1
|
Wang Y, Wang J, Lv W, Chen H, Yang Q, Zhang Y, Guo R, Ma XL, Zhang QY. Clinical intervention effect of Xuefu Zhuyu decoction on chronic heart failure complicated with depression. World J Psychiatry 2024; 14:857-865. [PMID: 38984345 PMCID: PMC11230100 DOI: 10.5498/wjp.v14.i6.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The diagnosis and treatment of depression in patients with chronic heart failure (CHF) is challenging, with no ideal treatment at present. AIM To analyze the clinical intervention effect of Xuefu Zhuyu decoction (XFZYD) on CHF complicated with depression. METHODS The study cohort comprised 116 patients with CHF complicated with depression who received treatment from July 2020 to July 2023, of which 55 received Western medicine (control group) and 61 received XFZYD (research group). Data on clinical effectiveness, traditional Chinese medicine (TCM) syndrome score, cardiac function, negative emotions, and serum inflammatory factors, were collected for comparative analyses. RESULTS Compared with the control group, the research group had an evidently higher total effective rate. Furthermore, there were marked reductions in TCM symptom score, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, Self-Rating Depression Scale, Hamilton Depression Scale, high-sensitivity C-reactive protein, monocyte chemoattractant protein-1, and matrix metalloproteinase-9 in the research group after treatment, and these were lower than the corresponding values in the control group. Left ventricular ejection fraction was increased and higher in the research group compared with the control group after treatment. CONCLUSION Our findings conclusively proved that XFZYD was considerably superior to Western medicine for treating CHF complicated with depression because it significantly alleviated patients' symptoms, improved cardiac function, relieved negative emotions, and reduced the levels of serum inflammatory factors.
Collapse
Affiliation(s)
- Ying Wang
- Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Jun Wang
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Wang Lv
- Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Hu Chen
- Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Qian Yang
- Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Yang Zhang
- Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Run Guo
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Xiao-Li Ma
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Qian-Yu Zhang
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| |
Collapse
|
2
|
Sun S, Wang L, Lin J, Sun Y, Ma C. An effective prediction model based on XGBoost for the 12-month recurrence of AF patients after RFA. BMC Cardiovasc Disord 2023; 23:561. [PMID: 37974062 PMCID: PMC10655386 DOI: 10.1186/s12872-023-03599-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is a common heart rhythm disorder that can lead to complications such as stroke and heart failure. Radiofrequency ablation (RFA) is a procedure used to treat AF, but it is not always successful in maintaining a normal heart rhythm. This study aimed to construct a clinical prediction model based on extreme gradient boosting (XGBoost) for AF recurrence 12 months after ablation. METHODS The 27-dimensional data of 359 patients with AF undergoing RFA in the First Affiliated Hospital of Soochow University from October 2018 to November 2021 were retrospectively analysed. We adopted the logistic regression, support vector machine (SVM), random forest (RF) and XGBoost methods to conduct the experiment. To evaluate the performance of the prediction, we used the area under the receiver operating characteristic curve (AUC), the area under the precision-recall curve (AP), and calibration curves of both the training and testing sets. Finally, Shapley additive explanations (SHAP) were utilized to explain the significance of the variables. RESULTS Of the 27-dimensional variables, ejection fraction (EF) of the left atrial appendage (LAA), N-terminal probrain natriuretic peptide (NT-proBNP), global peak longitudinal strain of the LAA (LAAGPLS), left atrial diameter (LAD), diabetes mellitus (DM) history, and female sex had a significant role in the predictive model. The experimental results demonstrated that XGBoost exhibited the best performance among these methods, and the accuracy, specificity, sensitivity, precision and F1 score (a measure of test accuracy) of XGBoost were 86.1%, 89.7%, 71.4%, 62.5% and 0.67, respectively. In addition, SHAP analysis also proved that the 6 parameters were decisive for the effect of the XGBoost-based prediction model. CONCLUSIONS We proposed an effective model based on XGBoost that can be used to predict the recurrence of AF patients after RFA. This prediction result can guide treatment decisions and help to optimize the management of AF.
Collapse
Affiliation(s)
- ShiKun Sun
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Li Wang
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Jia Lin
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - YouFen Sun
- The Shengcheng Street Health Center, Shouguang, 262700, China.
| | - ChangSheng Ma
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| |
Collapse
|
3
|
Zijian L, Fangqun W, Fenglian Z, Yu G, Shaojun W. Optimal assist strategy exploration for a direct assist device under stress‒strain dynamics. BIOMED ENG-BIOMED TE 2023; 68:511-521. [PMID: 37222653 DOI: 10.1515/bmt-2022-0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 04/13/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES The aim of this paper is to introduce a new assist strategy for a direct assist device that can enhance the heart's pumping efficiency and decrease the chances of myocardial injury in contrast to the conventional assist strategy. METHODS We established a finite element model of a biventricular heart, divided the ventricles into several regions, and applied pressure to each region separately in order to identify the primary and secondary assist areas. Then combined and tested these areas to obtain the optimal assist strategy. RESULTS The results indicate that our method exhibits an assist efficiency approximately ten times higher than that of the traditional assist method. Additionally, the stress distribution in the ventricles is more uniform after assistance. CONCLUSIONS In summary, this approach can result in a more homogenous stress distribution within the heart while also minimizing the contact area with it, which can reduce the incidence of allergic reactions and the likelihood of myocardial injury.
Collapse
Affiliation(s)
- Li Zijian
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Wang Fangqun
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Zhu Fenglian
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Gao Yu
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Wang Shaojun
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| |
Collapse
|
4
|
Herman R, Vanderheyden M, Vavrik B, Beles M, Palus T, Nelis O, Goethals M, Verstreken S, Dierckx R, Penicka M, Heggermont W, Bartunek J. Utilizing longitudinal data in assessing all-cause mortality in patients hospitalized with heart failure. ESC Heart Fail 2022; 9:3575-3584. [PMID: 35695324 DOI: 10.1002/ehf2.14011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/14/2022] [Accepted: 05/31/2022] [Indexed: 12/20/2022] Open
Abstract
AIMS Risk stratification in patients with a new onset or worsened heart failure (HF) is essential for clinical decision making. We have utilized a novel approach to enrich patient level prognostication using longitudinally gathered data to develop ML-based algorithms predicting all-cause 30, 90, 180, 360, and 720 day mortality. METHODS AND RESULTS In a cohort of 2449 HF patients hospitalized between 1 January 2011 and 31 December 2017, we utilized 422 parameters derived from 151 451 patient exams. They included clinical phenotyping, ECG, laboratory, echocardiography, catheterization data or percutaneous and surgical interventions reflecting the standard of care as captured in individual electronic records. The development of predictive models consisted of 101 iterations of repeated random subsampling splits into balanced training and validation sets. ML models yielded area under the receiver operating characteristic curve (AUC-ROC) performance ranging from 0.83 to 0.89 on the outcome-balanced validation set in predicting all-cause mortality at aforementioned time-limits. The 1 year mortality prediction model recorded an AUC of 0.85. We observed stable model performance across all HF phenotypes: HFpEF 0.83 AUC, HFmrEF 0.85 AUC, and HFrEF 0.86 AUC, respectively. Model performance improved when utilizing data from more hospital contacts compared with only data collected at baseline. CONCLUSIONS Our findings present a novel, patient-level, comprehensive ML-based algorithm for predicting all-cause mortality in new or worsened heart failure. Its robust performance across phenotypes throughout the longitudinal patient follow-up suggests its potential in point-of-care clinical risk stratification.
Collapse
Affiliation(s)
- Robert Herman
- Powerful Medical, Bratislava, Slovak Republic
- Sigmund Freud University, Vienna, Austria
- Department of Advanced Biomedical Sciences, University of Naples Frederico II, Naples, Italy
| | | | | | - Monika Beles
- Cardiovascular Center, OLV Hospital, Aalst, Belgium
| | | | | | | | | | - Riet Dierckx
- Cardiovascular Center, OLV Hospital, Aalst, Belgium
| | | | | | | |
Collapse
|
5
|
Zhang R, Sun X, Li Y, He W, Zhu H, Liu B, Zhang A. The Efficacy and Safety of Sacubitril/Valsartan in Heart Failure Patients: A Review. J Cardiovasc Pharmacol Ther 2022; 27:10742484211058681. [PMID: 34994233 DOI: 10.1177/10742484211058681] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, has been approved for the treatment of HF. At present, there have been few systematic and detailed reviews discussing the efficacy and safety of sacubitril/valsartan in HF. In this review, we first introduced the pharmacological mechanisms of sacubitril/valsartan, including the reduction in the degradation of natriuretic peptides in the natriuretic peptide system and inhibition of the renin-angiotensin system. Then, we summarized the efficacy of sacubitril/valsartan in HF patients with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) including the reduction in risks of mortality and hospitalization, reversal of cardiac remodeling, regulation of biomarkers of HF, improvement of the quality of life, antiarrhythmia, improving renal dysfunction and regulation of metabolism. Finally, we discussed the safety and tolerability of sacubitril/valsartan in the treatment of HFrEF or HFpEF. Compared with ACEIs/ARBs or placebo, sacubitril/valsartan showed good safety and tolerability, although the risk of hypotension might be high. In conclusion, the overwhelming majority of studies show that sacubitril/valsartan is effective and safe in the treatment of HFrEF patients but that it has little benefit in HFpEF patients. Sacubitril/valsartan will probably be a promising anti-HF drug in the near future.
Collapse
Affiliation(s)
- Rui Zhang
- Department of Cardiology, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Care Unit, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Rehabilitation Centre, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Xiaotong Sun
- Shandong Provincial Medicine and Health Key Laboratory of Clinical Anesthesia, Department of Anesthesiology, Weifang Medical University, Weifang, China
| | - Ya Li
- Department of Cardiology, Shanghai General Hospital, School of Medicine, 12474Shanghai Jiaotong University, Hongkou District, Shanghai, China
| | - Wenzheng He
- Intensive Care Unit, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Hongguang Zhu
- Dental Department, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Baoshan Liu
- Department of Cardiology, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Care Unit, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Rehabilitation Centre, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Aiyuan Zhang
- Department of Cardiology, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Care Unit, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China.,Cardiac Rehabilitation Centre, 117907Weifang People's Hospital, the First Affiliated Hospital of Weifang Medical University, Weifang, China
| |
Collapse
|
6
|
Yang L, Ye N, Bian W, Cheng H. Efficacy of medication therapy for patients with chronic kidney disease and heart failure with preserved ejection fraction: a systematic review and meta-analysis. Int Urol Nephrol 2021; 54:1435-1444. [PMID: 34669107 PMCID: PMC9085668 DOI: 10.1007/s11255-021-03025-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022]
Abstract
Background The prevalence and mortality of heart failure with preserved ejection fraction (HFpEF) are high in patients with chronic kidney disease (CKD). However, there is still a lack of recommendations for the medication therapy of these patients in the guideline so far. Methods We conducted a systematic review and meta-analysis of all the studies assessing medication therapy for patients with CKD and HFpEF by July 21, 2021. Pooled analysis was performed using a random-effect model and the quality assessment was performed. In our research, we followed to the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis was registered on PROSPERO. Results We finally identified six studies, three of which were randomized controlled trials and the others were retrospective cohort studies. The results of meta-analysis including three retrospective cohort studies showed that renin–angiotensin system inhibitors had significantly reduced all-cause mortality by 14% (3 studies, 3816 patients, HR 0.86; 95% CI 0.79–0.95; I2 = 49%; P = 0.003), and all-cause hospitalization by 11% (2 studies, 2350 patients, HR 0.89; 95% CI 0.85–0.94; I2 = 0%; P < 0.00001) in patients with CKD and HFpEF. However, there was no significant reduction in the risk of hospitalization for heart failure (3 studies, 3816 patients, HR 0.88; 95% CI 0.75–1.04; I2 = 75%; P = 0.13). One of the studies focused on the sacubitril–valsartan showed that sacubitril–valsartan was associated with a reduced risk of hospitalization for heart failure and cardiovascular death (RR 0.79, 95% CI 0.66–0.95). The study focused on the carvedilol did not show a significant reduction in the risk of hospitalization for heart failure and cardiovascular death (HR 0.917, 95% CI 0.501–1.678). Conclusions For patients with CKD and HFpEF, renin–angiotensin system inhibitors is associated with significant benefits in all-cause mortality and all-cause hospitalization but has no significant effect on hospitalization for heart failure. The subgroup analysis of one RCT study focused on ARNI showed that although long-term treatment with sacubitril–valsartan may reduce the risk of hospitalization for heart failure and cardiovascular death, more studies are needed to confirm that. Supplementary Information The online version contains supplementary material available at 10.1007/s11255-021-03025-z.
Collapse
Affiliation(s)
- Lei Yang
- Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Nan Ye
- Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Weijing Bian
- Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Hong Cheng
- Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Street, Chaoyang District, Beijing, 100029, People's Republic of China.
| |
Collapse
|
7
|
Tian C, Yang Y, Ke Y, Yang L, Zhong L, Wang Z, Huang H. Integrative Analyses of Genes Associated With Right Ventricular Cardiomyopathy Induced by Tricuspid Regurgitation. Front Genet 2021; 12:708275. [PMID: 34603374 PMCID: PMC8485137 DOI: 10.3389/fgene.2021.708275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/06/2021] [Indexed: 12/14/2022] Open
Abstract
Tricuspid regurgitation (TR) induces right ventricular cardiomyopathy, a common heart disease, and eventually leads to severe heart failure and serious clinical complications. Accumulating evidence shows that long non-coding RNAs (lncRNAs) are involved in the pathological process of a variety of cardiovascular diseases. However, the regulatory mechanisms and functional roles of RNA interactions in TR-induced right ventricular cardiomyopathy are still unclear. Accordingly, we performed integrative analyses of genes associated with right ventricular cardiomyopathy induced by TR to study the roles of lncRNAs in the pathogenesis of this disease. In this study, we used high-throughput sequencing data of tissue samples from nine clinical cases of right ventricular myocardial cardiomyopathy induced by TR and nine controls with normal right ventricular myocardium from the Genotype-Tissue Expression database. We identified differentially expressed lncRNAs and constructed a protein-protein interaction and lncRNA-messenger RNA (mRNA) co-expression network. Furthermore, we determined hub lncRNA-mRNA modules related to right ventricular myocardial disease induced by TR and constructed a competitive endogenous RNA network for TR-induced right ventricular myocardial disease by integrating the interaction of lncRNA-miRNA-mRNA. In addition, we analyzed the immune infiltration using integrated data and the correlation of each immune-related gene with key genes of the integrated expression matrix. The present study identified 648 differentially expressed mRNAs, 201 differentially expressed miRNAs, and 163 differentially expressed lncRNAs. Protein-protein interaction network analysis confirmed that ADRA1A, AVPR1B, OPN4, IL-1B, IL-1A, CXCL4, ADCY2, CXCL12, GNB4, CCL20, CXCL8, and CXCL1 were hub genes. CTD-2314B22.3, hsa-miR-653-5p, and KIF17ceRNA; SRGAP3-AS2, hsa-miR-539-5p, and SHANK1; CERS6-AS1, hsa-miR-497-5p, and OPN4; INTS6-AS1, hsa-miR-4262, and NEURL1B; TTN-AS1, hsa-miR-376b-3p, and TRPM5; and DLX6-AS1, hsa-miR-346, and BIRC7 axes were obtained by constructing the ceRNA networks. Through the immune infiltration analysis, we found that the proportion of CD4 and CD8 T cells was about 20%, and the proportion of fibroblasts and endothelial cells was high. Our findings provide some insights into the mechanisms of RNA interaction in TR-induced right ventricular cardiomyopathy and suggest that lncRNAs are a potential therapeutic target for treating right ventricular myocardial disease induced by TR.
Collapse
Affiliation(s)
- Chengnan Tian
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China.,The First Affiliated Hospital, Gannan Medical University, Ganzhou, China
| | - Yanchen Yang
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Yingjie Ke
- Nanhai Hospital of Guangdong Provincial People's Hospital, Foshan, China
| | - Liang Yang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Lishan Zhong
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Zhenzhong Wang
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Huanlei Huang
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| |
Collapse
|
8
|
Chen Y, Yang Y, Tan W, Fu L, Deng X, Xing Y. Hemodynamic effects of the human aorta arch with different inflow rate waveforms from the ascending aorta inlet: A numerical study. Biorheology 2021; 58:27-38. [PMID: 33682689 DOI: 10.3233/bir-201009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Heart failure (HF) is a common disease globally. Ventricular assist devices (VADs) are widely used to treat HF. In contrast to the natural heart, different VADs generate different blood flow waves in the aorta. OBJECTIVE To explore whether the different inflow rate waveforms from the ascending aorta generate far-reaching hemodynamic influences on the human aortic arch. METHODS An aortic geometric model was reconstructed based on computed tomography data of a patient with HF. A total of five numerical simulations were conducted, including a case with the inflow rate waveforms from the ascending aorta with normal physiological conditions, two HF, and two with typical VAD support. The hemodynamic parameters, wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT), and the strength of the helical flow, were calculated. RESULTS In contrast to the natural heart, numerical simulations showed that HF decreased WSS and induced higher OSI and RRT. Moreover, HF weakened helical flow strength. Pulsatile flow VADs that elevated the WSS, induced some helical flow, while continuous flow VADs could not. CONCLUSIONS HF leads to an adverse hemodynamic environment by decreasing WSS and reducing the helical flow strength. Based upon hemodynamic effects, pulsatile flow VADs may be more advantageous than continuous flow VADs. Thus, pulsatile flow VADs may be a better option for patients with HF.
Collapse
Affiliation(s)
- Ying Chen
- College of Engineering and Technology, Beijing Institute of Economics and Management, Beijing, China.,College of Engineering, Peking University, Beijing, China.,Shenzhen Graduate School, Peking University, Shenzhen, China
| | - Yunmei Yang
- Yanshan County People's Hospital of Hebei, Yanshan, Hebei, China
| | - Wenchang Tan
- College of Engineering, Peking University, Beijing, China.,Shenzhen Graduate School, Peking University, Shenzhen, China
| | - Liqin Fu
- College of Engineering and Technology, Beijing Institute of Economics and Management, Beijing, China
| | - Xiaoyan Deng
- Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China.,School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, Sichuan, China
| | - Yubin Xing
- Department of Infection Management and Disease Control, The General Hospital of People's Liberation Army, Beijing, China
| |
Collapse
|
9
|
Yoshinaga K. Ventricular phase analysis moves on to the next phase: What technologists should keep in mind. J Nucl Cardiol 2021; 28:1172-1174. [PMID: 32557150 DOI: 10.1007/s12350-020-02216-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
| |
Collapse
|
10
|
Pedraza LL, de Moraes JRW, Rabelo-Silva ER. Development and testing of a text messaging (SMS) monitoring software application for acute decompensated heart failure patients. Rev Lat Am Enfermagem 2020; 28:e3301. [PMID: 32901765 PMCID: PMC7478878 DOI: 10.1590/1518-8345.3519.3301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 03/14/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE to develop and test an SMS monitoring software application for patients with acute decompensated heart failure. METHOD the waterfall model was used for software development. All expected functionalities were defined, program modules were codified and tests were done so as to ensure good performance by the software application. Ten patients participated in the prototype test. RESULTS the system sends two types of messages: questions that should be answered by patients and unilateral educational reinforcements. In addition, the system generates alarms in case of no response or according to a flow chart to detect congestion in the patient previously created by the team. Of the 264 SMS texts sent, 247 were answered. The alarm was triggered seven times: three patients woke up with shortness of breath for two consecutive nights, and four patients felt more fatigued for two consecutive days. All patients took the prescribed medications during follow-up. The study nurse guided the patients who generated alarms in the system. CONCLUSION the SMS software application was successfully developed and a high response rate and preliminary evidence of improvements in self-management of HF were observed. With this regard, telehealth is a promising alternative in the treatment of chronic diseases.
Collapse
Affiliation(s)
| | | | - Eneida Rejane Rabelo-Silva
- Hospital de Clínicas de Porto Alegre, Serviço de Cardiologia, Grupo
de Insuficiência Cardíaca e Transplante Cardíaco, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem,
Departamento de Enfermagem Médico-Cirúrgica, Porto Alegre, RS, Brazil
| |
Collapse
|
11
|
Wang Z, Qin H, Chen G, Mok VCT, Dai Y, Cai Y, Cheng X, Qian Y, Chu M, Lu X. Association between advanced interatrial block and small vessel diseases in the brain. Quant Imaging Med Surg 2020; 10:585-591. [PMID: 32269919 DOI: 10.21037/qims.2020.02.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background The latest evidence shows the association of atrial cardiopathy with embolic strokes of undetermined source. Advanced interatrial block (aIAB) is an electrophysiological mark of atrial cardiopathy. This study investigated the relationship between aIAB and the burden of silent cerebral small vessel diseases (SVD) on magnetic resonance imaging in the absence of atrial fibrillation (AF) and atrial flutter. Methods This cross-sectional study included 499 patients with normal left ventricular ejection fraction (LVEF), who were free of AF, atrial flutter, stroke, and acute coronary syndrome in our hospital. aIAB was ascertained by digital electrocardiograms. Left atrial diameter, LVEF, and left ventricular posterior wall thickness (LVPWT) were measured on echocardiograms. Based on the presence of 4 manifestations of SVD, including white matter hyperintensity (WMH), lacunes, microbleeds, and enlarged perivascular spaces (EPVS) on magnetic resonance imaging, an ordinal SVD score (range, 0-4) was devised to reflect the total burden of cerebral SVD. The ordinal regression model was used to explore the association of aIAB with SVD burden after adjusting for confounding factors. Results The mean age was 67.7 years, and 327 (65.5%) were male. A total of 23 (4.6%) patients had aIAB. The number of patients with cerebral SVD scores of 0, 1, 2, 3, and 4 was 92 (18.4%), 122 (24.4%), 190 (38.1%), 83 (16.6%), and 12 (2.4%), respectively. After adjusting for age, sex, hypertension, diabetes, hyperlipidemia, left atrial diameter, LVEF, and LVPWT, the regression model showed a significant association of aIAB with cerebral SVD score (OR =2.408, 95% CI, 1.082-5.366). Conclusions Atrial cardiopathy indexed by aIAB was independently associated with a high burden of SVD in the brain.
Collapse
Affiliation(s)
- Zhaolu Wang
- Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Huiyuan Qin
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Guilin Chen
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Yan Dai
- The First School of Clinical Medicine, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yingyuan Cai
- Division of Neurology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xi Cheng
- Division of Neurology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yun Qian
- Division of Neurology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ming Chu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.,Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China
| | - Xiaowei Lu
- Division of Neurology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| |
Collapse
|
12
|
Chen Y, Tan W. A novel inflatable left ventricular partitioning device. Med Hypotheses 2020; 138:109571. [PMID: 32028194 DOI: 10.1016/j.mehy.2020.109571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/09/2019] [Accepted: 01/12/2020] [Indexed: 11/30/2022]
Abstract
Percutaneous ventricular restoration (PVR) is an established treatment for patients with combined ischemic coronary artery disease and hear failure (HF). The left ventricle (LV) partitioning device is an interventional medical device that can be implanted into the ventricles of patients to reduce LV volumes, resulting in improved LV remodeling. However, the isolation surface area of the device is invariant, while the LV size of each patient is different. Thus, we designed a novel inflatable LV partitioning device. The functional volume of our ventricular isolation device can be adjusted by inflating and exhausting the device via the stomata based on a patient's ventricle size. The novel design could potentially reduce ventricular functional volume and improve the LV hemodynamic environment, thus resulting in favorable outcomes with reassuring safety and efficacy.
Collapse
Affiliation(s)
- Ying Chen
- Shenzhen Graduate School, Peking University, Shenzhen, China; College of Engineering, Peking University, Beijing, China.
| | - Wenchang Tan
- Shenzhen Graduate School, Peking University, Shenzhen, China; College of Engineering, Peking University, Beijing, China.
| |
Collapse
|
13
|
Potential Beneficial Effects of Vitamin D in Coronary Artery Disease. Nutrients 2019; 12:nu12010099. [PMID: 31905893 PMCID: PMC7019525 DOI: 10.3390/nu12010099] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022] Open
Abstract
Vitamin D plays a pivotal role in bone homeostasis and calcium metabolism. However, recent research has indicated additional beneficial effects of vitamin D on the cardiovascular system. This review aims to elucidate if vitamin D can be used as an add-on treatment in coronary artery disease (CAD). Large-scale epidemiological studies have found a significant inverse association between serum 25(OH)-vitamin D levels and the prevalence of essential hypertension. Likewise, epidemiological data have suggested plasma levels of vitamin D to be inversely correlated to cardiac injury after acute myocardial infarction (MI). Remarkably, in vitro trials have showed that vitamin D can actively suppress the intracellular NF-κB pathway to decrease CAD progression. This is suggested as a mechanistic link to explain how vitamin D may decrease vascular inflammation and atherosclerosis. A review of randomized controlled trials with vitamin D supplementation showed ambiguous results. This may partly be explained by heterogeneous study groups. It is suggested that subgroups of diabetic patients may benefit more from vitamin D supplementation. Moreover, some studies have indicated that calcitriol rather than cholecalciferol exerts more potent beneficial effects on atherosclerosis and CAD. Therefore, further studies are required to clarify these assumptions.
Collapse
|
14
|
Gourronc Y, Grall S, Ingremeau D, Desprets L, Prunier F, Furber A, Bière L. De novo atrial fibrillation as an independent prognostic marker after ST-segment elevation myocardial infarction: Results from the RIMA registry. J Cardiol 2019; 74:123-129. [DOI: 10.1016/j.jjcc.2019.02.004] [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] [Received: 11/21/2018] [Revised: 01/24/2019] [Accepted: 02/13/2019] [Indexed: 11/29/2022]
|
15
|
Sakai T, Miura S. Effects of Sodium-Glucose Cotransporter 2 Inhibitor on Vascular Endothelial and Diastolic Function in Heart Failure With Preserved Ejection Fraction - Novel Prospective Cohort Study. Circ Rep 2019; 1:286-295. [PMID: 33693152 PMCID: PMC7892484 DOI: 10.1253/circrep.cr-19-0018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Pathogenesis of heart failure with preserved ejection fraction (HFpEF) may involve endothelial dysfunction and abnormal vascular structure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have beneficial cardiovascular effects and may improve vascular function in patients with HFpEF. Methods and Results: We recruited 184 patients with type 2 diabetes and HFpEF (mean age, 66.0±14.4 years) who were scheduled for treatment with SGLT2 inhibitors, had transthoracic echocardiogram to identify diastolic function, and flow-mediated dilation (FMD) to evaluate endothelial function, and assessed cardio-ankle vascular index (CAVI) and carotid intima-media thickness as indices of vascular function and vascular structure, respectively. Body weight, systolic blood pressure, diastolic blood pressure, triglycerides, remnant lipoprotein cholesterol, fasting plasma glucose, hemoglobin A1c, urinary albumin/creatinine ratio, and insulin resistance (IR) decreased, hematocrit and FMD increased significantly, and CAVI decreased significantly, after 12-week treatment (P<0.05). Short-term SGLT2 inhibitors improved diastolic function, significantly reducing the mitral ratios of septal E/early septal annular tissue Doppler velocity (P=0.003) and lateral E/early lateral e' (P=0.044). On multiple regression statistically significant associations were seen between ∆mean E/e' and ∆FMD, ∆CAVI, and ∆IR. Conclusions: SGLT2 inhibitors can improve diastolic function in patients with type 2 diabetes, suggesting that current treatment policies for diabetes should be re-examined. Further prospective studies with larger sample sizes could provide mechanistic insights into the benefits of SGLT2 inhibitors.
Collapse
Affiliation(s)
- Takaaki Sakai
- Department of Cardiology, Ichijyukai NISHIO Hospital Fukuoka Japan.,Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan
| | - Shinichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan
| |
Collapse
|
16
|
Hu CS, Wu QH, Hu DY, Tkebuchava T. Treatment of chronic heart failure in the 21st century: A new era of biomedical engineering has come. Chronic Dis Transl Med 2019; 5:75-88. [PMID: 31367696 PMCID: PMC6656907 DOI: 10.1016/j.cdtm.2018.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Indexed: 12/11/2022] Open
Abstract
Chronic heart failure (CHF) is a challenging burden on public health. Therapeutic strategies for CHF have developed rapidly in the past decades from conventional medical therapy, which mainly includes administration of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, to biomedical engineering methods, which include interventional engineering, such as percutaneous balloon mitral valvotomy, percutaneous coronary intervention, catheter ablation, biventricular pacing or cardiac resynchronization therapy (CRT) and CRT-defibrillator use, and implantable cardioverter defibrillator use; mechanical engineering, such as left ventricular assistant device use, internal artery balloon counterpulsation, cardiac support device use, and total artificial heart implantation; surgical engineering, such as coronary artery bypass graft, valve replacement or repair of rheumatic or congenital heart diseases, and heart transplantation (HT); regenerate engineering, which includes gene therapy, stem cell transplantation, and tissue engineering; and rehabilitating engineering, which includes exercise training, low-salt diet, nursing, psychological interventions, health education, and external counterpulsation/enhanced external counterpulsation in the outpatient department. These biomedical engineering therapies have greatly improved the symptoms of CHF and life expectancy. To date, pharmacotherapy, which is based on evidence-based medicine, large-scale, multi-center, randomized controlled clinical trials, is still a major treatment option for CHF; the current interventional and mechanical device engineering treatment for advanced CHF is not enough owing to its individual status. In place of HT or the use of a total artificial heart, stem cell technology and gene therapy in regenerate engineering for CHF are very promising. However, each therapy has its advantages and disadvantages, and it is currently possible to select better therapeutic strategies for patients with CHF according to cost-efficacy analyses of these therapies. Taken together, we think that a new era of biomedical engineering for CHF has begun.
Collapse
Affiliation(s)
- Chun-Song Hu
- Jiangxi Academy of Medical Science, Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi 330006, China
- Institute of Cardiovascular Diseases, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Qing-Hua Wu
- Institute of Cardiovascular Diseases, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Da-Yi Hu
- Department of Cardiology, People's Hospital of Peking University, Beijing 100044, China
- Department of Cardiology, Tongji University School of Medicine, Shanghai 200032, China
| | | |
Collapse
|
17
|
Jiang Y, Hu S, Cao M, Li X, Zhou J, Ding B, Zhang F, Chen T, Zhou Y. Evaluation of acute myocardial infarction patients with mid-range ejection fraction after emergency percutaneous coronary intervention. Postgrad Med J 2019; 95:355-360. [PMID: 31129629 DOI: 10.1136/postgradmedj-2018-136334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/26/2019] [Accepted: 04/08/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is currently no classification for acute myocardial infarction (AMI) according to left ventricular ejection fraction (LVEF). We aimed to perform a retrospective analysis of patients undergoing emergency percutaneous coronary intervention (PCI), comparing the clinical characteristics, in-hospital acute heart failure and all-cause death events of AMI patients with mid-range ejection fraction (mrEF), preserved ejection fraction (pEF) and reduced ejection fraction (rEF). MATERIAL AND METHODS Totally 1270 patients were stratified according to their LVEF immediately after emergency PCI into pEF group (LVEF 50% or higher), mrEF group (LVEF 40%-49%) and rEF group (LVEF <40%). Kaplan-Meier curves and log rank tests were used to assess the effects of mrEF, rEF and pEF on the occurrence of acute heart failure and all-cause death during hospitalisation. The Cox proportional hazards model was used for multivariate correction. RESULTS Compared with mrEF, rEF was an independent risk factor for acute heart failure events during hospitalisation (HR 5.01, 95% CI 3.53 to 7.11, p<0.001), and it was also an independent risk factor for all-cause mortality during hospitalisation (HR 7.05, 95% CI 4.12 to 12.1, p<0.001); Compared with mrEF, pEF was an independent protective factor for acute heart failure during hospitalisation (HR 0.49, 95% CI 0.30 to 0.82, p=0.01), and it was also an independent protective factor for all-cause death during hospitalisation (HR 0.33, 95% CI 0.11 to 0.96, p=0.04). CONCLUSIONS mrEF patients with AMI undergoing emergency PCI share many similarities with pEF patients in terms of clinical features, but the prognosis is significantly worse than that of pEF patients, suggesting that we need to pay attention to the management of mrEF patients with AMI.
Collapse
Affiliation(s)
- Yufeng Jiang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Shengda Hu
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Mingqiang Cao
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiaobo Li
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jing Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Bing Ding
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fangfang Zhang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Tan Chen
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yafeng Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| |
Collapse
|
18
|
Kresoja KP, Schmidt G, Kherad B, Krackhardt F, Spillmann F, Tschöpe C. Akute und chronische Herzinsuffizienz. Herz 2017; 42:699-712. [DOI: 10.1007/s00059-017-4613-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|