medical UniversityGuangzhouGuangdong 510080China Cardiology unit Department of Cardiac Thoracic Vascular Sciences and Public HealthUniversity of PadovaVia Giustiniani2Padova 35128Italy

Myocarditis is characterized by inflammatory cell infiltration into the myocardium and a high risk of deteriorating cardiac function with a heterogeneous etiology. Both viral- and myosin-induced myocarditis experimental models are used to mimic myocarditis in humans. Here, coxsackie virus B3-induced and non-virus-induced myocarditis models and data obtained in clinical studies were reviewed. Experimental murine myocarditis following immunization with α-myosin together with complete Freund adjuvant represents the classical immune-mediated model. T helper 1 (Th1) and Th2 pathways and important cytokines are involved in the autoimmunity of myocarditis, and the dynamic balance between Th17 and regulatory T cell seems to have an important role in the process of myocarditis. The purpose of this review is to summarize the existing understanding of the immunological mechanisms underlying myocarditis and exploring gaps in knowledge in both animal and human studies, since these mechanistic insights are a critical requirement for the development of novel therapeutic and vaccination strategies.

关键词： Myocarditis Immunity T cells Animal models Clinical study

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LncRNA CCRR maintains Ca2+ homeostasis against myocardial infarction through the FTO-SERCA2a pathway

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Science China Life Sciences 2024年第8期 1601-1619页

作者： Hua Yang Lina Xuan Shengjie Wang Huishan Luo Xiaomeng Duan Jianjun Guo Shijia Cui Jieru Xin Junwei Hao Xiufang Li Jun Chen Feihan Sun Xiaolin Hu Siyun Li Ying Zhang Lei Jiao Baofeng Yang Lihua Sun Department of Pharmacology Harbin Medical University (State Key Laboratory of Frigid Zone Cardiovascular Diseasethe State-Province Key Laboratories of Biomedicine-Pharmaceutics of ChinaKey Laboratory of Cardiovascular ResearchMinistry of EducationJoint International Research Laboratory of Cardiovascular Medicine ResearchMinistry of EducationChina)College of PharmacyHarbin Medical University

Cardiac conduction regulatory RNA（CCRR） has been documented as an antiarrhythmic lnc RNA in our earlier investigation.This study aimed to evaluate the effects of CCRR on SERCA2a and the associated Ca2+homeostasis in myocardial infarction（MI）.Overexpression of CCRR via AAV9-mediated delivery not only partially reversed ischemia-induced contractile dysfunction but also alleviated abnormal Ca2+homeostasis and reduced the heightened methylation level of SERCA2a following MI.These effects were also observed in CCRR overexpressing transgenic mice.A conserved sequence domain of CCRR mimicked the protective function observed with the full length.Furthermore,silencing CCRR in healthy mice led to intracellular Ca2+overloading of cardiomyocytes.CCRR increased SERCA2a protein stability by upregulating FTO expression.The direct interaction between CCRR and FTO protein was characterized by RNA-binding protein immunoprecipitation（RIP） analysis and RNA pulldown experiments.Activation of NFATc3 was identified as an upstream mechanism responsible for CCRR downregulation in MI.This study demonstrates that CCRR is a protective lnc RNA that acts by maintaining the function of FTO,thereby reducing the m6A RNA methylation level of SERCA2a,ultimately preserving calcium homeostasis for myocardial contractile function in MI.Therefore,CCRR may be considered a promising therapeutic strategy with a beneficial role in cardiac pathology.

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Facing ethical concerns in the age of precise gene therapy:Outlook on inherited arrhythmias

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World Journal of Cardiology 2024年第2期16卷 64-66页

作者： Federico Carbone Fabrizio Montecucco Department of Internal Medicine University of GenoaGenoa 16132Italy IRCCS Ospedale Policlinico San Martino Genoa Italian Cardiovascular NetworkGenoa 16132Italy

This editorial,comments on the article by Spartalis et al published in the recent issue of the World Journal of Cardiology.We here provide an outlook on potential ethical concerns related to the future application of gene therapy in the field of inherited arrhythmias.As monogenic diseases with no or few therapeutic options available through standard care,inherited arrhythmias are ideal candidates to gene therapy in their treatment.Patients with inherited arrhythmias typically have a poor quality of life,especially young people engaged in agonistic sports.While genome editing for treatment of inherited arrhythmias still has theoretical application,advances in CRISPR/Cas9 technology now allows the generation of knock-in animal models of the disease.However,clinical translation is somehow expected soon and this make consistent discussing about ethical concerns related to gene editing in inherited arrhythmias.Genomic off-target activity is a known technical issue,but its relationship with ethnical and individual genetical diversity raises concerns about an equitable accessibility.Meanwhile,the costeffectiveness may further limit an equal distribution of gene therapies.The economic burden of gene therapies on healthcare systems is is increasingly recognized as a pressing concern.A growing body of studies are reporting uncertainty in payback periods with intuitive short-term effects for insurance-based healthcare systems,but potential concerns for universal healthcare systems in the long term as well.Altogether,those aspects strongly indicate a need of regulatory entities to manage those issues.

关键词： Ethics Inherited arrhythmias CRISPR/Cas9 Gene therapy Equitable accessibility

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Abdominal Pain After Cardiac Surgery Caused by Crohn Disease, Intestinal Ischemia, and Colonic Diverticulitis, Respectively: A Report of 3 Cases

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Cardiology Discovery 2024年第1期4卷 55-57页

作者： Huanan Liu Zhaoming Lin Xiaoshen Zhang Department of cardiovascular Surgery The First Affiliated HospitalJinan UniversityGuangzhouGuangdong 510630China

Abdominal complications following cardiac surgery are rare events,but can be fatal if not diagnosed and managed in time.Aggressive treatments offer a better chance for survival in patients with risk factors.This case report describes the clinical presentation and details of 3 recently operated patients who suffered acute abdominal pain after cardiac surgery.The underlying causes were Crohn disease-associated ileal perforation,intestinal necrosis,and diverticulitis-associated colonic perforation.The presentation and management of these severe conditions are discussed.

关键词： Abdominal pain Cardiac surgery Ulceration Ischemia Diverticulitis

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Heart failure in China:epidemiology and current management

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Journal of Geriatric Cardiology 2024年第6期21卷 631-641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 cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensive analysis of heart failure(HF)in China.HF is one of the most important cardiovascular disease in the 21st century.Its mortality is equivalent to that of cancer.It is an important public health problem that seriously affects the health of Chinese residents.In recent years,with the deepeningof understanding,the change of treatment principles,the innovation of treatment methods and the update of treatment guidelines,the in-hospital mortality of HF patients has declined,and the long-term prognosis is also improving.However,there are stilldifferences in the management level of HF among different hospitals in China.How to improve the standardized diagnosis andtreatment level of HF in China remains an important challenge.

关键词： epidemiology diagnosis treatment

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