1
|
Hu L, Fu M, Wushouer H, Ling K, Shi L, Guan X. Association between β-lactam allergy documentation and outpatient antibiotic prescribing in primary healthcare facilities in China. J Hosp Infect 2023; 142:140-141. [PMID: 37660890 DOI: 10.1016/j.jhin.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Affiliation(s)
- L Hu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - M Fu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - H Wushouer
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - K Ling
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - L Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - X Guan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration, Peking University, Beijing, China.
| |
Collapse
|
2
|
Zhang Y, Fu M, Wang H, Sun H. Advances in the Construction and Application of Thyroid Organoids. Physiol Res 2023; 72:557-564. [PMID: 38015755 PMCID: PMC10751051 DOI: 10.33549/physiolres.935102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/06/2023] [Indexed: 01/05/2024] Open
Abstract
Organoids are complex multicellular structures that stem cells self-organize in three-dimensional (3D) cultures into anatomical structures and functional units similar to those seen in the organs from which they originate. This review describes the construction of thyroid organoids and the research progress that has occurred in models of thyroid-related disease. As a novel tool for modeling in a 3D multicellular environment, organoids help provide some useful references for the study of the pathogenesis of thyroid disease.
Collapse
Affiliation(s)
- Y Zhang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | | | | | | |
Collapse
|
3
|
Liu JD, Ye BT, Fu M, Zhang Q, Chen H, Sun J, Cai TY, Wang ZM, He HY, Zhao JJ, Li HJ, Wang XF, Sun YH. [Clinicopathological and molecular diagnostic features of early-onset gastric cancer: a study based on data from a single-center dedicated gastric cancer database]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:963-967. [PMID: 37849267 DOI: 10.3760/cma.j.cn441530-20230603-00190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Objective: To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies. Methods: In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups. Results: The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ2=5.442,P<0.001). HER-2 and Epstein-Barr virus positivity rates did not differ significantly between the two groups. Conclusion: Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.
Collapse
Affiliation(s)
- J D Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - B T Ye
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - M Fu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Q Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H Chen
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - T Y Cai
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Z M Wang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H Y He
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J J Zhao
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H J Li
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - X F Wang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y H Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
4
|
Dong HJ, Wang R, Wang X, Liu J, Pu BZX, Li J, Mo YJ, Fu M, Li G, Luo JF. [Simultaneous transcatheter aortic valve replacement and mitral balloon dilatation in patients with severe aortic stenosis and mitral stenosis: two case reports]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1082-1086. [PMID: 37859362 DOI: 10.3760/cma.j.cn112148-20230808-00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- H J Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - R Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - X Wang
- Department of Cardiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
| | - J Liu
- Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - B Z X Pu
- Nyingchi People's Hospital, Nyingchi 850400, China
| | - J Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Y J Mo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - M Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - G Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - J F Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| |
Collapse
|
5
|
Sun YH, Li J, Luo SY, Zheng SN, Chen JH, Fu M, Li G, Fan RX, Luo JF. [Short-term outcome of patients after transcatheter aortic valve replacement receiving different anticoagulants]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:838-843. [PMID: 37583332 DOI: 10.3760/cma.j.cn112148-20230629-00382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Objective: To compare the safety and efficacy of different anticoagulants in patients with indications for anticoagulation after transcatheter aortic valve replacement (TAVR). Methods: This is a retrospective study. Patients who underwent TAVR from April 2016 to February 2022 in Guangdong Provincial People's Hospital and had indications for anticoagulation were included and divided into two groups according to the type of anticoagulants, i.e. non-vitamin K antagonist oral anticoagulant (NOAC) and warfarin, and patients were followed up for 30 days. The primary endpoint was the combination of death, stroke, myocardial infarction, valve thrombosis, intracardiac thrombosis and major bleeding. The incidence of endpoints was compared between two groups, and multivariate logistic regression analysis was applied to adjust the bias of potential confounders. Results: A total of 80 patients were included. Mean age was (74.4±7.1) years, 43 (53.8%) were male. Forty-nine (61.3%) patients used NOAC, 31 used warfarin, and major indication for anticoagulants was atrial fibrillation (76/80, 95.0%). The adjusted risks of the primary endpoint (OR=0.23, 95%CI 0.06-0.94, P=0.040) of NOAC were lower than that of warfarin, mainly driven by a lower risk of major bleeding (OR=0.19, 95%CI 0.04-0.92, P=0.039). Conclusions: The short-term outcome of NOAC is better than that of warfarin in patients with indications for anticoagulation after TAVR. Randomized controlled trials of large sample size with long-term follow-up are needed to further testify this finding.
Collapse
Affiliation(s)
- Y H Sun
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S Y Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S N Zheng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J H Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - M Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - G Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - R X Fan
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J F Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| |
Collapse
|
6
|
Fu M, Ji X, Zhong L, Wu Q, Li H, Wang N. [Expression changes of Na V channel subunits correlate with developmental maturation of electrophysiological characteristics of rat cerebellar Purkinje neurons]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:1102-1109. [PMID: 37488792 PMCID: PMC10366519 DOI: 10.12122/j.issn.1673-4254.2023.07.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To investigate the variations in the expression of voltage-gated sodium (Nav) channel subunits during development of rat cerebellar Purkinje neurons and their correlation with maturation of electrophysiological characteristics of the neurons. METHODS We observed the changes in the expression levels of NaV1.1, 1.2, 1.3 and 1.6 during the development of Purkinje neurons using immunohistochemistry in neonatal (5-7 days after birth), juvenile (12-14 days), adolescent (21-24 days), and adult (42-60 days) SD rats. Using whole-cell patch-clamp technique, we recorded the spontaneous electrical activity of the neurons in ex vivo brain slices of rats of different ages to analyze the changes of electrophysiological characteristics of these neurons during development. RESULTS The expression of NaV subunits in rat cerebellar Purkinje neurons showed significant variations during development. NaV1.1 subunit was highly expressed throughout the developmental stages and increased progressively with age (P < 0.05). NaV1.2 expression was not detected in the neurons in any of the developmental stages (P > 0.05). The expression level of NaV1.3 decreased with development and became undetectable after adolescence (P < 0.05). NaV1.6 expression was not detected during infancy, but increased with further development (P < 0.05). NaV1.1 and NaV1.3 were mainly expressed in the early stages of development. With the maturation of the rats, NaV1.3 expression disappeared and NaV1.6 expression increased in the neurons. NaV1.1 and NaV1.6 were mainly expressed after adolescence. The total NaV protein level increased gradually with development (P < 0.05) and tended to stabilize after adolescence. The spontaneous frequency and excitability of the Purkinje neurons increased gradually with development and reached the mature levels in adolescence. The developmental expression of NaV subunits was positively correlated with discharge frequency (r=0.9942, P < 0.05) and negatively correlated with the excitatory threshold of the neurons (r=0.9891, P < 0.05). CONCLUSION The changes in the expression levels of NaV subunits are correlated with the maturation of high frequency electrophysiological properties of the neurons, suggesting thatmature NaV subunit expressions is the basis of maturation of electrophysiological characteristics of the neurons.
Collapse
Affiliation(s)
- M Fu
- Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - X Ji
- Department of Quality Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Zhong
- Disease Control Department, 74th Army Group Hospital of PLA, Guangzhou 510300, China
| | - Q Wu
- Department of Basic Medicine, Guangdong Jiangmen Chinese Medicine College, Jiangmen 529000, China
| | - H Li
- Department of Mathematical Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - N Wang
- Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
7
|
Fu M, Yang L, Wang H, Chen Y, Chen X, Hu Q, Sun H. Research progress into adipose tissue macrophages and insulin resistance. Physiol Res 2023; 72:287-299. [PMID: 37449743 PMCID: PMC10668993 DOI: 10.33549/physiolres.935046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/07/2023] [Indexed: 08/26/2023] Open
Abstract
In recent years, there has been an increasing incidence of metabolic syndrome, type 2 diabetes, and cardiovascular events related to insulin resistance. As one of the target organs for insulin, adipose tissue is essential for maintaining in vivo immune homeostasis and metabolic regulation. Currently, the specific adipose tissue mechanisms involved in insulin resistance remain incompletely understood. There is increasing evidence that the process of insulin resistance is mostly accompanied by a dramatic increase in the number and phenotypic changes of adipose tissue macrophages (ATMs). In this review, we discuss the origins and functions of ATMs, some regulatory factors of ATM phenotypes, and the mechanisms through which ATMs mediate insulin resistance. We explore how ATM phenotypes contribute to insulin resistance in adipose tissue. We expect that modulation of ATM phenotypes will provide a novel strategy for the treatment of diseases associated with insulin resistance.
Collapse
Affiliation(s)
- M Fu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | | | | | | | | | | | | |
Collapse
|
8
|
Yuan W, Huang W, Ren L, Liang HY, Du XY, Fu M, Xu C, Fang Y, Shen KT, Hou YY. [Clinicopathological features and prognostic factors of gastric intermediate-risk gastrointestinal stromal tumor after surgical resection: a retrospective study]. Zhonghua Bing Li Xue Za Zhi 2023; 52:384-389. [PMID: 36973200 DOI: 10.3760/cma.j.cn112151-20220623-00548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Objective: To investigate the clinicopathological features, treatment and prognosis of gastric intermediate-risk gastrointestinal stromal tumor (GIST), so as to provide a reference for clinical management and further research. Methods: A retrospective observational study of patients with gastric intermediate-risk GIST, who underwent surgical resection between January 1996 and December 2019 at Zhongshan Hospital of Fudan University, was carried out. Results: Totally, 360 patients with a median age of 59 years were included. There were 190 males and 170 females with median tumor diameter of 5.9 cm. Routine genetic testing was performed in 247 cases (68.6%, 247/360), and 198 cases (80.2%) showed KIT mutation, 26 cases (10.5%) showed PDGFRA mutation, and 23 cases were wild-type GIST. According to "Zhongshan Method"(including 12 parameters), there were 121 malignant and 239 non-malignant cases. Complete follow-up data were available in 241 patients; 55 patients (22.8%) received imatinib therapy, 10 patients (4.1%) experienced tumor progression, and one patient (PDGFRA mutation, 0.4%) died. Disease-free survival (DFS) and overall survival rate at 5 years was 96.0% and 99.6%, respectively. Among the intermediate-risk GIST, there was no difference in DFS between the overall population, KIT mutation, PDGFRA mutation, wild-type, non-malignant and malignant subgroups (all P>0.05). However, the non-malignancy/malignancy analysis showed that there were significant differences in DFS among the overall population (P<0.01), imatinib treatment group (P=0.044) and no imatinib treatment group (P<0.01). Adjuvant imatinib resulted in potential survival benefit for KIT mutated malignant and intermediate-risk GIST in DFS (P=0.241). Conclusions: Gastric intermediate-risk GIST shows a heterogeneous biologic behavior spectrum from benign to highly malignant. It can be further classified into benign and malignant, mainly nonmalignant and low-grade malignant. The overall disease progression rate after surgical resection is low, and real-world data show that there is no significant benefit from imatinib treatment after surgery. However, adjuvant imatinib potentially improves DFS of intermediate-risk patients with tumors harboring KIT mutation in the malignant group. Therefore, a comprehensive analysis of gene mutations in benign/malignant GIST will facilitate improvements in therapeutic decision-making.
Collapse
Affiliation(s)
- W Yuan
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W Huang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - L Ren
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H Y Liang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - X Y Du
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - M Fu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - C Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Fang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - K T Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Y Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
9
|
Fu M, Tabakaev D, Thew RT, Wesolowski TA. Fine-Tuning of Entangled Two-Photon Absorption by Controlling the One-Photon Absorption Properties of the Chromophore. J Phys Chem Lett 2023; 14:2613-2619. [PMID: 36888738 DOI: 10.1021/acs.jpclett.3c00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The detailed analysis of the sum-over-state formula for the entanglement-induced two-photon absorption (ETPA) transition moment shows that the magnitude of the ETPA cross-section is expected to vary significantly depending on the coherence time Te and the relative position of just two electronic states. Moreover, the dependency on Te is periodic. These predictions are confirmed by molecular quantum mechanical calculations for several chromophores.
Collapse
Affiliation(s)
- M Fu
- Department of Physical Chemistry, University of Geneva, CH-1211 Geneva, Switzerland
| | - D Tabakaev
- Department of Applied Physics, University of Geneva, CH-1211 Geneva, Switzerland
| | - R T Thew
- Department of Applied Physics, University of Geneva, CH-1211 Geneva, Switzerland
| | - T A Wesolowski
- Department of Physical Chemistry, University of Geneva, CH-1211 Geneva, Switzerland
| |
Collapse
|
10
|
Shu S, Fu M, Chen X, Song J. Different cellular landscape of four types of non-diseased cardiac valves contributes to their differences in susceptibility of pathological remodeling and disease. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): National Natural Science Foundation of China
Background
Exploring the mechanisms of valvular heart disease (VHD) at the cellular level may be useful to identify new therapeutic targets; however, the comprehensive cellular landscape of non-diseased human cardiac valve leaflets remains unclear.
Methods
The cellular landscapes of non-diseased human cardiac valve leaflets (five aortic valves, five pulmonary valves, five tricuspid valves, and three mitral valves) from end-stage heart failure patients undergoing heart transplantation were explored using single-cell RNA sequencing (scRNA-seq). Bioinformatics was used to identify the cell types, describe the cell functions, and investigate cellular developmental trajectories and interactions. Differences among the four types of cardiac valve at the cellular level were summarized. Pathological staining was performed to validate the key findings of scRNA-seq. An integrative analysis of our single-cell data and published genome-wide association study-based and bulk RNA sequencing-based data provided insights into the cell-specific contributions to calcific aortic valve diseases.
Results
Six cell types were identified among 128,412 cells from non-diseased human cardiac valve leaflets. Valvular interstitial cells were the largest population, followed by myeloid cells, lymphocytes, valvular endothelial cells, mast cells, and myofibroblasts. The four types of cardiac valve had distinct cellular compositions. The intercellular communication analysis revealed that valvular interstitial cells were at the center of the communication network. The integrative analysis of our scRNA-seq data revealed key cellular subpopulations involved in the pathogenesis of calcific aortic valve diseases.
Conclusions
The cellular landscape differed among the four types of non-diseased cardiac valve, which might explain their differences in susceptibility to pathological remodeling and VHD.
Collapse
Affiliation(s)
- S Shu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular D , Beijing , China
| | - M Fu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular D , Beijing , China
| | - X Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular D , Beijing , China
| | - J Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular D , Beijing , China
| |
Collapse
|
11
|
Li Y, Han H, Fu M, Zhou X, Ye J, Xu F, Zhang W, Liao Y, Yang X. Genome-wide identification and expression analysis of NAC family genes in Ginkgo biloba L. Plant Biol (Stuttg) 2023; 25:107-118. [PMID: 36377299 DOI: 10.1111/plb.13486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
NAC (NAM, ATAF, CUC2) transcription factors constitute one of the largest families of plant-specific transcription factors with important roles in plant growth and development and in biotic and abiotic stresses. The physicochemical properties, gene structure, cis-acting elements and expression patterns of NAC transcription factors in Ginkgo biloba were analysed using bioinformatics, and expression of this gene family was analysed via quantitative reverse transcription PCR. The family of G. biloba NAC transcription factors had 50 members, distributed on 12 chromosomes and divided into 11 groups. Members in the same group share a similar gene structure and motif distribution. Transcriptome data analysis of G. biloba showed that 35 genes were expressed in eight tissues. Correlation analysis suggested that GbNAC007 and GNAC008 might be involved in flavonoid biosynthesis. Expression levels of 12 GbNACs under cold, het, and salt stresses were analysed. Results indicate that NAC transcription factors play an important role in response to abiotic stresses. This study provides a reference for the functional analysis of the G. biloba family of NAC transcription factors, as well as a resource for studies on the involvement of this family in responses to abiotic stresses and flavonoid biosynthesis.
Collapse
Affiliation(s)
- Y Li
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - H Han
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - M Fu
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - X Zhou
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - J Ye
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - F Xu
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - W Zhang
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - Y Liao
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| | - X Yang
- College of Horticulture and Gardening, Yangtze University, Jingzhou, Hubei, China
| |
Collapse
|
12
|
Ljungman C, Bollano E, Rawshani A, Nordberg Backelin C, Dahlberg P, Valeljung I, Björkenstam M, Hjalmarsson C, Fu M, Mellberg T, Bartfay SE, Polte CL, Andersson B, Bergh N. Differences in phenotypes, symptoms, and survival in patients with cardiomyopathy-a prospective observational study from the Sahlgrenska CardioMyoPathy Centre. Front Cardiovasc Med 2023; 10:1160089. [PMID: 37139129 PMCID: PMC10150027 DOI: 10.3389/fcvm.2023.1160089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Cardiomyopathy is the fourth most common cause of heart failure. The spectrum of cardiomyopathies may be impacted by changes in environmental factors and the prognosis may be influenced by modern treatment. The aim of this study is to create a prospective clinical cohort, the Sahlgrenska CardioMyoPathy Centre (SCMPC) study, and compare patients with cardiomyopathies in terms of phenotype, symptoms, and survival. Methods The SCMPC study was founded in 2018 by including patients with all types of suspected cardiomyopathies. This study included data on patient characteristics, background, family history, symptoms, diagnostic examinations, and treatment including heart transplantation and mechanical circulatory support (MCS). Patients were categorized by the type of cardiomyopathy on the basis of the diagnostic criteria laid down by the European Society of Cardiology (ESC) working group on myocardial and pericardial diseases. The primary outcomes were death, heart transplantation, or MCS, analyzed by Kaplan-Meier and Cox proportional regression, adjusted for age, gender, LVEF and QRS width on ECG in milliseconds. Results In all, 461 patients and 73.1% men with a mean age of 53.6 ± 16 years were included in the study. The most common diagnosis was dilated cardiomyopathy (DCM), followed by cardiac sarcoidosis and myocarditis. Dyspnea was the most common initial symptom in patients with DCM and amyloidosis, while patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) presented with ventricular arrythmias. Patients with ARVC, left-ventricular non-compaction cardiomyopathy (LVNC), hypertrophic cardiomyopathy (HCM), and DCM had the longest time from the debut of symptoms until inclusion in the study. Overall, 86% of the patients survived without heart transplantation or MCS after 2.5 years. The primary outcome differed among the cardiomyopathies, where the worst prognosis was reported for ARVC, LVNC, and cardiac amyloidosis. In a Cox regression analysis, it was found that ARVC and LVNC were independently associated with an increased risk of death, heart transplantation, or MCS compared with DCM. Further, female gender, a lower LVEF, and a wider QRS width were associated with an increased risk of the primary outcome. Conclusions The SCMPC database offers a unique opportunity to explore the spectrum of cardiomyopathies over time. There is a large difference in characteristics and symptoms at debut and a remarkable difference in outcome, where the worst prognosis was reported for ARVC, LVNC, and cardiac amyloidosis.
Collapse
Affiliation(s)
- C. Ljungman
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Correspondence: Charlotta Ljungman
| | - E. Bollano
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A. Rawshani
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C. Nordberg Backelin
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P. Dahlberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - I. Valeljung
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M. Björkenstam
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C. Hjalmarsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M. Fu
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - T. Mellberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S.-E. Bartfay
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C. L. Polte
- Department of Clinical Physiology, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - B. Andersson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - N. Bergh
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
13
|
Ding YD, Zhang Y, He LQ, Fu M, Zhao X, Huang LK, Wang B, Chen YZ, Wang ZH, Ma ZQ, Zeng Y. [A deep-learning model for the assessment of coronary heart disease and related risk factors via the evaluation of retinal fundus photographs]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1201-1206. [PMID: 36517441 DOI: 10.3760/cma.j.cn112148-20221010-00783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective: To develop and validate a deep learning model based on fundus photos for the identification of coronary heart disease (CHD) and associated risk factors. Methods: Subjects aged>18 years with complete clinical examination data from 149 hospitals and medical examination centers in China were included in this retrospective study. Two radiologists, who were not aware of the study design, independently evaluated the coronary angiography images of each subject to make CHD diagnosis. A deep learning model using convolutional neural networks (CNN) was used to label the fundus images according to the presence or absence of CHD, and the model was proportionally divided into training and test sets for model training. The prediction performance of the model was evaluated in the test set using monocular and binocular fundus images respectively. Prediction efficacy of the algorithm for cardiovascular risk factors (e.g., age, systolic blood pressure, gender) and coronary events were evaluated by regression analysis using the area under the receiver operating characteristic curve (AUC) and R2 correlation coefficient. Results: The study retrospectively collected 51 765 fundus images from 25 222 subjects, including 10 255 patients with CHD, and there were 14 419 male subjects in this cohort. Of these, 46 603 fundus images from 22 701 subjects were included in the training set and 5 162 fundus images from 2 521 subjects were included in the test set. In the test set, the deep learning model could accurately predict patients' age with an R2 value of 0.931 (95%CI 0.929-0.933) for monocular photos and 0.938 (95%CI 0.936-0.940) for binocular photos. The AUC values for sex identification from single eye and binocular retinal fundus images were 0.983 (95%CI 0.982-0.984) and 0.988 (95%CI 0.987-0.989), respectively. The AUC value of the model was 0.876 (95%CI 0.874-0.877) with either monocular fundus photographs and AUC value was 0.885 (95%CI 0.884-0.888) with binocular fundus photographs to predict CHD, the sensitivity of the model was 0.894 and specificity was 0.755 with accuracy of 0.714 using binocular fundus photographs for the prediction of CHD. Conclusion: The deep learning model based on fundus photographs performs well in identifying coronary heart disease and assessing related risk factors such as age and sex.
Collapse
Affiliation(s)
- Y D Ding
- Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y Zhang
- Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - L Q He
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - M Fu
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - X Zhao
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - L K Huang
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - B Wang
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - Y Z Chen
- Beijing Airdoc Technology Co., Ltd, Beijing 100029, China
| | - Z H Wang
- iKang Guobin Healthcare Group Co., Ltd, Beijing 100000, China
| | - Z Q Ma
- iKang Guobin Healthcare Group Co., Ltd, Beijing 100000, China
| | - Y Zeng
- Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| |
Collapse
|
14
|
Basic C, Hansson PO, Zverkova Sandstrom T, Johansson B, Fu M, Mandalenakis Z. Sex-related differences in long-term outcome of heart failure in low-risk patients with atrial fibrillation. A Swedish registry case-control study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Knowledge about sex-related differences regarding long-term risk of heart failure (HF) among patients with atrial fibrillation (AF) is limited.
Aim
To evaluate the impact of sex on risks for new onset HF in patients with AF.
Methods
All patients from the Swedish National Patient Register, with a first-time diagnosis of AF between 1987 and 2018 were identified and compared with two matched controls without AF from the Total Population Register. Patients <18 years, or any previous cardiovascular disease, diabetes mellitus and renal failure at the baseline were excluded.
Results
In total 227,811 patients and 452,712 controls were included; 44.5% were women. The mean age (SD) for men was 65.5 (15) vs. 72.7 (13) in women (p<0.0001). The incidence rate for HF onset per 1000 person-years within one and five years after AF diagnosis was 77.3 (75.5–79.1) and 45.0 (44.3–45.7) in women vs. 66.5 (65.0–68.0) and 35.3 (34.8–35.9) in men, respectively. The incidence rate for HF onset increased with age in both patients with AF and controls, but was generally more pronounced in women. Women had 26% and 34% higher risk for HF onset, within five and thirty years, respectively. The highest risk for HF onset was found in women 18–34 years and 35–49 years of age, HR 24.64 (95%, confidence interval (CI) 7.59–80.0) and 8.09 (95%, CI 6.34–10.33) vs. 9.86 (95%, CI 6.81–14.27) and 6.52 (95%, CI 5.87–7.25) in equally old men. The mortality rate after HF was 42.3% and 33.1% in women and men with AF (p<0.0001).
Conclusion
In this nationwide, register-based cohort study, when compared to matched controls we found that the risk for HF onset was higher in women with AF, particularly in reproductive age, highlighting great importance of further research for prevention of HF in young women with AF but without any other cardiovascular risk factors.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- C Basic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk , Gothenburg , Sweden
| | - P O Hansson
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk , Gothenburg , Sweden
| | - T Zverkova Sandstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg , Gothenburg , Sweden
| | - B Johansson
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk , Gothenburg , Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk , Gothenburg , Sweden
| | - Z Mandalenakis
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk , Gothenburg , Sweden
| |
Collapse
|
15
|
Li MY, Feng Y, Guan X, Fu M, Wang CM, Jie JL, Li H, Bai YS, Li GYN, Wei W, Meng H, Guo H. [The relationship between peripheral blood mitochondrial DNA copy number and incident risk of liver cancer: a case-cohort study]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1289-1294. [PMID: 36207893 DOI: 10.3760/cma.j.cn112150-20220104-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the association between peripheral blood mitochondrial DNA copy number (mtDNAcn) and incident risk of liver cancer. Methods: At the baseline of Dongfeng-Tongji (DFTJ) cohort, 27 009 retirees were recruited from Dongfeng Motor Corporation in 2008. After excluding people without baseline DNA, with current malignant tumor and loss of follow-up, 1 173 participants were randomly selected into a sub-cohort by age-and gender-stratified sampling method at a proportion of 5% among all retirees. A total of 154 incident liver cancer cases identified from the cohort before December 31, 2018 (4 cases had been selected into the sub-cohort) were selected to form the case cohort of liver cancer. For the above 1 323 participants, their baseline levels of mtDNAcn in peripheral blood cells were measured by using quantitative real-time PCR method. The restricted cubic spline analysis was used to fit the shape of the association between baseline mtDNAcn and incident risk of liver cancer. The weighted Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95%CI. Results: In this case-cohort study, the median follow-up time was 10.3 years. The restricted cubic spline analysis indicated that the relationship between peripheral blood mtDNAcn and incident risk of liver cancer followed a U-shaped pattern (Pnon-linear<0.05). All case-cohort population were divided into four subgroups by sex-specific quartiles of mtDNAcn levels among sub-cohort participants, when compared to participants in the Q2 subgroup of mtDNAcn, those in the Q1 subgroup (HR=2.00,95%CI:1.08-3.70) and Q4 subgroup (HR=4.11,95%CI:2.32-7.26) both had a significantly elevated risk of liver cancer, while those in the Q3 subgroup (HR=1.05,95%CI:0.54-2.05) had not. There were no significant multiply interaction effects of aging, gender, tobacco smoking, alcohol drinking and history of chronic hepatitis on the above association (Pinteraction>0.05). Conclusion: Both extremely low and high baseline level of mtDNAcn in peripheral blood cells are associated with an increased risk of incident liver cancer, but the underlying mechanisms need to be further clarified.
Collapse
Affiliation(s)
- M Y Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Feng
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - X Guan
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - M Fu
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - C M Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J L Jie
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y S Bai
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - G Y N Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - W Wei
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Meng
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment & Health, Ministry of Education, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| |
Collapse
|
16
|
Basic C, Rosengren A, Dahlström U, Edner M, Fu M, Zverkova-Sandström T, Schaufelberger M. Sex-related differences among young adults with heart failure in Sweden. Int J Cardiol 2022; 362:97-103. [PMID: 35490786 DOI: 10.1016/j.ijcard.2022.04.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/09/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Differences between the sexes among the non-elderly with heart failure (HF) have been insufficiently evaluated. This study aims to investigate sex-related differences in early-onset HF. METHODS Patients aged 18 to 54 years who were registered from 2003 to 2014 in the Swedish Heart Failure Register were included. Each patient was matched with two controls from the Swedish Total Population Register. Data on comorbidities and outcomes were obtained through the National Patient Register and Cause of Death Register. RESULTS We identified 3752 patients and 7425 controls. Of the patients, 971 (25.9%) were women and 2781 (74.1%) were men with a mean (standard deviation) age of 44.9 (8.4) and 46.4 (7.3) years, respectively. Men had more hypertension and ischemic heart disease, whereas women had more congenital heart disease and obesity. During the median follow-up of 4.87 years, 26.5 and 24.7 per 1000 person-years male and female patients died, compared with 3.61 and 2.01 per 1000 person-years male and female controls, respectively. The adjusted hazard ratios for all-cause mortality, compared with controls, were 4.77 (3.78-6.01) in men and 7.84 (4.85-12.7) in women (p for sex difference = 0.11). When HF was diagnosed at 30, 35, 40, and 45 years, women and men lost up to 24.6 and 24.2, 24.4 and 20.9, 20.5 and 18.3, and 20.7 and 16.5 years of life, respectively. CONCLUSION Long-term mortality was similar between the sexes. Women lost more years of life than men.
Collapse
Affiliation(s)
- C Basic
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - A Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - U Dahlström
- Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - M Edner
- Division of Family Medicine, NVS, Karolinska Institute, Stockholm, Sweden
| | - M Fu
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - T Zverkova-Sandström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Schaufelberger
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
17
|
Li J, Sun YH, Li G, Fu M, Mo YJ, Zheng SN, Dong HJ, Fan RX, Luo JF. [Transcarotid transcatheter aortic valve replacement for pure aortic regurgitation: a case report]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:1240-1243. [PMID: 34905904 DOI: 10.3760/cma.j.cn112148-20201231-01026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- J Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Y H Sun
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - G Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - M Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Y J Mo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S N Zheng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - H J Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - R X Fan
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J F Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| |
Collapse
|
18
|
Chen XQ, Zheng DY, Xiao YY, Dong BL, Cao CW, Ma L, Tong ZS, Zhu M, Liu ZH, Xi LY, Fu M, Jin Y, Yin B, Li FQ, Li XF, Abliz P, Liu HF, Zhang Y, Yu N, Wu WW, Xiong XC, Zeng JS, Huang HQ, Jiang YP, Chen GZ, Pan WH, Sang H, Wang Y, Guo Y, Shi DM, Yang JX, Chen W, Wan Z, Li RY, Wang AP, Ran YP, Yu J. Aetiology of tinea capitis in China: A multicentre prospective study. Br J Dermatol 2021; 186:705-712. [PMID: 34741300 DOI: 10.1111/bjd.20875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time. OBJECTIVES This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China. METHODS A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. The pathogens were further identified by morphology or molecular sequencing when necessary in the central laboratory. RESULTS Among all enrolled patients, 74.1% of the cases were 2- to 8-year-olds. The children with tinea capitis were mainly boys (56.2%) and more likely to have an animal contact history (57.4% vs. 35.3%, P = 0.012) and zoophilic dermatophyte infection (73.5%). The adults were mainly females (83.3%) and more likely to have anthropophilic agent infection (53.5%). The most common pathogen was zoophilic Microsporum canis (354, 65.2%), followed by anthropophilic Trichophyton violaceum (74, 13.6%). In contrast to the eastern, western and northeastern regions where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69.2%, P < 0.0001), where the patients had the most tinea at other sites (20.3%) and dermatophytosis contact (25.9%) with the least animal contact (38.8%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang Province. CONCLUSIONS Boys aged approximately 5 years were mainly affected. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.
Collapse
Affiliation(s)
- X-Q Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - D-Y Zheng
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Y-Y Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - B-L Dong
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - C-W Cao
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - L Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Z-S Tong
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - M Zhu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Z-H Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - L-Y Xi
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - M Fu
- Department of Dermatology, Xijing Hospital, Xi'an, China
| | - Y Jin
- Department of Dermatology, Dermatology Hospital of Jiangxi Province, Nanchang, China
| | - B Yin
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - F-Q Li
- Department of Dermatology, the Second Hospital of Jilin University, Changchun, China
| | - X-F Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - P Abliz
- Department of Dermatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - H-F Liu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Y Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - N Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - W-W Wu
- Department of Dermatology, the Fifth People's Hospital of Hainan Province, Haikou, China
| | - X-C Xiong
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - J-S Zeng
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - H-Q Huang
- Department of Dermatology and Venereology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y-P Jiang
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - G-Z Chen
- Department of Dermatology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - W-H Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Naval Military Medical University, Shanghai, China
| | - H Sang
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Y Wang
- Department of Dermatology, Changhai Hospital of Shanghai, Shanghai, China
| | - Y Guo
- Department of Dermatology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - D-M Shi
- Department of Dermatology, Jining No, People's Hospital, Jining, China
| | - J-X Yang
- Department of Dermatology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - W Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Z Wan
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - R-Y Li
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - A-P Wang
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Y-P Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - J Yu
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| |
Collapse
|
19
|
Choha E, Henrysson J, Thunstrom E, Fu M, Basic C. Underlying causes of under-utilization of cardiac resynchronization therapy in real-world heart failure settings. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Despite well-established effectiveness of cardiac resynchronization therapy (CRT) in patients with heart failure (HF), it remained significantly under-utilized. The underlying causes are still not well described.
Aim
To investigate how many patients with HF were eligible for CRT and determine underlying causes why CRT was abstained for these patients in real life settings.
Methods
Retrospective review of medical data was carried out in all patients hospitalized for newly diagnosed HF from January 1, 2016 to December 31, 2019. Patients were identified from the local university hospital register with three afiliations by use of international classification of disease (ICD)-10 codes I50.0-I50.9. Medical journals, including electrocardiograms and echocardiograms, were reviewed. The indication for CRT was evaluated three months after mineralocorticoid receptor antagonists (MRA) were initiated as addition to angiotensin converting enzyme inhibitor /angiotensin-receptor blockers and beta-blocker treatment according to European guidelines for heart failure from 2016. Follow-up was minimum one year and up to two years after HF diagnosis.
Results
In 3456 patients with HF, 642 (18.6%) were patients hospitalized for new onset of HF with ejection fraction (EF) <40%. Out of those, 104 (16.2%) patients were excluded because of incomplete medical record as a result of referral to primary care. Finally, 538 were included in this study. Overall, 163 patients (30.3%) met CRT criteria with 22.5%, 2.6%, 1.9% complying with recommendation IA, IIA, IIB respectively, and 3.9% had more than 50% right ventricular pacing. Only 52 (9.7%) of patients received CRT with mean age 69.3±11.5 years, and 69.2% men and EF 31.9% ± 7.6. In all these patients with HF eligible for CRT, no difference was found in baseline data including hypertension, ischemic heart disease, atrial fibrillation, valvular heart disease, diabetes mellitus, stroke, cancer and renal failure nor medical treatment between those received CRT and those without CRT. Among underlying causes of under-utilization of CRT, 24.3% were due to multiple concomitant comorbidities, 4.5% due to patient's own wish, 12.5% due to other reasons such as socioeconomic problems and 58.6% with unknown reasons. Mortality rates were 20.7% in patients without treatment with CRT compared with 7.7% in those who received CRT (p=0.037).
Conclusion
In this real world HF cohort, 1/3 patients were eligible for CRT treatment. However only 1/3 received CRT and 58.6% had no contraindication but did not receive CRT, which emphasize urgent need for structured implementation methods for device treatment in patients with HF.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- E Choha
- Sahlgrenska Academy, Section of emergency and cardiovascular medicine, Cardiology Department, Gothenburg, Sweden
| | - J Henrysson
- Sahlgrenska Academy, Section of emergency and cardiovascular medicine, Cardiology Department, Gothenburg, Sweden
| | - E Thunstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - C Basic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
20
|
Basic C, Hansson P, Zverkova-Sandstrom T, Johansson B, Fu M, Mandalenakis Z. Heart failure in low risk patients with atrial fibrillation, nationwide registry case-control study based on 227811 patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is common in patients with atrial fibrillation (AF), and also associated with worse outcome. Consequently, it is commonly included in risk prediction models for AF, used in daily clinical praxis. However, knowledge about the association between solely AF and incidental HF is limited.
Aim
This study aims to evaluate the short and long-term risks for onset of HF in patients with AF and low cardiovascular risk profile.
Methods
All patients with first recorded hospitalization for AF in the Swedish National Patient Register, were included from the 1St January 1987 to 31st December 2018. Each patient with AF was matched by age, sex and county with two controls from the Swedish Total Population Register. Patients <18 years, or with concomitant hypertension, diabetes mellitus, coronary and periphery artery disease, previous stroke or transitory ischemic attack, cardiomyopathy, pulmonary arterial hypertension, congenital heart disease, valvular heart disease and renal failure prior or at baseline were excluded.
Results
In total 227 811 patients and 452 712 controls met the inclusion and exclusion criteria and were included in the study. The incidence rate for incidental HF per 1000 person-year within one year after AF diagnosis was 6.2 (95% CI: 4.5–8.6) among patient 18–34, increased with increasing age and was 142.8 (95% CI: 139.4–146.3) among those >80 years. Within five years the incidence rate decreased in all age categories and was 2.4 (95% CI: 1.8–3.0) among the youngest and 94.0 (95% CI: 92.4–95.6) in the oldest age group. When compared to matched controls from the general population patients with AF had a hazard ratio (HR) and CI 95% to develop HF within one year at 103.9 (46.3–233.1), 34.9 (26.5–45.9), 17.5 (15.5–19.8), 10.3 (9.6–11.1) and 6.1 (5.8–6.4) among patients aged 18–34, 35–49, 50–59, 60–69, 70–79 and >80 years, respectively.
Conclusion
Despite low cardiovascular risk profile AF still carries high risk for developing incidental HF in particular during the first observation year with increasing tendency along with increasing age. Younger patients with AF and without other cardiovascular comorbidities had more than 100 times higher relative risk to develop HF within one year when compared to matched controls.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- C Basic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk, Gothenburg, Sweden
| | - P Hansson
- Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk, Gothenburg, Sweden
| | - T Zverkova-Sandstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - B Johansson
- Sahlgrenska Academy, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk, Gothenburg, Sweden
| | - Z Mandalenakis
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Medicine, Geriatrics and Emergency medicine, Östra, Region Västra Götaland, Sahlgrensk, Gothenburg, Sweden
| |
Collapse
|
21
|
Henrysson J, Thunstrom E, Fu M, Basic C. Hyperkalemia as a cause of undertreatment with mineralcorticoid receptor antagonists for patients with newly onset of heart failure with reduced ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Despite beneficial effects on mortality and morbidity the use of mineralocorticoid receptor antagonists (MRA) in patients with reduced ejection fraction (<40%) (HFrEF) remains poor. Hyperkalemia is assumed as an important cause, but the reported incidence is low and varies hugely. Thus, available data of magnitude of hyperkalemia in real life settings are insufficient to explain why under-utilization of MRA occurred.
Aim
To determine the incidence and magnitude of documented hyperkalemia and potential risk of hyperkalemia in patients with HFrEF in a real-world HF population.
Methods
Patients aged 18–85 years at the time of the baseline, hospitalized for newly onset of HFrEF between
2016–01–01 and 2019–12–31, were identified retrospectively and consecutively from hospital discharge records, by use of international classification of disease (ICD)-10 codes I50.0-I50.9 as principal diagnosis. Potential higher risk of hyperkalemia was based on an overall assessment of current potassium level, presence of diabetes mellitus and eGFR <30 ml/min at patient level.
Results
In total, 3456 patients with HF were identified, 642 (18.6%) were eligible, hospitalized for newly onset of HFrEF (66.8±12.7 years, 68.4% men and EF 29.4% ±6.8%). After six months 336 (52.3%) did not have MRA of which 279 (83%) never received MRAs and 57 (17%) had MRAs discontinued. Among patients on MRA treatment, 306 (14.4%) needed dose reduction. Occurrence of hypertension, ischemic heart disease, diabetes mellitus and renal dysfunction at baseline did not differ between groups with or without MRA. The incidence and magnitude of documented and potentially higher risk of hyperkalemia were assessed both at baseline and as highest potassium within six months after established diagnosis. Among patients without MRA after six months, at baseline only 3 (0.9%) patients had documented S/P-K ≥6 mmol/L, 7 (2.1%) patients had S/P-K 5.5–5.9 mmol/L and 26 (7.7%) patients had S/P-K 4.8–5.4 mmol/L. Moreover, 12.4% had potentially high risk of hyperkalemia at baseline. During the six-month follow up after initiation of HF therapy, 15 (4.5%) patients had documented hyperkalemia with S/P-K ≥6 mmol/L,
23 (6.8%) patients had S/P-K 5.4–5.9 mmol/L, and 123 (36.6%) patients had S/P-K 4.8–5.4 mmol/L during at least one occasion. Besides, 13.4% had potentially high risk of hyperkalemia. Hyperkalemia occurred frequently
(40.4% vs 36.4%) in patients with discontinuation and dose reduction of MRA. Figure 1 presents the distribution of patients with risk of or documented hyperkalemia in the group without MRA.
Conclusions
Hyperkalemia was the most common cause for both discontinuation and dose reduction of MRA. Hyperkalemia was also increased significantly from baseline and during subsequent up-titration, with 4.6-fold increased risk for borderline hyperkalemia (S/P-K 4.8–5.4). This might explain why physicians refrain from prescribing MRAs to patients with HFrEF.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Vifor Pharma
Collapse
Affiliation(s)
- J Henrysson
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - E Thunstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - C Basic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| |
Collapse
|
22
|
Cui X, Mandalenakis Z, Thunstrom E, Fu M, Svardsudd K, Hansson P. The impact of time-updated resting heart rate on cause-specific mortality in a random middle-aged male population: a lifetime follow-up. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High resting heart rate (RHR) is associated with increased adverse events. However, the long-term prognostic value in a general population is unclear. We aimed at investigating the impact of RHR, based on baseline as well as time-updated, on mortality in a middle-aged men cohort.
Methods
A random population sample of 852 men, all born in 1913 was followed from age 50 until age 98 with repeated examinations including RHR during 48 years. The impact of baseline and time-updated RHR on cause-specific mortality was assessed using Cox proportional hazards models and cubic spline models.
Results
Baseline RHR ≥90 beats per minute (bpm) was associated with higher all-cause mortality as compared to RHR 60–70 bpm (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.17–2.19, P=0.003), but not with cardiovascular (CV) mortality. A time-updated RHR <60 bpm (HR 1.41, 95% CI 1.07–1.85, P=0.014) and a time-updated RHR of 70–80 bpm (HR 1.34, 95% CI 1.02–1.75, P=0.036) were both associated with higher CV mortality as compared with the RHR of 60–70 bpm after multivariable adjustment. Analyses using cubic spline models confirmed that the association of time-updated RHR with all-cause and CV mortality complied with a U-shaped curve with 60 bpm as a reference.
Conclusions
In this middle-aged men cohort, a time-updated RHR at 60–70 bpm was associated with lowest CV mortality, suggesting that time-updated RHR could be a useful long-term prognostic index in the general population.
RHR and Mortality
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): In recent years, funding has been received from the Swedish state under the agreement between the Swedish government and the county councils relating to the economic support of research and education under the ALF agreement (ALFGBG-721351).
Collapse
Affiliation(s)
- X.T Cui
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Z Mandalenakis
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - E Thunstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - K Svardsudd
- Uppsala University, Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala, Sweden
| | - P.O Hansson
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
23
|
Sjoland H, Silverdal J, Bollano E, Pivodic A, Fu M. Trends in outcome and patient composition in dilated cardiomyopathy in Sweden over time. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We studied prognosis and patient composition over time in dilated cardiomyopathy (DCM): a well-defined category of heart failure (HF), often affecting younger individuals. We expected improved prognosis over time, due to emerging diagnostic and therapeutic options.
Methods
All patients from the Swedish Heart Failure Registry (SwedeHF) fulfilling criteria for DCM (exclusion of ischemic, valvular, or alcoholic etiology and affirmed by clinical judgment in the protocol) (n=3739), were analyzed with respect to three time periods of inclusion in the registry, 2003–2007 (n=814), 2008–2011 (n=1448), 2012–2016 (n=1477), regarding mortality, transplantations, and hospital admissions during one year after inclusion.
Results
Over the three time periods, registered cohorts were older with time (mean 59.3 years/ 60 years/ 61.0 years, p=0.0035), and the proportion of females incresased (24.1% / 27.2% / 30.7%, p=0.0006).
For clinical variables, the distribution of left ventricular ejection fraction (LVEF) with time showed significantly higher LVEF (p=0.0024), and functional classification (NYHA) showed lower class (p=0.0011). Hypertension as a comorbidity (i.e. not judged to be responsible for HF) was more frequently occurring with time: (34.0%/ 40.6%/ 44.1%, p<0.0001). As for HF treatment: use of device increased (p<0.0001 for categorical combinations), mineralocorticoid receptor antagonists (MRA) increased (41.9%/ 37.3%/ 46.7%, p=0.0023), and diuretics dropped (76.1%/ 71.1%/ 67.0%, p≤0.0001) in the different cohorts with time.
Mortality (6.9%, 5.1%, 5.5%), transplantation (0.5%, 0.8%, 0.6%) and hospital admissions for HF (28.4%, 26.3%, 24.6%) were stable over time (ns for all), whereas cardiovascular (CV) (33.8%, 33.8%, 29.7%, p=0.043) and all cause admissions (39.1%, 38.8%, 33.7%, p=0.0099) decreased. After adjustment for age, sex, LVEF, NYHA, hypertension and device treatment only all cause admissions remained significantly decreased.
Conclusion
In this nationwide study between 2003–2016, one-year outcome in DCM in Sweden remained stationary over time, despite advances in HF therapy. During the time period, we observed a continuous change in the clinical profile in the DCM population.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Region Västra Götaland agreement concerning research and education of physicians.
Collapse
Affiliation(s)
- H Sjoland
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - J Silverdal
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - E Bollano
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - A Pivodic
- Statistiska konsultgruppen, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| |
Collapse
|
24
|
Kontogeorgos S, Thunstrom E, Lappas G, Rosengren A, Fu M. Lifelong cumulative incidence of acquired aortic stenosis and its predictors in a large middle-aged men population followed up to 42 years. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acquired aortic stenosis (AS) is the most common valvular disorder that rises exponentially with age; it has high mortality after symptoms appear. Factors that predict the development of AS are still unknown. Some studies imply that the atherosclerotic factors are involved in the development of AS, but the findings have been heterogeneous.
Purpose
To estimate lifelong cumulative incidence of AS and analyse its predictors.
Methods
We included a random sample of men, born 1915–1925 in Gothenburg, Sweden, and examined them in 1970–1973 (participation rate 75%). They were between 47 and 55 years in the beginning and 57–65 years when the examination-period ended. Out of 7493 men 57 were excluded due to myocardial infarction prior to baseline; 7436 were thus followed from the inclusion date until a discharge diagnosis of AS or death, with a maximum follow up time of 42 years and mean follow-up time 26.8 years. Men with AS were identified from the Swedish National Patient Register and those who died from the Swedish Cause of Death Register. We used machine learning to identify the most important factors that predict AS. For these factors, we then estimated hazard ratios for the risk to acquire AS through Cox proportional hazards model.
Results
The lifelong cumulative incidence to acquire AS was 2.66% (198 out of 7436 individuals). For men with measurements approximately at the quartiles of the pulse pressure distribution, more specifically 44, 52, 62 mm Hg, the estimated cumulative risk were 1.97%, 2.74% and 3.07% respectively. For the body mass index (BMI) we had accordingly for measurements around 23, 25 and 27 kg/m2 estimated cumulative risk 2.52%, 2.80%, 2.79% respectively. For cholesterol values of 5, 6 and 7 mmol/l (approximately at quartile divisions) the estimated cumulative risk was 1.77%, 1.79% and 3.20% respectively. The estimated cumulative risks for the younger, with age around 47 and the older participants, with age around 55 were 1.76% and 2.68 respectively. Men with family history of infarction in a sibling had an estimated cumulative risk at 4.66% level whereas those with not at 2.51%.
The factors that were significantly associated with the development of AS in the Cox proportional model are: cholesterol level (HR=1.24, CI 95% 1.11–1.39, p=0.0001), pulse pressure (HR=1.01, CI 95% 1.01–1.02, p=0.0037), BMI (HR=1.06, CI 95% 1.02–1.11, p=0.0089), age (HR=1.11, CI 95% 1.04–1.19, p=0.0010) and family history of myocardial infarction in a sibling (HR=2.38, CI 95% 1.50–3.79, p=0.0002).
Conclusion
Lifelong cumulative incidence of acquired AS is approximately 2.7%. Multiple factors known also to be associated with arteriosclerosis were identified to increase the life-long risk of developing AS.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- S.M Kontogeorgos
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - E Thunstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - G Lappas
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - A Rosengren
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
25
|
Cui X, Thunstrom E, Dahlstrom U, Zhou J, Ge J, Fu M. Trends in cause-specific readmissions in heart failure with preserved versus reduced and mid-range ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It remains unclear whether the readmission of heart failure (HF) patients has decreased over time and how it differs among HF with preserved ejection fraction (EF) (HFpEF) versus reduced EF (HFrEF) and mid-range EF (HFmrEF).
Methods
We evaluated HF patients index hospitalized from January 2004 to December 2011 in the Swedish Heart Failure Registry with 1-year follow-up. Outcome measures were the first occurring all-cause, cardiovascular (CV) and HF readmissions.
Results
Totally 20,877 HF patients (11,064 HFrEF, 4,215 HFmrEF, 5,562 HFpEF) were included in the study. All-cause readmission was highest in patients with HFpEF, whereas CV and HF readmissions were highest in HFrEF. From 2004 to 2011, HF readmission rates within 6 months (from 22.3% to 17.3%, P=0.003) and 1 year (from 27.7% to 23.4%, P=0.019) in HFpEF declined, and the risk for 1-year HF readmission in HFpEF was reduced by 7% after adjusting for age and sex (P=0.022). Likewise, risk factors for HF readmission in HFpEF changed. However, no significant changes in cause-specific readmissions were observed in HFrEF. Time to the first readmission did not change significantly from 2004 to 2011, regardless of EF subgroup (all P-values>0.05).
Conclusions
Although the burden of all-cause readmission remained highest in HFpEF versus HFrEF and HFmrEF, a declining temporal trend in 6-month and 1-year HF readmission rates was found in patients with HFpEF, suggesting that non-HF-related readmission represents a big challenge for clinical practice.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions.
Collapse
Affiliation(s)
- X.T Cui
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - E Thunstrom
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | | | - J.M Zhou
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - J.B Ge
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
26
|
Cui X, Zhou J, Pivodic A, Dahlstrom U, Ge J, Fu M. Temporal trends in cause-specific readmissions and their risk factors in heart failure patients in Sweden. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It remains unclear whether readmissions of patients with heart failure (HF) have decreased over time in an era of improved therapy and management of HF. This study aimed to determine the temporal short- and long-term trends of cause-specific rehospitalization and their risk factors in a Swedish context.
Methods
HF patients in the Swedish Heart Failure Registry (SwedeHF) were investigated. Maximum follow-up time was 1 year. Outcomes included the first occurrence of all-cause, cardiovascular (CV) and HF rehospitalizations. Cox proportional hazards models were performed to determine the impact of increasing years on risk for rehospitalization and its known risk factors.
Results
Totally, 25,644 index-hospitalized HF patients SwedeHF from 2004 to 2011 were enrolled in the study. For 8 years, the incidence risk of 1-year all-cause rehospitalization remained unchanged, whereas the incidence risk of CV (P=0.038) or HF (P=0.0038) rehospitalization decreased. After adjustment for age and sex, a 3% decrease per every second year was observed for 1-year CV and HF rehospitalizations (P<0.05). However, time to the first occurring all-cause, CV and HF rehospitalization did not change significantly from 2004–2011 (P-values 0.13–0.87). When two study periods (2004–2005 vs. 2010–2011) were compared, the risk factor profile for rehospitalization was found to change.
Conclusions
Throughout the 8-year study period, CV- and HF-related rehospitalizations decreased, whereas all-cause rehospitalization remained unchanged, indicating a parallel increase in non-CV rehospitalization in the HF patients.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish Society of Cardiology and the Swedish Heart-Lung Foundation.
Collapse
Affiliation(s)
- X Cui
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - J Zhou
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - A Pivodic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | | | - J Ge
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
27
|
Wideqvist M, Rosengren A, Schaufelberger M, Pivodic A, Fu M. Temporal trends in incidence of heart failure in relation to age and gender in western Sweden 2008–2017. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
During the last decades we have witnessed gradually improved cardiovascular primary and secondary prevention, while life expectancy is increasing, with a growing population of elderly people. Heart failure is a disease of the elderly and end stage of other cardiac diseases. Accordingly, trends in incidence of heart failure are dynamic and may differ by age and gender
Purpose
To investigate overall trends in incidence for HF over the last decades in Western Sweden. Additionally we wanted to study incidence in relation to age and gender.
Method
The VEGA database is an administrative database of all patients managed in hospital care (through direct linkage to the Swedish nationwide patient registry) and/or in primary care facilities (private and public) living in Western Sweden. All patients with a main or contributory diagnosis of HF (I50) >18 years of age between 2008 and 2017 were included in our cohort. HF incidence was calculated based on the entire population of Vastra Gotaland (a region of Western Sweden).
Results
The adult population in Western Sweden increased by 8% from 2008 (n=1,234,609) to 2017 (n=1,338,906), with 69% <60 years of age and 50% female, both constant over time.
In total, 62,229 incident cases of HF were identified during 2008–2017. In 2008 we identified 6464 cases with a mean age of 78.7 (11.5) and 49.8% (n=3222) male patients, while in 2017 5,727 cases were identified with a mean age of 78.3 (11.8) and 52.5% (n=3006) male cases.
The yearly incidence rate of HF remained constant over the 10-year period but with large variations by age and gender. A constantly higher incidence of HF was seen for men compared to women in all age categories. Although overall incidence remained constant in the last decade, we did observe decreasing incidence among those >80 years of age with incidence rates dropping from 4.4% to 3.0% between 2008–2017 (80–90 years) and from 7.8 to 5.5% in the same period (>90 years of age). A similar pattern was seen in both men and women in these age groups with incidence decreasing over the last ten years.
Conclusion
The overall incidence of HF remained unchanged over the last decade. However a declining trend in incidence was observed in the oldest part of the population, who, however, constitutes only approximately 5% of the population. Our findings emphasize the need for implementation of effective preventive strategies for HF.
Trends in HF incidence 2007-2018
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Swedish agreement between the government and the county councils concerning economic support for providing an infrastructure for research and education of doctors (ALF), and the Regional Development Fund, Västra Götaland County, Sweden (FOU-VGR)
Collapse
Affiliation(s)
- M Wideqvist
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - A Rosengren
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - M Schaufelberger
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| | - A Pivodic
- Statistical Consulting Gotheburg, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
28
|
Ekestubbe S, Fu M, Giang K, Lindgren M, Rosengren A, Schioler L, Schaufelberger M. Increasing home-time for patients with heart failure in Sweden 1992–2008. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart failure (HF) reduces survival and is one of the most common causes of hospitalizations in the elderly, imposing a major economic burden on the health care system, with frequency of rehospitalizations often used in interventional and observational studies in patients with HF. Home-time is a novel end-point measuring time spent alive and out of hospital and is easier for both clinicians and patients to relate to. Given the advances in treatment of HF over the last decades we postulated that an increase in home-time would follow.
Purpose
To investigate whether home-time for patients with HF has changed over the last decades in Sweden and if home-time differs between patients of working age and those retired, or between men and women.
Methods
Patients aged 18–84 years with a first hospitalization for HF in Sweden between 1992 and 2008 were identified using the National Inpatient Register which was linked to the Swedish Cause of Death Register. Information on rehospitalizations and mortality was collected and followed over a time period of 4 years. The patients were divided into two age groups: (i) <65 years and (ii) >65 years. The cut off 65 years was chosen being the official age of retirement over the study period in Sweden.
Results
A total of 324,907 patients were included in this study, mean age 73.5 years (standard deviation 9.3). Only 15.6% were <65 and 45.1% were women. In total, average home-time was 70.1% of the total follow up time, 2.1% of time was spent in hospital while, during a mean of 27.9% of the 4 year-period, patients were no longer alive. A small increase in home-time was observed over the study period. The older age group spent 67.7% at home compared with 83% in the younger group. After taking differences in mortality into account, the difference in home-time was no longer significant, with 92.7 and 95.8% home-time for the older and younger age groups, respectively. Over the entire study period older men had less home-time compared with older women. Since 1998 the reverse was true in younger men and women, where younger men had more home-time than younger women. Home-time increased for all subgroups over the study period with the most pronounced increase for younger men (see figure 1).
Conclusion
Home-time for patients in Sweden increased over the study period and the increase was more marked for younger patients, where men spent more time at home than women.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Swedish state (ALF), The Swedish Heart and Lung Foundation, Västra Götaland Region, The Göteborg Medical Society
Collapse
Affiliation(s)
- S Ekestubbe
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| | - M Fu
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| | - K.W Giang
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| | - M Lindgren
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| | - A Rosengren
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| | - L Schioler
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden
| | - M Schaufelberger
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of molecular and clinical medicine, Gothenburg, Sweden
| |
Collapse
|
29
|
Sun XF, Gao XD, Yuan W, Sun JY, Fu M, Xue AW, Li H, Shu P, Fang Y, Hou YY, Shen KT, Sun YH, Qin J, Qin XY. [Clinicopathological features and prognosis of 59 patients with platelet-derived growth factor α-mutant gastrointestinal stromal tumor]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:880-887. [PMID: 32927513 DOI: 10.3760/cma.j.cn.441530-20200320-00156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Platelet-derived growth factor α (PDGFRA)-mutant gastrointestinal stromal tumor (GIST) is a relatively rare disease, whose clinicopathological characteristics and prognosis have been poorly studied. In this paper, the clinicopathological features and prognostic factors of PDGFRA-mutant GIST are investigated to provide more data for its understanding and treatment. Methods: A retrospective case-control study was used to collect the medical records of patients with GIST who underwent surgical resection in Zhongshan Hospital of Fudan University from January 2015 to August 2019. Patients with PDGFRA-mutant GIST were enrolled, and those with synonymous PDGFRA mutations, non-tumor-related deaths, and lack of clinicopathological data were excluded. The clinicopathological data were collected and the risk factors associated with prognosis were analyzed. Results: Among the enrolled 59 patients, there were 41 males (69.5%) and 18 females (30.5%) with the median age of 60 (25-79) years. All tumors originated from the stomach. The tumor size was 5 (3-7) cm, and the mitotic count was 2 (1-4)/50 high-power fields (HPF). According to the modified NIH risk stratification, 8 cases were classified as very low risk (13.6%), 25 cases as low risk (42.4%), 14 cases as moderate risk (23.7%), and 12 cases as high risk (20.3%). There were 7 cases of exon 12 mutation and 52 cases of exon 18 mutation (including 36 cases of D842V mutation). A comparison of clinicopathological features between the D842V mutation group and the non-D842V mutation group showed no statistically significant difference (all P>0.05). During a median follow-up of 21 (0-59) months, the 1- and 3-year relapse-free survival (RFS) rates of all the patients were 96.6% and 91.5%, respectively. There were 8 cases of recurrence and 3 cases of death. Six GIST patients with D842V mutation had tumor recurrence after operation, of whom 4 cases achieved varying degrees of tumor remission after being treated with dasatinib or avapritinib. Log-rank analysis showed that the overall survival (OS) of male was better than that of female (100% vs. 83.3%, P=0.046), but there was no significant difference in OS among patients with different risk grades (P=0.057). The RFS and OS of patients with D842V mutation and non-D842V mutation, exon 12 and exon 18 mutation were similar (all P>0.05). Univariate Cox analysis showed that RFS was associated with gender (P=0.010), tumor size (P=0.042), mitotic count (P=0.003), and the modified NIH risk stratification (P=0.042), while multivariate analysis revealed that higher risk grade was an independent risk factor for recurrence of PDGFRA-mutant GIST (HR=12.796, 95%CI: 1.326-123.501, P=0.028). Gender was an independent factor for recurrence, and the risk of recurrence in males was lower than that in females (HR=0.154, 95%CI: 0.028-0.841, P=0.031). Conclusions: Gender and the modified NIH risk stratification are independent risk factors for recurrence of PDGFRA-mutant GIST, while patients with D842V and non-D842V mutation, and exon 12 and exon 18 mutation have a similar risk of recurrence and death.
Collapse
Affiliation(s)
- X F Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - X D Gao
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W Yuan
- Department of pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J Y Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - M Fu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - A W Xue
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H Li
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - P Shu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Fang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Y Hou
- Department of pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - K T Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y H Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - X Y Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
30
|
Li J, Sun YH, Li G, Fu M, Mo YJ, Zheng SN, Dong HJ, Fan RX, Luo JF. [Midterm outcome comparison between patients with bicuspid or tricuspid aortic stenosis undergoing transcatheter aortic valve replacement]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:759-764. [PMID: 32957759 DOI: 10.3760/cma.j.cn112148-20200803-00613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the prognosis of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) stenosis. Methods: This was a retrospective study. Patients with symptomatic severe aortic stenosis, who underwent TAVR with follow-up time more than one year in Guangdong Provincial People's Hospital from April 2016 to August 2018, were included. According to aortic CT angiography, the patients were divided into BAV group and TAV group. The primary endpoint was the composite event of all-cause death and stroke, and the secondary endpoints were TAVR-related complications. Incidence of clinical endpoints and parameters derived from echocardiography were compared between the groups, and Kaplan-Meier survival analysis was used to compare the composite event between the two groups. Results: A total of 49 patients were included. The age was (73.6±6.3) years, and 25(51.0%) were male. There were 32 patients in BAV group and 17 in TAV group, the follow-up time was 466 (390, 664) days. The incidence of composite endpoint of death and stroke at one year were comparable in BAV and TAV groups (6.3% (2/32) vs. 5.9% (1/17), P=1.00). Kaplan-Meier curves also showed a similar risk of the composite endpoint(HR=1.03,95%CI 0.09-11.24,Log-rank P=0.98) between two groups. The incidence of all-cause death, stroke, myocardial infarction, severe bleeding, major vascular complications, new-onset atrial fibrillation or atrial flutter, and permanent pacemaker implantation were all similar between the two groups(all P>0.05), and there was no acute kidney injury (stage 2 or 3) in both groups. Echocardiographic parameters at one year were similar between the two groups (all P>0.05). Conclusions: The midterm prognosis of TAVR in patients with BAV and TAV stenosis is similar. Clinical trials of large sample size with long-term follow-up are warranted to verify our findings.
Collapse
Affiliation(s)
- J Li
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Y H Sun
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - G Li
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - M Fu
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Y J Mo
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S N Zheng
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - H J Dong
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - R X Fan
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J F Luo
- Department of Vascular Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| |
Collapse
|
31
|
Necchi A, Siefker-Radtke A, Loriot Y, Park S, Garcia-Donas J, Huddart R, Burgess E, Fleming M, Rezazadeh A, Mellado B, Varlamov S, Joshi M, Duran I, Zakharia Y, Fu M, Santiago-Walker A, O'Hagan A, Monga M, Tagawa S. 750P Erdafitinib (ERDA) in patients (pts) with locally advanced or metastatic urothelial carcinoma (mUC): Subgroup analyses of long-term efficacy outcomes of a pivotal phase II trial (BLC2001). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
32
|
Ploetner KO, Al Haddad C, Antoniou C, Frank F, Fu M, Kabel S, Llorca C, Moeckel R, Moreno AT, Pukhova A, Rothfeld R, Shamiyeh M, Straubinger A, Wagner H, Zhang Q. Long-term application potential of urban air mobility complementing public transport: an upper Bavaria example. CEAS Aeronaut J 2020; 11:991-1007. [PMID: 33403052 PMCID: PMC7456445 DOI: 10.1007/s13272-020-00468-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/10/2020] [Accepted: 08/19/2020] [Indexed: 11/27/2022]
Abstract
In this paper, the required models and methods to analyze and quantify the potential demand for urban air mobility (UAM) complementing public transport and possible impacts were defined and applied to the Munich Metropolitan region. An existing agent-based transport model of the study area were used and extended to cover socio-demographic changes up to the year 2030 and intermodal UAM services. An incremental logit model for UAM was derived to simulate demand for this new mode. An airport access model was developed as well. Three different UAM networks with different numbers of vertiports were defined. Sensitivity studies of ticket fare and structure, flying vehicle cruise speed, passenger process times at vertiports and different Urban Air Mobility networks sizes were performed. For the reference case, UAM accounts for a modal share of 0.5%. The absolute UAM demand is concentrated on very short routes; hence, UAM vehicle flight speed variation shows low UAM demand impacts. Kilometer-based fare, number of UAM vehicles per vertiport and passenger process times at vertiports show a significant impact on UAM demand.
Collapse
Affiliation(s)
| | | | - C. Antoniou
- Technical University of Munich, Munich, Germany
| | - F. Frank
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - M. Fu
- Bauhaus Luftfahrt, Taufkirchen, Germany
| | - S. Kabel
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - C. Llorca
- Technical University of Munich, Munich, Germany
| | - R. Moeckel
- Technical University of Munich, Munich, Germany
| | | | - A. Pukhova
- Technical University of Munich, Munich, Germany
| | | | | | | | - H. Wagner
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - Q. Zhang
- Technical University of Munich, Munich, Germany
| |
Collapse
|
33
|
Zhang C, Wang G, Fu M. 577 Plasma exosomal miR-375-3p regulates ferroptosis in keratinocytes by targeting lipid transporter GPX4 in SJS/TEN. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
34
|
Liang H, Li GL, Liu J, Fu M, Huang H, Zhao K, Wei Y, Xiao J. The application value of PAX1 and ZNF582 gene methylation in high grade intraepithelial lesion and cervical cancer. Clin Transl Oncol 2020; 23:283-288. [PMID: 32514824 DOI: 10.1007/s12094-020-02416-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the possibility of using the methylation level of PAX1/ZNF582 gene as molecular marker to differentiate the progression of cervical cancer. METHODS From January 2016 to March 2018, 150 patients, who were admitted to Cervical Disease Diagnosis and Treatment Center of Xuzhu Maternity and Child Care Hospital, were enrolled in this study. Patients were classified into chronic cervicitis (for 19 cases), low-grade squamous intraepithelial lesion (LSIL) (18 cases), high-grade squamous intraepithelial lesion (HSIL) (37 cases) and squamous cell carcinoma (SCC) (31 cases). All patients underwent several tests including Thin-prep cytology test (TCT), HPV DNA detection and detection of methylation level of PAX1/ZNF582 genes. RESULTS For diagnosis of HSIL, the area under curve (AUC) was 0.878 (95% CI 0.806 ~ 0.950); the threshold for PAX1 was 12.285, the sensitivity and specificity were 91.9% and 72.8%, respectively. The AUC of ZNF582 gene detection was 0.900 (95% CI 0.842 ~ 0.959), the threshold was 11.56, while the sensitivity and specificity were 97.3% and 76.7%, respectively. Among various tests we conducted, PAX gene detection methods showed the highest specificity (97.30%). PAX1/ZNF582 gene detection method demonstrated the highest accuracy. CONCLUSIONS For patients with high-grade cervical lesion and cervical cancer, the methylation level of PAX1/ZNF582 gene could be applied as a noteworthy biomarker for diagnosis and for cervical cancer classification.
Collapse
Affiliation(s)
- H Liang
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China.
| | - G L Li
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - J Liu
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - M Fu
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - H Huang
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - K Zhao
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - Y Wei
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - J Xiao
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| |
Collapse
|
35
|
Shu P, Sun XF, Fang Y, Gao XD, Hou YY, Shen KT, Qin J, Sun YH, Qin XY, Xue AW, Fu M. Clinical outcomes of different therapeutic modalities for rectal gastrointestinal stromal tumor: Summary of 14-year clinical experience in a single center. Int J Surg 2020; 77:1-7. [PMID: 32173609 DOI: 10.1016/j.ijsu.2020.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/15/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The optimal treatment for gastrointestinal stromal tumor (GIST) of the rectum is controversial due to the extremely low incidence of the disease. The aim of the present study was to compare the clinical outcomes of different treatment modalities for rectal GIST by reviewing the 14-year experience in our center. METHOD Medical records of rectal GIST patients who received surgical treatment in our center between January 2004 to December 2017 were reviewed retrospectively. Overall survival (OS) and recurrence-free survival (RFS) were used as the observation endpoints. RESULTS Included in this study were 71 GIST patients, including 42 patients who underwent local excision (LE) and 29 patients who underwent segmental resection (SR). There were differences in tumor size (P = 0.001) and malignant risk grade (P = 0.007). The LE approach achieved a lower rate of R0 resection than SR (29/42 vs.27/29, P = 0.015) and shorter hospital stay (P = 0.004). Preoperative imatinib mesylate (IM) therapy improved the rate of sphincter-sparing surgery for patients with tumors in the very low segment of the rectum (P = 0.012) and offered better R0 resection margins (P = 0.027). Multivariate analysis showed that the resection margin status (P = 0.014), risk stratification (P = 0.001) and IM therapy (P = 0.042) were independent factors affecting RFS of rectal GIST patients but not the surgical modalities (LE vs. SR, P = 0.802). Multivariate analysis showed no significant impact of these variables on OS. CONCLUSION Selection of surgical modalities has no significant impact on the prognosis. Local excision is the preferred surgical modality for resectable rectal GIST by virtue of less injury and shorter hospital stay. IM therapy has proved to be associated with improved RFS for rectal GIST patients.
Collapse
Affiliation(s)
- P Shu
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X F Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y Fang
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X D Gao
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y Y Hou
- Department of Pathology, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - K T Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China.
| | - J Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - Y H Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - X Y Qin
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - A W Xue
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| | - M Fu
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai, 200032, China
| |
Collapse
|
36
|
Zhou J, Cao J, Jin X, Zhou J, Chen Z, Xu D, Yang X, Dong W, Li L, Fan Y, Chen L, Zhong Q, Fu M, Hu K, Ge J. Digoxin is associated with worse outcomes in patients with heart failure with reduced ejection fraction. ESC Heart Fail 2020; 7:138-146. [PMID: 31994361 PMCID: PMC7083440 DOI: 10.1002/ehf2.12539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/10/2022] Open
Abstract
AIMS The aim of this study was to investigate the impact of digoxin use on the outcomes of patients with heart failure with reduced ejection fraction (HFrEF) and its possible interaction with atrial fibrillation or use of currently guideline-recommended treatments in the real world in China. METHODS AND RESULTS Patients hospitalized with HFrEF from 45 hospitals participating in the China National Heart Failure Registration Study (CN-HF) were enrolled to assess the all-cause mortality, HF mortality, all-cause re-hospitalization, and HF re-hospitalization associated with digoxin use. Eight hundred eighty-two eligible HFrEF patients in the CN-HF registry were included: 372 patients with digoxin and 510 patients without digoxin. Among them, 794 (90.0%) patients were followed up for the endpoint events, with a median follow-up of 28.6 months. Kaplan-Meier survival analysis showed that the all-cause mortality (P < 0.001) and all-cause re-hospitalization (P = 0.020) were significantly higher in digoxin group than non-digoxin group, while HF mortality (P = 0.232) and HF re-hospitalization (P = 0.098) were similar between the two groups. The adjusted Cox proportional-hazards regression analysis demonstrated that digoxin use remained as an independent risk factor for increased all-cause mortality [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.27-2.44; P = 0.001] and all-cause re-hospitalization (HR 1.27; 95% CI 1.03-1.57; P = 0.029) in HFrEF patients and the predictive value of digoxin for all-cause mortality irrespective of rhythm or in combination with other guideline-recommended therapies. CONCLUSIONS Digoxin use is independently associated with increased risk of all-cause mortality and all-cause re-hospitalization in HFrEF patients.
Collapse
Affiliation(s)
- Jingmin Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Juan Cao
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China.,North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xuejuan Jin
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Jun Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Zhenyue Chen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingli Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinchun Yang
- Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China
| | - Wei Dong
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuyuan Fan
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China.,North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Li Chen
- North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qiaoqing Zhong
- Department of Cardiology, First People's Hospital of Chenzhou, Chenzhou, China
| | - Micheal Fu
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Kai Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | | |
Collapse
|
37
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- J Cao
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai 200032, China; North Sichuan Medical College, Nanchong 637000, China
| | - X J Jin
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai 200032, China
| | - J Zhou
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai 200032, China
| | - Z Y Chen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - D L Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X C Yang
- Heart Center, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
| | - W Dong
- Department of Cardiology, People's Liberation Army General Hospital, Beijing 100039, China
| | - L W Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J Luo
- North Sichuan Medical College, Nanchong 637000, China
| | - L Chen
- North Sichuan Medical College, Nanchong 637000, China
| | - M Fu
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg 41650, Sweden
| | - J M Zhou
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai 200032, China
| | - J B Ge
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai 200032, China
| |
Collapse
|
38
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- L Shi
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - L Jiang
- Preventive Medicine Laboratory, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - X Zhang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - G Yang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - C Zhang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - X Yao
- Department of Occupational and Environmental Health, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - X Wu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - M Fu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - X Sun
- Department of Occupational and Environmental Health, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| | - X Liu
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| |
Collapse
|
39
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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)
Collapse
Affiliation(s)
- J Silverdal
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - E Bollano
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - H Sjoland
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - A Pivodic
- Statistiska konsultgruppen, Gothenburg, Sweden
| | - U Dahlstrom
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - M Fu
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| |
Collapse
|
40
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- M Sakalaki
- Sahlgrenska Academy, Medical clinic, Cardiology department, Gothenburg, Sweden
| | - P.-O Hansson
- Sahlgrenska Academy, Medical clinic, Cardiology department, Gothenburg, Sweden
| | - A Rosengren
- Sahlgrenska Academy, Medical clinic, Cardiology department, Gothenburg, Sweden
| | - E Thunstrom
- Sahlgrenska Academy, Medical clinic, Cardiology department, Gothenburg, Sweden
| | - A Pivodic
- Statistiska Konsultgruppen, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Medical clinic, Cardiology department, Gothenburg, Sweden
| |
Collapse
|
41
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- S D'Amico
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G Alunni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - M D'Amico
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - M Fu
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - D Celentani
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - S Pidello
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - A Brustio
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - M Campana
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - M Baccega
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - C Giustetto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - S Marra
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - M Rinaldi
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| |
Collapse
|
42
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- C Ergatoudes
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| | - P.-O Hansson
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| | - K Svardsudd
- Uppsala University, Department of Public Health and Caring Sciences, Uppsala, Sweden
| | - A Rosengren
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| | - E Thunstrom
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| | - K Caidahl
- Karolinska Institute, Department of Molecular Medicine and Surgery, Clinical Physiology,, Stockholm, Sweden
| | - A Pivodic
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| | - M Fu
- University of Gothenburg, Dept of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy,, Gothenburg, Sweden
| |
Collapse
|
43
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
Collapse
Affiliation(s)
- H Sjoland
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - P O Hansson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, Sweden
| | - A Pivodic
- Statistiska konsultgruppen, Gothenburg, Sweden
| | - K Caidahl
- Karolinska Institute, Department of Clinical Physiology, Stockholm, Sweden
| |
Collapse
|
44
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- X Chen
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| | | | - A Pivodic
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| |
Collapse
|
45
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- C Hjalmarsson
- Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Medicine, Cardiology Unit, Östra, Gothenburg, Sweden
| | | | - M Schaufelberger
- Sahlgrenska Academy, Medicine, Cardiology Unit, Östra, Gothenburg, Sweden
| | - C Ljungman
- Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
| | - B Andersson
- Sahlgrenska University Hospital, Department of Internal Medicine, Gothenburg, Sweden
| | - E Bollano
- Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
| | - U Dahlstrom
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - A Rosengren
- Sahlgrenska Academy, Medicine, Cardiology Unit, Östra, Gothenburg, Sweden
| |
Collapse
|
46
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- X Chen
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| | - M Schaufelberger
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| | - M Fu
- Sahlgrenska Academy, Inst. Medicine, dept. Molecular and Clinical Medicine, Gothenburg, Sweden
| |
Collapse
|
47
|
Jin X, Cao J, Zhou J, Wang Y, Han X, Song Y, Fan Y, Chen Z, Xu D, Yang X, Dong W, Li L, Chen L, Zhong Q, Fu M, Hu K, Zhou J, Ge J. Outcomes of patients with anemia and renal dysfunction in hospitalized heart failure with preserved ejection fraction (from the CN-HF registry). Int J Cardiol Heart Vasc 2019; 25:100415. [PMID: 31508483 PMCID: PMC6726881 DOI: 10.1016/j.ijcha.2019.100415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/03/2019] [Accepted: 08/18/2019] [Indexed: 02/03/2023]
Abstract
Background Although a large number of studies on heart failure with reduced ejection fraction (HFrEF) have found that anemia and renal dysfunction (RD) independently predicted poor outcomes, there are still few reports on patients with heart failure with preserved ejection fraction (HFpEF). Methods Clinical data of HFpEF patients registered in the China National Heart Failure Registration Study (CN-HF) were evaluated and the clinical features of patients with or without anemia/RD were compared to explore the impact of anemia and RD on all-cause mortality and all-cause re-hospitalization. Results 1604 patients with HFpEF were enrolled, the prevalence of anemia was 51.0%. Although anemia was associated with increased risk of all-cause mortality and all-cause re-hospitalization in univariate COX regression (p < 0.05), multivariate COX model confirmed that anemia was not independently associated with all-cause mortality [hazard ratio (HR) 1.14, 95% confidence interval (CI) 0.85–1.52, p = 0.386] and all-cause re-hospitalization (HR 1.13, 95% CI 0.96–1.33, p = 0.152). Similarly, RD was not an independent predictor of all-cause mortality (HR 1.18, 95% CI 0.88–1.57, p = 0.269) and all-cause re-hospitalization (HR 0.94, 95% CI 0.79–1.12, p = 0.488) as assessed in the adjusted COX regression model. The interaction between RD and anemia on end-points events was also not statistically significant. However, anemia was associated with increased all-cause re-hospitalization in patients with New York Heart Association (NYHA) class III-IV. Conclusions In patients with HFpEF from CN-HF registry, anemia was common, but was not an independent predictor of all-cause mortality and all-cause re-hospitalization, except for the all-cause re-hospitalization in patients with NYHA class III-IV. Clinical Trial Registration: http://www.clinicaltrials.gov/ct2/home; ID: NCT02079428.
Collapse
Key Words
- ACEI, angiotensin converting enzyme inhibitors
- AF, atrial fibrillation
- ARB, angiotensin receptor blockers
- Anemia
- BNP, brain natriuretic peptide
- CI, confidence interval
- CN-HF, China National Heart Failure Registration Study
- CRFs, case report forms
- HDL, high density lipoprotein cholesterol
- HF, Heart failure
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- HR, hazard ratio
- Heart failure
- Heart failure with preserved ejection fraction
- LDL, low density lipoprotein cholesterol
- LVDD, left ventricular diastolic dimension
- LVEF, left ventricular ejection fraction
- MRA, mineralocorticoid receptor antagonist
- NT-proBNP, N-terminal pro-brain natriuretic peptide
- NYHA, New York Heart Association
- RD, renal dysfunction
- Renal dysfunction
- TC, serum total cholesterol
- TG, triglyceride
- eGFR, estimated glomerular filtration rate
Collapse
Affiliation(s)
- Xuejuan Jin
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Juan Cao
- North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.,Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Jun Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yanyan Wang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Xueting Han
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yu Song
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yuyuan Fan
- North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.,Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Zhenyue Chen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingli Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinchun Yang
- Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China
| | - Wei Dong
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Li Chen
- North Sichuan Medical College, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qiaoqing Zhong
- Department of Cardiology, First People's Hospital of Chenzhou, Chenzhou, China
| | - Micheal Fu
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Kai Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Jingmin Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | | |
Collapse
|
48
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- C Liu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
- Chinese Materia Medica School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - L Wang
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
- Chinese Materia Medica School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - R Zhu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - H Liu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - R Ma
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - B Chen
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - L Li
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Y Guo
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
- The Third Affiliated Clinical Hospital, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Q Jia
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - S Shi
- Chinese Materia Medica School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - D Zhao
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - F Mo
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - B Zhao
- Chinese Materia Medica School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - J Niu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - M Fu
- The Research Institute of McGill University Health Center, Montreal, Quebec, H4A 3J1, Canada
| | - A N Orekhov
- Laboratory of Angiopathology, Russian Academy of Medical Sciences, Institute of General Pathology and Pathophysiology, Moscow, 125315, Russia
| | - D Brömme
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - S Gao
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - D Zhang
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
| |
Collapse
|
49
|
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 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- J L X Yang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - Y Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - W W Feng
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - H Tang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - J Shao
- Zhejiang University School of Medicine Affiliated Children's Hospital, Hangzhou 310003, China
| | - N R Wang
- Chongqing Maternal and Child Health Hospital, Chongqing 400013, China
| | - H Wang
- Maternal and Child Health Hospital of Sichuan Province, Chengdu 610031, China
| | - J Sun
- Dalian Maternal and Child Health Hospital of Liaoning Province, Dalian 116033, China
| | - Y Luo
- Guiyang Maternal and Child Health Hospital, Guiyang 550003, China
| | - L Q Lyu
- Ningbo Women and Children's Hospital of Zhejiang Province, Ningbo 315000, China
| | - S Q Yan
- Ma'anshan Maternal and Child Health Hospital of Anhui Province, Ma'anshan 243011, China
| | - D M Zhao
- Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - L J Mu
- Fangshan District Maternal and Child Health Hospital of Beijing, Beijing 102488, China
| | - D M Yan
- Lianyungang Maternal and Child Health Hospital of Jiangsu Province, Lianyungang 222000, China
| | - H Wang
- Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, China
| | - X T Gao
- Northwest Women and Children's Hospital, Xi'an710061, China
| | - M F He
- Maternal and Child Health Hospital Hunan Province, Changsha 410008, China
| | - J Yang
- Qinhuangdao Maternal and Child Health Hospital of Hebei Province, Qinhuangdao 066001, China
| | - M Fu
- Maternal and Child Health Hospital of Guangdong Province, Guangzhou 510010, China
| | - M Sanders
- The University of Queensland, Australia, Queensland 4072, Australia
| | - D Haslam
- The University of Queensland, Australia, Queensland 4072, Australia
| |
Collapse
|
50
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- A Al-Awadhi
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Kono
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Marx
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Moseley
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Willey
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H Sun
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Fu
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - GJ Whitman
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - V Valero
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - NT Ueno
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Lim
- Cancer Medicine Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|