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Hu X, Xu Y, Zhong Z, Wu Y, Zhao J, Wang Y, Cheng H, Kong M, Zhang F, Chen Q, Sun J, Li Q, Jin J, Li Q, Chen L, Wang C, Zhan H, Fan Y, Yang Q, Yu L, Wu R, Liang J, Zhu J, Wang Y, Jin Y, Lin Y, Yang F, Jia L, Zhu W, Chen J, Yu H, Zhang J, Wang J. A Large-Scale Investigation of Hypoxia-Preconditioned Allogeneic Mesenchymal Stem Cells for Myocardial Repair in Nonhuman Primates: Paracrine Activity Without Remuscularization. Circ Res 2016; 118:970-83. [PMID: 26838793 PMCID: PMC4894788 DOI: 10.1161/circresaha.115.307516] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 01/19/2016] [Indexed: 02/07/2023]
Abstract
RATIONALE The effectiveness of transplanted bone marrow mesenchymal stem cells (MSCs) for cardiac repair has been limited; thus, strategies for optimizing stem-cell-based myocardial therapy are needed. OBJECTIVE The present study was designed to test our central hypothesis that hypoxia-preconditioned MSCs (HP-MSCs) are more effective than MSCs cultured under ambient oxygen levels for the treatment of myocardial injury in a large-scale (N=49), long-term (9 months), nonhuman primate (Cynomolgous monkeys) investigation. METHODS AND RESULTS MSCs were engineered to express green fluorescent protein, cultured under ambient oxygen or 0.5% oxygen (HP-MSCs) for 24 hours and then tested in the infarcted hearts of Cynomolgus monkeys (1×10(7) cells per heart). Hypoxia preconditioning increased the expression of several prosurvival/proangiogenic factors in cultured MSCs, and measurements of infarct size and left-ventricular function at day 90 after myocardial infarction were significantly more improved in monkeys treated with HP-MSCs than in monkeys treated with the control vehicle; functional improvements in normal cultured bone marrow mesenchymal stem cells-treated monkeys were not significant. HP-MSCs transplantation was also associated with increases in cardiomyocyte proliferation, vascular density, myocardial glucose uptake, and engraftment of the transplanted cells and with declines in endogenous cell apoptosis, but did not increase the occurrence of arrhythmogenic complications. CONCLUSIONS Hypoxia preconditioning improved the effectiveness of MSCs transplantation for the treatment of myocardial infarction in nonhuman primates without increasing the occurrence of arrhythmogenic complications, which suggests that future clinical trials of HP-MSCs transplantation are warranted.
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Affiliation(s)
- Xinyang Hu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Yinchuan Xu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Zhiwei Zhong
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Yan Wu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jing Zhao
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Yingchao Wang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Haifeng Cheng
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Minjian Kong
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Fengjiang Zhang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Qi Chen
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jianzhong Sun
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Qian Li
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jing Jin
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Qingju Li
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Lihong Chen
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Chen Wang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Hongwei Zhan
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Youqi Fan
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Qian Yang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Lei Yu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Rongrong Wu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jie Liang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jinyun Zhu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Ya Wang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Yiping Jin
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Yifan Lin
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Fan Yang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Liangliang Jia
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Wei Zhu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jinghai Chen
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Hong Yu
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang)
| | - Jianyi Zhang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang).
| | - Jian'an Wang
- From the Department of Cardiology (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J. L., J.Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.), Department of Cardiovascular Surgery (H.C., M.K.), Department of Anesthesiology (F.Z., Q.C.), Department of Radiology, (J.S., Qian Li), Department of Nuclear Medicine (H.Z.), and Department of Ultrasonography (Q.Y., L.Y.), Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, People's Republic of China (X.H., Y.X., Z.Z., Y. Wu, J. Zhao, Yingchao Wang, J.J., Qingju Li, L.C., C.W., Y.F., R.W., J.L., J. Zhu, Ya Wang, Y.J., Y.L., F.Y., L.J., W.Z., J.C., H.Y., J.W.); Institute of Translational Medicine, Zhejiang University, Hangzhou, People's Republic of China (J.C.); and Department of Biomedical Engineering, University of Alabama at Birmingham (J. Zhang).
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