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Cao J, Jin XJ, Zhou J, Chen ZY, Xu DL, Yang XC, Dong W, Li LW, Luo J, Chen L, Fu M, Zhou JM, Ge JB. [Prognostic value of N-terminal B-type natriuretic peptide on all-cause mortality in heart failure patients with preserved ejection fraction]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2019; 47:875-881. [PMID: 31744276 DOI: 10.3760/cma.j.issn.0253-3758.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) on all-cause mortality in heart failure patients with preserved ejection fraction (HFpEF) at real world scenarios. Methods: Patients who met the diagnostic criteria of HFpEF in the China National Heart Failure Registration Study (CN-HF) were divided into death and survival groups. The demographic data, physical examination, results of the first echocardiography, laboratory results at admission, complications, drug use and clinical outcomes were obtained from CN-HF. The univariate Cox proportional hazard model was used to screen the variates that might predict prognosis, and then the covariates with statistical significance were included in the multivariate Cox regression model to analyze the predictive value of baseline NT-proBNP on all-cause death. Spearman correlation analysis was used to evaluate the relationship between NT-proBNP and estimated glomerular filtration rate (eGFR), so as to further explore the predictive value of the interaction between renal dysfunction and NT-proBNP on death. Since NT-proBNP did not obey the binary normal distribution, it was expressed by the natural logarithm of NT-proBNP (LnNT-proBNP). Results: A total of 1 846 HFpEF patients were enrolled in this study, with an average age of 71.5 years, 1 017 males(55.1%), median NT-proBNP 860 ng/L, and median eGFR 73.9 ml·min-1·1.73m-2. After a median follow-up of 34 months, 213 (11.5%) patients died. Patients in the death group were older, with higher NYHA classification Ⅲ-Ⅳ ratio, longer hospital stay, higher serum potassium and NT-proBNP level, prevalence of complications of diabetes mellitus, arrhythmia and atrial fibrillation, use of angiotensin receptor antagonist(ARB), mineralocorticoid receptor antagonists (MRA), diuretic and digoxin was significantly higher in death group than in survival group. Body mass index (BMI), diastolic blood pressure, left ventricular ejection fraction (LVEF), hemoglobin, serum cholesterol(TC), serum triglycerides (TG) and eGFR, and use of angiotensin converting enzyme inhibitors (ACEI), statins and aspirin were lower in death group than in survival group. Univariate Cox regression analysis showed that NT-proBNP was a predictor of all-cause death in HFpEF patients (HR=2.522, 95%CI 2.040-3.119, P<0.001). Multivariate Cox regression analysis showed that the elevated NT-proBNP remains as the independent predictor of all-cause death in patients with HFpEF (HR=1.230, 95%CI 1.049-1.442, P=0.011) after adjusting for age, BMI, diastolic blood pressure, LVEF, hemoglobin, serum potassium, serum sodium, TC, serum high-density lipoprotein cholesterol (HDL-C), TG, eGFR, atrial fibrillation, as well as the treatment of ACEI/ARB, MRA, diuretics and digoxin. Spearman correlation analysis showed that LnNT-proBNP was negatively correlated with eGFR (r=-0.361, P<0.001), but there was no interaction between NT-proBNP and renal dysfunction in predicting death in HFpEF patients (P>0.05). Conclusion: The elevated level of NT-proBNP at admission is an independent predictor of all-cause mortality in HFpEF patients.
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Shi L, Jiang L, Zhang X, Yang G, Zhang C, Yao X, Wu X, Fu M, Sun X, Liu X. Pyrroloquinoline quinone protected autophagy-dependent apoptosis induced by mono(2-ethylhexyl) phthalate in INS-1 cells. Hum Exp Toxicol 2019; 39:194-211. [PMID: 31661991 DOI: 10.1177/0960327119882983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mono(2-ethylhexyl) phthalate (MEHP) is the main metabolite of di(2-ethylhexyl) phthalate (DEHP) in organisms and is commonly used as a plasticizer. Exposure to DEHP impairs the function of islet beta cells (INS-1 cells), which is related to insulin resistance and type 2 diabetes. At present, some research data have also confirmed that MEHP has a certain damage effect on INS-1 cells. In our experiment, we found that MEHP would lead to the increase of reactive oxygen species (ROS) and the upregulation of autophagy. And downregulated ROS production by N-acetyl-L-cysteine could also reduce autophagy. In addition, MEHP-induced lysosomal membrane permeability (LMP) subsequently released cathepsin D. Additionally, MEHP induced the collapse of mitochondrial transmembrane potential and release of cytochrome c. Addition of autophagy inhibitor 3-methyladenine relieved MEHP-induced apoptosis as assessed by the expression of cleaved caspase 3, cleaved caspase 9, and terminal deoxynucleotidyl transferase dUTP nick end labeling assay, indicating that MEHP-induced apoptosis was autophagy dependent. Cathepsin D inhibitor, pepstatin A, suppressed MEHP-induced mitochondria release of cytochrome c and apoptosis as well. Meanwhile, pyrroloquinoline quinone (PQQ), a new B vitamin, improved the above phenomenon. Taken together, our results indicate that MEHP induces autophagy-dependent apoptosis in INS-1 cells by lysosomal-mitochondrial axis. PQQ improved this process by downregulating ROS and provided a degree of protection. Our study provides a new perspective for MEHP on the cytotoxic mechanism and PQQ protection in INS-1 cells.
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Silverdal J, Bollano E, Sjoland H, Pivodic A, Dahlstrom U, Fu M. P6340Mortality and prognostic factors in dilated cardiomyopathy versus ischaemic heart disease in patients with heart failure with reduced ejection fraction - a Swedish population-based study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In heart failure with left ventricular ejection fraction reduction <40% (HFrEF) the increased mortality in patients with underlying ischaemic heart disease (IHD) compared to multi-aetiological non-ischaemic HFrEF is established. The prognostic difference over time in comparison with dilated cardiomyopathy (DCM) is less clear.
Purpose
To evaluate the difference in mortality between IHD and DCM in HFrEF, overall, in specific subgroups and over time.
Methods
By applying multivariable Cox regression analyses on Swedish Heart Failure Registry data from the years 2000 to 2012 (including 51,060 patients), the incidence of mortality in 8,982 patients with non-valvular clinical IHD-HFrEF was compared to 2,220 patients with DCM-HFrEF overall and for subgrouping variables of age category, sex and EF group (<30% and 30–39%), adjusted for additional 23 baseline variables.
Results
The overall mortality was higher in IHD-HFrEF with the crude mortality of 42.1% and the event rate 15.4 (95% confidence interval [CI]: 14.9 - 15.9) per 100 person years compared with 19.4% and 5.5 (95% CI: 5.0–6.1) in DCM-HFrEF. The probability of survival in IHD-HFrEF was lower than in DCM-HFrEF (Figure). After multivariable adjustment the risk for mortality in IHD-HFrEF remained increased with a hazard ratio (HR) of 1.34 (95% CI: 1.18–1.50). The adjusted HR was higher in all groups of age <80 years and in both sexes, with a significantly higher risk in women than in men (HR 1.85 vs 1.22, p for interaction = 0.002). Overall, HR was increased regardless of EF group but analyses by both age group and EF group revealed significantly increased mortality in EF <30% only for age groups <80 years. No significant temporal trend was seen between IHD-HFrEF and DCM-HFrEF.
Probability of survival
Conclusions
In patients with heart failure and reduced ejection fraction, ischaemic heart disease compared to dilated cardiomyopathy was associated with increased mortality in all age groups below 80 years of age, throughout the 13-year study period.
Acknowledgement/Funding
The Swedish Heart-Lung Foundation. The regional ALF agreement between Västra Götalandsregionen and University of Gothenburg (ALFGBG-72196, prof.Fu)
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Sakalaki M, Hansson PO, Rosengren A, Thunstrom E, Pivodic A, Fu M. P4155Multiple modality biomarkers predict ischemic heart disease in middle-aged men from the general population during a 21-year follow-up. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ischemic heart disease (IHD) often develops after decades of preceding subclinical coronary atherosclerosis. An early prediction of risk for IHD in a general population would be helpful for preventive decision-making. It is well known that biomarkers including troponine, natriuretic peptides and inflammatory biomarkers are useful prognostic predictors for IHD, their long-term predictive values in a general population for incident IHD have not been studied.
Purpose
The aim of the study was to investigate the predictive value of multi-modality biomarkers on the incident IHD in a random male sample from the general population followed from the age of 50 to 71 years.
Method
“The study of Men Born in 1943” is a longitudinal cohort study of men living in the city of Gothenburg in Sweden. All patients underwent a baseline examination in 1993, which included physical examination, questionnaires and blood samples. Because of multifactorial nature of atherosclerosis, a panel of biomarkers representing multiple mechanisms such as high-sensitivity troponine (hs-TNT), interleukin-6 (IL-6), cystatin C, high-sensitivity C-reactive protein (hs-CRP), urat, ferritin, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were analyzed from blood samples collected at 50 years of age. Incident IHD was defined as new-onset one of following (myocardial infarction, hospitalized unstable angina and intervention with either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) during 1993–2014. The impact of biomarkers on incident IHD was studied using univariable, followed by stepwise and multivariable Cox proportional hazards models.
Results
Among the, 753 patients in the study, 105 patients (13,9%) developed IHD during 21 years of follow up with an event rate per 1000 person years 7.49 and a 95% confidence interval (CI) of 6.19 - 9.07. In Cox proportional hazards model for time to first occurrence of IHD, univariable analyses showed that multi-modality biomarker (CRP >1 mg/ml, NT-proBNP >100 pg/mL, troponin >10 ng/L, IL-6 >8 ng/L) provide most powerful prediction, followed by total cholesterol and fasting plasma glucose. In multivariable Cox proportional hazards model for time to first of IHD, above four-biomarker combination modality remains a most powerful predictor with risk increased by one additional biomarker [Hazard Ratio (95% CI): 1.69 (1.26 - 2.26), p=0.0004], followed by total cholesterol (mmol/L) with risk increased by one [Hazard Ratio (95% CI: 1.31 (1.09 - 1.56), p=0.0031], and fasting plasma glucose (mmol/L) with risk increased by one unit [Hazard Ratio (95% CI): 1.11 (1.01 - 1.22), p=0.038].
Conclusion
A multi-modality biomarker strategy can be used to predict increased risk of developing IHD during the following two decades after 50 years, enabling us to identify individuals who might benefit from early intensive risk modification to prevent the development of IHD.
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D'Amico S, Alunni G, D'Amico M, Fu M, Celentani D, Pidello S, Brustio A, Campana M, Baccega M, Giustetto C, Marra S, Rinaldi M. P2685Improving myocardial perfusion in refractory angina: extracorporeal shockwave myocardial revascularization in a monocentric cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The incidence of patients with refractory angina (RA) is increasing. Medical therapy for RA is limited and prognosis is poor. Experimental data and small clinical studies suggest that the use of Extracorporeal shockwave myocardial revascularization (ESMR) may contribute to angiogenesis and improve symptoms in patients with RA.
Purpose
The aim of this study was to assess the efficacy of ESMR in the improvement of myocardial perfusion and symptoms in patients with RA.
Methods
Patients with RA despite optimal medical therapy and not suitable for further myocardial revascularization were enrolled and underwent ESMR. Characteristics such as angina class scores (CCS class score), nitroglycerin consumption and hospitalization rate among cases (patients with RA who received ESMR) and controls (patients with RA who did not receive ESMR) were compared at baseline and 6 months after ESMR therapy. In patients receiving ESMR the effect of on cardiac perfusion was assessed at six months.
Results
Among screened patients, 159 met the inclusion/exclusion criteria. 151 patients were enrolled in the present study and 121 treated with ESMR. There were 121 patients in the treatment group and 29 patients in the control group. The mean age of the patients was 70±8.8 years in the case group and 71±5.3 years in the control group. Other characteristics were similar in both groups. After ESMR myocardial perfusion by SPECT significantly improved: mean SSS was reduced from 21.2±9.42 to 14.2±10, with a 33% relative reduction (p=0.0001). Clinical follow up of both group demonstrated a significant improvement CCS class score at six months (1.5±0.6 in treatment and 1.92±0.69 in controls; p 0.0013) a significant improvement NYHA class score (1.4±0.6 in cases and 1.73±0.59 in controls; p 0.008); also, nitroglycerin consumption (29% in case cases, and 44.8% in controls; P 0.15) and hospitalization rate were reduced in the treatment group compared to control (16% vs. 37.9%; P 0.02).
Clinical outcome of two groups at 6 months follow up Treatment group (n=121) Control group (n=29) p CCS class 1.5±0.6 1.92±0.7 <0.001 NYHA class 1.4±0.6 1.7±0.6 <0.008 Nitrates uptake 35 (29%) 13 (45%) <0.15 Admission to emergency department 20 (16%) 11 (38%) <0.02
SPECT results after 6 months follow up
Conclusion
ESMR therapy is a non-invasive safe and potentially effective new option for patients with refractory angina. This study confirms the beneficial effect of ESMR therapy on cardiac symptoms, myocardial perfusion and hospitalizations in patients with refractory angina.
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Ergatoudes C, Hansson PO, Svardsudd K, Rosengren A, Thunstrom E, Caidahl K, Pivodic A, Fu M. P4151Changes in incidence and risk factors for heart failure over a 21-year follow-up period in two cohorts of middle aged men born 30 years apart. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Several characteristics or conditions are associated with increased risk for heart failure (HF). In recent years we have witnessed gradually improved cardiovascular prevention and treatment. However, how the risk profile of HF has changed during the last decades remains inadequately studied.
Purpose
To compare risk factors for heart failure in two generations of middle-aged men from the general population born 30 years apart.
Methods
Two cohorts of randomly selected men born in 1913 (n=855) and in 1943 (n=798) and resident in Gothenburg, Sweden were first examined at 50 years of age in 1963 and 1993, respectively, and followed longitudinally over 21 years until age 71. Data about medical history, concomitant diseases and general health were collected by questionnaires, repeated medical examinations and review of individual medical records. The outcome was defined as hospitalization with HF as a discharge diagnosis or HF reported on the death certificate. Cox-regression analysis was used to examine the impact of baseline characteristics and time-updated atrial fibrillation (AF), ischemic heart disease (IHD) and diabetes mellitus (DM) on the outcome. Furthermore the incidence of HF overall between the two cohorts was also compared. Significance was defined as p<0.05 for all two-sided tests, except for interaction terms where p<0.10 was applied.
Results
During a 21-year follow up, 80 men born in 1913 (9.4%) and 36 men born in 1943 (4.6%) developed HF. Men born in 1943 had a 52% lower risk for HF (adjusted HR 0.48 95% CI 0.29–0.77 p=0.003) compared to men born in 1913. Baseline characteristics associated with higher HF risk in both cohorts were higher body mass index (BMI) and the use of antihypertensive medication. Higher heart rate was associated with an increased risk only in men born 1913 whereas higher systolic blood pressure (SBP), smoking, higher glucose levels and higher total cholesterol levels were associated with higher risk in men born 1943. Onset of AF, IHD or DM was associated with higher HF risk in both cohorts. Multivariable models using stepwise regression showed that AF, IHD, higher BMI (continuous variable), use of antihypertensive medication and higher heart rate (piecewise linear) were independent predictors for HF in men born in 1913 whereas AF, higher glucose levels, IHD and higher SBP (piecewise linear) in men born in 1943. Finally, interaction analyses showed that in comparison with those born in 1913, the relative importance as risk factors for HF among those born in 1943 has decreased for AF whereas it has increased for systolic blood pressure and cholesterol. Of note, impact of IHD as risk factor decreased numerically, and that of physical activity increased, but for both without reaching statistical significance.
Cox proportional hazard analysis
Conclusions
The incidence of HF in middle aged men living in Gothenburg has decreased during the last decades, and in the meantime risk profile for incident HF has also changed.
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Sjoland H, Fu M, Hansson PO, Pivodic A, Caidahl K. P3436T-wave inversion in middle age is associated with higher mortality risk compared to occurrence of a new T-wave inversion later in life. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Minor ECG abnormalities, such as T-wave inversions, are frequently seen in clinical practice in asymptomatic patients. Its prognostic role is incompletely studied. We have previously reported an association between T-wave inversion, and all-cause mortality during lifetime.
Purpose
To study the prognostic prediction of new-onset of T-wave inversion in ECG recorded at various ages, in a male random population-based cohort in lifetime follow up.
Methods
Subjects from a random longitudinal, prospective, population-based study: “The study of men born in 1913” (n=854) were examined at 50-years of age and re-examined at 60, 67, 75 and 80 years, including a 12-lead ECG recording, classified according to the Minnesota code. Participants were followed until death or year 2015 (48 years follow-up), and data were obtained through the Cause of Death Register. Unadjusted and adjusted Cox proportional hazards models, producing an overall hazard ratio (HR), and flexible parametric models for survival data by Royston and Parmar, producing continuous HR over studied time, were applied for prediction of time to all-cause death and cardiovascular disease (CVD) death by the incident negative T-wave.
Results
An increased risk of all-cause and CVD death associated with negative T-waves was evident at the majority of observational ages in unadjusted analyses. After adjustment for other conditions (smoking, physical activity level, BMI, systolic blood pressure (BP), hypertension, BP medication, s-cholesterol, hematocrit, Q/QS patterns, and ST-junction/segment depression), a negative T-wave at 50 years of age was significantly associated with all-cause and CVD death, [HR 1.46 (95% CI 1.06–2.01), p=0.021, and HR 1.58 (95% CI 1.06–2.36), p=0.025], respectively. However, the HR of 1.58 for CVD death interacted significantly with time (p=0.034), with greater risk in the years adjacent to observation than for later follow-up (Figure, right panel). The corresponding adjusted analyses of a newly diagnosed negative T-wave appearing at 60, 67 and 75 years were not statistically significant for either of the two outcomes. However, an incident negative T-wave at 80 years of age was shown to have numerically higher overall impact, but not statistically significant for all-cause death [HR 1.52 (95% CI 0.80–2.86), p=0.20], but for CVD death [HR 2.41 (95% CI 1.03–5.66), p=0.043], with no significant interaction with time.
Conclusion
In this population cohort, a first time registered negative T-wave at 50 years carried a considerably increased risk of mortality, specifically CVD mortality, which cannot be explained by other cardiovascular risk factors. The risk was greatest in middle age, and weakened with increasing age. Our findings warrant verification in other cohorts. If an independent risk indication of negative T-wave at middle age is confirmed it could be a valuable adjunct in screening and cardiovascular risk assessment.
Acknowledgement/Funding
Sweden Heart-Lung Foundation, ALF Västra Götalandsregionen-Göteborgs Universitet
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Chen X, Dahlstrom ULF, Pivodic A, Fu M. P1630Improved outcome by guideline-directed medical therapy in real-world heart failure patients despite low blood pressure and renal dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Among patients with heart failure and reduced ejection fraction (HFrEF), angiotensin-converting enzyme inhibitors (ACEI/ARB), β-adrenergic receptor blockers (BB) and aldosterone antagonists (AA) are guideline-directed medical therapy (GDMT) to improve prognosis and well-being. However, low blood pressure (BP) and renal dysfunction are often challenges and barriersof the clinical implementation in real-world.
Purpose
To investigate whether it is beneficial to apply GDMT in real-world patients with HFrEF despite low blood pressure and renal dysfunction.
Methods
This study initially included 51060 HF patients from the Swedish Heart Failure Registry. After the exclusion of patients with ejection fraction ≥40% (53.4%), systolic BP>100mmHg (40.0%), eGFR>45ml/min/1.73m2 (3.3.%) and those died during hospitalization (0.3%), 1386 patients were ultimately enrolled in this study. Patients were grouped into five subgroups (ACEI/ARB+BB+AA, ACEI/ARB+BB, ACEI/ARB+AA, ACEI/ARB and BB). Outcome is all cause mortality.
Results
Among the study patients, 485 (35.0%) were treated with ACEI/ARB+BB+AA, 672 (48.5%) with ACEI/ARB+BB, 41 (3.0%) with ACEI/ARB+AA, 68 (4.9%) with ACEI/ARB and 120 (8.7%) with BB. Patients in ACEI/ARB+BB+AA group were younger (72.9±9.7 vs. 76.1±9.2 vs. 73.9±9.7 vs. 79.5±8.0 vs. 79.3±8.9), with higher BMI (25.4±4.5 vs. 25.5±4.7 vs. 23.7±4.2 vs. 23.4±3.8 vs. 24.7±6.3), more in NYHA I/II (30.8% vs. 33.3% vs. 1.7% vs. 18.9% vs. 24.3%). During the follow-up, all cause mortality was lowest in patients treated with ACEI/ARB+BB+AA (59% vs. 60.4% vs. 75.6% vs. 75% vs. 79.2%). After adjustement for age and gender, when compared with the ACEI/ARB+BB+AA group, the hazard ratio for ACEI/ARB+BB is 1.05 (0.91–1.23), ACEI/ARB+AA 1.16 (0.80–1.68), ACEI/ARB 1.51 (1.11–2.04), and BB 2.36 (1.86–2.98) respectively
Conclusions
In real-world HFrEF patients with low blood pressure and renal dysfunction, full medication of GDMT is associated with improved long-term survival.
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Hjalmarsson C, Fu M, Zverkova-Sandstrom T, Schaufelberger M, Ljungman C, Andersson B, Bollano E, Dahlstrom U, Rosengren A. P1635A risk score for prediction of TIA/ischemic stroke in patients with heart failure and sinus rhythm. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Prediction of ischemic cerebral events in patients with heart failure (HF) in the absence of atrial fibrillation (AF) is challenging.
Purpose
To prospectively test a staged approach to identify patients with HF and sinus rhythm who are at high risk of developing TIA/ischemic stroke (TIA/IS) during the first two years after diagnosis.
Methods
The analysis is based on patient data reported in the Swedish Heart Failure Register from January 2003 until December 2013. Patients with AF and those treated with anticoagulants were excluded. The study population was categorized in two groups according to left ventricular ejection fraction: LVEF ≤40% and LVEF >40%. Factors associated with TIA/IS were determined by univariate proportional hazard regression. The risk score included: age (1p for 65–74y; 2p for 75–84y; 3p for ≥85y), previous ischemic heart disease (1p), hypertension (1p), diabetes mellitus (1p), TIA/IS (2p), and kidney dysfunction (1p). Two-year hazard ratios with death as competing risk were computed. The probability of observing the outcome was calculated using the cumulative incidence function.
Results
A total of 16,865 patients (mean age 72.1±13.2y) were included in the study, 39.9% women; 59.7% had LVEF ≤40%. The two-year crude rate of TIA/IS, hemorrhagic stroke, and all-cause mortality were 3.3%, 0.3%, and 26%, respectively.
An incremental absolute risk for TIA/IS was observed for patients with LVEF ≤40% and score 1- ≥6: 1.6, 2.3, 3.6, 2.9, 6.3, and 7.1%, respectively. The corresponding HRs with 95% confidence interval (CI) and the patients with 0 points as reference group were: 2.8 (1.1–7.3), 4.0 (1.6–10.1), 6.6 (2.7–16.2), 5.5 (2.2–13.8), 14.4 (5.8–35.9) for score 1- ≥6, where all p-values were less than 0.05 and Wald χ2 for overall model fit <0.0001. The cumulative incidence per 1000 person-years was: 8.2 (5.4–12.5), 11.8 (8.3–16.7), 19.4 (15.1–24.8), 16.3 (12.6–21.1), 36.6 (29.4–45.4), and 42.1 (33.0–53.8), respectively.
In patients with LVEF >40% and score 1–≥6, the absolute TIA/IS risk was: 1.3, 3.1, 3.1, 3.3, 4.6, and 5.3%, respectively. The corresponding HRs with 95% CI and patients with 1 point as reference group was: 2.4 (1.1–5.2), 2.5 (1.2–5.3), 2.7 (1.3–5.7), 3.9 (1.8–8.2); and 4.6 (2.2–9.8), for score 1- ≥6 (all p<0.05 and Wald χ2 for overall model fit p=0.0002). The cumulative incidence per 1000 person-year was: 6.7 (3.4–13.2), 16.0 (10.8–23.8), 16.7 (12.5–22.2), 18.0 (13.9–23.4), 25.8 (19.4–34.3), and 30.6 (21.7–43.0), for score 1- ≥6, respectively.
Conclusion
In the current study, a risk score compiling age and specific comorbidity was shown to predict increased risk of TIA/IS, regardless of LVEF, during the first two years after diagnosis in patients with incident HF in sinus rhythm.
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Chen X, Schaufelberger M, Fu M. P779Eligible patients for the PARADIGM-HF trial in a real-world outpatient clinic and its cardiovascular risk. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the PARADIGM-HF trial sacubitril-valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), was more effective than enalapril for some patients with heart failure (HF). However, the eligibility of the PARADIGM-HF study to a real-world heart failure population was not well established.
Purpose
To investigate the eligibility of PARADIGM-HF Trial in a real-world clinical setting and its cardiovascular risk.
Methods
We made secondary analysis of patients (n=4872) with heart failure prospectively enrolled in the Swedish Heart Failure Registry from the Outpatient Clinic, during 2005–2016. The eligibility for PARADIGM-HF in real world was studied based on patients whether they were either fully or partially compatible with the PARADIGM-HF study population. Mortality data during follow-up were obtained from the Death Registry of the National Board of Health and Welfare in Sweden.
Results
Heart failure with reduced LVEF (≤40%) (HFrEF) were found in 2165 patients, 653 patients (30%) were fully and 958 (44%) were partially compatible with PARADIGM-HF criteria respectively (figure). In both the fully and partially eligible groups there were more male. Despite that the fully eligible patients were younger than non-eligible patients (77.6±12.7 vs. 84.0±13.7 years), they were clearly older than in PARADIGM-HF trial. Moreover, those fully-eligible patients had lower all-cause mortality compared with both partially-and non-eligible patients (45.6% vs. 68.5, HR 1.43 (1.18–1.75) p<0.001) after adjusted for sex, age, BMI, smoking, hypertension and diabetes. However, both fully- and partially eligible patients had higher all-cause mortality than that in PARADIGM-HF.
figure
Conclusion
In a real world outpatient clinical setting, around 35% to 50% of HFrEF were eligible for treatment with ARNI except that they are older, sicker and carried higher risk for all-cause mortality than the PARADIGM-HF trial population.
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Liu C, Wang L, Zhu R, Liu H, Ma R, Chen B, Li L, Guo Y, Jia Q, Shi S, Zhao D, Mo F, Zhao B, Niu J, Fu M, Orekhov AN, Brömme D, Gao S, Zhang D. Correction to: Rehmanniae Radix Preparata suppresses bone loss and increases bone strength through interfering with canonical Wnt/β-catenin signaling pathway in OVX rats. Osteoporos Int 2019; 30:1537-1540. [PMID: 31214751 DOI: 10.1007/s00198-019-05028-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There was a mistake in the part of OVX rats model and RRP intervention in the original publication.
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Yang JLX, Zhang Y, Feng WW, Tang H, Shao J, Wang NR, Wang H, Sun J, Luo Y, Lyu LQ, Yan SQ, Zhao DM, Mu LJ, Yan DM, Wang H, Gao XT, He MF, Yang J, Fu M, Sanders M, Haslam D. [Practice of parenting and related factors on children aged 0-5 in the urban areas of China]. ZHONGHUA LIU XING BING XUE ZA ZHI = ZHONGHUA LIUXINGBINGXUE ZAZHI 2019; 40:422-426. [PMID: 31006202 DOI: 10.3760/cma.j.issn.0254-6450.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To characterize the relations between the practice of parenting and associated factors on children (0-5 years old) in urban areas of China, in order to provide evidence for promoting the early development of children and to provide positive guidance and service programs on parenting. Methods: A total of 4 515 parents from 15 cities (14 provinces) were surveyed with a self-administered questionnaire. Parenting and Family Adjustment Scales (PAFAS) was used, including parameters as: consistency and coercive parenting, positive encouragement, parent-child relationship and parental emotion adjustment, family relationship and parental teamwork aspects, etc. Both single factor analysis and multiple linear regression were used to examine the associations between parenting practice, individual, parental and family factors. Results: The mean score of PAFAS was 21.00 (15.00-28.00), associated with factors as children's age, only-child family, premature delivery, father's education level, confidence on parenting, problems regarding the parental mood, annual family income, family structure and behavior on seeking professional help, etc. Results showed that there were big differences on the practice of parenting in China and influenced by variety of factors. Conclusions: The general situation of parenting was well, in the urban areas of China. The practice of parenting was associated with a series of individual, parental and family factors. Programs on improving the parenting skills and promoting the early development of children, should be highlighted.
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Al-Awadhi A, Kono M, Marx A, Moseley T, Willey J, Sun H, Fu M, Whitman GJ, Valero V, Ueno NT, Lim B. Abstract OT2-07-09: A phase Ib study of neratinib, pertuzumab, and trastuzumab with paclitaxel in patients with metastatic and locally advanced breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-07-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neratinib, a potent irreversible pan-ErbB tyrosine kinase inhibitor that blocks signal transduction through HER1, HER2, and HER4, has demonstrated activity against metastatic HER2-positive breast cancer (HER2+ BC) in patients pretreated with trastuzumab. The FDA recently approved neratinib as an adjuvant treatment for HER2+ BC patients who have received trastuzumab for at least 1 year. Preclinical data demonstrate that trastuzumab-resistant BC cells remain sensitive to neratinib. Also, neratinib enhances responses to trastuzumab possibly by increasing trastuzumab's internalization, immune-mediated action, and other mechanisms. Taken together, these findings provide the rationale for adding neratinib to the standard of care combination of trastuzumab and pertuzumab with paclitaxel to enhance anti-HER2 efficacy in advanced HER2+ BC. Here, we report on the phase Ib portion of an ongoing phase Ib/II trial of this drug combination.
Trial Design: Patients with metastatic or locally advanced HER2+ BC will be enrolled in the phase Ib portion of the trial. Neratinib is given orally in 3-week cycles. The initial neratinib dose of 80 mg daily is increased to 120, 160, and 200 mg daily after safety assessments of each dose level. Other agents are administered as per the standard of care. Patients continue therapy with per-protocol dose escalation and de-escalation according to toxicity until the maximum tolerated dose (MTD) of neratinib is reached. The target maximum dose-limiting toxicity rate is 20%. All patients receive 4 cycles of the combination therapy. If patients do not have disease progression or excessive toxicity, they may receive 2-4 additional cycles at the treating physician's discretion. During therapy, patients undergo blood tests every week and have clinical visits and restaging scans every 3 weeks. Because gastrointestinal toxicity, mainly diarrhea, is anticipated, patients receive prophylactic antidiarrheal medication (e.g., loperamide, budesonide) beginning with the first dose of neratinib.
Eligibility Criteria: Eligible patients must have histologically confirmed metastatic or locally advanced HER2+ BC (BC may be inflammatory or non-inflammatory and have any hormone receptor status); an ECOG performance status score of 0 or 1; and adequate hematologic and organ function, including adequate cardiac function (as indicated by a left ventricle ejection fraction of ≥50%).
Specific Aims:
1- To determine the MTD of neratinib in combination with paclitaxel, pertuzumab, and trastuzumab.
2- Pharmacodynamic markers will be measured on biologic specimens. Neratinib-induced changes in pEGFR and/or HER2 expression will be analyzed and compared between dose levels.
Statistical Methods: The Bayesian modified toxicity probability interval is used to determine dose adjustment.
Accrual: The target enrollment for the phase Ib cohort is 20 patients. The trial has enrolled 3 patients since its activation in January 2018. This trial is supported by Puma Biotechnology, Aggressive Breast Cancer Research Program Grant.
Citation Format: Al-Awadhi A, Kono M, Marx A, Moseley T, Willey J, Sun H, Fu M, Whitman GJ, Valero V, Ueno NT, Lim B. A phase Ib study of neratinib, pertuzumab, and trastuzumab with paclitaxel in patients with metastatic and locally advanced breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-07-09.
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Liu C, Wang L, Zhu R, Liu H, Ma R, Chen B, Li L, Guo Y, Jia Q, Shi S, Zhao D, Mo F, Zhao B, Niu J, Fu M, Orekhov AN, Brömme D, Gao S, Zhang D. Rehmanniae Radix Preparata suppresses bone loss and increases bone strength through interfering with canonical Wnt/β-catenin signaling pathway in OVX rats. Osteoporos Int 2019; 30:491-505. [PMID: 30151623 DOI: 10.1007/s00198-018-4670-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
Abstract
UNLABELLED Rehmanniae Radix Preparata (RRP) improves bone quality in OVX rats through the regulation of bone homeostasis via increasing osteoblastogenesis and decreasing osteoclastogenesis, suggesting it has a potential for the development of new anti-osteoporotic drugs. INTRODUCTION Determine the anti-osteoporotic effect of RRP in ovariectomized (OVX) rats and identify the signaling pathway involved in this process. METHODS OVX rats were treated with RRP aqueous extract for 14 weeks. The serum levels of tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa-Β ligand (RANKL), alkaline phosphatase (ALP), and osteoprotegerin (OPG) were determined by ELISA. Bone histopathological alterations were evaluated by H&E, Alizarin red S, and Safranin O staining. Bone mineral density (BMD) and bone microstructure in rat femurs and lumbar bones were determined by dual-energy X-ray absorptiometry and micro-computed tomography. Femoral bone strength was detected by a three-point bending assay. The expression of Phospho-glycogen synthase kinase 3 beta (p-GSK-3β), GSK-3β, Dickkopf-related protein 1 (DKK1), cathepsin K, OPG, RANKL, IGF-1, Runx2, β-catenin, and p-β-catenin was determined by western blot and/or immunohistochemical staining. RESULTS Treatment of OVX rats with RRP aqueous extract rebuilt bone homeostasis demonstrated by increasing the levels of OPG as well as decreasing the levels of TRAP, RANKL, and ALP in serum. Furthermore, RRP treatment preserved BMD and mechanical strength by increasing cortical bone thickness and epiphyseal thickness as well as improving trabecular distribution in the femurs of OVX rats. In addition, RRP downregulated the expression of DKK1, sclerostin, RANKL, cathepsin K, and the ratio of p-β-catenin to β-catenin, along with upregulating the expression of IGF-1, β-catenin, and Runx2 and the ratio of p-GSK-3β to GSK-3β in the tibias and femurs of OVX rats. Echinacoside, jionoside A1/A2, acetoside, isoacetoside, jionoside B1, and jionoside B2 were identified in the RRP aqueous extract. CONCLUSION RRP attenuates bone loss and improves bone quality in OVX rats partly through its regulation of the canonical Wnt/β-catenin signaling pathway, suggesting that RRP has the potential to provide a new source of anti-osteoporotic drugs.
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Papadopoulos K, Harb W, Lu N, Ma X, He Y, Yuan L, Fu M, Lin Y, Xu W, Wang X, Wang P, Xu T, Dong R, Gong J. Phase I study of KN035, a novel fusion Anti-PD-L1 antibody administered subcutaneously in patients with advanced solid tumors in the USA. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bengtsson M, Hansson PO, Ergatoudes C, Mandalenakis Z, Morales D, Rosengren A, Fu M, Thunstrom E. P2465Middle age men with short sleep duration have two times higher risk of cardiovascular events than those with normal sleep duration, a cohort study with 21 years follow-up. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Huang Y, Fu M. [Therapeutic effects of postauricularinjection of lidocaine in tinnitus]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 32:1139-1142. [PMID: 30282144 DOI: 10.13201/j.issn.1001-1781.2018.15.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Indexed: 11/12/2022]
Abstract
Objective:To observe clinical efficacy of postauricular injection of lidocaine for subjective tinnitus and explore the clinical effective method in the treatment of tinnitus. METHOD Eighty patients with tinnitus as their first complaint were included in our study. They were randomly divided into four groups, each with 20 cases.They were treated with oral ginaton and mecobalamin tablets,and at the same time with postauricular injection of lidocaine at different doses (Group A, 2% lidocaine 3 ml; Group B, 2% lidocaine 2 ml+physiological saline 1 ml;Group C, 2% lidocaine 1 ml+physiological saline 2 ml; Group D, physiological saline 3 ml). TEQ scores were evaluated and compared before treatment, at the end of treatment, and one month after treatment.Result:At the end of treatment, the clinical effiCIency rates of four groups were 80%,70%,65% and 25% respectively. One month after treatment, the clinical effiCIency rates of four groups were 80%, 55%, 45% and 0% respectively. There were significant differences among four groups by chi square test (P<0.05).Patients' TEQ scores of the four groups after treatment were analyzed and compared by one-way ANOVA. TEQ scores of Group A,B and C were lower than Group D(P<0.05). TEQ scores of Group A were lower than Group C(P<0.05).TEQ scores at the end of treatment and one month after treatment were analyzed by paired t-test. Group B and C had higher TEQ scores one month after treatment(P<0.05).The total effective rate at the end of treatment for acute, subacute and chronic tinnitus patients was 79.31%, 70.83% and 42.86% respectively. The total effective rate of one month after treatment was 75.86%, 45.83% and 42.86%, respectively. The results of chi square test showed that the total effective rate of acute tinnitus patients was significantly higher than that of subacute and chronic tinnitus in one month after treatment (P<0.05). CONCLUSION Postauricular injection of lidocaine is effective for simple subjective tinnitus, and the dose and concentration of lidocaine affect the efficacy and durability. Postauricular injection of lidocaine for the treatment of subjective tinnitus is a therapeutic method worthy of further research and popularization.
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Chen X, Hansson PO, Rosengren A, Thunstrom E, Mandalenakis Z, Zhong Y, Ergatoudes C, Caidahl K, Fu M. P4422Increasing QRS width from age 50 to 60 years among randomly selected men associated with higher incidence of cardiovascular disease the following decade. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sjoland H, Hansson PO, Pivodic A, Caidahl K, Fu M. P4454T-wave inversions in ECG in middle-age were associated with increased risk for all-cause mortality during lifetime. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fu M, Qin Z, Meng X, Li Y, Zhou YJ. P3864Surgical left atrial appendage occlusion for stroke prevention compared with long-term warfarin therapy in patients with nonvalvular atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hjalmarsson C, Fu M, Schaufelberger M, Ljungman C, Andersson B, Bollano E, Dahlstrom U, Rosengren A. P6518The risk of stroke/transient ischemic attack in patients with heart failure and sinus rhythm: a longitudinal 2-year follow-up study based on the Swedish Heart Failure Registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Silverdal J, Sjoland H, Bollano E, Pivodic A, Dahlstrom U, Fu M. P5672Prognostic impact of ischemic heart disease in heart failure, and its trend over time. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sakalaki M, Barywani S, Bjorck L, Rosengren A, Fu M. P783Determinants of suboptimal long-term secondary prevention of acute myocardial infarction (SEPAT) - a subgroup analysis of a prospective study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chen X, Barywani S, Hansson PO, Rosengren A, Thunstrom E, Zhong Y, Ergatoudes C, Mandalenakis Z, Caidahl K, Fu M. 3025High normal blood pressure conferred higher risk for cardiovascular disease in a random population sample of 50-year-old men during 21-years follow-up. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pérez-Ortuño R, Fu M, Martínez-Sánchez JM, Pascual JA. Assessment of E-cigarette humectants exposure by quantification of 1,2-propileneglicol, 1,3- propileneglicol and glycerol in human urine and oral fluid. Tob Prev Cessat 2018. [DOI: 10.18332/tpc/91510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Huang HM, Huang Y, Cui Y, Ge RM, Fu M. [Diagnosis and treatment of canal conversion during canalith repositioning procedure for benign paroxysmal positional vertigo]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 32:816-818. [PMID: 29921048 DOI: 10.13201/j.issn.1001-1781.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Indexed: 06/08/2023]
Abstract
Objective:To investigate the diagnosis and treatment of canal conversion during canalith repositioning procedure for benign paroxysmal positional vertigo.Method:The clinic features, nystagmus characteristics, diagnosis and treatment of the patients with benign paroxysmal positional vertigo who suffered from canal conversion during canalith repositioning procedure were analyzed retrospectively.All patients'positioning test and canalith repositioning procedure were done with the aid of videonystagmography.Result:A total of 186 patients with benign paroxysmal positional vertigo were diagnosed and performed canalith repositioning procedure.Eight patients (4.3%) developed canal conversion after canalith repositioning procedure.Of these 8 patients,5 cases with posterior canal canalolithiasis converted to lateral canal canalolithiasis,2 cases with lateral canal canalolithiasis converted to posterior canal canalolithiasis,and 1 case with posterior canal canalolithiasis converted to anterior canal canalolithiasis. All cases recovered well under the corresponding repositioning procedure.Conclusion:The change of the characteristics of positioning nystagmus is the major diagnostic feature of canal conversion. Accurate diagnosis and targeted repositioning procedure are the key to the success of canal conversion treatment.
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Qian L, Jiang C, Sun P, Xu D, Wang Y, Fu M, Zhong S, Ouyang J. A comparison of the biomechanical stability of pedicle-lengthening screws and traditional pedicle screws: an in vitro instant and fatigue-resistant pull-out test. Bone Joint J 2018; 100-B:516-521. [PMID: 29629595 DOI: 10.1302/0301-620x.100b4.bjj-2017-0877.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to compare the peak pull-out force (PPF) of pedicle-lengthening screws (PLS) and traditional pedicle screws (TPS) using instant and cyclic fatigue testing. Materials and Methods A total of 60 lumbar vertebrae were divided into six groups: PLS submitted to instant pull-out and fatigue-resistance testing (groups A1 and A2, respectively), TPS submitted to instant pull-out and fatigue-resistance testing (groups B1 and B2, respectively) and PLS augmented with 2 ml polymethylmethacrylate, submitted to instant pull-out and fatigue-resistance testing (groups C1 and C2, respectively). The PPF and normalized PPF (PPFn) for bone mineral density (BMD) were compared within and between all groups. Results In all groups, BMD was significantly correlated with PPF (r = 0.83, p < 0.001). The PPFn in A1 was significantly less than in B1 (p = 0.006) and C1 (p = 0.002). The PPFn of A2 was significantly less than in B2 (p < 0.001) and C2 (p < 0.001). The PPFn in A1, B1, and C1 was significantly greater than in A2 (p = 0.002), B2 (p = 0.027), and C2 (p = 0.003). There were no significant differences in PPFn between B1 and C1, or between B2 and C2. Conclusion Pedicle lengthening screws with cement augmentation can provide the same fixation stability as traditional pedicle screws and may be a viable clinical option. Cite this article: Bone Joint J 2018;100-B:516-21.
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Fu M, Huang X, He W, Hou B. Effects of ultrasonic removal of fractured files from the middle third of root canals on dentinal cracks: a micro-computed tomography study. Int Endod J 2018; 51:1037-1046. [DOI: 10.1111/iej.12909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/07/2018] [Indexed: 12/28/2022]
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Xu X, Ni S, Fu M, Zheng X, Luo N, Weng W. Numerical investigation of airflow, heat transfer and particle deposition for oral breathing in a realistic human upper airway model. J Therm Biol 2017; 70:53-63. [DOI: 10.1016/j.jtherbio.2017.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 04/30/2017] [Accepted: 05/17/2017] [Indexed: 11/26/2022]
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Martínez C, Castellano Y, Andrés A, Fu M, Antón L, Ballbè M, Fernández P, Cabrera S, Riccobene A, Gavilan E, Feliu A, Baena A, Margalef M, Fernández E. Factors associated with implementation of the 5A's smoking cessation model. Tob Induc Dis 2017; 15:41. [PMID: 29142531 PMCID: PMC5669025 DOI: 10.1186/s12971-017-0146-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/23/2017] [Indexed: 12/04/2022] Open
Abstract
Background Several health organizations have adopted the 5A’s brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A’s performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A’s. Methods A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580). The survey included questions about individual characteristics as well as cognitive, behavioral, and organizational factors previously identified in research. We assessed self-reported performance of the 5A’s, assessed on a scale from 0 to 10, and used Multivariate regression to examine factors associated with its performance. Results The performance means (standard deviation) were moderate for the first 3A’s [Ask: 6.4 (3.1); Advise: 7.1 (2.7); Assess: 6.3 (2.8)] and low for the last 2A’s [Assist: 4.4 (2.9); Arrange: 3.2 (3.3)]. We observed a high correlation between Assist and Arrange (r = 0.704, p < 0.001). Having positive experiences and feeling competent were positively associated with performing the 5A’s model and having organizational support with Assist and Arrange. Personal tobacco use among healthcare workers was negatively associated with Advice and Arrange. Conclusions Our study found that clinical healthcare workers do not perform the 5A’s completely. The main barriers identified suggest the need of training and making available practical guidelines in healthcare services. Organizational support is essential for moving towards the implementation of Assist and Arrange. Electronic supplementary material The online version of this article (10.1186/s12971-017-0146-7) contains supplementary material, which is available to authorized users.
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Roura E, Fu M. Taste, nutrient sensing and feed intake in pigs (130 years of research: then, now and future). Anim Feed Sci Technol 2017. [DOI: 10.1016/j.anifeedsci.2017.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Qi Y, Purtell L, Fu M, Zhang L, Zolotukhin S, Campbell L, Herzog H. Hypothalamus Specific Re-Introduction of SNORD116 into Otherwise Snord116 Deficient Mice Increased Energy Expenditure. J Neuroendocrinol 2017; 29. [PMID: 28094877 DOI: 10.1111/jne.12457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 12/21/2016] [Accepted: 01/11/2017] [Indexed: 02/02/2023]
Abstract
The Snord116 gene cluster has been recognised as a critical contributor to the Prader-Willi syndrome (PWS), with mice lacking Snord116 displaying many classical PWS phenotypes, including low postnatal body weight, reduced bone mass and increased food intake. However, these mice do not develop obesity as a result of increased energy expenditure. To understand the physiological function of SNORD116 better and potentially rescue the altered metabolism of Snord116-/- mice, we used an adeno-associated viral (AAV) approach to reintroduce the product of the Snord116 gene into the hypothalamus in Snord116-/- mice at different ages. The results obtained show that mid-hypothalamic re-introduction of SNORD116 in 6-week-old Snord116-/- mice leads to significantly reduced body weight and weight gain, which is associated with elevated energy expenditure. Importantly, when the intervention targets other areas such as the anterior region of the hypothalamus or the reintroduction occurs in older mice, the positive effects on energy expenditure are diminished. These data indicate that the metabolic symptoms of PWS develop gradually and the Snord116 gene plays a critical role during this process. Furthermore, when we investigated the consequences of SNORD116 re-introduction under conditions of thermoneutrality where the mild cold stress influences are avoided, we also observed a significant increase in energy expenditure. In conclusion, the rescue of mid-hypothalamic Snord116 deficiency in young Snord116 germline deletion mice increases energy expenditure, providing fundamental information contributing to potential virus-mediated genetic therapy in PWS.
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Morales D, Ergatoudes C, Zhong Y, Thunstrom E, Mandalenakis Z, Hansson PO, Rosengren A, Caidahl K, Fu M. P3451Iron deficiency as risk factor for heart failure and myocardial dysfunction in a male general population sample during 21-years follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ergatoudes C, Thunstrom E, Morales D, Zhong Y, Mandalenakis Z, Xiaojing C, Hansson PO, Caidahl K, Rosengren A, Fu M. P2470Biomarkers and risk of heart failure in middle-aged men from a random sample of the general population during a 21-year follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chen X, Thunstrom E, Ergatoudes C, Hansson PO, Zhong Y, Rosengren A, Mandalenakis Z, Caidahl K, Fu M. P2453Less than half of men aged 71 in a general population have normal heart function: a prospective longitudinal 21-year follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Basic C, Thunstrom E, Hansson P, You C, Rosengren A, Ergatoudes C, Morales D, Mandalenakis Z, Caidahl K, Fu M. P2615Prevalence and lifetime risk factors for aortic stenosis in a general population of middle aged men in Sweden with 21 years follow up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fu M, Ahrenmark U, Berglund S, Lindholm C, Lehto A, Mansson Broberg A, Tasevska-Dinevska G, Wikstrom G, Agard A, Andersson B. P5273Adherence to optimal heart rate control in heart failure with reduced ejection fraction: Insight from a survey of heart rate in heart failure in Sweden (HR-HF study) - a prospective multicenter study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fu M, Ye Q, Jiang C, Qian L, Xu D, Wang Y, Sun P, Ouyang J. The segment-dependent changes in lumbar intervertebral space height during flexion-extension motion. Bone Joint Res 2017; 6:245-252. [PMID: 28450317 PMCID: PMC5415903 DOI: 10.1302/2046-3758.64.bjr-2016-0245.r1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/07/2017] [Indexed: 11/09/2022] Open
Abstract
Objectives Many studies have investigated the kinematics of the lumbar spine and the morphological features of the lumbar discs. However, the segment-dependent immediate changes of the lumbar intervertebral space height during flexion-extension motion are still unclear. This study examined the changes of intervertebral space height during flexion-extension motion of lumbar specimens. Methods First, we validated the accuracy and repeatability of a custom-made mechanical loading equipment set-up. Eight lumbar specimens underwent CT scanning in flexion, neural, and extension positions by using the equipment set-up. The changes in the disc height and distance between adjacent two pedicle screw entry points (DASEP) of the posterior approach at different lumbar levels (L3/4, L4/5 and L5/S1) were examined on three-dimensional lumbar models, which were reconstructed from the CT images. Results All the vertebral motion segments (L3/4, L4/5 and L5/S1) had greater changes in disc height and DASEP from neutral to flexion than from neutral to extension. The change in anterior disc height gradually increased from upper to lower levels, from neutral to flexion. The changes in anterior and posterior disc heights were similar at the L4/5 level from neutral to extension, but the changes in anterior disc height were significantly greater than those in posterior disc height at the L3/4 and L5/S1 levels, from neutral to extension. Conclusions The lumbar motion segment showed level-specific changes in disc height and DASEP. The data may be helpful in understanding the physiologic dynamic characteristics of the lumbar spine and in optimising the parameters of lumbar surgical instruments. Cite this article: M. Fu, Q. Ye, C. Jiang, L. Qian, D. Xu, Y. Wang, P. Sun, J. Ouyang. The segment-dependent changes in lumbar intervertebral space height during flexion-extension motion. Bone Joint Res 2017;6:245–252. DOI: 10.1302/2046-3758.64.BJR-2016-0245.R1.
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Zhang W, Hong R, Xue L, Ou Y, Liu X, Zhao Z, Xiao W, Dong D, Dong L, Fu M, Ma L, Lu N, Chen H, Song Y, Zhan Q. Piccolo mediates EGFR signaling and acts as a prognostic biomarker in esophageal squamous cell carcinoma. Oncogene 2017; 36:3890-3902. [PMID: 28263981 DOI: 10.1038/onc.2017.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 02/07/2023]
Abstract
The presynaptic cytomatrix protein Piccolo, encoded by PCLO, is frequently mutated and amplified in esophageal squamous cell carcinoma (ESCC), but its exact roles in ESCC remain unclear. Here we report that Piccolo expression correlates significantly with clinical stage, patient survival and tumor embolus. Functional studies demonstrate that PCLO knockdown remarkably attenuates ESCC malignancy in vitro and in vivo, and ectopic EGFR expression partially compensates for Piccolo loss. PCLO knockdown promotes ubiquitination and degradation of EGFR, which is associated with the negative regulatory effect of Piccolo on E3 ligase Siah1. An anti-Piccolo monoclonal antibody inhibited tumor proliferation in a mouse model of ESCC. These results demonstrate that Piccolo contributes to tumor aggressiveness in ESCC, likely by stabilizing EGFR and promoting EGFR-dependent signaling. Our results further suggest that Piccolo may represent a novel prognostic biomarker and therapeutic target for patients with ESCC.
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Qi Y, Purtell L, Fu M, Sengmany K, Loh K, Zhang L, Zolotukhin S, Sainsbury A, Campbell L, Herzog H. Ambient temperature modulates the effects of the Prader-Willi syndrome candidate gene Snord116 on energy homeostasis. Neuropeptides 2017; 61:87-93. [PMID: 27823858 DOI: 10.1016/j.npep.2016.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/18/2016] [Accepted: 10/24/2016] [Indexed: 02/05/2023]
Abstract
Germline deletion of the Prader-Willi syndrome (PWS) candidate gene Snord116 in mice leads to some classical symptoms of human PWS, notably reductions in body weight, linear growth and bone mass. However, Snord116 deficient mice (Snord116-/-) do not develop an obese phenotype despite their increased food intake and the underlying mechanism for that is unknown. We tested the phenotypes of germline Snord116-/- as well as neuropeptide Y (NPY) neuron specific Snord116lox/lox/NPYcre/+ mice at 30°C, the thermoneutral temperature of mice, and compared these to previous reports studies conducted at normal room temperature. Snord116-/- mice at 30°C still weighed less than wild type but had increased body weight gain. Importantly, food intake and energy expenditure were no longer different at 30°C, and the reduced bone mass and nasal-anal length observed in Snord116-/- mice at room temperature were also normalized. Mechanistically, the thermoneutral condition led to the correction of the mRNA expression of NPY and pro-opiomelanocortin (POMC), which were both previously observed to be significantly up-regulated at room temperature. Importantly, almost identical phenotypes and NPY/POMC mRNA expression alterations were also observed in Snord116lox/lox/NPYcre/+ mice, which lack the Snord116 gene only in NPY neurons. These data illustrate that mild cold stress is a critical factor preventing the development of obesity in Snord116-/- mice via the NPY system. Our study highlights that the function of Snord116 in the hypothalamus may be to enhance energy expenditure, likely via the NPY system, and also indicates that Snord116 function in mice is strongly dependent on environmental conditions such as cold exposure.
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Tang N, Ting V, Fu M, Roura E. The expression of bitter taste receptors (T2Rs) in the porcine gastrointestinal tract epithelium and smooth muscle. ANIMAL PRODUCTION SCIENCE 2017. [DOI: 10.1071/anv57n12ab108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wang J, Fu M, Navarro M, Roura E. A double-choice model to quantify negative preference to bitterness in pigs. ANIMAL PRODUCTION SCIENCE 2017. [DOI: 10.1071/anv57n12ab081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sigurjonsdottir R, Barywani S, Albertsson P, Fu M. Long-term major adverse cardiovascular events and quality of life after coronary angiography in elderly patients with acute coronary syndrome. Int J Cardiol 2016; 222:481-485. [PMID: 27505338 DOI: 10.1016/j.ijcard.2016.07.237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/30/2016] [Accepted: 07/29/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND Although the elderly comprise the majority of acute coronary syndrome (ACS) patients, limited data exist on major adverse cardiovascular events (MACEs) and quality of life (QoL). OBJECTIVES To study MACEs and QoL prospectively in ACS patients >70years referred for coronary angiography. METHODS A prospective observational study that included ACS patients >70years undergoing coronary angiography. The outcomes were MACEs and QoL 3years after inclusion. MACEs were defined as death, recurrent ACS, new-onset of heart failure and repeated revascularization by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). A QoL questionnaire was completed by the patients along with a physical examination and a personal interview at the 3-year follow-up. Multivariate analysis was performed to identify the predictors for MACEs. RESULTS In total, 138 patients (mean age 78.8±3.8years) with ACS were included in the study. Mean follow-up was 1196±296days. In all, 42% of the patients had MACEs and 25% had post-ACS heart failure. The mortality rate was 11%. After adjusting for significant cardiovascular risk factors, the following factors were significantly associated with MACEs: Age, high-sensitive troponin T (hsTNT), use of diuretics and reduced left ventricular ejection fraction (LVEF). Furthermore, the QoL evaluated with SF-36 in survivors from ACS at the end of study was similar to the QoL in an age-matched healthy Swedish population. CONCLUSIONS In this prospective study on elderly ACS patients MACEs still occurred in 42% of the cases (despite low mortality and good QoL), with post-ACS heart failure as the most important event.
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Xu Y, Fu M, Zhang N. [Efficacy of different treatment on residual symptoms aftercanalith repositioning procedure in patients withbenign paroxysmal positional vertigo]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2016; 30:1146-1149. [PMID: 29798443 DOI: 10.13201/j.issn.1001-1781.2016.14.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Indexed: 06/08/2023]
Abstract
Objective:To assess which methods are effective for residual symptoms after canalith repositioning procedure in patients with benign paroxysmal positional vertigo(BPPV) then guide the clinical treatment.Method:A total of 93 cases who were diagnosed with BPPV,then after the canalith repositioning procedure,which still have residual symptoms were enrolled in our study.They were randomized into three groups,The control group(A),The drug group(Ginkgo Leaves Soft-gel Capsule and Qiangli Dingxuan tablets)(B),The vestibular rehabilitation gymnastics group(C).Then compare the efficacy of different treatment.Result:In the follow-up of 30 days,the number of DHI scores decline of group A is significantly lower than that of group B(P<0.05) and C(P<0.05),making statistical significance.The residual symptom duration of group A is significantly longer than that of group B(P<0.05) and C(P<0.05),making statistical significance.There is no significant statistical difference in comparing the number of DHI scores decline in the follow-up of 30 days,and the residual symptom duration of B and C(P>0.05).Conclusion:The drugs for improve the microcirculation and vestibular rehabilitation gymnastics can reduce the duration of residual symptoms.
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Liu YF, Lin J, Fu M, Ma JC, Chen Q, Qian W. [Progress of study on changes of mitochondrial and its role in obstructive sleep apnea hypopnea syndrome]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2016; 30:510-512. [PMID: 29871056 DOI: 10.13201/j.issn.1001-1781.2016.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Indexed: 11/12/2022]
Abstract
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common respiratory disease which has become an important public health problem. A high prevalence of OSAHS in the elderly may suggest that aging could be considered as a risk factor for the development of OSAHS. Recent work that has advanced understanding of mutations accumulating over time in the mitochondrial DNA (mtDNA) has been closely associated with aging. More and more researchers pay attention to changes of mitochondria morphology, electron transport chain enzymes and mtDNA. The process research of accumulation of circular mtDNA bearing deletions or mtDNA with accumulated point mutations in OSAHS subjects might be able to make mitochondrial become a representative biomarker for adverse outcomes from oxidative stress and cardiovascular diseases in the future.
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Li S, Barywani S, Fu M. Prognostic significance of mitral regurgitation in long-term all-cause mortality in patients aged ≥80years with acute coronary syndrome. [Int J Cardiol. 2014, 176(2):340-5]. Int J Cardiol 2016; 206:12. [DOI: 10.1016/j.ijcard.2015.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fu M, Chen L, Jiang Y, Jiang ZX, Yang Z. Copper-Catalyzed Intermolecular Chloro- and Bromotrifluoromethylation of Alkenes. Org Lett 2016; 18:348-51. [DOI: 10.1021/acs.orglett.5b03080] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Almodares Q, Cordeiro F, Van Der Ven JPG, Garweg C, Wahi S, Mo VY, Beladan CC, Yang LT, Wallentin Guron C, Thurin A, Fu M, Thunstrom E, Johansson MC, Leao S, Moz M, Magalhaes P, Trigo J, Mateus PS, Ferreira A, Moreira JI, Bossers S, Korteweg L, Duppen N, Kapusta L, Kuipers I, Kroft L, Ten Harkel A, Van Iperen G, Helbing W, Haemers P, De Buck S, Willems R, Ector J, Chong A, Bellucci BM, Fisher JM, Balekian AA, Mateescu AD, Predescu L, Calin A, Rosca M, Inta O, Egher L, Platon P, Ginghina C, Popescu BA, Tsai WC. Moderated Posters session: there are other cardiac chambers than the left ventricleP977Right atrial enlargement is a predictor of five-year mortality in elderly patients with heart failureP978Left atrial enlargement and long-term prognosis of ST-segment elevation myocardial infarction: comparison of indexed volume and area.P979Atrial function in total cavopulmonary connection: differences between ILT and ECC and relation with exercise capacityP980Imaging of the right atrium anatomy using 3D rotational angiography during ablation: comparison between right atrial flutter and atrioventricular nodal reentrant tachycardiaP983Direct comparison of non-invasive estimation of mean pulmonary artery pressure with right heart catheter measurements - which echocardiographic technique is best?P984PAAT, RVET, and Vmax versus RVSP to predict pulmonary hypertensionP985Correlates of brain natriuretic peptide in patients with pulmonary hypertension and pressure versus volume right ventricular overload: an echocardiographic-catheterization studyP986Incremental prognostic value of echocardiographic parameters over CHA2DS2-VASc score in atrial fibrillation. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tong MS, Chai HT, Liu WH, Chen CL, Fu M, Lin YH, Lin CC, Chen SM, Hang CL. Prevalence of hypertension after living-donor liver transplantation: a prospective study. Transplant Proc 2015; 47:445-50. [PMID: 25769588 DOI: 10.1016/j.transproceed.2014.10.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/10/2014] [Accepted: 10/28/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hypertension is common among patients who have undergone liver transplantation and is a major contributor to cardiovascular events. Few studies have studied the risk factors associated with post-liver transplantation (LT) hypertension. This prospective study assessed the prevalence of post-LT hypertension and associated preoperative risk factors. METHODS From May 2008 to December 2009, 79 normotensive adult patients (≥ 18 years old) who underwent living-donor LT with a median follow up of 4.79 ± 0.88 years were enrolled. Patients' pre-LT demographics, clinical data, pre-LT diabetes, and immunosuppressive agents used after LT were studied for their association with post-LT hypertension. RESULTS The prevalence of post-LT hypertension was 49.4%. The independent risk factors for post-living-donor LT hypertension were pre-LT systolic blood pressure (SBP; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.00-1.09; P = .039) and post-LT administration of mammalian target of rapamycin (mTOR) inhibitors (OR, 4.08; 95% CI, 1.40-11.94; P = .010). Pre-LT diabetes had a negative predictive value (OR, 0.15; 95% CI, 0.03-0.74; P = .019). Neither age, male sex, smoking, pre-LT serum cholesterol and triglyceride levels, tacrolimus, nor glucocorticoid was associated with post-LT hypertension. CONCLUSIONS The prevalence of hypertension is high after LT. Higher pre-LT SBP and post-LT mTOR inhibitor administration predispose patients to post-LT hypertension.
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