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Intensive blood pressure control on arterial stiffness among older patients with hypertension

中华医学杂志(英文版) 2024年第9期137卷 2023 Nov 15页

作者： Zhang Shuyuan Zhong Yixuan Wu Shouling Wu Hailei Cai Jun Zhang Weili National Clinical Research Center of cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Peking Union Medical College &amp Chinese Academy of Medical Sciences Beijing China Department of Cardiology State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences &amp Peking Union Medical College Beijing China State Key Laboratory of cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Peking Union Medical College &amp Department of Cardiology Kailuan General Hospital Tangshan Hebei China Central China Subcenter of National Center for cardiovascular Diseases Henan Cardiovascular Disease Center Fuwai Central-China Cardiovascular Hospital Central China Fuwai Hospital of Zhengzhou University Zhengzhou Henan China

Background: Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease (CVD), but the relationship between blood pressure lowering and arterial stiffening is still uncertain, especially in older people. This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods: The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial was a multicenter, randomized, controlled trial performed at 42 clinical centers throughout China, and 8511 patients aged 60–80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure (SBP) target of 110 mmHg to study. Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model. The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results: The changes in baPWV were 61.5 cm/s (95% confidence interval [CI]: 49.8–73.2 cm/s) in the intensive treatment group and 98.4 cm/s (95% CI: 86.7–110.1 cm/s) in the standard treatment group (P groups, respectively. During a median follow-up period of 3.36 years, primary CVD outcomes occurred in 77 (2.9%) patients in the intensive treatment group compared with 93 (3.5%) in the standard treatment group. Intensive treatment

关键词： Hypertension Arterial stiffness cardiovascular disease Older people Blood pressure Pulse wave velocity

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Effect of cardiac rehabilitation care after coronary intervention on cardiac function recovery and negative mood in patients with myocardial infarction

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World Journal of Clinical Cases 2024年第1期12卷 59-67页

作者： Ming Yang Yuan-Tao Huang Xi-Wen Hu Chun-Ling Wu Division of cardiovascular First Ward Departments of Internal MedicineLiyuan HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430077Hubei ProvinceChina Division of cardiovascular First Ward Departments of Internal MedicineJianli People's HospitalJianli 433300Hubei ProvinceChina Department of Integrated Traditional Chinese and Western Medicine People's Hospital of Dongxihu DistrictWuhan 430040Hubei ProvinceChina

BACKGROUND cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical technology have led to the emer-gence of coronary intervention as an essential method for treating MI.AIM To assess the effects of cardiac rehabilitation care on cardiac function recovery and negative emotions in MI after coronary intervention.METHODS This study included a total of 180 patients with MI during the period from June 2022 to July 2023.Selected patients were divided into two groups:An observation group,which receiving cardiac rehabilitation care;a control group,which re-ceiving conventional care.By comparing multiple observation indicators such as cardiac function indicators,blood pressure,exercise tolerance,occurrence of adverse cardiac events,and negative emotion scores between the two groups of patients.All the data were analyzed and compared between two groups.RESULTS There were 44 males and 46 females in the observation group with an average age of 36.26±9.88 yr;there were 43 males and 47 females in the control group,with an average age of 40.87±10.5 yr.After receiving the appropriate postoperative nursing measures,the results of the observation group showed significant improvement in several indicators compared with the control group.Indicators of cardiac function,such as left ventricular end-diastolic internal diameter and left ventricular ejection fraction were significantly better in the observation group than in the control group(Pgroup(Pgroup,and negative mood scores were significantly reduced(P<0.05).CONCLUSION Cardiac rehabilitation care after coronary intervention has a significant positive impact on functional recovery.This emphasizes t

关键词： Myocardial infarction Coronary artery intervention Cardiac rehabilitation Cardiac function recovery Negative emotions

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Effect of dapagliflozin on uric acid in patients with chronic heart failure and hyperuricemia

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World Journal of Clinical Cases 2024年第18期12卷 3468-3475页

作者： Meng-Jiao Lin Shu-Bin Zou Bai-Xiang Zhu Three departments of cardiovascular medicine Harbin 242 HospitalHarbin 150066Heilongjiang ProvinceChina

BACKGROUND Patients with chronic heart failure(CHF)frequently develop hyperuricemia,an elevated serum uric acid level,associated with adverse outcomes.Dapagliflozin,a sodium-glucose cotransporter-2 inhibitor,demonstrates reduction in cardiovascular mortality and hospitalization in patients with CHF and ejection fraction(HFrEF),irrespective of diabetes.However,dapagliflozin’s effect on the uric acid levels in patients with CHF and hyperuricemia remain unclear.AIM To investigate the effects of dapagliflozin on uric acid levels in CHF patients with hyperuricemia.METHODS We conducted a randomized,double-blind,placebo-controlled trial in 200 patients with CHF and hyperuricemia,with HFrEF and serum uric acid levels≥7 mg/dL(≥416μmol/L).The participants were randomly assigned to receive a daily dose of 10 mg dapagliflozin or placebo for 24 months.The primary endpoint was the change in serum uric acid level from baseline to 24 months.Secondary endpoints included changes in left ventricular ejection fraction(LVEF),Nterminal pro-B-type natriuretic peptide(NT-proBNP),and quality of life(QoL)scores,as well as the incidence of cardiovascular death and hospitalization for heart failure.RESULTS At 24 months,dapagliflozin significantly reduced serum uric acid levels by 1.2 mg/dL(71μmol/L)compared with placebo(95%CI:-1.5 to-0.9;Pcardiovascular death and hospitalization for heart failure by 35%(95%CI:15–50;P=0.002)compared with the placebo.Adverse events were similar between the two groups,except for a higher rate of genital infections in the dapagliflozin group(10%vs 2%,P=0.01).CONCLUSION Dapagliflozin significantly lowered serum uric acid levels and improved the clinical outcomes in patients with CHF and hyperuricemia.Therefore,dapagliflozin may be a useful therapeutic option for this high-risk population.

关键词： Dapagliflozin Hyperuricemia Chronic heart failure Sodium-glucose cotransporter-2 inhibitor Uric acid levels cardiovascular mortality

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Shuxuening Injection Inhibits Apoptosis and Reduces Myocardial Ischemia-Reperfusion Injury in Rats through PI3K/AKT Pathway

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Chinese Journal of Integrative Medicine 2024年第5期30卷 421-432页

作者： YUE Tong-tong CAO Ying-jie CAO Ya-xuan LI Wei-xia WANG Xiao-yan SI Chun-ying XIA Han ZHU Ming-jun TANG Jin-fa WANG He The First Clinical Medical College of Henan University of Chinese Medicine Zhengzhou 450046China Department of Pharmacy the First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 451200China Department of cardiovascular Diseases the First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 451200China

Objective: To investigate the main components and potential mechanism of Shuxuening Injection(SXNI) in the treatment of myocardial ischemia-reperfusion injury(MIRI) through network pharmacology and in vivo research. Methods: The Traditional Chinese Medicine Systems Pharmacology(TCMSP) and Pharm Mapper databases were used to extract and evaluate the effective components of Ginkgo biloba leaves, the main component of SXNI. The Online Mendelian Inheritance in Man(OMIM) and Gene Cards databases were searched for disease targets and obtain the drug target and disease target intersections. The active ingredient-target network was built using Cytoscape 3.9.1 software. The STRING database, Metascape online platform, and R language were used to obtain the key targets and signaling pathways of the anti-MIRI effects of SXNI. In order to verify the therapeutic effect of different concentrations of SXNI on MIRI in rats, 60 rats were first divided into 5 groups according to random number table method: the sham operation group, the model group, SXNI low-dose(3.68 mg/kg), medium-dose(7.35 mg/kg), and high-dose(14.7 mg/kg) groups, with 12 rats in each group. Then, another 60 rats were randomly divided into 5 groups: the sham operation group, the model group, SXNI group(14.7 mg/kg), SXNI+LY294002 group,and LY294002 group, with 12 rats in each group. The drug was then administered intraperitoneally at body weight for 14 days. The main biological processes were validated using in vivo testing. Evans blue/triphenyltetrazolium chloride(TTC) double staining, hematoxylin-eosin(HE) staining, terminal deoxynucleotidyl transferase d UTP nick end labeling(TUNEL) assay, enzyme-linked immunosorbent assay(ELISA), and Western blot analysis were used to investigate the efficacy and mechanism of SXNI in MIRI rats. Results: Eleven core targets and 30 Kyoto Encyclopedia of Genes and Genomes(KEGG) pathways were selected. Among these, the phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT) pathway was closely related to SXNI treatment of MIRI. In v

关键词： myocardial ischemia reperfusion injury PI3K/AKT signaling pathway Shuxuening Injection apoptosis Ginkgo biloba leaves

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Efficacy of scraping therapy on blood pressure and sleep quality in stage Ⅰ and Ⅱ essential hypertension: A systematic review and meta-analysis

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Journal of Integrative Medicine 2024年第1期22卷 12-21页

作者： Zheng-gang Zhu Jian-ru Wang Xiao-yan Pan School of Nursing Hunan University of Chinese MedicineChangsha 410208Hunan ProvinceChina School of Health Sciences Universiti Sains MalaysiaKubang Kerian 16150KelantanMalaysia Department of cardiovascular Medicine the First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 450000Henan ProvinceChina

Background Scraping therapy is widely used in treating stage I and II essential hypertension in China.However,there has been no systematic evaluation of the efficacy of scraping therapy on blood pressure and sleep quality in stage I and II essential hypertension.Search strategy Seven electronic databases(PubMed,Scopus,Cochrane Library,Web of Science,EBSCO,China National Knowledge Infrastructure and Wanfang Data electronic databases)were searched from inception to December 2022.Based on the principle of combining subject words with text words,the search strategy was constructed around search terms for“scraping therapy,”“scraping,”“Guasha,”“Gua sha,”“hypertension,”and“high blood pressure”during the database searches.Inclusion criteria Randomized controlled trials(RCTs)were included if they recruited patients with stage I and II essential hypertension and included a scraping therapy intervention.The intervention group received antihypertensive drugs and scraping therapy,while the control group only took antihypertensive drugs.Data extraction and analysis Review Manager 5.4.0 and STATA 15.1 were used to enter all the relevant outcome variables to conduct the meta-analysis.The quality of the selected RCTs was assessed using the PEDro scale.The sensitivity analysis was carried out by iteratively excluding individual studies and repeating the analysis to determine the stability of the findings and identify any studies with greater influence on the outcome.Subgroup analysis was performed to find the source of heterogeneity.Funnel plots were used to evaluate the publication bias of included studies.Results Nine RCTs including 765 participants were selected.Meta-analysis showed that scraping therapy combined with medication had an advantage over the use of medication alone in lowering systolic blood pressure(mean difference[MD]=?5.09,95%confidence interval[CI]=?6.50 to?3.67,Pgroup analysis showed that scraping therapy improved sleep quality in mid

关键词： Scraping therapy Essential hypertension Efficacy Blood pressure Sleep quality Systematic review Meta-analysis

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Cardiac Syndromes in Liver Disease:A Clinical Conundrum

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 975-986页

作者： Milos Brankovic Paul Lee Nikolaos Pyrsopoulos Mark Klapholz Department of Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA transatlantic cardiovascular study group BloomfieldNJUSA Division of Gastroenterology and Hepatology Department of MedicineRutgers New Jersey Medical SchoolNewarkNJUSA Division of Cardiology Heart Failure Prevention and Treatment ProgramRutgers New Jersey Medical SchoolNewarkNJUSA

Understanding the interaction between the heart and liver is pivotal for managing patients in whom both organs are affected.Studies have shown that cardio-hepatic interactions are bidirectional and that their identification,assessment,and treatment remain challenging.Congestive hepatopathy is a condition that develops in the setting of long-standing systemic venous congestion.If left untreated,congestive hepatopathy may lead to hepatic fibrosis.Acute cardiogenic liver injury develops as a combination of venous stasis and sudden arterial hypoperfusion due to cardiac,circulatory,or pulmonary failure.The treatment of both conditions should be directed toward optimizing the cardiac substrate.Hyperdynamic syndrome may develop in patients with advanced liver disease and lead to multiorgan failure.Cirrhotic cardiomyopathy or abnormalities in pulmonary vasculature,such as hepatopulmonary syndrome and portopulmonary hypertension may also develop.Each complication has unique treatment challenges and implications for liver transplantation.The presence of atrial fibrillation and atherosclerosis in liver disease brings another layer of complexity,particularly in terms of anticoagulation and statin use.This article provides an overview of cardiac syndromes in liver disease,focusing on current treatment options and future perspectives.

关键词： Liver disease Congestive hepatopathy Cardiogenic liver injury Cirrhotic cardiomyopathy Hepatopulmonary syndrome Portopulmonary hypertension

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Rosmarinic acid improves tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats

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Asian Pacific Journal of Tropical Biomedicine 2024年第3期14卷 100-105页

作者： Vahideh Abbasnia Mohsen Foadoddini Delaram Eslimi Esfahani Mohammad Reza Khazdair Shahrbanoo Oryan Department of Biology Payame Noor UniversityTehranIran cardiovascular Diseases Research Center Birjand University of Medical SciencesBirjandIran Department of Animal Sciences Faculty of Biological SciencesKharazmi UniversityTehranIran

Objective:To evaluate the effect of rosmarinic acid on tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats.Methods:Rats were randomly divided into six groups:the control group,the asthmatic group,and the asthmatic groups treated with dexamethasone(1 mg/kg;oral gavage)or three doses of rosmarinic acid(0.5,1,and 2 mg/kg;oral gavage).For induction of asthma,rats received intraperitoneal injections and inhalation of ovalbumin.After 21 days,bronchoalveolar lavage fluid and lung samples were collected for histopathological analyses.Moreover,total and differential white blood cell counts were determined.Results:The rosmarinic acid-treated group had significantly lower tracheal smooth muscle responses to methacholine than the asthmatic group.In addition,rosmarinic acid reduced white blood cell count and the percentages of eosinophils,monocytes,and neutrophils while increasing the percentage of lymphocytes.Ovalbumin-induced lung pathological changes were significantly improved by treatment with rosmarinic acid.Conclusions:Rosmarinic acid improves tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats.

关键词： Rosmarinic acid Asthma Ovalbumin Tracheal responsiveness Inflammation White blood cell

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Application of seven-step finger method combined with external counterpulsation in cardiac rehabilitation after coronary intervention

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South China Journal of Cardiology 2024年第2期 129-135页

作者：钟秋苑徐二喜郭翡翠徐进芳梁嘉敏黄萍易莉莉 Department of cardiovascular Medicine The Fourth People's Hospital of Nanhai District

Background Interventional surgery for coronary heart disease(CHD) is one of the important surgical schemes for the treatment of CHD, which can help patients recover heart function and improve life quality. The purpose of this study was to observe the application of seven-step finger method combined with extracorporeal counterpulsation in cardiac rehabilitation after CHD intervention and its effect on readmission rate. Methods A total of 60 patients who underwent coronary intervention in our hospital from February 2022 to October 2023 were selected as the study objects, and were divided into the conventional group and the study group by random number table method, with 30 cases in each group. The conventional group received routine postoperative care, and the study group carried out seven-step finger method combined with external counterpulsation intervention on the basis of the conventional postoperative care. The postoperative pain and numbness of the two groups evaluated by visual analogue scale(VAS) at 1h, 2h, 4h after surgery and 1h after removal of the hemostatic apparatus, cardiac function indicators including left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDD), and perihospital indicators including 6-minute walking distance, barthel index(BI), length of stay and readmission rate were compared. Results The VAS scores of pain and numbness in the study group were significantly lower than those in the conventional group at 2h, 4h and 1h after the hemostat was removed(Pstudy group was significantly higher than that in the conventional group, and LVEDD was significantly lower than that in the conventional group(Pstudy group were significantly higher than that of the conventional group, and the length of hospital stay was significantly lower than that of the conventional group(Pstudy group(3.33%) was significantly lower than tha

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Application of multi-planar reconstruction technique in endovascular repair of aortic dissection

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World Journal of Clinical Cases 2024年第17期12卷 2989-2994页

作者： Guo-Jie Li Ming-Xian Zhao Department of Vascular Surgery Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist HospitalXining 810000Qinghai ProvinceChina

BACKGROUND Endovascular repair of aortic dissection is an effective method commonly used in the treatment of Stanford type B aortic dissection.Stent placement during the operation was one-time and could not be repeatedly adjusted during the operation.Therefore,it is of great significance for cardiovascular physicians to fully understand the branch status,position,angle,and other information regarding aortic arch dissection before surgery.AIM To provide more references for clinical cardiovascular physicians to develop treatment plans.METHODS Data from 153 patients who underwent endovascular repair of aortic dissection at our hospital between January 2021 and December 2022 were retrospectively collected.All patients underwent multi-slice spiral computed tomography angiography.Based on distinct post-image processing techniques,the patients were categorized into three groups:Multiplanar reconstruction(MPR)(n=55),volume reconstruction(VR)(n=46),and maximum intensity projection(MIP)(n=52).The detection rate of aortic rupture,accuracy of the DeBakey classification,rotation,and tilt angles of the C-arm during the procedure,dispersion after stent release,and the incidence of late complications were recorded and compared.RESULTS The detection rates of interlayer rupture in the MPR and VR groups were significantly higher than that in the MIP group(Pgroup were higher than those in the MIP group,and the detection rate of typeⅢin the MPR group was significantly higher than that in the VR group(Pgroup(P>0.05).The scatter rate of markers and the incidence of complications in the MPR group were significantly lower than those in the VR and MIP groups(P<0.05).CONCLUSION The application of MPR in the endovascular repair of aortic dissection has improved the detection rate of dissection rupture,the accuracy of anatomical classification,and safety.

关键词： Multiplanar reconstruction Endovascular repair of aortic dissection Image-processing technology Rate of aortic rupture Volume reconstruction

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Effect study of the Recombinant Human Brain Natriuretic Peptide in Patients with Heart Failure Combined with Hypotension

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Journal of Biosciences and Medicines 2024年第6期12卷 1-6页

作者： Yuhui Ding Keping Yang Department of cardiovascular Medicine Jingzhou Hospital Affiliated to Yangtze University Jingzhou China

Objective: This paper aims to investigate the effect of applying recombinant human brain natriuretic peptide in patients with heart failure combined with hypotension. Recombinant human brain natriuretic peptide is a synthetic polypeptide drug that is primarily used to treat acute heart failure. Its mechanism of action closely mimics that of human endogenous brain natriuretic peptide. By binding to receptors on cardiomyocytes, it exerts its pharmacological effects. Methods: For the study, 76 heart failure patients with hypotension were selected from our hospital between May 2022 and June 2023. These patients were divided into two groups: a control group and an observation group, each comprising 38 patients. The control group received dopamine treatment, while the observation group was treated with recombinant brain natriuretic peptide. The objective was to compare the effects of the treatments in both groups by analyzing cardiac function indices and levels of vasoactive substances to identify any significant differences in outcomes. Results: The overall response rate of the patients in the observation group and the control group was 94.74% and 73.68%, significantly higher as compared with the observation group (P 0.05). After the following treatment, BNP, ANNP and urine output in the observation group were significantly different compared with the control group, of the statistical significance (P Conclusion: For the treatment of heart failure patients with hypotension, the clinical application of recombinant human brain natriuretic peptide is the most ideal, and significantly improves the cardiac function of patients, which is worth popularizing.

关键词： Recombinant Human Brain Natriuretic Peptide Heart Failure Hypotension

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