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Psychological Status and Warfarin Therapy in Patients after Valve Replacement during the COVID-19 Pandemic:A Cross-sectional Study

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Current Medical Science 2024年第4期44卷 686-691页

作者： Xiao-yan CHEN Sheng HE Zhen TAN Feng GAO Hui JIANG Lu CHEN Li YANG Yu-shan LIU Si-yi HE department of cardiovascular Surgery The General Hospital of Western Theater CommandChengdu610083China department of Digestive Medicine The General Hospital of Western Theater CommandChengdu610083China department of General Surgery The General Hospital of Western Theater CommandChengdu610083China

Objective The standardization of warfarin anticoagulant therapy is the key to lifelong treatment for patients after heart valve *** present study explored the possible risk factors for anxiety and depression during the coronavirus disease 2019(COVID-19)pandemic and analyzed the influence of psychological state on medication *** Eligible patients received a web-based questionnaire survey via the Wenjuanxing platform during outpatient *** was evaluated by the Self-Rating Depression Scale(SDS).Anxiety was evaluated by the Self-Rating Anxiety Scale(SAS).Medication adherence was evaluated by the Morisky *** A total of 309 patients(aged 52.2±11.4 years)were included in the present *** SDS score of all included patients was 36.9±9.4 points,of which 11(3.6%)patients were diagnosed as having *** SAS score of all included patients was 43.1±9.3 points,of which 71(23%)patients were diagnosed as having *** patients(2.3%)had both anxiety and *** regression analysis revealed that only monthly income was an independent influencing factor for *** anxiety,patients who underwent repeated operations had a 2.264-fold greater risk,and patients who received combination medication had a 2.140-fold greater *** bleeding events and coagulation disorders could be observed in patients with anxiety,depression or *** anxiety occurred,patients showed worse medication ***,depression had no significant effect on medication *** During the COVID-19 pandemic,the detection rate of mental illnesses such as anxiety and depression was high,which seriously affected the medication safety of *** of its influencing factors will provide a reference for further standardized regulation of warfarin anticoagulant therapy after valve replacement.

关键词： Warfarin COVID-19 valve replacement depression anxiety

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Targeting deubiquitinase OTUB1 protects vascular smooth muscle cells in atherosclerosis by modulating PDGFRβ

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Frontiers of Medicine 2024年第3期18卷 465-483页

作者： Fei Xu Han Chen Changyi Zhou Tongtong Zang Rui Wang Shutong Shen Chaofu Li Yue Yu Zhiqiang Pei Li Shen Juying Qian Junbo Ge department of Cardiology and Laboratory of Heart Valve Disease West China HospitalSichuan UniversityChengdu610041China department of Cardiology Zhongshan HospitalFudan UniversityResearch Unit of Cardiovascular Techniques and DevicesChinese Academy of Medical SciencesShanghai200032China Shanghai Institute of cardiovascular Diseases Shanghai200032China National Clinical Research Center for Interventional Medicine&Shanghai Clinical Research Center for Interventional Medicine(19MC1910300) Shanghai200032China

Atherosclerosis is a chronic artery disease that causes various types of cardiovascular *** smooth muscle cells(VSMCs),the main components of atherosclerotic plaque,switch from contractile to synthetic phenotypes during *** is crucial in regulating VSMC phenotypes in atherosclerosis,and it can be reversely regulated by ***,the specific effects of deubiquitinases on atherosclerosis have not been thoroughly *** this study,RNAi screening in human aortic smooth muscle cells was performed to explore the effects of OTU family deubiquitinases,which revealed that silencing OTUB1 inhibited PDGF-BB-stimulated VSMC phenotype *** in vivo studies using Apoe−/−mice revealed that knockdown of OTUB1 in VSMCs alleviated atherosclerosis plaque burden in the advanced stage and led to a stable plaque ***,VSMC proliferation and migration upon PDGF-BB stimulation could be inhibited by silencing OTUB1 in *** RNA-sequencing data indicated that knocking down OTUB1 influenced VSMC differentiation,adhesion,and *** spectrometry of ubiquitinated protein confirmed that proteins related to cell growth and migration were differentially ***,we found that OTUB1 recognized the K707 residue ubiquitylation of PDGFRβwith its catalytic triad,thereby reducing the K48-linked ubiquitylation of PDGFRβ.Inhibiting OTUB1 in VSMCs could promote PDGFRβdegradation via the ubiquitin–proteasome pathway,so it was beneficial in preventing VSMCs’phenotype *** findings revealed that knocking down OTUB1 ameliorated VSMCs’phenotype switch and atherosclerosis progression,indicating that OTUB1 could be a valuable translational therapeutic target in the future.

关键词： atherosclerosis vascular smooth muscle cell ubiquitylation deubiquitinase OTUB1 PDGFRβ

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Immune checkpoint inhibitors break whose heart? Perspectives from cardio-immuno-oncology

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Genes & Diseases 2024年第2期11卷 807-818页

作者： Yingying He Hui Yu Shuang Dai Miao He Ling Ma Zihan Xu Feng Luo Li Wang Oncology department Deyang People's HospitalDeyangSichuan 618000China department of Medical Oncology Lung Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610000China cardiovascular department Mianyang Central HospitalMianyangSichuan 621000China department of Rheumatology and Immunology Deyang People's HospitalDeyangSichuan 618000China

Immune checkpoint inhibitors (ICIs) are monoclonal antibody antagonists,which can block cytotoxic T lymphocyte antigen-4 (CTLA-4),programmed death-1/ligand-1 (PD-1/PD-L1) pathways,and other molecules exploited by tumor cells to evade T cell-mediated immune *** have transformed the treatment landscape for various cancers due to their amazing *** anti-tumor therapies,including targeted therapy,radiotherapy,and chemotherapy,combine ICIs to make the treatment more ***,the off-target immune activation caused by ICIs may lead to a broad spectrum of immune-related adverse events (irAEs) affecting multiple organ *** irAEs,cardiotoxicity induced by ICIs,uncommon but fatal,has greatly offset survival benefits from ICIs,which is heartbreaking for both patients and ***,such cardiotoxicity requires special vigilance,and it has become a common challenge both for patients and *** article reviewed the clinical manifestations and influence of cardiotoxicity from the view of patients and clinicians,elaborated on the underlying mechanisms in conjunction with animal studies,and then attempted to propose management strategies from a cardio-immuno-oncology multidisciplinary perspective.

关键词： Cancer management Cardio-immuno-oncology multidisciplinary Cardiotoxicity Immune checkpoint inhibitors Immune tolerance

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Soft,body conformable electronics for thermoregulation enabled by kirigami

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Bio-Design and Manufacturing 2024年第4期7卷 453-462页

作者： Lung Chow Guangyao Zhao Pengcheng Wu Xingcan Huang Jiyu Li Jian Li Wanying Wang Guihuan Guo Zhiyuan Li Jiachen Wang Jingkun Zhou Yawen Yang Yuyu Gao Binbin Zhang Qiang Zhang Dengfeng Li Ya Huang Kuanming Yao Jian Lu Xinge Yu department of Biomedical Engineering City University of Hong KongHong Kong 999077China Hong Kong Centre for Cerebro-cardiovascular Health Engineering Hong Kong 999077China department of Biomedical Sciences City University of Hong KongHong Kong 999077China department of Mechanical Engineering City University of Hong KongHong Kong 999077China

The application of thermoelectric devices(TEDs)for personalized thermoregulation is attractive for saving energy while balancing the quality of *** that directly attach to human skin remarkably minimized the energy wasted for cooling the entire ***,facing the extreme dynamic geometry change and strain of human skin,conventional TEDs cannot align with the contour of our bodies for the best thermoregulation ***,we designed a kirigami-based wearable TED with excellent water vapor permeability,flexibility,and *** analysis and experimental results reveal that our product can withstand various types of large mechanical deformation without circuit *** stated outcome and proposed facile approach not only reinforce the development of wearable TEDs but also offer an innovative opportunity for different electronics that require high conformability.

关键词： Thermoregulation Thermoelectric Kirigami Body conformable Wearable

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Identifying coronary artery bypass grafting patients at high risk for adverse long-term prognosis using serial health-related quality of life assessments

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Chinese Medical Journal 2024年第9期137卷 1069-1077页

作者： Juncheng Wang Hanning Liu Chao Yue Limeng Yang Kai Yang Yan Zhao Huan Ren Ying Zhang Zhe Zheng National Clinical Research Center for cardiovascular Diseases State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China department of cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China department of Vascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China department of Cardiac Surgery Wuhan Asia Heart HospitalWuhanHubei 430022China

Background:Patients who undergo coronary artery bypass grafting(CABG)are known to be at a significant risk of experiencing long-term adverse events,emphasizing the importance of regular *** health-related quality of life(HRQoL)serves as a direct method to gauge *** objective is to ascertain the prognostic significance of consecutive HRQoL assessments using the Physical Component Summary(PCS)and Mental Component Summary(MCS)derived from the Short-Form 36(SF-36)health survey in CABG ***:The study population consisted of 433 patients who underwent isolated elective CABG at Fuwai Hospital between 2012 and ***-36 assessments were conducted during both the hospitalization period and *** primary endpoint of the study was all-cause mortality,while the secondary outcome was a composite measure including death,myocardial infarction,stroke,and repeat *** assessed the relationships between the PCS and MCS at baseline,as well as their changes during the first 6 months after the surgery(referred to asΔPCS andΔMCS,respectively),and the observed ***:The patients were followed for an average of 6.28 years,during which 35 individuals(35/433,8.1%)*** adjusting for clinical variables,it was observed that baseline MCS scores(hazard ratio[HR]for a 1-standard deviation[SD]decrease,1.57;95%confidence interval[CI],1.07-2.30)andΔMCS(HR for a 1-SD decrease,1.67;95%CI,1.09-2.56)were associated with all-cause ***,baseline PCS scores andΔPCS did not exhibit a significant relationship with all-cause ***,there was a dose-response relationship observed betweenΔMCS and the likelihood of all-cause mortality(HRs for the 2nd,3rd and 4th quartiles compared to the 1st quartile,0.33,0.45 and 0.11,respectively).Conclusions:Baseline MCS and changes in MCS were independent predictors for long-term mortality of *** mental health status and recovery indicated better prognosis.

关键词： Coronary artery bypass grafting Coronary artery disease Prognosis Quality of life Short-Form 36 Risk factor Serial measurements

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Initial decrease in the lipoprotein(a)level is a novel prognostic biomarker in patients with acute coronary syndrome

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World Journal of Cardiology 2024年第6期16卷 329-338页

作者： Yasuhiko Saeki Jun Sawaguchi Satori Akita Taka-aki Takamura Kosuke Fujibayashi Minoru Wakasa Hironobu Akao Michihiko Kitayama Yasuyuki Kawai Kouji Kajinami department of Cardiology Kanazawa Medical UniversityUchinada 9200293Japan Trans-catheter cardiovascular Therapeutics Kanazawa Medical UniversityUchinada 9200293Japan

BACKGROUND Lipoprotein(a)[Lp(a)]is a causal risk factor for atherosclerotic cardiovascular diseases;however,its role in acute coronary syndrome(ACS)remains *** To investigate the hypothesis that the Lp(a)levels are altered by various conditions during the acute phase of ACS,resulting in subsequent cardiovascular *** From September 2009 to May 2016,377 patients with ACS who underwent emergent coronary angiography,and 249 who completed≥1000 d of follow-up were ***(a)levels were measured using an isoform-independent assay at each time point from before percutaneous coronary intervention(PCI)to 48 h after *** primary endpoint was the occurrence of major adverse cardiac events(MACE;cardiac death,other vascular death,ACS,and non-cardiac vascular events).RESULTS The mean circulating Lp(a)level decreased significantly from pre-PCI(0 h)to 12 h after(19.0 mg/dL to 17.8 mg/dL,P<0.001),and then increased significantly up to 48 h after(19.3 mg/dL,P<0.001).The changes from 0 to 12 h[Lp(a)Δ0-12]significantly correlated with the basal levels of creatinine[Spearman’s rank correlation coefficient(SRCC):-0.181,P<0.01]and Lp(a)(SRCC:-0.306,P<0.05).Among the tertiles classified according to Lp(a)Δ0-12,MACE was significantly more frequent in the lowest Lp(a)Δ0-12 group than in the remaining two tertile groups(66.2%vs 53.6%,P=0.034).A multivariate analysis revealed that Lp(a)Δ0-12[hazard ratio(HR):0.96,95%confidence interval(95%CI):0.92-0.99]and basal creatinine(HR:1.13,95%CI:1.05-1.22)were independent determinants of subsequent *** Circulating Lp(a)levels in patients with ACS decreased significantly after emergent PCI,and a greater decrease was independently associated with a worse prognosis.

关键词： Lipoprotein(a) Acute coronary syndrome Percutaneous coronary intervention Major adverse cardiac events Prognosis

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Integrin β5 subunit regulates hyperglycemia-induced vascular endothelial cell apoptosis through FoxO1-mediated macroautophagy

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Chinese Medical Journal 2024年第5期137卷 565-576页

作者： Xuze Lin Sizhuang Huang Side Gao Jinxing Liu Jiong Tang Mengyue Yu department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100037China department of Cardiology Fuwai Yunnan Cardiovascular HospitalKunmingYunnan 650000China

Background:Hyperglycemia frequently induces apoptosis in endothelial cells and ultimately contributes to microvascular dysfunction in patients with diabetes mellitus(DM).Previous research reported that the expression of integrins as well as their ligands was elevated in the diseased vessels of DM ***,the association between integrins and hyperglycemia-induced cell death is still *** research was designed to investigate the role played by integrin subunit β5(ITGB5)in hyperglycemia-induced endothelial cell ***:We used leptin receptor knockout(Lepr-KO)(db/db)mice as spontaneous diabetes animal *** deletion of ITGB5 in endothelial cell was achieved by injecting vascular targeted adeno-associated virus via tail ***,we also applied small interfering RNA in vitro to study the mechanism of ITGB5 in regulating high glucose-induced cell ***:ITGB5 and its ligand,fibronectin,were both upregulated after exposure to high glucose in vivo and in ***5 knockdown alleviated hyperglycemia-induced vascular endothelial cell apoptosis and microvascular rarefaction in *** vitro analysis revealed that knockdown of either ITGB5 or fibronectin ameliorated high glucose-induced apoptosis in human umbilical vascular endothelial cells(HUVECs).In addition,knockdown of ITGB5 inhibited fibronectin-induced HUVEC apoptosis,which indicated that the fibronectin-ITGB5 interaction participated in high glucose-induced endothelial cell *** using RNA-sequencing technology and bioinformatic analysis,we identified Forkhead Box Protein O1(FoxO1)as an important downstream target regulated by ***,we demonstrated that the excessive macroautophagy induced by high glucose can contribute to HUVEC apoptosis,which was regulated by the ITGB5-FoxO1 ***:The study revealed that high glucose-induced endothelial cell apoptosis was positively regulated by ITGB5,which suggested that ITGB5 could potentially be used

关键词： Endothelial cell apoptosis Integrin Autophagy Diabetes

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A novel mouse model of calcific aortic valve stenosis

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Animal Models and Experimental Medicine 2024年第4期7卷 523-532页

作者： Ningjing Qian Yaping Wang Wangxing Hu Naifang Cao Yi Qian Jinyong Chen Juan Fang Dilin Xu Haochang Hu Shuangshuang Yang Dao Zhou Hanyi Dai Dongdong Wei Jian'an Wang Xianbao Liu department of Cardiology The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina State Key Laboratory of Transvascular Implantation Devices China cardiovascular Key Laboratory of Zhejiang Province HangzhouChina department of cardiovascular Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina department of Endocrinology The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina Binjiang Institute of Zhejiang University HangzhouChina

Background:Calcific aortic valve stenosis(CAVS)is one of the most challenging heart diseases in clinical with rapidly increasing ***,study of the mecha-nism and treatment of CAVS is hampered by the lack of suitable,robust and efficient models that develop hemodynamically significant stenosis and typical calcium ***,we aim to establish a mouse model to mimic the development and features of ***:The model was established via aortic valve wire injury(AVWI)combined with vitamin D subcutaneous injected in wild type C57/BL6 *** transthoracic echocardiography was applied to evaluate aortic jet peak velocity and mean *** specimens were collected and examined in respect of valve thickening,calcium deposition,collagen accumulation,osteogenic differentiation and ***:Serial transthoracic echocardiography revealed that aortic jet peak velocity and mean gradient increased from 7 days post model establishment in a time depend-ent manner and tended to be stable at 28 *** with the sham group,sim-ple AVWI or the vitamin D group,the hybrid model group showed typical pathological features of CAVS,including hemodynamic alterations,increased aortic valve thicken-ing,calcium deposition,collagen accumulation at 28 *** addition,osteogenic dif-ferentiation,fibrosis and inflammation,which play critical roles in the development of CAVS,were observed in the hybrid ***:We established a novel mouse model of CAVS that could be induced efficiently,robustly and economically,and without genetic *** provides a fast track to explore the underlying mechanisms of CAVS and to identify more effec-tive pharmacological targets.

关键词： animal model calcific aortic valve stenosis valve calcification

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Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure

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World Journal of Diabetes 2024年第6期15卷 1226-1233页

作者： Jie Pang Lin-Yan Qian Ping Lv Xiao-Ru Che Heart Center Department of Cardiovascular MedicineZhejiang Provincial People’s Hospital(The Affiliated People’s Hospital)Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina

BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular *** To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December *** NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were *** receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of *** correlation between NLR and RDW with the presence or absence of cardiac events was also *** Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of ***,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac *** NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic ***,NLR and RDW values were directly proportional to patient outcomes.

关键词： Neutrophil-lymphocyte ratio Red blood cell distribution width Type 2 diabetes Heart failure Early diagnosis

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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

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

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