Launched：February 1989
Editor-in-Chief：PEI Jian-ming
ISSN：1009-7236
CN：61-1268/R
Supervisor: Fourth Military Medical University
Sponsor: Medical Informatics Association Shaanxi Provincial Association for Physiological Sciences
Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes /issues, but are citable by Digital Object Identifier (DOI).
Display Method:
Display Method:
2022, 34(3): 249-255, 261.
doi: 10.12125/j.chj.202109076
[Abstract]
[FullText HTML]
[PDF 1521KB]
Abstract:
TIM To investigate the effect of HSP110 expression regulated by ATF3 on the proliferation and autophagy of human pulmonary artery smooth muscle cells stimulated by hypoxia. METHODS Human pulmonary artery smooth muscle cells were cultured in vitro and infected with ATF3 silencing adenovirus alone or co-infected with HSP110 over-expressing adenovirus. After 48 h, the autophagy activator rapamycin was added and pretreated for 3 h, and then the hypoxic cell model was established. After 24 h, CCK-8 assay was used to detect the proliferation ability of the cells and cell apoptosis was analyzed by flow cytometry. Real-time PCR was used to detect the mRNA expression of ATF3 and HSP110 and Western blot was used to detect the protein expression of ATF3, HSP110, LC3Ⅱ/Ⅰ, Beclin-1 and p62. The formation of LC3 puncta was observed by immunofluorescence and the regulatory effect of ATF3 on HSP110 was identified by luciferase reporting system. RESULTS The expressions of ATF3 and HSP110 were significantly increased in hypoxia group (P<0.01), the proliferation ability of cells was decreased and the apoptosis rate was increased after ATF3 silencing (P<0.01). Meanwhile, the expressions of autophagy protein LC3 Ⅱ/Ⅰ, Beclin-1 and LC3 puncta were significantly decreased (P<0.01), and theexpression of autophagy degradation substrate p62 was significantly increased(P<0.01). However, after addition of rapamycin or co-infection with HSP110 over-expressing adenovirus, the inhibition of cell proliferation and autophagy by ATF3 silencing was significantly reduced (P<0.01). CONCLUSION ATF3 up-regulates the expression of HSP110 and promotes the proliferation of human pulmonary artery smooth muscle cells, and the mechanism may be related to autophagy.
2022, 34(3): 256-261.
doi: 10.12125/j.chj.202111123
Abstract:
AIM To determine the regulatory role of branched chain amino acid aminotransferase-1 (BCAT1) in the survival of adipose-derived mesenchymal stem cells (ADSCs). METHODS ADSCs were isolated from white adipose tissues of male Sprague Dawley rats. BCAT1 expression was knocked down or over-expressed in ADSCs by adenovirus transfection and ADSC apoptosis was induced by hydrogen dioxide stimulation. ADSC apoptosis was evaluated by CCK-8 cell viability assay, cleaved caspase-3 expression, and TUNEL staining. The activity of P53 was suppressed by the specific inhibitor PFT-1α in control or BCAT1 silencing ADSCs. RESULTS BCAT1, rather than BCAT2, was the predominant subtype expressed in ADSCs. Silencing of BCAT1 exacerbated, whereas BCAT1 over-expression ameliorated hydrogen dioxide-induced ADSC apoptosis. The downstream targets of P53 were significantly increased in BCAT1 knock-downed ADSCs when stimulated by hydrogen dioxide. Inhibition of P53 by its specific inhibitor PFT-1α reversed the adverse impact of BCAT1 silencing on ADSC survival. CONCLUSION BCAT1 regulates ADSC survival via a P53-dependent manner, revealing that BCAT1 is a promising target to enhance ADSC survival and their cardioprotective efficacy.
2022, 34(3): 262-265, 270.
doi: 10.12125/j.chj.202108118
Abstract:
AIM To explore the effects of stage 3 hypertension on the cardiac structure and function in young patients with isolated diastolic blood pressure up to the range or with both diastolic blood pressure and systolic blood pressure up to the range. METHODS Ninety-three healthy subjects were recruited in control group, 86 subjects were recruited in isolated diastolic blood pressure (DBP) group and 101 subjects were recruited in both diastolic blood pressure and systolic blood pressure (DBP+SBP) group. The heart structure and function were measured by echocardiography and left ventricular mass fraction (LVMI) and relative wall thickness (RWT) were calculated by data from echocardiograph measurement. The differences of the heart structure and function were compared between the three groups. RESULTS Compared with those in control group, the levels of SBP, DBP and mean blood pressure (MBP) were increased in DBP group. Compared with those in DBP group, the levels of SBP and MBP in DBP + SBP group were higher, but there was no marked difference in the DBP level （P<0.05）. The cardiac structure analyzed by echocardiography showed that between the three groups there were no marked differences in the left ventricular transverse or anteroposterior diameter, right ventricular transverse or anteroposterior diameter, right atrial transverse diameter and left atrial transverse diameter. But the left atrium anteroposterior diameter in DBP group or DBP+SBP group was higher than that in control group, but there was no marked difference between the former two groups （P<0.01）.The analysis of related left ventricular hypertrophy showed that the thickness of ventricular septum, the thickness of left ventricular posterior wall, LVMI and RWT in DBP group or DBP + SBP group were higher than those in control group （P<0.05）, but there was no significant difference between the former two groups. In the analysis of cardiac functions, we found that there was no marked difference in EF and FS between the three groups. However, compared with that in control group, E/A was markedly decreased in DBP group and DBP + SBP group （P<0.05）, but there was no marked difference between the latter two groups. CONCLUSION Left ventricular hypertrophy and left atrium anteroposterior diameter are increased and left ventricular diastolic ability is decreased in young patients with stage 3 diastolic hypertension, and stage 3 systolic hypertension has no clear effect on these changes.
2022, 34(3): 266-270.
doi: 10.12125/j.chj.202106100
Abstract:
AIM To evaluate the impact of obesity on left ventricular geometry and functions in type 2 diabetes mellitus (T2DM) patients using conventional echocardiography and three-dimensional speckle tracking imaging and to explore the risk factors that could affect left ventricular strain values in these patients. METHODS Ninety-five T2DM patients were divided into T2DM without obesity group (n=45, BMI<25 kg/m2) and T2DM with obesity group (n=50, BMI≥25 kg/m2). Thirty age-and-gender matched healthy volunteers were selected as the controls. Conventional echocardiography and three-dimensional speckle tracking imaging were performed for all participants. RESULTS Significant differences in left ventricular geometry were found between the three groups (P<0.05). Compared with those in the controls, left ventricular remodeling was more prevalent in the T2DM patients and left ventricular hypertrophy was most prevalent in the T2DM with obesity group. Compared with those in the controls, e' in T2DM without obesity group was significantly lower (P<0.05) and E/e' was significantly increased (P<0.05). Both the left atrial volume index and E/e' in T2DM with obesity group were significantly increased (P<0.05), while e' was significantly decreased (P<0.05). Global longitudinal strain in T2DM without obesity group was significantly lower than that in the controls (P<0.05). The global longitudinal strain, global circumferential strain, global area strain, and global radial strain values in T2DM with obesity group were all significantly lower than those in the controls (all P<0.05) and were also significantly lower than those in T2DM without obesity group. Both HbA1c and BMI were independently associated with all strain values in patients with T2DM. RWT and LVMI had negative effects on some directions strain. CONCLUSION Obesity may exacerbate left ventricular remodeling and left ventricular dysfunction in T2DM patients, and these subclinical left ventricular abnormalities with retained ejection fraction can be detected using conventional echocardiography and three-dimensional speckle-tracking imaging.
2022, 34(3): 271-274, 279.
doi: 10.12125/j.chj.202010076
Abstract:
AIM To assess the factors affecting the left ventricular (LV) end-diastolic vortex and the relationships between the vortex and mitral inflow patterns by vector flow mapping (VFM). METHODS Forty-eight healthy volunteers, 51 patients with coronary artery disease and 51 patients with dilated cardiomyopathy were divided into 4 groups according to their transmitral flow patterns: 29 with normal filling, 85 with E/A ratio <1, 22 with pseudonormal filling, and 14 with restrictive filling. Color Doppler data in LV were recorded in apical long axis view and area and flux of the end-diastolic vortex were measured by VFM. RESULTS In the cohort of all the subjects, the area of the end-diastolic vortex was significantly correlated with heart rate, transmitral A velocity, mitral annulus a’ velocity and LV size. Transmitral A velocity, heart rate and LV end-diastolic long diameter were the independent predictors of vortex area (adjusted R2=0.181, P<0.01). Flux of the vortex was significantly correlated with age, heart rate, transmitral A velocity, LV size and parameters of LV function. Transmitral A velocity, heart rate, and LV end-systolic short and end-diastolic long diameters were the independent predictors of vortex flux (adjusted R2=0.575, P<0.01). There were significant differences between the 4 groups in area and flux of the vortex. The group with E/A ratio <1 had a larger vortex area than the group with restrictive filling, and the groups with normal filling and E/A ratio <1 had a larger vortex flux than the groups with pseudonormal and restrictive filling (all P<0.05). CONCLUSION The formation of the end-diastolic vortex is associated with transmitral A velocity, heart rate, and LV size. The difference in the vortex of different LV filling patterns suggests that the end-diastolic vortex can be used to distinguish between a normal and pseudonormal LV filling pattern.
2022, 34(3): 275-279.
doi: 10.12125/j.chj.202107028
Abstract:
AIM To investigate the predictive value of high sensitive cardiac troponin I (Hs-cTnI) and coronary artery calcification score (CACS) using spiral CT in patients with heart failure with preserved ejection fraction (HFpEF). METHODS We retrospectively analyzed HFpEF patients in our hospital from January 2017 to December 2019. The occurrence of adverse events was recorded via telephone follow-up. A total of 235 HFpEF patients were collected, 16 were lost to follow-up, and 219 were included. The follow-up time was (40±21) months. A total of 80 all-cause deaths occurred and 56 were cardiac death. Single-factor analysis and multi-factor analysis were carried out through COX regression model, and indicators that had predictive value for HFpEF death were obtained. Finally, receiver operating characteristic curve (ROC) was used to analyze the predictive value of CACS and Hs-cTnI for death of HFpEF patients. RESULTS CACS classification, Hs-cTnI and brain natriuretic peptide (BNP) levels were positively correlated (r=0.3081, P<0.05 and r=0.7081, P<0.05); Multivariate COX regression showed that BNP, CACS and Hs-cTnI were independent predictors for the occurrence of all-cause death and cardiac death in patients with HFpEF patients (P<0.05). ROC analysis showed that the AUC value, sensitivity and specificity of combining CACS and Hs-cTnI for adverse events in HFpEF patients were higher than those of one individual predictor. CONCLUSION Hs-cTnI and CACS are good predictors for all-cause death and cardiovascular death in patients with HFpEF, and Hs-cTnI combined with CaCS has higher predictive value.
2022, 34(3): 280-284.
doi: 10.12125/j.chj.202107085
Abstract:
AIM To explore the safety and efficacy of transcatheter patent foramen ovale (PFO) occlusion in the treatment of high-risk PFO in the elderly patients on the basis of multidisciplinary evaluation. METHODS Included in this study were the elderly patients admitted to our department from March 2014 to December 2020, who were diagnosed as having embolic strokes of undetermined source or transient ischemic attack (TIA) with high-risk PFO and received PFO closure. All the patients underwent multidisciplinary evaluation before the operation to rule out stroke/TIA that had a clear cause or other possible factors and after the operation the patients were followed up for complications and recurrent ischemic events. RESULTS A total of 122 patients were enrolled (average age of 64(5)years) with mean follow-up time of 2.5±1.7 years. Two kinds of occluders were used in the study and there was no difference in the endpoint events between the two occluders and no serious adverse events occurred. The annual risk of recurrent ischemic stroke/TIA after PFO closure in elderly patients was 0.67%. CONCLUSION It is safe and effective for high-risk elderly PFO patients to undergo transcatheter PFO closure after strict multidisciplinary evaluation. Such patients can be treated with percutaneous patent foramen ovale occlusion to prevent recurrence of cerebrovascular events.
2022, 34(3): 285-288, 298.
doi: 10.12125/j.chj.202105101
Abstract:
AIM To explore the application value of real-time three-dimensional transesophageal echocardiography for the structural characteristics of oval foramen. METHODS The patients who received the foramen ovale from January 2018 to December 2020 were selected. The exit width, middle width, entrance width and channel length were measured by comparing the real-time three-dimensional transesophageal echocardiography (RT3D tee) and real-time two-dimensional transesophageal echocardiography (2D-TEE), and the median plane, right atrial PFO entrance surface and left atrial PFO exit surface were obtained. RESULTS There was no significant difference in PFO alignment width between 2D-TEE and RT3D tee, but there were significant differences in average width, average length, entrance width, middle width and exit width. The number of shunt cases detected by 2D-TEE and rt3d-tee were 120 and 134 respectively, with significant difference between the two ultrasound methods. There was no significant difference between 2D-TEE and rt3d-tee in the detection rate of atrial septal aneurysm, left atrial septal pocket, mitral valve filaments and aortic valve filaments. PFO with dilated tumor and longer oval valve had no significant correlation with the time of closure, but the right atrial diameter of PFO had significant correlation with the time of closure. CONCLUSION Real time three-dimensional transesophageal echocardiography clearly displays the three-dimensional structural characteristics of foramen ovale and it provides more accurate information for the morphological information of foramen ovale.
2022, 34(3): 289-292.
doi: 10.12125/j.chj.202107021
Abstract:
AIM To observe the clinical efficacy and safety of thrombolytic therapy using recombinant prourokinase (rhPro-UK) in patients with acute myocardial infarction with ST-segment elvation (STEMI). METHODS STEMI patients with thrombolysis were selected and were divided into recombinant prourokinase group (n=206) and urokinase group (n=92). Baseline data of the two groups were collected, and clinical coronary recanalization rate, coronary angiography TIMI≥2 opening rate, major bleeding events and complication rate were compared between the two groups. RESULTS Compared with those in urokinase group, the clinical recanalization rate [164 (79.62%) vs. 52 (63.04%), P<0.01] and the opening rate of TIM≥2 [149 (82.78%) vs. 50 (65.79%), P<0.01] were significantly improved in recombinant prourokinase group, while the major bleeding events [15 (7.8%) vs. 14(15.22%), P<0.05] and the complication rate [5 (2.3%) vs. 8 (8.70%), P<0.05] were significant reduced. CONCLUSION Recombinant prourokinase has a higher rate of thrombolytic vascular recanalization and a lower incidence of bleeding events and complications.
2022, 34(3): 293-298.
doi: 10.12125/j.chj.202110101
Abstract:
AIM To observe the effects of evolocumab and alirocumab --- two inhibitors of the preprotein converting enzyme, Bacillus subtilis protease Kexin-9 (PCSK9) --- on the efficacy and safety of lipid-lowering therapy in patients with atherosclerotic cardiovascular disease (ASCVD). METHODS A total of 148 ASCVD patients who received PCSK9i after percutaneous coronary intervention (PCI) in Xijing Hospital of Air Force Military Medical University from February 2019 to July 2021 were consecutively collected. They were divided into evolocumab group (n=103) and alirocumab group (n=45). The primary treatment regimen was statin based lipid-lowering regimen combined with PCSK9i, and 20 patients received PCSK9i monotherapy. Baseline data during hospitalization (age, sex, BMI, blood pressure, heart rate, alanine aminotransferase, aspartate aminotransferase, creatinine, LVEF, education background, length of stay, past medical history and postoperative medication) were recorded 48h before surgery in the 2 groups. Blood lipid levels were reviewed after 2 months of medication, and the decrease of blood lipid and the occurrence of adverse drug reactions were observed. RESULTS Compared with the alirocumab group, patients in the evolocumab group had lower diastolic blood pressure (P<0.05) and aspartate aminotransferase (P<0.01) levels, lower LVEF (P<0.05) levels, and a higher proportion of patients taking aspirin (P<0.05) and ACEI/ARB (P<0.05) after surgery. After treatment, TC and LDL-C levels in 2 groups were significantly decreased, with statistical significance (P<0.01), but HDL-C level in eluzumab group was significantly increased (P<0.05). At the same time, the LDL-C level of the alirocumab group was lower than that of the evolocumab group after treatment (P<0.01). In evolocumab group and alirocumab group, the compliance rate of LDL-C<1.4 mmol/L was 65.3% vs. 84.2% and the standard rate of LDL-C<1.8 mmol/L was 80.0% vs. 94.1%. In terms of postoperative adverse reactions, no adverse reactions occurred in the two groups, and there was no statistical difference in the effects of the two drugs on liver and kidney functions. CONCLUSION Both evolocumab and alirocumab have good effect in reducing total cholesterol and low density lipoprotein , and the safety of them are good.Alirocumab is slightly better than evolocumab in lipid lowering rate.
2022, 34(3): 299-303.
doi: 10.12125/j.chj.202106065
Abstract:
AIM To explore the value of hemoglobin (Hb) and serum albumin (ALB) in evaluating the long-term prognosis of elderly patients with chronic heart failure. METHODS The clinical data of 200 elderly patients with chronic heart failure in our hospital from February 2018 to April 2019 were collected, and the levels of hemoglobin and serum albumin were detected. The patients after discharge were followed up for 3 years, and were divided into survival group (n=142) and death group (n=58) according to whether the follow-up patients died. Logistic multivariate regression was used to analyze the independent risk factors of patients' death, and the optimal cut-off points of Hb and ALB levels were determined by characteristic curve (ROC). A nomogram prediction model was established and verified according to the independent risk factors of patients' prognosis. RESULTS Compared with the survival group, Compared with the survival group, the proportion of previous myocardial infarction in the death group was significantly higher (P<0.05); High sensitity C-reactive protein (hs-CRP), N-terminal pro brain natriuretic peptise (NT-proBNP) and cardiac troponin I (CTnI) increased significantly (P<0.05) and the levels of serum Hb, ALB and left ventricular ejection fraction (LVEF) decreased significantly (P<0.01). Multivariate Logistic regression analysis showed that myocardial infarction, elevated serum hs-CRP, elevated serum NT-proBNP, decreased serum Hb, decreased serum ALB and decreased LVEF were independent risk factors for death. The area under the ROC curve for Hb to predict the death of patients is 0.753, the cut-off point is 117.8g/L, its sensitivity is 72.00%, and its specificity is 75.20%. The area under ROC curve of ALB for predicting patient death is 0.878, the cutoff point is 34.70 g/L, and its sensitivity is 86.00% and specificity is 79.20%. According to the independent risk factors of prognosis, the nomogram model was constructed, and its consistency index (C-index) was 0.768 (95%CI: 0.716~0.820), and its ROC curve AUC was 0.840 (95%CI: 0.791~0.889), which had good discrimination. The evaluation results of Calibration curve indicate that the model has good consistency. CONCLUSION Low Hb and ALB levels are independent risk factors for the prognosis of elderly patients with chronic heart failure, and have good predictive value for the prognosis of these patients.
2022, 34(3): 304-309, 315.
doi: 10.12125/j.chj.202110033
Abstract:
AIM To identify factors influencing the long-term (>1 year) quality of life (QoL) after first percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). METHODS A sample of 451 consecutive ACS patients over 1 year after their first PCI was included. The Seattle angina questionnaire (SAQ) was completed and the baseline and review data were collected. The scores of each dimension and summary score of SAQ were calculated, the influencing factors were sorted out by multivariate analysis and the prediction model was established by linear regression. RESULTS More than 1 year after the first PCI, the scores of SAQ physical limitation, angina stability, angina frequency, treatment satisfaction and disease perception were 70.190 ± 16.972, 42.180 ± 19.109, 82.680 ± 21.790, 88.561 ± 10.448 and 70.972 ± 23.670 respectively, and the summary score was 74.615 ± 15.551. Linear regression showed that the factors affecting scores on more than three dimensions were: current type of coronary artery disease, male, angina symptom onset, baseline leukocyte count, and baseline glycosylated hemoglobin. CONCLUSION Current type of coronary heart disease, male, angina symptom onset, baseline leukocyte count, and baseline glycosylated hemoglobin are the main influencing factors of long-term QoL after the first PCI in ACS patients. These findings may help clinicians to prospectively understand which patients are most likely to benefit from the long term after first PCI, so as to improve the long-term QoL of patients as much as possible.
2022, 34(3): 310-315.
doi: 10.12125/j.chj.202112115
Abstract:
AIM To investigate the quality of life (QOL) and its influencing factors in patients with hypertrophic cardiomyopathy (HCM), and provide evidence for improving the QOL of HCM patients. METHODS A total of 150 HCM patients were consecutively enrolled as subjects, and 150 healthy volunteers matched with age and sex were selected as control group. The QOL was measured with 36-item short-form Health Survey (SF-36), while clinical data and echocardiographic indicators were collected at the same time, and the influencing factors were further analyzed. RESULTS The score of every domain and component summary in SF-36 for HCM patients was lower than control group (P<0.05). Further analysis showed that age ≥65 years (β=−0.153, P<0.05), female gender (β=−0.130, P<0.05), New York Heart Association (NYHA) functional class Ⅲ~Ⅳ (β=−0.213, P<0.01), left ventricular outflow tract obstruction (LVOTO) (β=−0.418, P<0.01), comorbidity (β=−0.174, P<0.01), depression (β=−0.389, P<0.01) and anxiety (β=−0.176, P<0.05) were independent risk factors in HCM patients. CONCLUSION The QOL of HCM patients decrease in all dimensions, which is closely related to demographic factors, clinical features and emotional disorders. Therefore, in order to improve the QOL of HCM patients, health education and psychological intervention should be carried out according to the specific situation, in addition to relieving LVOTO and treating concomitant diseases.
2022, 34(3): 316-319.
doi: 10.12125/j.chj.202106089
Abstract:
AIM To investigate the application of Qishen Yiqi dropping pills in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), and its influence on cardiac functions, physical activity and the incidence of major adverse cardiovascular events (MACE). METHODS A total of 84 patients with CHD treated by PCI in Minda Hospital Affiliated to Hubei University for Nationalities were selected between October 2019 and November 2020. Using random number table method, the patients were divided into control group and study group, with 42 patients in each group. The control group was treated with conventional western medicines and the study group was treated with Qishen Yiqi dropping pills based on the treatment of control group. Clinical effects, cardiac functions, TCM syndrome scores, 6-min walking distance, physical activity level and the occurrence of MACE were compared between the two groups. RESULTS The total effective rate of clinical treatment in the study group was 92.86%, higher than 76.19% in the control group (P<0.05). After treatment, stroke volume, left ventricular ejection fraction, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, TCM syndrome scores and 6-min walking distance in the study group were better than those in the control group (P<0.01). After treatment, the proportions of patients with high-level and medium-level physical activities in the study group were higher than those in the control group (P<0.05). The incidence of MACE in the study group was 9.52%, significantly lower than 28.57% in the control group (P<0.05). CONCLUSION Qishen Yiqi dropping pills increase the stroke volume and ejection fraction, improve cardiac functions, promote physical activity and reduce the incidence of MACE in CHD patients after PCI, which are conducive to the patients’ recovery.
2022, 34(3): 320-324.
doi: 10.12125/j.chj.202107084
Abstract:
AIM To explore the application of extracorporeal circulation in transcatheter aortic valve replacement (TAVR). METHODS We retrospectively analyzed 25 consecutive cases of TAVR assisted by extracorporeal circulation completed from May 2018 to December 2019 in the Department of Cardiovascular Surgery of Xijing Hospital, and compared the efficacy of extracorporeal membrane oxygenation (ECMO, n=8) and cardiopulmonary bypass (CPB, n=15), the left two patients received CPB and ECMO one after another. Besides, we compared the basic conditions of patients in emergency (n=13) and non-emergency (n=12) groups based on clinical experience. RESULTS Compared with the ECMO group, the ratio of male and body weight were lower and the ejection fraction was higher in the CPB group (all P<0.05). Compared with the non-emergency group, the ratio of male and body weight were lower and the ejection fraction was higher in the emergency group (all P<0.05). Compared with the ECMO group, the operation time was significantly increased in the CPB group (P<0.01). Compared with the non-emergency group, the operation time was significantly increased in the emergency group (P<0.01). Compared with the ECMO group, postoperative arterial blood PaO2 (P<0.01) was increased, postoperative urine volume (P<0.01) and CCU time (P<0.01) were significantly decreased in the CPB group. Compared with the non-emergency group, postoperative arterial blood PaO2 (P<0.01), postoperative urine volume (P<0.01) and CCU time (P<0.01) were significantly increased in the non-emergency group. CONCLUSION Extracorporeal circulation is necessary in the process of TAVR. CPB should be the first choice for circulatory assistance, followed by ECMO. But, the circulatory assistance method should be flexibly selected based on the specific conditions of the patient and various emergencies during the operation so as to achieve the best results.
2022, 34(3): 325-328.
doi: 10.12125/j.chj.202111016
Abstract:
AIM To investigate the perioperative effect and clinical significance of recombinant human brain natriuretic peptide in valve replacement surgery for patients with low left ventricular ejection fraction (LVEF) valve. METHODS Seventy patients with LVEF≤50% who underwent valve replacement surgery in our hospital from June 2020 to October 2021 were randomly divided into control group and observation group, with 35 cases in each group. The control group was treated with standard anti-heart failure drugs and the observation group was treated with recombinant human brain natriuretic peptide on the basis of standard anti-heart failure drugs. The perioperative cardiac function recovery related indicators (NT-proBNP, urine volume, LVEF value, FS value and changes of left ventricular end-diastolic diameter) in the two groups were compared and statistical analysis was conducted. RESULTS There was no statistical difference in preoperative clinical indicators between the two groups. The level of NT-proBNP in observation group decreased 24 h and 72 h after medication, and urine volume increased 24 h and 72 h after medication. The duration of ventilator use and ICU were shortened and there were significant differences compared with those in control group (P<0.01). However, there was no significant difference in serum creatinine level between the two groups and the clinical outcomes (complication, cure and mortality) were not statistically significant. CONCLUSION Perioperative use of recombinant human brain natriuretic peptide in valve replacement surgery for patients with low LVEF value is beneficial to postoperative cardiac function recovery, shortens the duration of ventilator use and ICU, but has no effect on serum creatinine level.
2022, 34(3): 329-333.
doi: 10.12125/j.chj.202107052
Abstract:
AIM To evaluate the clinical value of left atrial function in patients with preeclampsia by two-dimensional speckle tracking technique. METHODS A total of 33 patients with preeclampsia admitted to Air Force Medical University Tangdu hospital were included in the study group and other 35 age and gestational week matched normal pregnant women served as the control group. The conventional ultrasound parameters were measured by Esaote MyLab Twice Color Doppler Ultrasonography. The original data were imported into the machine with original format of Archive and the left atrial strain was analyzed. RESULTS Compared with those in the healthy control group, the left ventricular end- diastolicdiameter and E(P<0.05), left atrial volume index and E/ e’ were significantly increased in patients with preeclampsia (P<0.01). However, no significant difference was observed in the left ventricular end- systolicdiameter, ejection fraction and E/A between the two groups. Moreover, compared with those in the healthy control group, the left atrial strain reserve function （54±18）% vs. （76±21）%, P<0.01）, conduit function (26±19）% vs. （39±19） %, P<0.05) and pump function (28±11）% vs.（ 37±19）%,P<0.05) were significantly reduced in patients with preeclampsia, indicating a significant difference. CONCLUSION Two-dimensional speckle tracking technology can be used to assess the reserve function, channel function and pump function of left atrial strain in patients with preeclampsia at early stage, which has important clinical application value for the evaluation of left atrial function changes.
2022, 34(3): 334-338.
doi: 10.12125/j.chj.202202018
Abstract:
AIM To explore the effect of 3D roller uniaxial rotation test on the evaluation of human stability of vestibular function and cardiovascular function. METHODS Twelve subjects were tested by electric swivel chair and 3D roller uniaxial rotation with leaning forward of 30° respectively. The changes of blood pressure, heart rate and heart rate variability were observed during the above processes. The vestibular stability was graded and scored according to the Vestibular Function Scale and the Graybiel Motion Sickness Scale. The failure rates were compared between the two tests. RESULTS Compared with the data of pre-tests, the scores of Graybiel motion sickness increased significantly after the above two tests (P<0.05). And there was no significant difference in the failure rates of vestibular function classification between 3D roller and electric swivel chair tests. The systolic and diastolic blood pressures of the subjects were significantly elevated (P<0.05), whereas there was no significant difference in heart rates in the above two tests. What’s more, the normalized low-frequency power (LF) decreased, the normalized high-frequency power (HF) increased and LF/HF showed a decreasing trend, which did not reach a significant level. CONCLUSION The application effect of 3D roller uniaxial rotation test and electric swivel chair test in the evaluation of human vestibular stability and cardiovascular function is basically the same.
2022, 34(3): 339-343.
doi: 10.12125/j.chj.202111080
Abstract:
Weightlessness can lead to change the structure and function of endothelial cells, autophagy and endoplasmic reticulum stress are cells in order to maintain its steady state and response to environmental changes and the stress response, study shows that the simulated weightlessness can improve the standards of vascular endothelial cell proliferation, apoptosis is restrained, cell migration, These physiological changes were accompanied by enhanced autophagy activity of vascular endothelial cells, and increased apoptosis in er stress induced by weightlessness, suggesting that autophagy and ER stress may play a regulatory role in the functional changes of vascular endothelial cells induced by weightlessness. This paper reviews the role of autophagy and endoplasmic reticulum stress in the functional changes of vascular endothelial cells induced by weightlessness.
Weightlessness can lead to change the structure and function of endothelial cells, autophagy and endoplasmic reticulum stress are cells in order to maintain its steady state and response to environmental changes and the stress response, study shows that the simulated weightlessness can improve the standards of vascular endothelial cell proliferation, apoptosis is restrained, cell migration, These physiological changes were accompanied by enhanced autophagy activity of vascular endothelial cells, and increased apoptosis in er stress induced by weightlessness, suggesting that autophagy and ER stress may play a regulatory role in the functional changes of vascular endothelial cells induced by weightlessness. This paper reviews the role of autophagy and endoplasmic reticulum stress in the functional changes of vascular endothelial cells induced by weightlessness.
2022, 34(3): 344-347, 351.
doi: 10.12125/j.chj.202103023
Abstract:
Percutaneous coronary intervention (PCI) has become an effective means for the treatment of coronary stenosis. Even with the wild use of drug-eluting stent and drug-coated balloons, restenosis after PCI is an important factor affecting its long-term efficacy and prognosis. In-stent restenosis (ISR) remains a major group of restenosis after PCI, which can lead to the recurrence of major adverse cardiovascular events, including angina, acute myocardial infarction, and even sudden cardiac death. Therefore, focusing again on the therapy of ISR is still of important clinical significance.
Percutaneous coronary intervention (PCI) has become an effective means for the treatment of coronary stenosis. Even with the wild use of drug-eluting stent and drug-coated balloons, restenosis after PCI is an important factor affecting its long-term efficacy and prognosis. In-stent restenosis (ISR) remains a major group of restenosis after PCI, which can lead to the recurrence of major adverse cardiovascular events, including angina, acute myocardial infarction, and even sudden cardiac death. Therefore, focusing again on the therapy of ISR is still of important clinical significance.
2022, 34(3): 348-351.
doi: 10.12125/j.chj.202103061
Abstract:
Heart failure (HF) is a clinical syndrome with high mortality and morbidity rate. The risk of readmission and death of patients with acute HF is extremely high within 2-3 months after they are discharged from the hospital. This period is termed as the vulnerable phase after hospitalization for HF. The vulnerable phase of HF is the transition stage from acute decompensated HF to chronic stable HF. Thus, optimizing the monitoring and the treatment during the vulnerable phase is very important to improve the prognosis of HF patients. The present article reviews the definition, pathophysiological mechanisms, clinical features and therapies of the vulnerable phase after hospitalization for HF.
Heart failure (HF) is a clinical syndrome with high mortality and morbidity rate. The risk of readmission and death of patients with acute HF is extremely high within 2-3 months after they are discharged from the hospital. This period is termed as the vulnerable phase after hospitalization for HF. The vulnerable phase of HF is the transition stage from acute decompensated HF to chronic stable HF. Thus, optimizing the monitoring and the treatment during the vulnerable phase is very important to improve the prognosis of HF patients. The present article reviews the definition, pathophysiological mechanisms, clinical features and therapies of the vulnerable phase after hospitalization for HF.
2022, 34(3): 352-355.
doi: 10.12125/j.chj.202107017
Abstract:
IL-37, a novel anti-inflammatory factor, has recently been shown to protect against vascular calcification and arteriosclerosis, as well as other calcification reactions such as valve calcification. IL-37 can inhibit the inflammatory reaction and the autoimmune reaction, and it also has some effect on the differentiation of osteoblasts. IL-37 may be a new target to slow down or even treat vascular calcification-related cardiovascular diseases. This article reviews the specific mechanism of IL-37 inhibiting calcification.
IL-37, a novel anti-inflammatory factor, has recently been shown to protect against vascular calcification and arteriosclerosis, as well as other calcification reactions such as valve calcification. IL-37 can inhibit the inflammatory reaction and the autoimmune reaction, and it also has some effect on the differentiation of osteoblasts. IL-37 may be a new target to slow down or even treat vascular calcification-related cardiovascular diseases. This article reviews the specific mechanism of IL-37 inhibiting calcification.
2022, 34(3): 356-361.
doi: 10.12125/j.chj.202106004
Abstract:
Coronary heart disease (CHD) is a global disease with high mortality that affects human life and health. At present, percutaneous coronary intervention (PCI) is a common method for the treatment of CHD in China. But the exploration of the pathogenesis of coronary heart disease and the effective prevention and treatment of CHD has remained a hot research topic in clinical research. In recent years, a large number of studies have shown the correlation between intestinal microecology and coronary heart disease, and the theory of “heart and spleen correlation” in Chinese medicine coincides with modern research results. The relationship between intestinal microecology and coronary heart disease has become a breakthrough in the prevention and treatment of coronary heart disease and the Chinese medicine based on the theory of the heart and spleen may play an important role in it. Based on this theory, this paper aims to explore the relationship between intestinal flora and coronary heart disease, the influence of traditional Chinese medicine on intestinal microecology and the possible intervention methods for coronary heart disease.
Coronary heart disease (CHD) is a global disease with high mortality that affects human life and health. At present, percutaneous coronary intervention (PCI) is a common method for the treatment of CHD in China. But the exploration of the pathogenesis of coronary heart disease and the effective prevention and treatment of CHD has remained a hot research topic in clinical research. In recent years, a large number of studies have shown the correlation between intestinal microecology and coronary heart disease, and the theory of “heart and spleen correlation” in Chinese medicine coincides with modern research results. The relationship between intestinal microecology and coronary heart disease has become a breakthrough in the prevention and treatment of coronary heart disease and the Chinese medicine based on the theory of the heart and spleen may play an important role in it. Based on this theory, this paper aims to explore the relationship between intestinal flora and coronary heart disease, the influence of traditional Chinese medicine on intestinal microecology and the possible intervention methods for coronary heart disease.
2022, 34(3): 362-366.
doi: 10.12125/j.chj.202111091
Abstract:
AIM To explore the application of formative assessment system based on clinical thinking ability cultivation in courses of cardiovascular diseases. METHODS The application effect of the formative assessment system based on clinical thinking ability cultivation was explored by analyzing the characteristics of assessment object, establishing the assessment team, developing and implementing the assessment plan, and analyzing students’ performances and the questionnaire results. RESULTS Ninety-two percent of the students supported the exploration of the new assessment system and the students’ scores followed the pattern of normal distribution. Eighty-nine of the experts agreed that the new assessment system not only tested the students’ learning effect, but also fully cultivated their clinical thinking ability, which played a vital role in their future clinical learning. CONCLUSION The formative assessment system based on the cultivation of clinical thinking ability is an important measure to achieve teaching reform in the new period, worthy to be promoted.
2022, 34(3): 367-370.
doi: 10.12125/j.chj.202112118
Abstract:
AIM To investigate the effect of clinical application of in vitro procedural simulation using 3D printed cardiovascular model in teaching of transcatheter aortic valve replacement (TAVR). METHODS From March 2021 to September 2021, 40 students who participated in the valvular diseases interventional therapy training course held by the Department of Cardiovascular Surgery of Xijing Hospital were selected as trainees, and they were divided into teaching experimental group and control group. Twenty-five students in the control group used the traditional teaching methods of theoretical teaching + surgical observation, and 15 students in the teaching experiment group used 3D printed cardiovascular models to simulate surgery in vitro on the basis of the teaching methods used in control group. The teaching time between the two groups are the same. After the training course, the learning outcome between the two groups was evaluated and compared. RESULTS The examination papers mainly tested and evaluated the trainees from three aspects, namely, surgical indications and contraindications (30 points), imaging evaluation (30 points) and standardized surgical procedures (40 points). There was no significant difference in the test scores of surgical indications and contraindications, and imaging evaluation between the two groups. But the test scores of standardized surgical procedures in the experimental group were significantly higher than those in the control group (P<0.01). The total test scores in the teaching experiment group were significantly higher than those in the control group (P<0.01). After the course, the results of the questionnaire showed that adding 3D printed cardiovascular models to simulate surgery in vitro can significantly improve learning interest, improve teamwork ability, problem analysis ability, teacher-student interaction and practical work ability when compared with the traditional teaching method. And a higher proportion of students in the teaching experimental group like this new teaching method (all P<0.05). After the assessment, the control group was supplemented with 3D printed cardiovascular model in vitro surgery simulation video teaching. After the reassessment, there was no significant difference in the scores of the two groups, which fully guaranteed the fairness of teaching. CONCLUSION In the teaching of TAVR surgery, the teaching method of using 3D printed cardiovascular models to simulate the surgical process in vitro plays an important role in improving the students’ mastery of surgical procedures and learning efficiency.
