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Association between non-culprit healed plaque and plaque progression in acute coronary syndrome patients:an optical coherence tomography study

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Journal of Geriatric cardiology 2021年第8期18卷 631-644页

作者： Wei-Jun YIN Jing JING Ying-Qian ZHANG Feng TIAN Tao ZHANG Shan-Shan ZHOU Yun-Dai CHEN Department of cardiology Chinese PLA General HospitalBeijingChina

BACKGROUND Healed plaques are frequently found in patients with acute coronary syndrome,but the prognostic value is *** study investigated the clinical features of non-culprit healed plaques detected by optical coherence tomography(OCT)with the aim of predicting plaque progression of healed *** This study retrospectively analyzed 113 non-culprit lesions from 85 patients who underwent baseline OCT ima-ging and follow-up angiography from January 2015 to December *** progression predictors were assessed by multivariate *** Among 113 non-culprit lesions,27 healed plaques(23.9%)were *** with non-culprit healed plaques had prior antiplatelet therapy(65.0%vs.33.8%,P=0.019),hypertension(85.0%vs.50.7%,P=0.009),and dyslipidemia(70.0%vs.41.5%,P=0.04)which were more frequently than those without healed *** thickness(r=0.674,P<0.001),arc(r=0.736,P<0.001),and volume(r=0.541,P=0.004)of healed plaque were correlated with minimum lumen diameter *** a mean follow-up of 11.5 months,the non-culprit healed plaques had a lower minimum lumen diameter(1.61±0.46 mm vs.1.91±0.73 mm,P=0.016),lower average lumen diameter(1.86 mm vs.2.10 mm,P=0.033),and a higher degree of diameter stenosis(41.4%±11.9%vs.35.5%±13.1%,P=0.031)when compared to baseline *** plaque progression rate was higher in the healed plaque group(33.3%vs.8.1%,P=0.002),and multivariate analysis identified healed plaques[odds ratio(OR)=8.49,95%CI:1.71−42.13]and lumen thrombus(OR=10.69,95%CI:2.21−51.71)as predictors of subsequent lesion *** Healed plaques were a predictor for rapid plaque *** quantitative parameters of healed plaque showed a good agreement with plaque *** with healed plaque were associated with prior antiplatelet therapy and high level of low-density lipoprotein *** lesions might be the predilection sites of healed plaques.

关键词： patients coronary acute

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A risk prediction score model for predicting occurrence of post-PCI vasovagal reflex syndrome： a single center study in chinese population

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Journal of Geriatric cardiology 2017年第8期14卷 509-514页

作者： Hai-Yan LI Yu-Tao GUO Cui TIAN Chao-Qun SONG Yang MU Yang LI Yun-Dai CHEN Department of cardiology Chinese PLA General Hospital Beijing China

Background The vasovagal reflex syndrome （VVRS） is common in the patiems undergoing percutaneous coronary intervemion （PCI） However, prediction and prevention of the risk for the VVRS have not been completely fulfilled. This study was conducted to develop a Risk Prediction Score Model to identify the determinants of VVRS in a large chinese population cohort receiving PCI. Methods From the hos- pital electronic medical database, we idemified 3550 patients who received PCI （78.0% males, mean age 60 years） in chinese PLA General Hospital from January 1, 2000 to August 30, 2016. The multivariate analysis and receiver operating characteristic 01OC） analysis were performed. Results The adverse events of VVRS in the patients were significantly increased after PCI procedure than before the operation （all P 〈 0.001）. The rate of VVRS [95% confidence interval （CI）] in patients receiving PCI was 4.5% （4.1%-5.6%）. Compared to the patients suffering no VVRS, incidence of VVRS involved the following factors, namely female gender, primary PCI, hypertension, over two stems im- plantation in the left anterior descending （LAD）, and the femoral puncture site. The multivariate analysis suggested that they were independ- ent risk factors for predicting the incidence of VVRS （all P 〈 0.001）. We developed a risk prediction score model for VVRS. ROC analysis showed that the risk prediction score model was effectively predictive of the incidence of VVRS in patients receiving PCI （c-statistic 0.76, 95% CI： 0.72-0.79, P 〈 0.001）. There were decreased evems of VVRS in the patients receiving PCI whose diastolic blood pressure dropped by more than 30 mmHg and heart rate reduced by 10 times per minute （AUC： 0.84, 95% CI： 0.81-0.87, P 〈 0.001）. Conclusion The risk prediction score is quite efficient in predicting the incidence of VVRS in patients receiving PCI. In which, the following factors may be in- volved, the femoral puncture site, female gender, hypertension, primary PCI, and over 2 stents

关键词： Post-percutaneous coronary intervention Risk prediction score model Vasovagal reflex syndrome

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Liraglutide directly protects cardiomyocytes against reperfusion injury possibly via modulation of intracellular calcium homeostasis

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Journal of Geriatric cardiology 2017年第1期14卷 57-66页

作者： Shun-Ying HU Ying ZHANG Ping-Jun ZHU Hao ZHOU Yun-Dai CHEN Department of cardiology Chinese PLA General Hospital Beijing China

Background Liraglutide is glucagon-like peptide-1 receptor agonist for treating patients with type 2 diabetes mellitus. Our previous studies have demonstrated that liraglutide protects cardiac function through improving endothelial function in patients with acute myocardial infarction undergoing percutaneous coronary intervention. The present study will investigate whether liraglntide can perform direct protective effects on cardiomyocytes against reperfusion injury. Methods In vitro experiments were performed using H9C2 cells and neonatal rat ventricular cadiomyocytes undergoing simulative hypoxia/reoxygenation （H/R） induction. Cardiomyocytes apoptosis was detected by fluorescence TUNEL. Mitochondrial membrane potential （AWm） and intracellular reactive oxygen species （ROS） was assessed by JC-1 and DHE, respectively. Fura-2/AM was used to measure intracellular Ca2＋ concentration and calcium transient. Immtmofluorescence staining was used to assess the expression level of sarcoplasmic reticulum Ca2＋-ATPase （SERCA2a）. In vivo experiments, myocardial apoptosis and expression of SERCA2a were detected by colorimetric TUNEL and by immunofluorescence staining, respectively. Results In vitro liraglutide inhibited cardiomyotes apoptosis against H/R. △mψ of cardiomyocytes was higher in liraglntide group than H/R group. H/R increased ROS production in H9C2 cells which was attenuated by liraglutide. Liraglutide significantly lowered Ca2＋ overload and improved calcium transient compared with H/R group, lmmunofluorescence staining results showed liraglutide promoted SERCA2a expression which was decreased in H/R group. In ischemia/reperfusion rat hearts, apoptosis was significantly attenuated and SERCA2a expression was increased by liraglutide compared with H/R group. Conclusions Liraglutide can directly protect cardiomyocytes against reperfusion injury which is possibly through modulation of intracellular calcium homeostasis.

关键词： Calcium overload Cardiomyocyte Liraglutide Reperfusion injury Sarcoplasmic reticulum Ca2+-ATPase

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Effects of allocryptopine on outward potassium current and slow delayed rectifier potassium current in rabbit myocardium

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Journal of Geriatric cardiology 2016年第4期13卷 316-325页

作者： Yi-Cheng FU Yu ZHANG Liu-Yang TIAN Nan LI Xi CHEN Zhong-Qi CAI Chao ZHU Yang LI Division of cardiology Chinese PLA General Hospital Beijing China

Objective Allocryptopine （ALL） is an effective alkaloid of Corydalis decumbens （Thunb.） Pers. Papaveraceae and has proved to be an- ti-arrhythmic. The purpose of our study is to investigate the effects of ALL on transmural repolarizing ionic ingredients of outward potassium current （Ito） and slow delayed rectifier potassium current （IKs）. Methods The monophasic action potential （MAP） technique was used to record the MAP duration of the epicardium （Epi）, myocardium （M） and endocardium （Endo） of the rabbit heart and the whole cell patch clamp was used to record/to and IKs in cardiomyocytes of Epi, M and Endo layers that were isolated from rabbit ventricles. Results The effects of ALL on MAP of Epi, M and Endo layers were disequilibrium. ALL could effectively reduce the transmural dispersion of repolarization （TDR） in rabbit transmural ventricular wall. ALL decreased the current densities of/to and IKs in a voltage and concentration dependent way and narrowed the repolarizing differences among three layers. The analysis of gating kinetics showed ALL accelerated the channel activation ofIto in M layers and partly inhibit the channel openings of/to in Epi, M and Endo cells. On the other hand, ALL mainly slowed channel deactivation of IKs channel in Epi and Endo layers without affecting its activation. Conclusions Our study gives partially explanation about the mechanisms of tmnsmural inhibition of/to and IKs channels by ALL in rabbit myocardium. These findings provide novel perspective regarding the anti-arrhythmogenesis application of ALL in clinical settings.

关键词： Allocryptopine Endocardium Epicardium Midcardium Slow delayed rectifier potassium channel Transient outward potassiumcurrent

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Safflower yellow injection combined with conventional therapy in treating unstable angina pectoris:a meta-analysis

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Journal of Traditional chinese Medicine 2013年第5期33卷 553-561页

作者： Dezhao Kong Wei Xia Zhe Zhang Lei Xiao Dongchao Yuan Yue Liu Guanlin Yang Department of cardiology Liaoning University Of Traditional Chinese Medicine Department of Cardiol-ogy the Affiliated Hospital of Liaoning University of Tradi-tional Chinese Medicine Department of cardiology Liaoning University Of Tra-ditional Chinese Medicine

OBJECTIVE： To evaluate the clinical efficacy of safflower yellow injection combined with conventional therapy in treating unstable angina ***： We searched online databases： chinese journal full-text database, China National Knowledge Infrastructure, Wanfang database, chinese journal full-text database, Pubmed, ScienceDirect,Embase, and the Cochrane Library with manual-screening of relevant literature. Eligible randomized controlled trials（RCT） on angina pectoris were included. We conducted meta-analysis using the RevMan 5.1 software from The Cochrane Collaboration. We treated the relief rate of angina symptoms and electrocardiograph（ECG） as ***： Seven articles, including in 1134 patients, were enrolled after the evaluation. Therewas no significant heterogeneity among the studies（χ2=1.08, df=6, P=0.98, I2=0%）. The safflower yellow injection with conventional therapy has a higher effective rate than the control group in relieving the symptoms of angina pectoris [odds ratio（OR）=2.95, 95%（CI）（1.81, 4.81）] and improving ischemic ECG [OR=2.85, 95% CI（1.67, 4.86）]. The difference was statistically significant in the ＂80 mg dosage＂ and ＂100 mg dosage＂ subgroups（P0.05） for improving clinical symptoms and ECG. The funnel graphic was nearly symmetrical. Sensitivity analysis suggested that the results were ***： Safflower yellow injection as an adjunct therapy with conventional drugs shows advantages in easing the clinical symptoms of unstable angina and improving ECG over basic therapy alone. However, the conclusions should be interpreted with care until more high-quality RCTs are reported.

关键词： Safflower yellow injection Angina unstable Meta-analysis

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Mitochondrial quality control mechanisms as molecular targets in cardiac ischemia-reperfusion injury

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Acta Pharmaceutica Sinica B 2020年第10期10卷 1866-1879页

作者： Jin Wang Hao Zhou Department of cardiology Chinese PLA General HospitalMedical School of Chinese PLABeijing 100853China

Mitochondrial damage is a critical contributor to cardiac ischemia/reperfusion(I/R)*** quality control(MQC)mechanisms,a series of adaptive responses that preserve mitochondrial structure and function,ensure cardiomyocyte survival and cardiac function after I/R *** includes mitochondrial fission,mitochondrial fusion,mitophagy and mitochondria-dependent cell *** interplay among these responses is linked to pathological changes such as redox imbalance,calcium overload,energy metabolism disorder,signal transduction arrest,the mitochondrial unfolded protein response and endoplasmic reticulum *** mitochondrial fission is an early marker of mitochondrial damage and cardiomyocyte *** mitochondrial fusion has been observed in stressed cardiomyocytes and correlates with mitochondrial dysfunction and cardiac *** allows autophagosomes to selectively degrade poorly structured mitochondria,thus maintaining mitochondrial network ***,abnormal mitophagy is maladaptive and has been linked to cell *** mitochondria serve as the fuel source of the heart by continuously producing adenosine triphosphate,they also stimulate cardiomyocyte death by inducing apoptosis or necroptosis in the reperfused ***,defects in MQC may determine the fate of *** this review,we summarize the regulatory mechanisms and pathological effects of MQC in myocardial I/R injury,highlighting potential targets for the clinical management of reperfusion.

关键词： Mitochondrial quality control Mitochondrial fission Fusion Mitophagy Mitochondrial death Cardiomyocyte I/R injury Apoptosis Necroptosis

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Role of chinese Herbal Medicines in Regulation of Energy Metabolism in Treating Cardiovascular Diseases

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chinese Journal of Integrative Medicine 2019年第4期25卷 307-315页

作者： LI Jie GUAN Xuan-ke LIU Ru-xiu Department of cardiology Guang'anmen HospitalChinese Academy of Chinese Medical SciencesBeijing(100053)China

Recently,studying myocardial energy metabolism pathways or improving myocardial metabolism through drugs is another effective strategy for treating ischemic heart *** active components of chinese herbal medicines(CHMs) have been found to modulate energy metabolism in myocardial cells,cerebral vascular cells,endothelial cells and tumour *** paper reviews the advances in studies on the active components of CHMs that modulating energy metabolism in treating cardiovascular diseases over the past ?ve years.

关键词： biologically active ingredient chinese herbal medicine cardiovascular disease ischemic heart disease heart failure

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Clinical Significance of Inflammation Factors in Acute Coronary Syndrome from Pathogenic Toxin

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chinese Journal of Integrative Medicine 2009年第4期15卷 307-312页

作者：冯妍张京春郗瑞席 Department of cardiology Xiyuan HospitalChina Academy of Chinese Medical Sciences Department of cardiology iyuan HospitalChina Academy of Chinese Medical Sciences

The inflammation factors and roles of them in acute coronary syndrome(ACS)were explored. The similarity between the theory of pathogenic toxin in chinese Medicine and the inflammation response theory in ACS was *** ex... 详细信息

关键词： pathogenic toxin inflammation factors acute coronary syndrome

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Astragaloside Ⅳ for Heart Failure: Preclinical Evidence and Possible Mechanisms, A Systematic Review and Meta-Analysis

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chinese Journal of Integrative Medicine 2023年第7期29卷 626-633页

作者： LI Xing-xing LI Dong CUI Xiao-yun ZHOU Kun LIU Jing LU Jin-jin WU Yang LIN Qian LI Yan Department of cardiology Dongfang HospitalBeijing University of Chinese MedicineBeijing100078China Department of cardiology Dongzhimen HospitalBeijing University of Chinese MedicineBeijing100700China

Objective:To explore the cardioprotective effects of astragaloside Ⅳ(AS-Ⅳ) in heart failure(HF).Methods:PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,Wanfang Database,chinese Bio-medical Literature and Retrieval System(SinoMed),China Science and Technology Journal Database(VIP),and China National Knowledge Infrastructure(CNKI) were searched from inception to November 1,2021for animal experiments to explore AS-Ⅳ in treating HF in rats or mice. The left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-diastolic dimension(LVEDD),left ventricular endsystolic dimension(LVESD),left ventricular weight-to-body weight(LVW/BW) and B-type brain natriuretic peptide(BNP) were *** qualities of included studies were assessed by the risk of bias according to the Cochrane ***-analysis was performed using Stata ***:Twenty-one articles involving 558 animals were *** with the control group,AS-Ⅳ improved cardiac function,specifically by increasing LVEF(mean difference(MD)=6.97,95% confidence interval(CI)=5.92 to 8.03,P<0.05;fixed effects model) and LVFS(MD=7.01,95% CI=5.84 to 8.81,P<0.05;fixed effects model),and decreasing LVEDD(MD=-4.24,95% CI=-4.74to-3.76,P<0.05;random effects model) and LVESD(MD-4.18,95% CI=-5.26 to-3.10,P<0.05;fixed effects model).In addition,the BNP and LVW/BW levels were decreased in the AS-Ⅳ treatment group(MD=-9.18,95%CI=-14.13 to-4.22,P<0.05;random effects model;MD=-1.91,95% CI=-2.42 to-1.39,P<0.05;random effects model).Conclusions:AS-Ⅳ is a promising therapeutic agent for ***,this conclusion needs to be clinically validated in the future.

关键词： astragaloside IV heart failure pre-clinical evidence systematic review

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Additional manual thrombus aspiration for ST-segment elevation myocardial infarction during percutaneous coronary intervention： an updated meta- analysis

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Journal of Geriatric cardiology 2016年第4期13卷 344-354页

作者： Yan ZHANG Li PENG Yong-Yan FAN Cai-Yi LU Department of cardiology Chinese PLA General Hospital Beij'ing China

Background The clinical efficacy and safety of adjunctive thrombus aspiration （TA） in patients with ST-segment elevation myocardial infarction （STEMI） during percutaneous coronary intervention （PCI） remain controversial. Methods Twenty five eligible randomized controlled trials were included to compare the use of thrombus aspiration （TA） with PCI and PCI-only for STEMI. The primary endpoint was all-cause mortality and death. The secondary endpoints were major adverse cardiac events （MACE）, recurrent infarction （RI）, target vessel revascularization （TVR）, stent thrombosis （ST）, perfusion surrogate markers and stroke. Results TIMI flow grade 3 and MBG 2-3 were significantly increased in the TA plus PCI arm compared with the PCI-only arm [relative risk （RR）： 1.05, 95% confidence intervals （CI）： 1.02-1.09, P = 0.004] and （RR： 1.68, 95% CI： 1.40-2.00, P 〈 0.001）, respectively. There were no significant differences in all-cause mortal- ity, MACEs, TVR and ST rates between the two groups. The RI rate was lower in the TA plus PCI arm than that in the PCI-only arm with short-term follow-up duration （RR： 0.60, 95% CI： 0.38-0.96, P = 0.03）, but there was no significant difference in RI incidence over the me- diumor long-term follow-up periods （RR： 1.00, 95% CI： 0.77-1.29, P = 0.98）, and （RR： 0.96, 95% CI： 0.81-1.15, P = 0.69）, respectively. There were statistically significant differences in the rates of crude stroke and stroke over the medium- or long-term follow-up periods and the crude stroke rate in the TA plus PCI （RR： 1.60, 95% CI： 1.08-2.38, P = 0.02） and （RR： 1.43, 95% CI： 1.03-1.98, P = 0.03）, respectively; this was not observed between the two arms during the short-term follow-up period （RR： 1.47, 95% CI： 0.97-2.21, P = 0.07）. Conclusions Routine TA-assisted PCI in STEMI patients can improve myocardial reperfusion and get limited benefits related to the clinical endpoints, which may be associated with stroke risk.

关键词： Manual thrombus aspiration Meta-analysis percutaneous coronary intervention Randomized controlled trials ST-segment ele-vation myocardial infarction

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