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Macrophages in cardiovascular diseases:molecular mechanisms and therapeutic targets

Signal Transduction and Targeted Therapy 2024年第6期9卷 2598-2641页

作者： Runkai Chen Hongrui Zhang Botao Tang Yukun Luo Yufei Yang Xin Zhong Sifei Chen Xinjie Xu Shengkang Huang Canzhao Liu Department of Cardiology Laboratory of Heart CenterHeart CenterTranslational Medicine Research CenterZhujiang HospitalSouthern Medical University253 Industrial AvenueGuangzhou 510280China State Key Laboratory of Cardiovascular disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

The immune response holds a pivotal role in cardiovascular disease *** multifunctional cells of the innate immune system,macrophages play an essential role in initial inflammatory response that occurs following cardiovascular injury,thereby inducing subsequent damage while also facilitating ***,the diverse phenotypes and phenotypic alterations of macrophages strongly associate with distinct types and severity of cardiovascular diseases,including coronary heart disease,valvular disease,myocarditis,cardiomyopathy,heart failure,atherosclerosis and aneurysm,which underscores the importance of investigating macrophage regulatory mechanisms within the context of specific ***,recent strides in single-cell sequencing technologies have revealed macrophage heterogeneity,cell–cell interactions,and downstream mechanisms of therapeutic targets at a higher resolution,which brings new perspectives into macrophage-mediated mechanisms and potential therapeutic targets in cardiovascular ***,myocardial fibrosis,a prevalent characteristic in most cardiac diseases,remains a formidable clinical challenge,necessitating a profound investigation into the impact of macrophages on myocardial fibrosis within the context of cardiac *** this review,we systematically summarize the diverse phenotypic and functional plasticity of macrophages in regulatory mechanisms of cardiovascular diseases and unprecedented insights introduced by singlecell sequencing technologies,with a focus on different causes and characteristics of diseases,especially the relationship between inflammation and fibrosis in cardiac diseases(myocardial infarction,pressure overload,myocarditis,dilated cardiomyopathy,diabetic cardiomyopathy and cardiac aging)and the relationship between inflammation and vascular injury in vascular diseases(atherosclerosis and aneurysm).Finally,we also highlight the preclinical/clinical macrophage targeting strategies and translational

关键词： diseases cardiovascular therapeutic

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Comparison of fungal vs bacterial infections in the medical intensive liver unit:Cause or corollary for high mortality?

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World Journal of Hepatology 2024年第3期16卷 379-392页

作者： Sarah Khan Hanna Hong Stephanie Bass Yifan Wang Xiao-Feng Wang Omar T Sims Christine E Koval Aanchal Kapoor Christina C Lindenmeyer Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Cleveland clinic Lerner College of Medicine Cleveland ClinicClevelandOH 44195United States Department of Pharmacy Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences/Biostatistics Section Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States Department of Infectious disease Cleveland ClinicClevelandOH 44195United States Department of Critical Care Medicine Cleveland ClinicClevelandOH 44195United States

BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as *** data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver *** To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial *** From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial *** compared outcomes between patients admitted to the MILU with fungal infections to bacterial *** was extracted through chart *** All fungal infections were due to Candida species,and were most frequently blood *** among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,Pfailure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,Pdisease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical *** Mortality was worse among patients with fungal infections,likely attributable to severe ACLF *** studies examinin

关键词： Fungal Infection Sepsis Acute on chronic liver failure Intensive care

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Transplant-associated thrombotic microangiopathy:a rare but deadly complication post orthotopic heart transplantation

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Journal of Geriatric Cardiology 2022年第6期19卷 485-486页

作者： Jose Ruiz-Morales Maedeh Ganji Rohan Goswami Division of Advanced heart failure&Transplant Cardiology Mayo ClinicJacksonvilleFloridaUSA Cardiology Department University of FloridaJacksonvilleFloridaUSA

Thrombotic microangiopathy(TMA)is potentially life-threatening condition caused by small-vessel microthrombi and is associated with schistocyte formation,low platelets and end-organ damage that may not be reversible.[1,2]As a life-threatening condition,TMA recognition in hospitalized patients after organ transplantation is key to improving ***-associated TMA(TATMA)can occur after both solid organ or hematopoietic stem cell transplantation and often mimics other disease processes such as thrombotic throm-bocytopenic purpura(TTP)with similar constellation of symptoms during *** present a rare case of a patient with TATMA after orthotopic heart transplantation.

关键词： thrombotic microangiopathy orthotopic

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Unique presentation of neonatal liver failure:A case report

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World Journal of clinical Pediatrics 2024年第2期13卷 221-226页

作者： Eman Al Atrash Amer Azaz Samar Said Mohammad Miqdady Department of Pediatrics Division of Pediatric GastroenterologySheikh Khalifa Medical CityAbu Dhabi 971United Arab Emirates Department of Pathology Mayo ClinicRochesterMN 55905United States

BACKGROUND Acute fulminant liver failure rarely occurs in the neonatal *** etiologies include viral infection(15%),metabolic/genetic disease(10%),hematologic disorders(15%),and ischemic injury(5%).Gestational alloimmune liver disease usually manifests as severe neonatal liver failure,with extensive hepatic and extrahepatic iron overload,sparing the reticuloendothelial *** liver failure is a rare cause of liver failure where a patient presents with liver failure in the neonatal period with no hepatocytes in liver *** SUMMARY A 5-week-old male presented with *** examination revealed an alert but deeply icteric *** data demonstrated direct hyperbilirubinemia,a severely deranged coagulation profile,normal transaminase,and normal *** resonance imaging of the abdomen was suggestive of perinatal *** biopsy showed histiocytic infiltration with an absence of *** hemosiderin deposition was identified in a buccal mucosa *** Neonatal liver failure in the absence of hepatocellular regeneration potentially reflects an acquired or inborn defect in the regulation of hepatic regeneration.

关键词： Liver Hyperbilirubinemia Le foie vide Neonatal hemochromatosis Case report

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Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of Intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches Department of Intensive Care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory Intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare *** incidence is rising due to poor public awareness and delays in its recognition and subsequent *** sepsis,mortality increases with every hour left *** intelligence(AI)is transforming worldwide healthcare delivery at *** review has outlined how AI can augment strategies to address this global disease *** and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional *** review highlights how these models can predict the risk of sepsis and organ failure even before it *** gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of *** potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare *** these advantages,clinicians have been slow to adopt AI into clinical *** of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical ***,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such ***,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning Intensive care unit(ICU) Critical care Sepsis

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Septic cardiomyopathy phenotype in the critically ill may depend on antimicrobial resistance

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Journal of Intensive Medicine 2024年第3期4卷 355-361页

作者： Vasiliki Tsolaki Kyriaki Parisi George E.Zakynthinos Efrosini Gerovasileiou Nikitas Karavidas Vassileios Vazgiourakis Epaminondas Zakynthinos Demosthenes Makris Intensive Care Unit University Hospital of LarissaUniversity of Thessaly Faculty of MedicineLarissaGreece Third Cardiology clinic University of AthensSotiria HospitalAthensGreece Respiratory Department University Hospital of LarissaUniversity of Thessaly Faculty of MedicineLarissaGreece

Background Sepsis is a life-threatening organ dysfunction,and septic cardiomyopathy(SCM)may complicate the course of the *** with multidrug-resistant(MDR)pathogens has been linked with worse *** study aims to evaluate SCM in patients with infections caused by different antimicrobial-resistant *** This retrospective study included patients with sepsis/septic shock,hospitalized,and intubated in the intensive care unit of the University Hospital of Larissa between January 2022 and September 2023 with echocardiographic data during the first two days after infection *** patients were divided into two groups:non-MDR-SCM group and MDR-SCM *** cardiac function was compared between the two *** A total of 62 patients were included in the ***-four patients comprised the MDR-SCM and 18 the non-MDR-SCM ***-six patients(41.9%)presented with left ventricular(LV)systolic dysfunction,and≤35%right ventricular fractional area change(RVFAC)was present in 56.4%.LV systolic function was more severely impaired in the non-MDR-SCM group(left ventricular ejection fraction,35.8%±4.9%vs.45.6%±2.4%,P=0.049;LV outflow tract velocity time integral,[10.1±1.4]cm vs.[15.3±0.74]cm,P=0.001;LV-Strain,–9.02%±0.9%vs.–14.02%±0.7%,P=0.001).The MDR-SCM group presented with more severe right ventricular(RV)dilatation(right ventricular end-diastolic area/left ventricular end-diastolic area,0.81±0.03 vs.0.7±0.05,P=0.042)and worse RV systolic function(RVFAC,32.3%±1.9%vs.39.6%±2.7%,P=0.035;tricuspid annular plane systolic excursion,[15.9±0.9]mm vs.[18.1±0.9]mm,P=0.165;systolic tissue Doppler velocity measured at the lateral tricuspid annulus,[9.9±0.5]cm/s vs.[13.1±0.8]cm/s,P=0.002;RV-strain,–11.1%±0.7%vs.–15.1%±0.9%,P=0.002).Conclusion SCM related to MDR infection presents with RV systolic dysfunction predominance,while non-MDR-SCM is mainly depicted with LV systolic dysfunction impairment.

关键词： Septic cardiomyopathy Multidrug-resistant pathogen Left ventricular failure Right ventricular dysfunction Left/right ventricular longitudinal strain Ventriculoarterial Coupling

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护士主导的心力衰竭门诊的效果:一项系统综述

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International Journal of Nursing Sciences 2024年第3期11卷 315-329,I0002页

作者：吴筱筱黎珍田庆秀季诗明张辰 Nursing Department Fuwai HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijingChina Nursing Department Peking Union Medical College HospitalBeijingChina Department of Nursing The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan HospitalJinanChina Ward 2 of Coronary heart disease Fuwai HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijingChina

目的心力衰竭是全球日益严重的主要公共卫生问题。护士主导的心力衰竭门诊在管理心力衰竭方面发挥着重要作用。该研究进行了一项系统综述,以描述护士主导心力衰竭门诊的内容及其影响。方法在PubMed、Embase、Web of Science和Cochrane L... 详细信息

目的心力衰竭是全球日益严重的主要公共卫生问题。护士主导的心力衰竭门诊在管理心力衰竭方面发挥着重要作用。该研究进行了一项系统综述,以描述护士主导心力衰竭门诊的内容及其影响。方法在PubMed、Embase、Web of Science和Cochrane Library中对护士主导心力衰竭门诊的研究进行了检索。检索最初于2022年10月23日进行,并于2023年11月21日进行更新。文章由两名独立研究者按照乔安娜-布里格斯研究所标准进行评估。本系统综述已在PROSPERO上注册(CRD42022352209)。结果共纳入12篇文献。护士主导心衰门诊的内容包括:药物滴定、教育咨询、基于循证的延续护理、社会心理支持、体格检查和心理健康评估、治疗监测和调整、随访和电话咨询。多数研究报告认为护士主导的心力衰竭门诊取得了积极的临床效果。4项研究对生活质量进行了调查,结果不一;4项研究对药物滴定的疗效进行了调查,结果总体上是积极的。仅2项研究对成本效果进行了评估,仍需更多相关研究进行验证。结论护士主导的心力衰竭门诊在很大程度上显示出对患者结局、生活质量、药物滴定效果的积极影响。

关键词：心力衰竭系统综述护士实践模式

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COVID-19 and liver injury: An ongoing challenge

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World Journal of Gastroenterology 2023年第2期29卷 257-271页

作者： Ioanna Papagiouvanni Serafeim-Chrysovalantis Kotoulas Athanasia Pataka Dionisios G Spyratos Konstantinos Porpodis Afroditi K Boutou Georgios Papagiouvannis Ioanna Grigoriou Christos Vettas Ioannis Goulis Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Respiratory Medicine G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department Aristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 54642Greece Department of Pharmacy School of Health SciencesFrederick UniversityNicosia 1036Cyprus Respiratory failure clinic Papanikolaou General HospitalThessloniki 57001Greece Fourth Department of Internal Medicine Hippokration General HospitalThessaloniki 54642Greece

The new coronavirus severe acute respiratory syndrome coronavirus 2(SARSCoV-2)was identified in December 2019,in Wuhan,*** virus was rapidly spread worldwide,causing coronavirus disease 2019(COVID-19)*** COVID-19 is presented,usually,with typical respiratory symptoms(i.e.,dyspnea,cough)and fever,extrapulmonary manifestations are also *** injury is a common feature in patients with COVID-19 and ranges from mild and temporary elevation of liver enzymes to severe liver injury and,even,acute liver *** pathogenesis of liver damage is not clearly defined;multiple mechanisms contribute to liver disorder,including direct cytopathic viral effect,cytokine storm and immune-mediated hepatitis,hypoxic injury,and druginduced liver *** with underlying chronic liver disease(i.e.,cirrhosis,non-alcoholic fatty liver disease,alcohol-related liver disease,hepatocellular carcinoma,etc.)may have greater risk to develop both severe COVID-19 and further liver deterioration,and,as a consequence,certain issues should be considered during disease *** aim of this review is to present the prevalence,clinical manifestation and pathophysiological mechanisms of liver injury in patients with SARS-CoV-2 ***,we overview the association between chronic liver disease and SARS-CoV-2 infection and we briefly discuss the management of liver injury during COVID-19.

关键词： COVID-19 Liver injury Cytokine storm Hypoxic hepatitis Drug-induced liver injury Chronic liver disease

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Assessment of voluntary rhythmic muscle contraction-induced exercising blood flow variability measured by Doppler ultrasound

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Open Journal of Molecular and Integrative Physiology 2013年第4期3卷 158-165页

作者： Takuya Osada Bengt Saltin Goran Radegran Department of Sports Medicine for Health Promotion Tokyo Medical UniversityTokyoJapan The Copenhagen Muscle Research Centre RigshospitaletUniversity of CopenhagenCopenhagenDenmark the clinic for heart failure and valvular disease Skane University HospitalLundSweden Department of Cardiology Clinical SciencesLund UniversityLundSweden

Given recent technological developments, ultrasound Doppler can provide valuable measurements of blood velocity/flow in the conduit artery with high temporal resolution. In human-applied science such as exercise physiology, hemodynamic measurements in the conduit artery is commonly performed by blood flow feeding the exercising muscle, as the increase in oxygen uptake (calculated as a product of arterial blood flow to the exercising limb and the arterio-venous oxygen difference) is directly proportional to the work performed. The increased oxygen demand with physical activity is met through a central mechanism, an increase in cardiac output and blood pressure, as well as a peripheral mechanism, an increase in vascular conductance and oxygen extraction (a major part of the whole exercising muscles) from the blood. The increase in exercising muscle blood flow in relation to the target workload (quantitative response) may be one indicator in circulatory adjustment for the ac- tivity of muscle metabolism. Therefore, the determination of local blood flow dynamics (potential oxygen supply) feeding repeated (rhythmic) muscle contractions can contribute to the understanding of the factors limiting work capacity including, for instance, muscle metabolism, substance utilization and magnitude of vasodilatation in the exercising muscle. Using non-invasive measures of pulsed Doppler ultrasound, the validity of blood velocity/flow in the forearm or lower limb conduit artery feeding to the muscle has been previously demonstrated during rhythmic muscle exercise. For the evaluation of exercising blood flow, not only muscle contraction induced internal physiological variability, or fluctuations in the magnitude of blood velocity due to spontaneous muscle contraction and relaxation induced changes in force curve intensity, superimposed in cardiac beat-by-beat, but also the alterations in the blood velocity (external variability) due to a temporary sudden change in the achieved workloa

关键词： Exercising Blood Flow Doppler Ultrasound Muscle Contraction Blood Flow Alterations

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Unplanned J-valve implantation during open heart surgery for severe valvular annulus and ventricle calcification

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Journal of Geriatric Cardiology 2022年第12期19卷 1003-1006页

作者： Tian-Ge LUO Bo LI Jie HAN Hai-Bo ZHANG Cardiac Valve Centre Department of Cardiac SurgeryBeijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijingChina Department of Cardiac Surgery People’s Hospital of Liaoning ProvinceShenyangChina

Aortic annulus calcification(AC)and mitral AC are common in patients with cardiac valvular disease.[1]Procedures to resect or debride aortic AC and mitral AC may lead to cerebral emboli,heart failure,arrhythmia,coronary artery lesions,and even ventricular rupture.[2]Therefore,it is often a challenge for surgeons to choose an appropriate surgical strategy for patients with severe valvular AC.[3,4]A sutureless valve is a good choice,doing away with the need to take time to remove the AC,but many countries do not have this *** aortic valve implantation(TAVI)and transcatheter mitral valve replacement(TMVR)have developed rapidly during recent years.

关键词： mitral implantation calcification

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