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Wang D, Shang W, Jin Y, Gong M, Huang W, Shan P, Liang D. Admission proteinuria predicts the incidence of acute kidney injury among patients with acute ST-segment elevation myocardial infarction: a retrospective cohort study. Coron Artery Dis 2024; 35:215-220. [PMID: 38436048 DOI: 10.1097/mca.0000000000001345] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND Proteinuria indicates renal dysfunction and is associated with the development of acute kidney injury (AKI) in several conditions, but the association between proteinuria and AKI in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. This research aims to investigate the predictive value of proteinuria for the development of AKI in STEMI patients. METHODS A total of 2735 STEMI patients were enrolled. The present study's endpoint was AKI incidence during hospitalization. AKI is defined according to the Kidney Disease: Improving Global Outcomes criteria. We defined proteinuria, measured with a dipstick, as mild (1+) or heavy (2+ to 4+). Multivariate logistic regression and subgroup analyses were used to testify to the association between proteinuria and AKI. RESULTS Overall, proteinuria was observed in 634 (23.2%) patients. Multivariate logistic regression analyses revealed that proteinuria [odds ratio (OR), 1.58; 95% confidence interval (CI), 1.25-2.00; P < 0.001] was the independent predictive factor for AKI. Severe proteinuria was associated with a higher adjusted risk for AKI compared with the nonproteinuria group (mild proteinuria: OR, 1.35; 95% CI, 1.04-1.75; P = 0.025; severe proteinuria: OR, 2.50; 95% CI, 1.70-3.68; P < 0.001). The association was highly consistent across all studied subgroups. (all P for interaction >0.05). CONCLUSION Admission proteinuria measured using a urine dipstick is an independent risk factor for the development of AKI in STEMI patients.
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Affiliation(s)
- Dingzhou Wang
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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2
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Xu D, Ye B, Lin L, Jin Y, Jiang Y, Zheng Z, Chen Y, Han X, Wang W, Wu G, Zhuang Z, Shan P, Liang G. Carnosol attenuates angiotensin II-induced cardiac remodeling and inflammation via directly binding to p38 and inhibiting p38 activation. Int Immunopharmacol 2024; 134:112143. [PMID: 38692016 DOI: 10.1016/j.intimp.2024.112143] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
Chronic inflammation is a significant contributor to hypertensive heart failure. Carnosol (Car), primarily derived from the sage plant (Salvia carnosa), exhibits anti-inflammatory properties in a range of systems. Nevertheless, the influence of angiotensin II (Ang II) on cardiac remodeling remains uncharted. Car was shown to protect mice's hearts against Ang II-induced heart damage at dosages of 20 and 40 mg/kg/d. This protection was evident in a concentration-related decrease in the remodeling of the heart and dysfunction. Examination of the transcriptome revealed that the pivotal roles in mediating the protective effects of Car involved inhibiting Ang II-induced inflammation and the activation of the mitogen-activated protein kinase (MAPK) pathway. Furthermore, Car was found to inhibit p38 phosphorylation, therefore reducing the level of inflammation in cultured cardiomyocytes and mouse hearts. This effect was attributed to the direct binding to p38 and inhibition of p38 protein phosphorylation by Car both in vitro and in vivo. In addition, the effects of Car on inflammation were neutralized when p38 was blocked in cardiomyocytes.
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Affiliation(s)
- Diyun Xu
- The Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou 325800, Zhejiang, China; Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bozhi Ye
- Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liming Lin
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanhong Jin
- Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuchen Jiang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhaozheng Zheng
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanghao Chen
- Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Han
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Neurosurgery, Affiliated Yongkang First People's Hospital, Hangzhou Medical College, Yongkang, Zhejiang 321399, China
| | - Gaojun Wu
- Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zaishou Zhuang
- The Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou 325800, Zhejiang, China.
| | - Peiren Shan
- Department of Cardiology and the Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Guang Liang
- The Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou 325800, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China; School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Yang N, Zou C, Luo W, Xu D, Wang M, Wang Y, Wu G, Shan P, Liang G. Correction to: Sclareol attenuates angiotensin II-induced cardiac remodeling and inflammation via inhibiting MAPK signaling. Phytother Res 2024; 38:1715-1716. [PMID: 38317321 DOI: 10.1002/ptr.8144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Na Yang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chunpeng Zou
- Department of Ultrasonography, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wu Luo
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Diyun Xu
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengyang Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Yanbian University, Yanji, China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Gaojun Wu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guang Liang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, China
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Gong M, Liang D, Xu D, Jin Y, Wang G, Shan P. Analyzing predictors of in-hospital mortality in patients with acute ST-segment elevation myocardial infarction using an evolved machine learning approach. Comput Biol Med 2024; 170:107950. [PMID: 38237236 DOI: 10.1016/j.compbiomed.2024.107950] [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: 10/23/2023] [Revised: 12/08/2023] [Accepted: 01/01/2024] [Indexed: 02/28/2024]
Abstract
Acute ST-segment elevation myocardial infarction (STEMI) is a severe cardiac ailment characterized by the sudden complete blockage of a portion of the coronary artery, leading to the interruption of blood supply to the myocardium. This study examines the medical records of 3205 STEMI patients admitted to the coronary care unit of the First Affiliated Hospital of Wenzhou Medical University from January 2014 to December 2021. In this research, a novel predictive framework for STEMI is proposed, incorporating evolutionary computational methods and machine learning techniques. A variant algorithm, AGCOSCA, is introduced by integrating crossover operation and observation bee strategy into the original Sine Cosine Algorithm (SCA). The effectiveness of AGCOSCA is initially validated using IEEE CEC 2017 benchmark functions, demonstrating its ability to mitigate the deficiency in local mining after SCA random perturbation. Building upon this foundation, the AGCOSCA approach has been paired with Support Vector Machine (SVM) to forge the predictive framework referred to as AGCOSCA-SVM. Specifically, AGCOSCA is employed to refine the selection of predictors from a substantial feature set before SVM is utilized to forecast the occurrence of STEMI. In our analysis, we observed that SVM excels at managing nonlinear data relationships, a strength that becomes particularly prominent in smaller datasets of STEMI patients. To assess the effectiveness of AGCOSCA-SVM, diagnostic experiments were conducted based on the STEMI sample data. Results indicate that AGCOSCA-SVM outperforms traditional machine learning methods, achieving superior Accuracy, Sensitivity, and Specificity values of 97.83 %, 93.75 %, and 96.67 %, respectively. The selected features, such as acute kidney injury (AKI) stage, fibrinogen, mean platelet volume (MPV), free triiodothyronine (FT3), diuretics, and Killip class during hospitalization, are identified as crucial for predicting STEMI. In conclusion, AGCOSCA-SVM emerges as a promising model framework for supporting the diagnostic process of STEMI, showcasing potential applications in clinical settings.
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Affiliation(s)
- Mengge Gong
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
| | - Dongjie Liang
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
| | - Diyun Xu
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
| | - Youkai Jin
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
| | - Guoqing Wang
- Zhejiang Suosi Technology Co. Ltd, Wenzhou, 325000, Zhejiang, China.
| | - Peiren Shan
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China; Key Laboratory of Intelligent Treatment and Life Support for Critical Diseases of Zhejiang Province, Wenzhou, 325000, Zhejiang, China; Zhejiang Engineering Research Center for Hospital Emergency and Process Digitization, Wenzhou, 325000, Zhejiang, China.
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He J, Kong L, An D, Chen B, Zhao C, Li Z, Yang F, Dong J, Wei L, Shan P, Chen Y, Wu L, Xu J, Ge H, Pu J. Prognostic Value of Segmental Strain After ST-Elevation Myocardial Infarction: Insights From the EARLY Assessment of MYOcardial Tissue Characteristics by Cardiac Magnetic Resonance (EARLY-MYO-CMR) Study. J Magn Reson Imaging 2024. [PMID: 38363170 DOI: 10.1002/jmri.29274] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND The prognostic value of left ventricular segmental strain (SS) in ST-elevation myocardial infarction (STEMI) remains unclear. HYPOTHESIS To assess the prognostic value and application of SS. STUDY TYPE Retrospective analysis of a prospective registry. POPULATION Five hundred and forty-four patients after STEMI (500 in Cohort 1, 44 in Cohort 2). FIELD STRENGTH/SEQUENCE 3 T, balanced steady-state free precession, gradient echo, and gradient echo contrast-enhanced images. ASSESSMENT Participants underwent cardiac MR during the acute phase after STEMI. Infarct-related artery (IRA) strain was determined based on SS obtained from cine images. The primary endpoint was the composite of major adverse cardiovascular events (MACEs) after 8 years of follow-up. In Cohort 2, SS stability was assessed by MR twice within 8 days. Contrast and non-contrast risk models based on SS were established, leading to the development of an algorithm. STATISTICAL TEST Student's t-test, Mann-Whitney U-test, Cox and logistic regression, Kaplan-Meier analysis, net reclassification index (NRI). P < 0.05 was considered significant. RESULTS During a median follow-up of 5.2 years, 83 patients from Cohort 1 experienced a MACE. Among SS, IRA peak circumferential strain (IRA-CS) was an independent factor for MACEs (adjusted hazard ratio 1.099), providing incremental prognostic value (NRI 0.180, P = 0.10). Patients with worse IRA-CS (>-8.64%) demonstrated a heightened susceptibility to MACE. Additionally, IRA-CS was significantly associated with microvascular obstruction (MVO) (adjusted odds ratio 1.084) and infarct size (r = 0.395). IRA-CS showed comparable prognostic effectiveness to global peak circumferential strain (NRI 0.100, P = 0.39), also counterbalancing contrast and non-contrast risk models (NRI 0.205, P = 0.05). In Cohort 2, IRA-CS demonstrated stability between two time points (P = 0.10). Based on risk models incorporating IRA-CS, algorithm "HJKL" was preliminarily proposed for stratification. DATA CONCLUSIONS IRA-CS is an important prognostic factor, and an algorithm based on it is proposed for stratification. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jie He
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lingcong Kong
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dongaolei An
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Binghua Chen
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chengxu Zhao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Li
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Yang
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianxun Dong
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lai Wei
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peiren Shan
- Department of Cardiology, Wenzhou Medical University Affiliated NO. 1 Hospital, Wenzhou, China
| | - Yingmin Chen
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lianming Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Heng Ge
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Zhou X, Wang D, Jin Y, Gong M, Lin Q, He Y, Huang W, Shan P, Liang D. Sex differences in the association between D-dimer and the incidence of acute kidney injury in patients admitted with ST-segment elevation myocardial infarction: a retrospective observational study. Intern Emerg Med 2024; 19:91-98. [PMID: 37837488 DOI: 10.1007/s11739-023-03443-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/20/2023] [Indexed: 10/16/2023]
Abstract
Identifying the predictors of acute kidney injury (AKI) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains important. We aimed to investigate the predictive value of D-dimer levels for the incidence of AKI in such a population, with particular attention paid to sex differences. A total of 2668 patients with STEMI who underwent PPCI were retrospectively included in this study and divided into quartiles according to their plasma D-dimer levels upon admission (Q1: < 0.36; Q2: 0.36-0.67; Q3: 0.68-1.17; Q4: > 1.17 mg/L). The primary endpoint was the occurrence of AKI during hospitalization. AKI was observed in 503 (18.8%) patients. The mean age of the patients was 63.0 ± 13.2 years, 2155 (80.8%) of whom were men. Multivariate analysis indicated that higher D-dimer levels were associated with a significantly increased risk of AKI (Q4 vs. Q1: OR: 1.57; 95% CI 1.11-2.23; P = 0.011). However, the prognostic effect of D-dimer was only observed in male patients (Q4 vs. Q1: OR: 2.07; 95% CI 1.37-3.13; P < 0.001), not in female patients (Q4 vs. Q1: OR: 0.72; 95% CI 0.37-1.41; P = 0.342) (P for interaction = 0.003). We demonstrated a notable sex difference in the association between D-dimer level upon admission and AKI in a large STEMI patient sample. A higher D-dimer level was associated with an increased risk of AKI in male patients but not in female patients.
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Affiliation(s)
- Xi Zhou
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dingzhou Wang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Youkai Jin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Mengge Gong
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Qingcheng Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Yanlei He
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China.
| | - Dongjie Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, China.
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Zhou XD, Chen QF, Katsouras CS, Nijjar PS, Zheng KI, Zhu H, Gong M, Lin Q, Jin Y, Huang W, Shan P. Clinical Outcome After Left Ventricular Thrombus Resolution: Who Needs Long-Term or Lifetime Use of Anticoagulants? J Am Heart Assoc 2023; 12:e029070. [PMID: 37066808 DOI: 10.1161/jaha.122.029070] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Patients with left ventricular thrombus (LVT) resolution can have LVT recurrence and risk for thromboembolism. However, these outcomes after LVT resolution are not well known. We aimed to assess the prevalence, risk factors, and clinical outcomes for LVT recurrence in patients with LVT resolution to inform follow-up and treatment. Methods and Results Patients with LVT resolution were identified retrospectively from a large echocardiography database between January 2009 and May 2022. Participants had echocardiograms at 3 time points, including baseline at LVT diagnosis, at LVT resolution, and a follow-up for identification of LVT recurrence. The cumulative LVT recurrence rate was estimated by the Kaplan-Meier method, and predictors of LVT recurrence were evaluated using Cox regression analysis. Among 115 patients with LVT resolution, 28 (24.3%) had LVT recurrence at a median follow-up of 1.2 (0.5-2.8) years. LV aneurysm (hazard ratio [HR], 2.59 [95% CI, 1.20-5.58], P=0.015) and anticoagulant use (HR, 0.12 [95% CI, 0.04-0.41], P=0.001) were predictors of LVT recurrence on multivariable analysis. Patients with an LV aneurysm who did not receive any anticoagulation demonstrated an LVT recurrence rate of 69.5%, whereas those without an LV aneurysm who received anticoagulation had a recurrence rate of 0%. Patients with LVT recurrence had a higher incidence of an embolic event (10.7% versus 1.1%, P=0.016). Conclusions LVT recurrence after LVT resolution is common, especially in those with an LV aneurysm, and is associated with a higher embolic risk. Continued anticoagulation is protective against LVT recurrence, although bleeding risk needs to be considered. These findings can inform follow-up and treatment of patients with documented LVT resolution.
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Affiliation(s)
- Xiao-Dong Zhou
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Qin-Fen Chen
- Medical Care Center The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Christos S Katsouras
- Second Department of Cardiology, University Hospital of Ioannina Faculty of Medicine, School of Health Sciences University of Ioannina Ioannina Greece
| | - Prabhjot S Nijjar
- Division of Cardiovascular Medicine, Department of Medicine University of Minnesota Medical School Minneapolis MN
| | - Kenneth I Zheng
- MAFLD Research Center, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Haihui Zhu
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Mengge Gong
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Qingcheng Lin
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Youkai Jin
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Weijian Huang
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Peiren Shan
- Department of Cardiovascular Medicine The Heart Center, The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
- Key Laboratory of Intelligent Treatment and Life Support for Critical Diseases of Zhejiang Province Wenzhou Zhejiang China
- Zhejiang Engineering Research Center for Hospital Emergency and Process Digitization Wenzhou Zhejiang China
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Yang N, Wang M, Lin K, Wang M, Xu D, Han X, Zhao X, Wang Y, Wu G, Luo W, Liang G, Shan P. Dectin-1 deficiency alleviates diabetic cardiomyopathy by attenuating macrophage-mediated inflammatory response. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166710. [PMID: 37054997 DOI: 10.1016/j.bbadis.2023.166710] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023]
Abstract
Cardiovascular diseases are the primary cause of mortality in patients with diabetes and obesity. Hyperglycemia and hyperlipidemia in diabetes alters cardiac function, which is associated with broader cellular processes such as aberrant inflammatory signaling. Recent studies have shown that a pattern recognition receptor called Dectin-1, expressed on macrophages, mediates pro-inflammatory responses in innate immunity. In the present study, we examined the role of Dectin-1 in the pathogenesis of diabetic cardiomyopathy. We observed increased Dectin-1 expression in heart tissues of diabetic mice and localized the source to macrophages. We then investigated the cardiac function in Dectin-1-deficient mice with STZ-induced type 1 diabetes and high-fat-diet-induced type 2 diabetes. Our results show that Dectin-1 deficient mice are protected against diabetes-induced cardiac dysfunction, cardiomyocyte hypertrophy, tissue fibrosis, and inflammation. Mechanistically, our studies show that Dectin-1 is important for cell activation and induction of inflammatory cytokines in high-concentration glucose and palmitate acid (HG + PA)-challenged macrophages. Deficiency of Dectin-1 generate fewer paracrine inflammatory factors capable of causing cardiomyocyte hypertrophy and fibrotic responses in cardiac fibroblasts. In conclusion, this study provides evidence that Dectin-1 mediates diabetes-induced cardiomyopathy through regulating inflammation. Dectin-1 may be a potential target to combat diabetic cardiomyopathy.
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Affiliation(s)
- Na Yang
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Minxiu Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Lin
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengyang Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Diyun Xu
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Han
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xia Zhao
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gaojun Wu
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wu Luo
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guang Liang
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China; School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China.
| | - Peiren Shan
- Department of Cardiology and The Key Laboratory of Cardiovascular Disease of Wenzhou, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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9
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Yang N, Zou C, Luo W, Xu D, Wang M, Wang Y, Wu G, Shan P, Liang G. Sclareol attenuates angiotensin II-induced cardiac remodeling and inflammation via inhibiting MAPK signaling. Phytother Res 2023; 37:578-591. [PMID: 36178264 DOI: 10.1002/ptr.7635] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 11/08/2022]
Abstract
Chronic inflammation plays an important role in hypertensive heart failure. Suppressing angiotensin II (Ang II)-induced cardiac inflammation may contribute to the treatment of hypertension-associated heart failure. Sclareol, a natural product initially isolated from the leaves and flowers of Salvia sclarea, possesses antiinflammatory and immune-regulation activity in various systems. However, its effect on Ang II-induced cardiac remodeling remains unknown. In this study, we have explored the potential effects of sclareol on Ang II-induced heart failure. In vivo experiments were conducted in mice with Ang II-pump infusion for 28 days. Sclareol administration at 5 mg·kg-1 ·d-1 significantly reduced the expression of myocardial injury markers. Sclareol also exerts protective effects against Ang II-induced cardiac dysfunction in mice which is associated with alleviated cardiac inflammation and fibrosis. Transcriptome analysis revealed that inhibition of the Ang II-activated mitogen-activated protein kinase (MAPK) pathway contributed to the protective effect of sclareol. Sclareol inhibits Ang II-activated MAPKs pathway to reduce inflammatory response in mouse hearts and cultured cardiomyocytes. Blockage of MAPKs in cardiomyocytes abolished the antiinflammatory effects of sclareol. In conclusion, we show that sclareol protects hearts against Ang II-induced injuries through inhibiting MAPK-mediated inflammation, indicating the potential use of sclareol in the prevention of hypertensive heart failure.
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Affiliation(s)
- Na Yang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Chunpeng Zou
- Department of Ultrasonography, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Wu Luo
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Diyun Xu
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Mengyang Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Yanbian University, Yanji, People's Republic of China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Gaojun Wu
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Peiren Shan
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Guang Liang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- School of Pharmaceutical Sciences, Hangzhou Medical College, Zhejiang, Hangzhou, People's Republic of China
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10
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Zhou X, He Y, Hu L, Zhu Q, Lin Q, Hong X, Huang W, Shan P, Liang D. Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study. Front Cardiovasc Med 2022; 9:930202. [PMID: 36312228 PMCID: PMC9606207 DOI: 10.3389/fcvm.2022.930202] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Hyperlactatemia is a prognostic marker among patients with ST-segment elevation acute myocardial infarction (STEMI). However, the predictive value of lactate and the dynamic change associated with acute kidney injury (AKI) among patients with STEMI, remain poorly understood. We aimed to compare single lactate values at admission (Lacadm) and 12 h after admission (Lac12h) with lactate clearance (LC) 12 h after admission for AKI prediction in patients with STEMI. Methods A total of 1,784 patients with STEMI were included. The study endpoint was AKI occurrence during hospitalization. The predictive value of lactate levels measured at admission and 12 h after admission and LC for AKI prediction was determined using multivariate logistic regression analyses and compared with receiver operator characteristic (ROC) curve analysis. Results Overall, AKI was observed in 353 (19.8%) patients. In multivariate logistic regression analyses, Lacadm ≥ 4.3 mmol/L (OR: 1.53; 95% CI: 1.01–2.30), Lac12h ≥ 2.1 mmol/L (OR: 1.81; 95% CI: 1.36–2.42), and LC ≥ −7.5% (OR: 0.40; 95% CI: 0.30–0.53) were the independent predictive factors for AKI after adjusting for confounders. ROC curve analysis results revealed that Lac12h (0.639; 95% CI: 0.616–0.661) exhibited a significantly higher area under the curve (AUC) than those of Lacadm (0.551; 95% CI: 0.527–0.574) and LC (0.593; 95% CI: 0.570–0.616) in the prediction of AKI. LC (△AUC = 0.037, p < 0.001) and Lac12h (△AUC = 0.017, p = 0.029) enhanced the discrimination capacity of Mehran Risk Score (MRS) for AKI among patients undergoing emergency coronary angiography. Conclusion Lac12h is more effective for AKI prediction among patients with STEMI than Lacadm and LC. Furthermore, Lac12h and LC enhance the prediction capacity of MRS for AKI among patients after emergency coronary angiography.
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Affiliation(s)
- Xi Zhou
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yanlei He
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Long Hu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianli Zhu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qingcheng Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xia Hong
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,*Correspondence: Peiren Shan,
| | - Dongjie Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,Dongjie Liang,
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11
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Zhao Y, Lu X, Wan F, Gao L, Lin N, He J, Wei L, Dong J, Qin Z, Zhong F, Qiao Z, Wang W, Ge H, Ding S, Yang Y, Xiu J, Shan P, Yan F, Zhao S, Ji Y, Pu J. Disruption of Circadian Rhythms by Shift Work Exacerbates Reperfusion Injury in Myocardial Infarction. J Am Coll Cardiol 2022; 79:2097-2115. [PMID: 35618347 DOI: 10.1016/j.jacc.2022.03.370] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [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: 01/03/2022] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Shift work is associated with increased risk of acute myocardial infarction (AMI) and worsened prognosis. However, the mechanisms linking shift work and worsened prognosis in AMI remain unclear. OBJECTIVES This study sought to investigate the impact of shift work on reperfusion injury, a major determinant of clinical outcomes in AMI. METHODS Study patient data were obtained from the database of the EARLY-MYO-CMR (Early Assessment of Myocardial Tissue Characteristics by CMR in STEMI) registry, which was a prospective, multicenter registry of patients with ST-segment elevation myocardial infarction (STEMI) undergoing cardiac magnetic resonance (CMR) imaging after reperfusion therapy. The primary endpoint was CMR-defined post-reperfusion infarct size. A secondary clinical endpoint was the composite of major adverse cardiac events (MACE) during follow-up. Potential mechanisms were explored with the use of preclinical animal AMI models. RESULTS Of 706 patients enrolled in the EARLY-MYO-CMR registry, 412 patients with STEMI were ultimately included. Shift work was associated with increased CMR-defined infarct size (β = 5.94%; 95% CI: 2.94-8.94; P < 0.0001). During a median follow-up of 5.0 years, shift work was associated with increased risks of MACE (adjusted HR: 1.92; 95% CI: 1.12-3.29; P = 0.017). Consistent with clinical findings, shift work simulation in mice and sheep significantly augmented reperfusion injury in AMI. Mechanism studies identified a novel nuclear receptor subfamily 1 group D member 1/cardiotrophin-like cytokine factor 1 axis in the heart that played a crucial role in mediating the detrimental effects of shift work on myocardial injury. CONCLUSIONS The current study provided novel findings that shift work increases myocardial infarction reperfusion injury. It identified a novel nuclear receptor subfamily 1 group D member 1/cardiotrophin-like cytokine factor 1 axis in the heart that might play a crucial role in mediating this process. (Early Assessment of Myocardial Tissue Characteristics by CMR in STEMI [EARLY-MYO-CMR] registry; NCT03768453).
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Affiliation(s)
- Yichao Zhao
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Xiyuan Lu
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Fang Wan
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Lingchen Gao
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Nan Lin
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Jie He
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Lai Wei
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Jianxun Dong
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Zihan Qin
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Fangyuan Zhong
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Zhiqin Qiao
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Wei Wang
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Heng Ge
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Song Ding
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Yining Yang
- The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China
| | - Jiancheng Xiu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Peiren Shan
- The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shihua Zhao
- Department of Cardiovascular Magnetic Resonance, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Ji
- Key Laboratory of Cardiovascular and Cerebrovascular Medicine, Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Jun Pu
- State Key Laboratory for Oncogenes and Related Genes, Division of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China.
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12
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Liang D, Lin Q, Zhu Q, Zhou X, Fang Y, Wang L, Xiang G, Zheng KI, Huang W, Shan P. Short-Term Postoperative Use of Rivaroxaban to Prevent Radial Artery Occlusion After Transradial Coronary Procedure: The RESTORE Randomized Trial. Circ Cardiovasc Interv 2022; 15:e011555. [PMID: 35317614 DOI: 10.1161/circinterventions.121.011555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 01/23/2023]
Abstract
BACKGROUND Adequate procedural anticoagulation is crucial for radial artery occlusion (RAO) prevention in patients undergoing transradial access coronary catheterization, although the effect of postprocedural anticoagulation lack thorough investigation. The aim of this study was to evaluate the clinical value of short-term postoperative anticoagulation with rivaroxaban for 24 hours and 1-month RAO prevention in patients who received transradial coronary procedures. METHODS A total of 382 patients were randomized to receive either placebo (control group) or rivaroxaban 10 mg once daily for a period of 7 days (rivaroxaban group) to evaluate the effect of the rivaroxaban in the prevention of 24 hours and 1-month RAO assessed by Doppler ultrasound. RESULTS There was no significant difference in the incidence of 24-hour RAO (8.9% versus 11.5%; P=0.398) between the rivaroxaban group and control group (odds ratio, 0.75 [95% CI, 0.39-1.46]; P=0.399). In contrast, the 1-month RAO (3.8% versus 11.5%; P=0.011) was significantly reduced in patients who received rivaroxaban as compared with those who did placebo (odds ratio, 0.22 [95% CI, 0.08-0.65]; P=0.006). For patients with 24-hour RAO, the rivaroxaban group was associated with higher recanalization rate of the radial artery (69.2% versus 30.0%; P=0.027) compared with the control group. No significant differences can be observed between the 2 groups for access-site complications or bleeding events. CONCLUSIONS Short-term postoperative anticoagulation with rivaroxaban did not reduce the rate of 24-hour RAO but improved 1-month RAO, because of higher recanalization of the radial artery. However, larger clinical trials are needed to prove our results. REGISTRATION URL: https://www.chictr.org.cn; Unique identifier: ChiCTR1900026974.
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Affiliation(s)
- Dongjie Liang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Qingcheng Lin
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Qianli Zhu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Xiaodong Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Ying Fang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Liangguo Wang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Guangze Xiang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Kenneth I Zheng
- NAFLD Research Center, Department of Hepatology (K.I.Z.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou (D.L., Q.L., Q.Z., X.Z., Y.F., L.W., G.X., W.H., P.S.), the First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
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13
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He Y, Wang D, Zhou X, Zhu Q, Lin Q, Hong X, Huang W, Shan P, Liang D. Interaction between Hyperuricemia and Admission Lactate Increases the Risk of Acute Kidney Injury in Patients with ST-Segment Elevation Myocardial Infarction. Cardiorenal Med 2022; 12:189-195. [PMID: 35917797 DOI: 10.1159/000526104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/15/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Acute kidney injury (AKI) is a common complication associated with adverse outcomes among patients with ST-segment elevation myocardial infarction (STEMI). This is conflicting information about the relationship between hyperuricemia and AKI in STEMI. This work aimed to investigate the effect of the interaction between hyperuricemia and lactate on the risk of AKI. METHODS We analyzed 2,008 consecutive STEMI patients between January 2014 and January 2019. Hyperuricemia was defined as a serum uric acid level >7 mg/dL for males and >6 mg/dL for females. AKI was defined based on the Kidney Disease: Improving Global Outcomes (KDIGO). Logistic regression models were applied to establish the relationship between hyperuricemia and AKI in the overall population and subgroups stratified as per lactate levels at admission (≤2.2 mmol/L or >2.2 mmol/L). RESULTS In total, we included 1,887 STEMI patients. Multivariate analysis showed that hyperuricemia is associated with the risk of AKI (OR: 1.34; 95% CI: 1.01-1.77; p = 0.045). Nonetheless, the predictive effect of hyperuricemia was only observed in patients with lactate level >2.2 mmol/L (OR: 2.05; 95% CI: 1.36-3.10; p < 0.001), but not in those with lactate level ≤2.2 mmol/L (OR: 0.86, 95% CI: 0.56-1.32; p = 0.493). The interaction between hyperuricemia and lactate levels demonstrated a significant effect on AKI. CONCLUSIONS In summary, hyperuricemia increases the risk of AKI in STEMI patients with lactate levels> 2.2 mmol/L, but not in those with lactate levels ≤2.2 mmol/L.
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Affiliation(s)
- Yanlei He
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dingzhou Wang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xi Zhou
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianli Zhu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qingcheng Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xia Hong
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongjie Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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14
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Zhou C, Lin Q, Xiang G, Chen M, Cai M, Zhu Q, Zhou R, Huang W, Shan P. Impact of Pre-Revascularization and Post-Revascularization Cardiac Arrest on Survival Prognosis in Patients With Acute Myocardial Infarction and Following Emergency Percutaneous Coronary Intervention. Front Cardiovasc Med 2021; 8:705504. [PMID: 34869623 PMCID: PMC8639596 DOI: 10.3389/fcvm.2021.705504] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/11/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To evaluate the effects of occurrence and timing of sudden cardiac arrest (SCA) on survival in patients with acute myocardial infarction (AMI) who underwent emergency percutaneous coronary intervention (PCI). Methods: We analyzed 1,956 consecutive patients with AMI with emergency PCI from 2014 to 2018. Patients with cardiac arrest events were identified, and their medical records were reviewed. Results: Patients were divided into non-cardiac arrest group (NCA group, n = 1,724), pre-revascularization cardiac arrest (PRCA group, n = 175), and post-revascularization SCA (POCA group, n = 57) according to SCA timing. Compared to NCA group, PRCA group and POCA group presented with higher brain natriuretic polypeptide (BNP), more often Killip class 3/4, atrial fibrillation, and less often completed recovery of coronary artery perfusion (all p < 0.05). Both patients with PRCA and POCA showed increased 30-day all-cause mortality when compared to patients with NCA (8.0 and 70.2% vs. 2.9%, both p < 0.001). However, when compared to patients with NCA, patients with PRCA did not lead to higher mortality during long-term follow-up (median time 917 days) (16.3 vs. 18.6%, p = 0.441), whereas patients with POCA were associated with increased all-cause mortality (36.3 vs. 18.6%, p < 0.001). Multivariate analysis identified Killip class 3/4, atrial fibrillation, high maximum MB isoenzyme of creatine kianse, and high creatinine as predictive factors for POCA. In Cox regression analysis, POCA was found as a strong mortality-increase predictor (HR, 8.87; 95% CI, 2.26–34.72; p = 0.002) for long-term all-cause death. Conclusions: POCA appeared to be a strong life-threatening factor for 30-day and long-term all-cause mortality among patients with AMI who admitted alive and underwent emergency PCI. However, PRCA experience did not lead to a poorer long-term survival in patients with AMI surviving the first 30 days.
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Affiliation(s)
- Changzuan Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Cardiology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Qingcheng Lin
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guangze Xiang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengmeng Chen
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengxing Cai
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianli Zhu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rui Zhou
- Department of Cardiology, Wenzhou People's Hospital, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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15
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Pu J, Yan F, Yang Y, Xiu J, Shan P. Circadian disruption on the susceptibility to sepsis-induced cardiac dysfunction: a prospective multi-modal imaging study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0279] [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
Sepsis is a significant cause of mortality, and cardiac dysfunction is one of the vital predictors for mortality of sepsis. However, the factors associated with the susceptibility to sepsis-induced cardiac dysfunction remain unclear. Disruption of circadian rhythms can profoundly influence cardiac health; however, to the knowledge of the authors, the relationship of circadian disruption to cardiac involvement in patients with sepsis is unknown.
Purpose
We aim to investigate the impact of circadian disruption on the susceptibility to sepsis-induced cardiac dysfunction.
Methods
Study patient data were obtained from the image database of EARLY-MYO-SEPSIS (EARLY assessment of MYOcardial tissue characteristics by multi-modal imaging in SEPSIS) registry, which was a prospective, multi-center registry of sepsis patients who have undergone cardiac magnetic resonance imaging (MRI) and echocardiography from 8 sites (clinical trial number NCT04513795). Cardiac involvement was evaluated using a comprehensive assessment comprising of echocardiography (with global longitudinal strain calculation), cardiac MRI and cardiac biomarker evaluation. Logistic regression was performed to identify independent predictors of left ventricular systolic dysfunction in sepsis.
Results
A total of 216 intensive care unit patients with sepsis was enrolled in the present analysis. Septic patients with a history of circadian disruption (i.e., sleep insufficiency <6 hours) presented more cardiac involvements (as indicated by edema on the cardiac MRI along with cardiac deformation and increased cardiac biomarkers) compared with those without circadian disruption history. Moreover, septic patients with a history of circadian disruption had increased mortality and incidence of heart failure. A history of circadian disruption was identified as an independent predictor of left ventricular systolic dysfunction in sepsis.
Conclusions
Our data from EARLY-MYO-SEPSIS registry demonstrated a previously unappreciated circadian sensitivity to sepsis-induced cardiac dysfunction.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by grants from the National Science Fund for Distinguished Young Scholars (81625002) and National Natural Science Foundation of China (81930007)
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Affiliation(s)
- J Pu
- Renji Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - F Yan
- Rui Jin Hospital- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Y Yang
- The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China
| | - J Xiu
- Nanfang Hospital affiliated Hospital of Southern Medical University, Guangzhou, China
| | - P Shan
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Ye S, Lin K, Wu G, Xu MJ, Shan P, Huang W, Wang Y, Liang G. Toll-like receptor 2 signaling deficiency in cardiac cells ameliorates Ang II-induced cardiac inflammation and remodeling. Transl Res 2021; 233:62-76. [PMID: 33652137 DOI: 10.1016/j.trsl.2021.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 11/04/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 11/28/2022]
Abstract
Activation of the innate immune system represents a vital step in inflammation during cardiac remodeling induced by the angiotensin II (Ang II). This study aimed to explore the role of Toll-like receptors 2 (TLR2) in Ang II-induced cardiac remodeling. We investigated the effect of TLR2 deficiency on Ang II-induced cardiac remodeling by utilizing TLR2 knockout mice, bone marrow transplantation models, and H9C2 cells. Though TLR2 deficiency had no effect on body weight change, cardiac Ang II content and blood pressure, it significantly ameliorated cardiac hypertrophy, fibrosis and inflammation, as well as improved heart function. Further bone marrow transplantation studies showed that TLR2-deficiency in cardiac cells but not bone marrow-derived cells prevented Ang II-induced cardiac remodeling and cardiac dysfunction. The underlying mechanism may involve increased TLR2-MyD88 interaction. Further in vitro studies in Ang II-treated H9C2 cells showed that TLR2 knockdown by siRNA significantly decreased Ang II-induced cell hypertrophy, fibrosis and inflammation. Moreover, Ang II significantly increased TLR2-MyD88 interaction in H9C2 cells in a TLR4-independent manner. TLR2 deficiency in cardiac cells prevents Ang II-induced cardiac remodeling, inflammation and dysfunction through reducing the formation of TLR2-MyD88 complexes. Inhibition of TLR2 pathway may be a therapeutic strategy of hypertensive heart failure.
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Affiliation(s)
- Shiju Ye
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Lin
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gaojun Wu
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ming-Jiang Xu
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peiren Shan
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weijian Huang
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China; Zhuji Biomedicine Institute, School of Pharmaceutical Sciences, Wenzhou Medical University, Zhuji, Zhejiang, China.
| | - Guang Liang
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China; Zhuji Biomedicine Institute, School of Pharmaceutical Sciences, Wenzhou Medical University, Zhuji, Zhejiang, China; School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Shan P, Kaimal A, Shiney J, Derwin J. A No-Reference Quality Metric for Parameter Tuning of Edge-Aware Filters – An Anti-Image Forensic Method. Ing Rech Biomed 2021. [DOI: 10.1016/j.irbm.2020.02.004] [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]
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18
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Ye S, Su L, Shan P, Ye B, Wu S, Liang G, Huang W. LCZ696 Attenuated Doxorubicin-Induced Chronic Cardiomyopathy Through the TLR2-MyD88 Complex Formation. Front Cell Dev Biol 2021; 9:654051. [PMID: 33928085 PMCID: PMC8076895 DOI: 10.3389/fcell.2021.654051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/15/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022] Open
Abstract
Background and Purpose The profibrotic and proinflammatory effects induced by doxorubicin (DOX) are key processes in the development of serious heart damage. Lack of effective drugs and the unclear mechanisms of its side effects limit the clinical treatment of DOX-induced cardiac injury. This study aimed to explore the protective role of LCZ696 and the potential mechanism of Toll-like receptor 2 (TLR2) in doxorubicin-induced cardiac failure. Experimental Approach DOX (5 mg/kg/week, three times) was used to establish a chronic cardiomyopathy mouse model. Heart function tests, pathology examinations and molecular biology analyses were used to explore the effects of LCZ696 and TLR2 deficiency in vivo and in vitro. Computational docking was applied to predict the key residues for protein-ligand interaction. Key Results The EF% declined, and the LVIDd, pro-fibrosis marker levels and NF-κB related inflammatory response increased in the chronic cardiomyopathy group induced by DOX. LCZ696 treatment and TLR2 deficiency reversed these heart damage in vivo. In H9C2 cells, pre-treatment with LCZ696 and TLR2 knockdown suppressed the DOX-induced high expression of profibrotic and proinflammatory markers. Moreover, DOX notably increased the TLR2-MyD88 interaction in vivo and in vitro, which was inhibited by LCZ696. Finally, we demonstrated the direct interaction between DOX and TLR2 via hydrogen bonds on Pro-681 and Glu-727 and Pro-681 and Ser-704 may be the key residues by which LCZ696 affects the interaction between DOX and TLR2. Conclusion and Implications LCZ696 prevents DOX-induced cardiac dilation failure, fibrosis and inflammation by reducing the formation of TLR2-MyD88 complexes. LZC696 may be a potential effective drug to treat DOX-induced heart failure.
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Affiliation(s)
- Shiju Ye
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China.,Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Lan Su
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Bozhi Ye
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Shengjie Wu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Guang Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Cardiovascular Disease of Wenzhou, Wenzhou, China
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Zhou X, Zheng KI, Shan P. Toward reducing thrombus recurrence rate in management of patients with confirmed left ventricular thrombi. ESC Heart Fail 2021; 8:2359-2360. [PMID: 33749165 PMCID: PMC8120361 DOI: 10.1002/ehf2.13319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/11/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Xiaodong Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Kenenth I Zheng
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
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20
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Zhou X, Yu L, Hu W, Shi R, Ji Y, Zhou C, Xue C, Yu G, Huang W, Shan P. A novel risk model to predict first-ever ischemic stroke in heart failure with reduced ejection fraction. Aging (Albany NY) 2021; 13:5332-5341. [PMID: 33535186 PMCID: PMC7950228 DOI: 10.18632/aging.202458] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/09/2020] [Indexed: 12/28/2022]
Abstract
Patients with heart failure are at increased risk for ischemic stroke. We aim to develop a more accurate stroke risk prediction tools identify high-risk patients with heart failure with reduced ejection fraction (HFrEF). Patient data were extracted retrospectively from the electronic medical database between January 2009 and February 2019. Univariate and multivariate Cox regression analysis were performed to identify independent predictors, which were utilized to construct a nomogram for predicting ischemic stroke. AUROC analysis was used to compare the prognostic value between the new risk score and CHADS2/CHA2DS2-VASc scores. In 6087 patients with HFrEF, the risk of first-ever ischemic stroke was 5.8% events/pts-years (n=468) during 8007.2 person-years follow-up. A nomogram constructed by integrating 6 variables, including age, atrial fibrillation (AF), deep vein thrombosis (DVT), d-dimer, anticoagulant use and spontaneous echocardiographic contrast (SEC)/left ventricular thrombus (LVT), exhibited a greater area under the curve of 0.727, 0.728 and 0.714 than that by CHADS2 score (0.515, 0.522 and 0.540), and by CHA2DS2-VASc score (0.547, 0.553 and 0.562) for predicting first-ever ischemic stroke at hospitalization, 30-day and 6-month follow-up (all p<0.001). This novel stroke risk score performed better than existing CHADS2/ CHA2DS2-VASc scores and showed improvement in predicting first-ever ischemic stroke in HFrEF patients.
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Affiliation(s)
- Xiaodong Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Lingfang Yu
- Department of Nephrology, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Weizhen Hu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Ruiyu Shi
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Yinan Ji
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Changzuan Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Chenglong Xue
- Department of Cardiology, Longgang People's Hospital, Longgang 325802, Zhejiang, P.R. China
| | - Guojia Yu
- Department of Cardiology, Longgang People's Hospital, Longgang 325802, Zhejiang, P.R. China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China.,Department of Cardiology, Longgang People's Hospital, Longgang 325802, Zhejiang, P.R. China
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21
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Zhou X, Shi R, Wu G, Zhu Q, Zhou C, Wang L, Xue C, Jiang Y, Cai X, Huang W, Shan P. The prevalence, predictors, and outcomes of spontaneous echocardiographic contrast or left ventricular thrombus in patients with HFrEF. ESC Heart Fail 2021; 8:1284-1294. [PMID: 33496071 PMCID: PMC8006613 DOI: 10.1002/ehf2.13196] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 08/15/2020] [Revised: 12/12/2020] [Accepted: 12/23/2020] [Indexed: 12/28/2022] Open
Abstract
Aims This study aimed to determine prevalence, predictors, and association with ischaemic stroke risk of spontaneous echocardiographic contrast (SEC) or left ventricular thrombus (LVT) in patients with heart failure with reduced ejection fraction (HFrEF). Methods and results Clinical, echocardiographic, and follow‐up data from January 2009 through February 2019 were retrospectively extracted from electronic medical records of patients with heart failure with left ventricular ejection fraction < 40% by echocardiography on admission, with follow‐up to February 2020. Of 9485 consecutive patients with HFrEF, 123 (1.3%) presented LVT and 331 (3.5%) presented SEC. Patients with vs. those without SEC/LVT had larger left ventricular end‐diastolic volume (199.5 ± 77.7 vs. 165.8 ± 61.3 mL, P < 0.001), lower left ventricular ejection fractions (29.5 ± 7.0% vs. 33.7 ± 5.5%, P < 0.001), and more often ischaemic cardiomyopathy, apical aneurysm, chronic kidney diseases, and smoking habit. In Cox regression analysis, SEC and LVT were independent predictors for ischaemic stroke occurrence [hazard ratio (HR) = 2.40, 95% confidence interval (CI): 1.74–3.31; HR = 4.52, 95% CI: 2.77–7.40, both P < 0.001]. In patients with those without SEC or LVT, stroke risk was higher among those not on anticoagulants (HR = 2.55, 95% CI: 1.85–3.53; HR = 4.71, 95% CI: 2.84–7.81, both P < 0.001), but similar among those on anticoagulants (P > 0.05). In patients with sinus rhythm, the associations between SEC/LVT and ischaemic stroke persist with HRs of 2.57 (95% CI: 1.69–3.92) and 5.74 (95% CI: 3.38–9.75). Conclusions In patients with HFrEF, SEC was not uncommon and increased risk of ischaemic stroke as well as LVT. Anticoagulants could play a role in the reduction of stroke risk, suggesting that patients with SEC/LVT, even those in sinus rhythm, would benefit from systemic anticoagulation treatment.
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Affiliation(s)
- Xiaodong Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Ruiyu Shi
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Gaojun Wu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Qianli Zhu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Changzuan Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Liangguo Wang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Chenglong Xue
- Department of Cardiology, Longgang City People's Hospital, Longgang, Zhejiang, China
| | - Yuanyuan Jiang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Xueli Cai
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, Zhejiang, 325000, China.,Department of Cardiology, Longgang City People's Hospital, Longgang, Zhejiang, China
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Zhou C, Yu L, Zhu Q, Xiang G, Xv P, Chen C, Cai M, Huang W, Shan P. Clinical outcome of new-onset atrial fibrillation after emergency percutaneous coronary intervention for myocardial infarction. Am J Emerg Med 2020; 45:162-168. [PMID: 33041127 DOI: 10.1016/j.ajem.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/26/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Changzuan Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China; Department of Cardiology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, PR China
| | - Lingfang Yu
- Department of Nephrology, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Qianli Zhu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Guangze Xiang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Pengfei Xv
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Chen Chen
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Menxing Cai
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China.
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Shan P, Huang W, Xiao D, Shi R. TCT CONNECT-436 A Novel Risk Model to Predict First-Ever Ischemic Stroke in Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.464] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shan P, Yu L, Xiao D, Shi R, Huang W. TCT CONNECT-441 The Prevalence, Predictors, and Clinical Outcomes of Spontaneous Echocardiographic Contrast or Left Ventricular Thrombus in Patients With HFrEF. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.573] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leng S, Ge H, He J, Kong L, Yang Y, Yan F, Xiu J, Shan P, Zhao S, Tan RS, Zhao X, Koh AS, Allen JC, Hausenloy DJ, Mintz GS, Zhong L, Pu J. Long-term Prognostic Value of Cardiac MRI Left Atrial Strain in ST-Segment Elevation Myocardial Infarction. Radiology 2020; 296:299-309. [PMID: 32544032 DOI: 10.1148/radiol.2020200176] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Left atrial (LA) dysfunction is associated with morbidity and mortality. To the knowledge of the authors, the relationship of LA strain to long-term prognosis in participants with ST-segment elevation myocardial infarction (STEMI) is unknown. Purpose To evaluate LA strain as a long-term outcome predictor in STEMI in a prospective, multicenter cardiac MRI cohort. Materials and Methods Participants with STEMI who underwent primary percutaneous coronary intervention and cardiac MRI from 10 sites (EARLY-MYO-CMR registry, clinical trial number NCT03768453) were included. The parent study took place between August 2013 and December 2018. LA longitudinal strain and strain rate parameters were derived from cine cardiac MRI by using an in-house semiautomated method. Major adverse cardiac events (MACEs) were defined as cardiovascular death, myocardial reinfarction, hospitalization for heart failure, and stroke. The association between LA performance and MACE was evaluated by using time-dependent receiver operating characteristic analysis, Kaplan-Meier analysis, and multivariable Cox regression analysis. Results A total of 321 participants (median age, 59 years; age range, 27-75 years; 90% men) were included in this study. During median follow-up of 3.7 years, MACE occurred in 76 participants (23.7%). Participants with impaired reservoir (≤22%) and conduit strain (≤10%) had a higher risk of MACE than those with reservoir strain greater than 22% and conduit strain greater than 10% (P < .001). Reservoir strain (hazard ratio, 0.84; 95% confidence interval: 0.77, 0.91; P < .001) and conduit strain (hazard ratio, 0.81; 95% confidence interval: 0.73, 0.89; P < .001) were independent predictors for MACE after adjustment for known risk factors. Finally, LA reservoir and conduit strains provided incremental prognostic value over traditional outcome predictors (Uno C statistic comparing models, 0.75 vs 0.68; P = .04). Conclusion Assessment of left atrial strain, as a measure of left atrial function, provided incremental prognostic information to established predictors in ST-segment elevation myocardial infarction. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Kawel-Boehm and Bremerich in this issue.
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Affiliation(s)
- Shuang Leng
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Heng Ge
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Jie He
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Lingcong Kong
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Yining Yang
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Fuhua Yan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Jiancheng Xiu
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Peiren Shan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Shihua Zhao
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Ru-San Tan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Xiaodan Zhao
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Angela S Koh
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - John C Allen
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Derek J Hausenloy
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Gary S Mintz
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Liang Zhong
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
| | - Jun Pu
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (S.L., R.S.T., X.Z., A.S.K., D.J.H., L.Z.); Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Road, Pudong New District, Shanghai 200127, China (H.G., J.H., L.K., J.P.); The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi, China (Y.Y.); Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (F.Y.); Nanfang Hospital, Southern Medical University, Guangzhou, China (J.X.); The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China (P.S.); Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (S.Z.); Duke-NUS Medical School, Singapore (R.S.T., A.S.K., J.C.A., D.J.H., L.Z.); Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.); The Hatter Cardiovascular Institute, University College London, London, England (D.J.H.); Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan (D.J.H.); and Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (G.S.M.)
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Wu G, Wang Z, Shan P, Huang S, Lin S, Huang W, Huang Z. Suppression of Netrin-1 attenuates angiotension II-induced cardiac remodeling through the PKC/MAPK signaling pathway. Biomed Pharmacother 2020; 130:110495. [PMID: 32688140 DOI: 10.1016/j.biopha.2020.110495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/24/2019] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Myocardial remodeling caused by angiotensin II (Ang II) is essential for the pathological process of heart failure. Netrin-1, which is an axonal guidance cue, has been shown to be involved in the inflammatory response, tumorigenesis, and angiogenesis in non-neuronal tissues. However, the role of Netrin-1 in cardiac remodeling has not been fully elucidated. METHODS The rat cardiomyocyte cell line H9c2 and primary neonatal rat cardiomyocytes were treated with Ang II. Cells were transfected with siRNA to silence Netrin-1 expression. Real-time polymerase chain reaction and Western blot analysis were used to detect the markers for fibrosis, apoptosis, and hypertrophy in cardiomyocytes. An Annexin V-EGFP/PI cell apoptosis detection kit was used to measure the level of apoptosis caused by angiotensin II. RESULTS We found that Netrin-1 expression was upregulated in the H9c2 cells and the neonatal rat cardiomyocytes stimulated by Ang II. The increased Netrin-1 expression was decreased by valsartan to block AT1R. Importantly, the application of Netrin-1 siRNA significantly alleviated the degrees of myocardial hypertrophy, fibrosis (reflected by Myhc, collagen I, and TGF-β) and apoptosis (reflected by the level of Caspase 3, Bax, and Bcl-2) induced by Ang II. In addition, the silencing of Netrin-1 substantially decreased the phosphorylation of PKCα, JNK, and P38. We treated H9c2 cells with LY317615, SP600125, and SB203580, inhibitors of PKCα, JNK, and P38, respectively, thereby resulting in a substantial decrease in hypertrophy, fibrosis, and apoptosis. CONCLUSIONS Ang II produces cardiac hypertrophy, fibrosis, and apoptosis through the upregulation of Netrin-1 and the activation of the AT1R/PKCα/MAPK (JNK, P38) pathway. Suppression of Netrin-1 can relieve Ang II-induced cardiac remodeling via inhibition of the PKCα/MAPK (JNK and P38) signaling pathway. Thus, Netrin-1 may be a novel therapeutic target for Ang II-mediated cardiac remodeling.
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Affiliation(s)
- Gaojun Wu
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Zhengxian Wang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Peiren Shan
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Shanjun Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Shuang Lin
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Weijian Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
| | - Zhouqing Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, WenZhou, ZheJiang, China.
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Xiang G, Shan P, Zhou C, Zhou J, Ji G, Zhou H, Li S, Hu K, Hong C, Huang W. Clinical features and prognosis of acute myocardial infarction caused by non-tumor origin coronary artery embolism. Am J Emerg Med 2020; 38:1185-1191. [PMID: 32229223 DOI: 10.1016/j.ajem.2020.03.043] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Several studies have indicated that acute myocardial infarction (AMI) secondary to coronary artery embolism (CE) has a poor prognosis. However, in the latter studies, CE of tumor origin accounts for a considerable proportion of cases and the clinical features and contribution to overall prognosis of non-tumor CE are unknown and therefore the subject of this study. METHODS We retrospectively studied 2006 consecutive patients with AMI at our medical center from January 2014 to October 2018. Non-tumor CE was diagnosed based on angiographic, biochemical, and imaging criteria. Patients were divided into two groups: patients without CE (control) and patients with non-tumor CE. RESULTS Atrial fibrillation was the most frequent etiology (n = 32, 69.6%) in the non-tumor CE group (n = 46). Compared with the control group, the non-tumor CE group had (all p < 0.05): higher incidence of atrial fibrillation; larger left atrial diameter, left ventricular end-diastolic diameter and left ventricular end-systolic diameter; lower left ventricular ejection fraction, ST-segment-elevation myocardial infarction incidence and low density lipoprotein cholesterol level; lower incidence of multivessel coronary stenosis, level of culprit lesion stenosis and proportion of angioplasty; higher ratio of manual thrombectomy and antithrombotic drugs alone therapy; lower thrombolysis in myocardial infarction (TIMI) grade and higher corrected TIMI frame counts (CTFC) after reperfusion; and statistically similar overall survival at median 864 (interquartile range, 413-1272) days. CONCLUSIONS The overall incidence of non-tumor CE was 2.3%, with atrial fibrillation as its most common etiology. Midterm overall survival was similar between AMI patients secondary to non-tumor CE and those without CE.
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Affiliation(s)
- Guangze Xiang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China.
| | - Changzuan Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Jian Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Guang Ji
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Hao Zhou
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Sheng Li
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Kaiyu Hu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Chenglv Hong
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
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Chen T, Huang W, Qian J, Luo W, Shan P, Cai Y, Lin K, Wu G, Liang G. Macrophage-derived myeloid differentiation protein 2 plays an essential role in ox-LDL-induced inflammation and atherosclerosis. EBioMedicine 2020; 53:102706. [PMID: 32151799 PMCID: PMC7063167 DOI: 10.1016/j.ebiom.2020.102706] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 12/25/2022] Open
Abstract
Background Atherosclerosis is a chronic inflammatory disease. Although Toll-like receptor 4 (TLR4) has been involved in inflammatory atherosclerosis, the exact mechanisms by which oxidized-low-density lipoproteins (ox-LDL) activates TLR4 and elicits inflammatory genesis are not fully known. Myeloid differentiation factor 2 (MD2) is an extracellular molecule indispensable for lipopolysaccharide recognition of TLR4. Method Apoe−/−Md2−/− mice and pharmacological inhibitor of MD2 were used in this study. We also reconstituted Apoe−/− mice with either Apoe−/− or Apoe−/−Md2−/− marrow-derived cells. Mechanistic studies were performed in primary macrophages, HEK-293T cells, and cell-free system. Finding MD2 levels are elevated in atherosclerotic lesion macrophages, and MD2 deficiency or pharmacological inhibition in mice reduces the inflammation and stunts the development of atherosclerotic lesions in Apoe−/− mice fed with high-fat diet. Transfer of marrow-derived cells from Apoe-Md2 double knockout mice to Apoe knockout mice confirmed the critical role of bone marrow-derived MD2 in inflammatory factor induction and atherosclerosis development. Mechanistically, we show that MD2 does not alter ox-LDL uptake by macrophages but is required for TLR4 activation and inflammation via directly binding to ox-LDL, which triggers MD2/TLR4 complex formation and TLR4-MyD88-NFκB pro-inflammatory cascade. Interpretation We provide a mechanistic basis of ox-LDL-induced macrophage inflammation, illustrate the role of macrophage-derived MD2 in atherosclerosis, and support the therapeutic potential of MD2 targeting in atherosclerosis-driven cardiovascular diseases. Funding This work was supported by the National Key Research Project of China (2017YFA0506000), National Natural Science Foundation of China (21961142009, 81930108, 81670244, and 81700402), and Natural Science Foundation of Zhejiang Province (LY19H020004).
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Affiliation(s)
- Taiwei Chen
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weijian Huang
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinfu Qian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wu Luo
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peiren Shan
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan Cai
- The Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Lin
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gaojun Wu
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Guang Liang
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China; Zhuji Biomedicine Institute, School of Pharmaceutical Sciences, Wenzhou Medical University, Zhuji, Zhejiang, China.
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Ye S, Luo W, Khan ZA, Wu G, Xuan L, Shan P, Lin K, Chen T, Wang J, Hu X, Wang S, Huang W, Liang G. Celastrol Attenuates Angiotensin II-Induced Cardiac Remodeling by Targeting STAT3. Circ Res 2020; 126:1007-1023. [PMID: 32098592 DOI: 10.1161/circresaha.119.315861] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [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] [Indexed: 12/11/2022]
Abstract
RATIONALE Excessive Ang II (angiotensin II) levels lead to a profibrotic and hypertrophic milieu that produces deleterious remodeling and dysfunction in hypertension-associated heart failure. Agents that disrupt Ang II-induced cardiac dysfunction may have clinical utility in the treatment of hypertension-associated heart failure. OBJECTIVE We have examined the potential effect of celastrol-a bioactive compound derived from the Celastraceae family-on Ang II-induced cardiac dysfunction. METHODS AND RESULTS In rat primary cardiomyocytes and H9C2 (rat cardiomyocyte-like H9C2) cells, celastrol attenuates Ang II-induced cellular hypertrophy and fibrotic responses. Proteome microarrays, surface plasmon resonance, competitive binding assays, and molecular simulation were used to identify the molecular target of celastrol. Our data showed that celastrol directly binds to and inhibits STAT (signal transducer and activator of transcription)-3 phosphorylation and nuclear translocation. Functional tests demonstrated that the protection of celastrol is afforded through targeting STAT3. Overexpression of STAT3 dampens the effect of celastrol by partially rescuing STAT3 activity. Finally, we investigated the in vivo effect of celastrol treatment in mice challenged with Ang II and in the transverse aortic constriction model. We show that celastrol administration protected heart function in Ang II-challenged and transverse aortic constriction-challenged mice by inhibiting cardiac fibrosis and hypertrophy. CONCLUSIONS Our studies show that celastrol inhibits Ang II-induced cardiac dysfunction by inhibiting STAT3 activity.
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Affiliation(s)
- Shiju Ye
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China.,Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Wu Luo
- Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Zia A Khan
- Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Gaojun Wu
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Lina Xuan
- Department of Pharmacology at College of Pharmacy (the Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), Harbin Medical University, Heilongjiang, China (L.X., S.W.)
| | - Peiren Shan
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Ke Lin
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China.,Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Taiwei Chen
- Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Jingying Wang
- Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Xiang Hu
- Department of Endocrinology in the First Affiliated Hospital (X.H.), Wenzhou Medical University, Zhejiang, China
| | - Shengjie Wang
- Department of Pharmacology at College of Pharmacy (the Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), Harbin Medical University, Heilongjiang, China (L.X., S.W.)
| | - Weijian Huang
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China
| | - Guang Liang
- From the Department of Cardiology in the First Affiliated Hospital (S.Y., G.W., P.S., K.L., T.C., W.H., G.L.), Wenzhou Medical University, Zhejiang, China.,Chemical Biology Research Center in School of Pharmaceutical Sciences (S.Y., W.L., Z.A.K., K.L., T.C., J.W., G.L.), Wenzhou Medical University, Zhejiang, China
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Zhang Y, Chen H, Zhang W, Cai Y, Shan P, Wu D, Zhang B, Liu H, Khan ZA, Liang G. Arachidonic acid inhibits inflammatory responses by binding to myeloid differentiation factor-2 (MD2) and preventing MD2/toll-like receptor 4 signaling activation. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165683. [PMID: 31953218 DOI: 10.1016/j.bbadis.2020.165683] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 12/06/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 12/29/2022]
Abstract
Arachidonic acid (AA) plays a fundamental role in the function of all cells. Metabolites of AA contribute to inflammation as well as for resolving inflammation. Although AA-derived metabolites exhibit well-substantiated bioactivity, it is not known whether AA regulates inflammatory responses independent of its metabolites. With the recent discovery that saturated fatty acids activate toll-like receptor-4 (TLR4), we tested the hypothesis that AA directly regulates inflammatory responses through modulating the activity of TLR4. In cultured cardiomyocytes and macrophages, we found that AA prevents saturated fatty acid-induced TLR4 complex formation with accessory proteins and the induction of proinflammatory cytokines. We discovered that AA directly binds to TLR4 co-receptor, myeloid differentiation factor 2 (MD2) and prevents saturated fatty acids from activating TLR4 pro-inflammatory signaling pathway. Similarly, AA reduced lipopolysaccharide (LPS)-induced inflammation in macrophages and septic death in mice through binding to MD2. In high-fat diet mouse model of obesity and LPS-induced model of acute lung injury, both mediating inflammatory responses through TLR4, treatment with AA prevented MD2/TLR4 dimerization, induction of inflammatory factors, and tissue injuries. In summary, we have discovered that AA interacts with MD2 and disrupts TLR4 activation by LPS and saturated fatty acids. These findings provide experimental evidence for a direct mechanism of AA-induced regulation of inflammation.
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Affiliation(s)
- Yali Zhang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325800, China
| | - Hongjin Chen
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, China
| | - Wenxin Zhang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, China
| | - Yan Cai
- Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, China
| | - Peiren Shan
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325025, China
| | - Di Wu
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Bing Zhang
- Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325800, China
| | - Hui Liu
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Zia A Khan
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Guang Liang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Affiliated Cangnan Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325800, China; Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, China.
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Xu T, Liang D, Wu S, Zhou X, Shi R, Xiang W, Zhou J, Wang S, Shan P, Huang W. Association of hemoglobin with incidence of in-hospital cardiac arrest in patients with acute coronary syndrome complicated by cardiogenic shock. J Int Med Res 2019; 47:4151-4162. [PMID: 31296079 PMCID: PMC6753539 DOI: 10.1177/0300060519857021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 11/17/2022] Open
Abstract
Objective This study was performed to investigate the association of the admission hemoglobin level with the incidence of in-hospital cardiac arrest (IHCA) in patients with acute coronary syndrome (ACS) complicated by cardiogenic shock (CS). Methods In this retrospective study, we reviewed the medical records of consecutive patients with ACS complicated by CS admitted to the coronary care unit from January 2014 to October 2017. Logistic regression models were carried out to evaluate the association between hemoglobin and the incidence of IHCA. Interaction and subgroup analyses were also performed. Results In total, 211 patients were included in the study, and 61 (28.9%) patients developed IHCA. In the multivariable analysis, hemoglobin was a strong independent predictor of IHCA (odds ratio, 0.971; 95% confidence interval, 0.954–0.989). In the fully adjusted model, patients in the higher hemoglobin tertile were less likely to develop IHCA than patients in the lowest hemoglobin tertile (odds ratio, 0.194; 95% confidence interval, 0.071–0.530). The relationship remained stable in most subgroups except patients aged ≥70 years. Conclusion In patients with ACS complicated by CS, the incidence of IHCA is related to the hemoglobin concentration, and a high hemoglobin concentration is a protective factor against the development of IHCA.
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Affiliation(s)
- Tiancheng Xu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Dongjie Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Shengjie Wu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Xiaodong Zhou
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Ruiyu Shi
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Wenhao Xiang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Jian Zhou
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Songjie Wang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China
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Yang G, Wang W, Sheng X, Yang F, Kong L, He J, Ding S, Shan P, Shang Y, Xiu J, Yang Y, Mintz GS, Pu J. Tissue characteristics of culprit lesion and myocardial tissue-level perfusion in non-ST-segment elevation acute coronary syndromes: The EARLY-MYO-ACS study. Int J Cardiol 2019; 287:32-38. [DOI: 10.1016/j.ijcard.2019.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 01/01/2019] [Accepted: 02/07/2019] [Indexed: 12/30/2022]
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Su L, Wu S, Wang S, Wang Z, Xiao F, Shan P, Zhou H, Huang Z, Xu L, Huang W. Pacing parameters and success rates of permanent His-bundle pacing in patients with narrow QRS: a single-centre experience. Europace 2018; 21:763-770. [PMID: 30561576 DOI: 10.1093/europace/euy281] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 10/30/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lan Su
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Shengjie Wu
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Songjie Wang
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Zhengxian Wang
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Fangyi Xiao
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Peiren Shan
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Hao Zhou
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Zhouqing Huang
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Lei Xu
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China
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Huang Z, Ye B, Wang Z, Han J, Lin L, Shan P, Cai X, Huang W. Inhibition of LncRNA-HRIM Increases Cell Viability by Regulating Autophagy Levels During Hypoxia/Reoxygenation in Myocytes. Cell Physiol Biochem 2018; 46:1341-1351. [PMID: 29689566 DOI: 10.1159/000489149] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/27/2018] [Indexed: 11/19/2022] Open
Abstract
Backgrund/Aims: Ischemia reperfusion (I/R) promotes the severity of cardiomyocyte injury. Long noncoding RNAs (LncRNAs) are key regulators in cardiovascular diseases. However, the association between LncRNAs and myocardial I/R injury has not been thoroughly characterized to date. We attempted to clarify the potential biological role of a LncRNA (E230034O05Rik), which we named hypoxia/reoxygenation (H/R) injury-related factor in myocytes (HRIM), by investigating the differential expression of LncRNAs between groups of myocytes exposed to either a normal level of oxygen or to H/R. METHODS Microarray analysis was used to determine analyze the global differential expression of LncRNAs in H9c2 myocytes exposed either to a normal level of oxygen or to H/R. Target LncRNA levels were further verified in vitro and ex vivo by real-time polymerase chain reaction (qPCR). Cell viability was analyzed using the Cell Counting Kit-8 assay. Autophagy levels were confirmed by Western blotting, transmission electron microscopy, and autophagic double-labeled (mRFP-GFP-LC3) adenovirus analyses. RESULTS Gene expression profiling revealed that 797 LncRNAs and 1898 mRNAs were differentially expressed in the H/R group compared with the normal oxygen group. Among these LncRNAs and mRNAs, 6 upregulated LncRNAs and 2 downregulated LncRNAs in the H/R group were selected and further validated by qPCR in vitro and ex vivo. Additionally, LncRNA-HRIM was inhibited by specific siRNAs in H9c2 myocytes exposed to H/R. The inhibition of LncRNA-HRIM by siRNA prevented cell death by suppressing excessive autophagic activity in myocytes, This finding suggests a detrimental role of LncRNA-HRIM in the regulation of I/R injury. CONCLUSIONS LncRNAs are involved in H/R injury of H9c2 myocytes. Inhibition of LncRNA-HRIM increased cell viability by reducing autophagy in myocytes during H/R.
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Shan P, Su L, Zhou X, Wu S, Xu L, Xiao F, Zhou X, Ellenbogen KA, Huang W. Beneficial effects of upgrading to His bundle pacing in chronically paced patients with left ventricular ejection fraction <50%. Heart Rhythm 2018; 15:405-412. [DOI: 10.1016/j.hrthm.2017.10.031] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Indexed: 11/30/2022]
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Shan P, Huang W, Hoosen R, Zhou C, Mintz GS, Fu G. Spontaneous dissection in the left main coronary artery. Am J Emerg Med 2018; 36:907.e1-907.e3. [PMID: 29478722 DOI: 10.1016/j.ajem.2018.01.065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/23/2018] [Indexed: 10/18/2022] Open
Abstract
We present two cases of spontaneous left main stem coronary artery dissection. One was underdiagnosed with suboptimal percutaneous coronary artery intervention followed by acute vessel occlusion again during the hospitalization. The other one was identified and confirmed by intravascular ultrasound, followed by conservative medical treatment, with completed healing of SCAD during two-month follow up.
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Affiliation(s)
- Peiren Shan
- Department of Cardiology, Sir Run Run Shaw Hospital Affiliated to Medicine College of Zhejiang University, PR China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, PR China
| | - Rukhsaar Hoosen
- Department of Cardiology, Sir Run Run Shaw Hospital Affiliated to Medicine College of Zhejiang University, PR China
| | - Changzuan Zhou
- Department of Cardiology, Sir Run Run Shaw Hospital Affiliated to Medicine College of Zhejiang University, PR China
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, United States
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital Affiliated to Medicine College of Zhejiang University, PR China.
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Hong C, Zhou X, Huang W, Shan P, Dong F. Synthesis and anti-myocarditis activity in a multifunctional lanthanide microporous metal-organic framework with 1D helical chain building units. Braz J Med Biol Res 2018; 51:e7050. [PMID: 29340528 PMCID: PMC5769762 DOI: 10.1590/1414-431x20177050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/10/2017] [Indexed: 11/22/2022] Open
Abstract
A new microporous lanthanide metal-organic framework, {[Yb(BTB)(H2O) (DEF)2}n (1, DEF=N,N-Diethylformamide), with 1D nano-sized channels has been constructed by bridging helical chain secondary building units with 1,3,5-benzenetrisbenzoic acid (H3BTB) ligand. Structural characterization suggests that this complex crystallizes in the hexagonal space group P6122 and possesses 1D triangular channels with coordinated water molecules pointing to the channel center. In addition, anti-myocarditis properties of compound 1 were evaluated in vivo. The results showed that compound 1 can improve hemodynamic parameters of, and it may be a good therapeutic option for heart failure in the future.
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Affiliation(s)
- Chenglv Hong
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinlang Zhou
- Department of Cardiology, Wenzhou City Hospital of Traditional Chinese Medicine and Western Medicine Combined, Wenzhou, Zhejiang, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fengquan Dong
- Department of Cardiology, Shenzhen University General Hospital, Shenzhen, Guangdong, China
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Shushan Z, Shan P, Wei Z, Yirong W, Juming Y. Resting-state fMRI study on drug-naive Parkinson’s disease patients with hyposmia. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.262] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huang Z, Ye B, Han J, Kong F, Shan P, Lu Z, Huang Z, Huang W. NACHT, LRR and PYD domains-containing protein 3 inflammasome is activated and inhibited by berberine via toll-like receptor 4/myeloid differentiation primary response gene 88/nuclear factor-κB pathway, in phorbol 12-myristate 13-acetate-induced macrophages. Mol Med Rep 2017; 17:2673-2680. [PMID: 29207123 DOI: 10.3892/mmr.2017.8189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 06/20/2017] [Indexed: 11/06/2022] Open
Abstract
The nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP-3) inflammasome has recently emerged as a pivotal regulator of chronic inflammation. The present study investigated the expression of NLRP3 inflammasome in phorbol 12-myristate 13-acetate (PMA)-induced macrophages, and aimed to identify the effects of berberine on the inflammasome. Human monocytic THP-1 cells were pretreated with berberine for 1 h and then induced with PMA for 48 h. Total RNA and protein were collected for reverse transcription-quantitative polymerase chain reaction and western blot analysis, respectively. Supernatants were collected to determine IL-1β levels by using ELISA. The present study demonstrated that NLRP3 inflammasome and IL-1β were activated in PMA-induced macrophages in a time-dependent manner, whereas berberine significantly inhibited their expression in a dose-dependent manner in PMA-induced macrophages. Furthermore, berberine also suppressed the toll-like receptor 4 (TLR4)/myeloid differentiation primary response gene 88 (Myd88)/nuclear factor (NF)-κB signaling pathway which was activated during the conversion of THP-1 cells to macrophages by PMA. In conclusion, berberine reduced NLRP3 inflammasone expression by suppressing the activation of the TLR4/Myd88/NF-κB signaling pathway in PMA-induced macrophages. This inhibitory effect may imply an important role of berberine on chronic inflammation and atherogenic progression in coronary artery disease.
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Affiliation(s)
- Zhouqing Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Bozhi Ye
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Jibo Han
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Fanqi Kong
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Zhongqiu Lu
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Zhouqing Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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Wang L, Han J, Shan P, You S, Chen X, Jin Y, Wang J, Huang W, Wang Y, Liang G. MD2 Blockage Protects Obesity-Induced Vascular Remodeling via Activating AMPK/Nrf2. Obesity (Silver Spring) 2017; 25:1532-1539. [PMID: 28726347 DOI: 10.1002/oby.21916] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Obesity and increased free fatty acid (FFA) levels are tightly linked with vascular oxidative stress and remodeling. Myeloid differentiation 2 (MD2), an important protein in innate immunity, is requisite for endotoxin lipopolysaccharide responsiveness. This study shows that palmitic acid (PA) also bonds to MD2, initiating cardiac inflammatory injury. However, it is not clear whether MD2 plays a role in noninflammatory systems such as obesity- and FFA-related oxidative stress involved in vascular remodeling and injury. The aim of this study is to examine whether MD2 participates in reactive oxygen species increase and vascular remodeling. METHODS Male MD2-/- mice and wild-type littermates with a C57BL/6 background were fed a high-fat diet (HFD) to establish obesity-induced vascular remodeling. Rat aortic endothelial cells (RAECs) and vascular smooth muscle cells (VSMCs) were treated with PA to induce oxidative stress and injury. RESULTS In vivo, MD2 deficiency significantly reduced HFD-induced vascular oxidative stress, fibrosis, and remodeling, accompanied with AMP-activated kinase (AMPK) activation and nuclear factor erythroid (Nrf2) upregulation. In VSMCs and RAECs, inhibition of MD2 by neutralizing monoclonal antibody to MD2 or small interfering RNA knockdown significantly activated the AMPK/Nrf2-signaling pathway and reduced PA-induced oxidative stress and cell injury. CONCLUSIONS It was demonstrated that the deletion or inhibition of MD2 protects against HFD/FFA-induced vascular oxidative stress and remodeling by activating the AMPK/Nrf2-signaling pathway.
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MESH Headings
- AMP-Activated Protein Kinases/metabolism
- Animals
- Aorta
- Diet, High-Fat
- Endothelial Cells/drug effects
- Endothelial Cells/metabolism
- Enzyme Activation/drug effects
- Lymphocyte Antigen 96/antagonists & inhibitors
- Lymphocyte Antigen 96/deficiency
- Lymphocyte Antigen 96/physiology
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/drug effects
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- NF-E2-Related Factor 2/physiology
- Obesity/complications
- Obesity/metabolism
- Oxidative Stress/drug effects
- Palmitic Acid/pharmacology
- RNA, Small Interfering/pharmacology
- Rats
- Signal Transduction/drug effects
- Vascular Remodeling/physiology
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Affiliation(s)
- Lintao Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jibo Han
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peiren Shan
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shengban You
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuemei Chen
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiyi Jin
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingying Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guang Liang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Shan P, Mintz GS, Witzenbichler B, Metzger DC, Rinaldi MJ, Duffy PL, Weisz G, Stuckey TD, Brodie BR, Généreux P, Crowley A, Kirtane AJ, Stone GW, Maehara A. Does calcium burden impact culprit lesion morphology and clinical results? An ADAPT-DES IVUS substudy. Int J Cardiol 2017; 248:97-102. [PMID: 28818353 DOI: 10.1016/j.ijcard.2017.08.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 01/23/2017] [Revised: 06/13/2017] [Accepted: 08/09/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Increasing coronary lesion calcification is thought to be associated with adverse percutaneous coronary intervention (PCI) and clinical outcomes. We investigated the effects of calcium burden on culprit lesion morphology and clinical events after intravascular ultrasound (IVUS)-guided PCI in the ADAPT-DES study. METHODS ADAPT-DES was a prospective, multicenter registry of 8582 consecutive patients undergoing successful PCI using DES. A pre-specified virtual histology (VH)-IVUS substudy of 638 culprit lesions (638 patients) had both pre- and post-PCI VH-IVUS. We divided lesions into tertiles according to pre-PCI percent dense calcium volume (DCV%=dense calcium/plaque volume×100). RESULTS Compared with low and intermediate DCV% tertiles, patients in the high DCV% tertile had the largest arc of superficial calcium, highest percentage of necrotic core volume, and smallest remodeling index; they were also more likely to have advanced lesion morphology such as attenuated plaque and VH thin-cap fibroatheromas. In the high DCV% tertile IVUS guidance was associated with a minimum stent area that was smaller than tertiles with less calcium (p=0.01), but acceptable range, and similar stent expansion (73.8±16.8% vs. 74.0±19.2% vs. 72.4±17.3%, p=0.62) after more frequent use of rotational atherectomy and higher maximum inflation pressure. There was no significant association between pre-PCI DCV% and 2-year target lesion revascularization or major adverse cardiac events (cardiac death, myocardial infarction, or stent thrombosis). CONCLUSIONS Increasing coronary artery calcification burden was associated with more advanced, complex VH-IVUS lesion morphology, but not with adverse clinical outcomes, perhaps due to more aggressive PCI techniques that optimized stent expansion.
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Affiliation(s)
- Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China; Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, USA
| | | | | | - Michael J Rinaldi
- Sanger Heart & Vascular Institute, Carolinas HealthCare System, Charlotte, NC, USA
| | - Peter L Duffy
- Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC, USA
| | - Giora Weisz
- Cardiovascular Research Foundation, New York, NY, USA; Montefiore Medical Center, Bronx, NY, USA
| | - Thomas D Stuckey
- LeBauer-Brodie Center for Cardiovascular Research and Education/Cone Health, Greensboro, NC, USA
| | - Bruce R Brodie
- LeBauer-Brodie Center for Cardiovascular Research and Education/Cone Health, Greensboro, NC, USA
| | - Philippe Généreux
- Cardiovascular Research Foundation, New York, NY, USA; Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Canada; Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA
| | - Aaron Crowley
- Cardiovascular Research Foundation, New York, NY, USA
| | - Ajay J Kirtane
- Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - Gregg W Stone
- Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - Akiko Maehara
- Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
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Wang L, Huang Z, Huang W, Chen X, Shan P, Zhong P, Khan Z, Wang J, Fang Q, Liang G, Wang Y. Inhibition of epidermal growth factor receptor attenuates atherosclerosis via decreasing inflammation and oxidative stress. Sci Rep 2017; 8:45917. [PMID: 28374780 PMCID: PMC5379239 DOI: 10.1038/srep45917] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022] Open
Abstract
Atherosclerosis is a progressive disease leading to loss of vascular homeostasis and entails fibrosis, macrophage foam cell formation, and smooth muscle cell proliferation. Recent studies have reported that epidermal growth factor receptor (EGFR) is involved vascular pathophysiology and in the regulation of oxidative stress in macrophages. Although, oxidative stress and inflammation play a critical role in the development of atherosclerosis, the underlying mechanisms are complex and not completely understood. In the present study, we have elucidated the role of EGFR in high-fat diet-induced atherosclerosis in apolipoprotein E null mice. We show increased EGFR phosphorylation and activity in atherosclerotic lesion development. EGFR inhibition prevented oxidative stress, macrophage infiltration, induction of pro-inflammatory cytokines, and SMC proliferation within the lesions. We further show that EGFR is activated through toll-like receptor 4. Disruption of toll-like receptor 4 or the EGFR pathway led to reduced inflammatory activity and foam cell formation. These studies provide evidence that EGFR plays a key role on the pathogenesis of atherosclerosis, and suggests that EGFR may be a potential therapeutic target in the prevention of atherosclerosis development.
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Affiliation(s)
- Lintao Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Zhouqing Huang
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Weijian Huang
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Xuemei Chen
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Peiren Shan
- Department of Cardiology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Peng Zhong
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Zia Khan
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A5C1, Canada
| | - Jingying Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Qilu Fang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Guang Liang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
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Huang Z, Wu S, Kong F, Cai X, Ye B, Shan P, Huang W. MicroRNA-21 protects against cardiac hypoxia/reoxygenation injury by inhibiting excessive autophagy in H9c2 cells via the Akt/mTOR pathway. J Cell Mol Med 2017; 21:467-474. [PMID: 27680680 PMCID: PMC5323864 DOI: 10.1111/jcmm.12990] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 08/18/2016] [Indexed: 12/28/2022] Open
Abstract
MicroRNAs and autophagy play critical roles in cardiac hypoxia/reoxygenation (H/R)-induced injury. Here, we investigated the function of miR-21 in regulating autophagy and identified the potential molecular mechanisms involved. To determine the role of miR-21 in regulating autophagy, H9c2 cells were divided into the following six groups: control group, H/R group, (miR-21+ H/R) group, (miR-21-negative control + H/R) group, (BEZ235+ H/R) group and (miR-21+ BEZ235+ H/R) group. The cells underwent hypoxia for 1 hr and reoxygenation for 3 hrs. Cell count kit-8 was used to evaluate cell function and apoptosis was analysed by Western blotting. Western blotting and transmission electron microscopy were used to investigate autophagy. We found that miR-21 expression was down-regulated, and autophagy was remarkably increased in H9c2 cells during H/R injury. Overexpression of miR-21 with a miR-21 precursor significantly inhibited autophagic activity and decreased apoptosis, accompanied by the activation of the AKT/mTOR pathway. In addition, treatment with BEZ235, a novel dual Akt/mTOR inhibitor, resulted in a significant increase in autophagy and apoptosis. However, we found that miR-21-mediated inhibition of apoptosis and autophagy was partly independent of Akt/mTOR activation, as demonstrated in cells treated with both miR-21 and BEZ235. We showed that miR-21 could inhibit H/R-induced autophagy and apoptosis, which may be at least partially mediated by the Akt/mTOR signalling pathway.
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Affiliation(s)
- Zhouqing Huang
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Shengjie Wu
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Fanqi Kong
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Xueli Cai
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Bozhi Ye
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Peiren Shan
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Weijian Huang
- Department of CardiologyThe Key Lab of Cardiovascular Disease of WenzhouThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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44
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Huang Z, Chen C, Li S, Kong F, Shan P, Huang W. Combined Treatment with Amlodipine and Atorvastatin Calcium Reduces Circulating Levels of Intercellular Adhesion Molecule-1 and Tumor Necrosis Factor-α in Hypertensive Patients with Prediabetes. Front Aging Neurosci 2016; 8:206. [PMID: 27610083 PMCID: PMC4996984 DOI: 10.3389/fnagi.2016.00206] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/11/2016] [Indexed: 01/23/2023] Open
Abstract
Objective: To assess the effect of amlodipine and atorvastatin on intercellular adhesion molecule (ICAM)-1 and tumor necrosis factor (TNF)-α expression, as endothelial function and inflammation indicators, respectively, in hypertensive patients with and without prediabetes. Methods: Forty-five consecutive patients with hypertension, diagnosed according to JNC7, were divided into two groups based on the presence (HD group, n = 23) or absence (H group, n = 22) of prediabetes, diagnosed according to 2010 ADA criteria, including impaired glucose tolerance (IGT) and fasting glucose tests. All patients simultaneously underwent 12-week treatment with daily single-pill amlodipine besylate/atorvastatin calcium combination (5/10 mg; Hisun-Pfizer Pharmaceuticals Co. Ltd). Serum isolated before and after treatment from overnight fasting blood samples was analyzed by ELISA. Results: In the HD and H groups after vs. before 12-week amlodipine/atorvastatin treatment, there were significantly (all P < 0.01) lower levels of ICAM-1 (3.06 ± 0.34 vs. 4.07 ± 0.70 pg/ml; 3.26 ± 0.32 vs. 3.81 ± 0.60 pg/ml, respectively) and TNF-α (78.71 ± 9.19 vs. 110.94 ± 10.71 pg/ml; 80.95 ± 9.33 vs. 101.79 ± 11.72 pg/ml, respectively), with more pronounced reductions in HD vs. H group (ICAM-1Δ: 1.01 ± 0.80 vs. 0.55 ± 0.64 pg/ml, respectively, P = 0.037; TNF-αΔ: 32.23 ± 14.33 vs. 20.84 ± 14.89 pg/ml, respectively, P = 0.011), independent of the blood pressure (BP) and cholesterol level reduction. Conclusions: Amlodipine/atorvastatin improved endothelial function and inflammation, as reflected by lower circulating levels of ICAM-1 and TNF-α, more prominently in hypertensives with than without prediabetes. Starting statin treatment before overt diabetes in hypertensives might thus improve cardiovascular outcomes.
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Affiliation(s)
- Zhouqing Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Chen Chen
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Sheng Li
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Fanqi Kong
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Peiren Shan
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Weijian Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
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Huang Z, Chen C, Li S, Kong F, Shan P, Huang W. Serum Markers of Endothelial Dysfunction and Inflammation Increase in Hypertension with Prediabetes Mellitus. Genet Test Mol Biomarkers 2016; 20:322-7. [PMID: 27167462 DOI: 10.1089/gtmb.2015.0255] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AIMS The aim of this study was to examine endothelial dysfunction and inflammation in hypertension and prediabetes by studying adhesion molecules and inflammatory factors. METHODS AND RESULTS This study included 133 outpatients. Participants were categorized into three groups based on the presence or absence of hypertension and prediabetes: control subjects without prediabetes and hypertension (N group, n = 39); patients with hypertension only (H group, n = 34); and patients with hypertension and prediabetes (HD group, n = 60). Hypertension was diagnosed according to JNC7 criteria. Prediabetes was defined according to 2010 American Diabetes Association criteria. Plasma was isolated from overnight fasting blood samples for enzyme-linked immunosorbent assay (ELISA) analysis of concentrations of intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α), P-selectin, and interleukin-6 (IL-6) as indicators of endothelial function and inflammation. We found that the H and HD groups showed significantly higher levels of all four biomarkers compared with the N group (all p < 0.01). The HD group also showed significantly higher levels of ICAM-1 (p = 0.042) and TNF-α (p < 0.01) compared with the H group; no significant differences in P-selectin (p = 0.59) and IL-6 (p = 0.70) levels were observed among these groups. CONCLUSIONS Prediabetes and hypertension induce endothelial dysfunction and inflammation by elevating levels of soluble adhesion molecules and inflammatory cytokines. The comorbidity of these diseases may exacerbate inflammation and endothelial dysfunction by enhancing the expression of ICAM-1 and TNF-α.
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Affiliation(s)
- Zhouqing Huang
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Chen Chen
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Sheng Li
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Fanqi Kong
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Peiren Shan
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Weijian Huang
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
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Huang Z, Han Z, Ye B, Dai Z, Shan P, Lu Z, Dai K, Wang C, Huang W. Berberine alleviates cardiac ischemia/reperfusion injury by inhibiting excessive autophagy in cardiomyocytes. Eur J Pharmacol 2015; 762:1-10. [DOI: 10.1016/j.ejphar.2015.05.028] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 05/18/2015] [Indexed: 01/12/2023]
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47
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Shan P, Mintz G, Witzenbichler B, Metzger C, Rinaldi M, Duffy P, Weisz G, Stuckey T, Brodie B, Xu K, Kirtane A, Stone G, Maehara A. DOES CALCIUM BURDEN IMPACT ON CULPRIT LESION MORPHOLOGY AND CLINICAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61770-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huang Z, Ye B, Dai Z, Wu X, Lu Z, Shan P, Huang W. Curcumin inhibits autophagy and apoptosis in hypoxia/reoxygenation-induced myocytes. Mol Med Rep 2015; 11:4678-84. [PMID: 25673156 DOI: 10.3892/mmr.2015.3322] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 12/02/2014] [Indexed: 11/05/2022] Open
Abstract
Primary percutaneous coronary intervention, or thombolytic therapy, provides effective myocardial blood reconstruction in patients with acute myocardial infarction to reduce acute myocardial ischemic injury. However, reperfusion can itself induce cardiomyocyte death, termed myocardial reperfusion injury (I/R). Hypoxia/reoxygenation (H/R) induces apoptosis and excessive autophagy among cardiomyocytes, leading to cell death. The present study investigated the effect of curcumin, a natural extract from Curcuma longa, on these two cellular processes in H9c2 myocytes. The levels of cellular apoptosis and autophagy were found to be upregulated in the H9c2 myocytes during H/R and were correlated with a reduced rate of cell survival. However, curcumin significantly suppressed the levels of H/R‑induced apoptosis (expression of annexin V) and autophagy (LC3B‑II/LC3B‑I ratio) in the H9c2 myocytes and promoted cell survival. Additionally, the expression of B‑cell lymphoma 2 (Bcl‑2) was significantly downregulated and the expression levels of Bcl‑2‑associated X protein, beclin‑1, Bcl‑2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3) and silent information regulation 1 (SIRT1) were significantly upregulated in myocytes following H/R injury. These effects on the expression of these proteins were reversed by curcumin treatment. These findings suggested that the protective effect of curcumin against H/R injury in the H9c2 myocytes was through the inhibition of apoptosis and autophagy by inducing the expression of Bcl‑2 and inhibiting the expression levels of Bax, beclin‑1, BNIP3 and SIRT1. Therefore, curcumin may offer a promising therapeutic approach for the treatment of cardiomyocyte injury resulting from I/R.
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Affiliation(s)
- Zhouqing Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Bozhi Ye
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Zhenyu Dai
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Xinlei Wu
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Zhongqiu Lu
- Department of Emergency, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Peiren Shan
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Weijian Huang
- Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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Huang Z, Cai X, Li S, Zhou H, Chu M, Shan P, Huang W. Berberine‑attenuated monocyte adhesion to endothelial cells induced by oxidized low‑density lipoprotein via inhibition of adhesion molecule expression. Mol Med Rep 2012; 7:461-5. [PMID: 23241897 DOI: 10.3892/mmr.2012.1236] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/07/2012] [Indexed: 11/06/2022] Open
Abstract
Recruitment of monocytes to endothelial cells is important during early stages of atherosclerosis development. This process is predominantly mediated by cellular adhesion molecules, including vascular cell adhesion molecule‑1 (VCAM‑1) and intercellular adhesion molecule‑1 (ICAM‑1), which are expressed by activated endothelial cells in response to a number of inflammatory stimuli, including oxidized low‑density lipoprotein (oxLDL). Previous studies have demonstrated that berberine, a natural extract from Rhizoma coptidis, prevents oxLDL‑induced endothelial cellular apoptosis. However, its effect on the adhesion of monocytes to endothelial cells and the mechanism associated with this process remains unclear. In the present study, berberine was revealed to markedly reduce oxLDL‑induced monocyte adhesion to human umbilical vein endothelial cells. In addition, the inhibitory mechanism of berberine was associated with suppression of adhesion molecule expression, including VCAM‑1 and ICAM‑1. Results indicate that berberine plays a protective role in the early stages of atherosclerosis.
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Affiliation(s)
- Zhouqing Huang
- Cardiac Center, The First Affiliated Hospital of Wenzhou Medical College, Zhejiang 325000, P.R. China
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Shan P, Huang Z, Huang W. ACTIVATION OF RETINOID X RECEPTOR PROTECTS AGAINST HYPOXIA-REOXYGENATION INDUCED APOPTOSIS AND LOSS OF MITOCHONDRIAL MEMBRANE POTENTIAL IN H9C2 RAT VENTRICULAR CELLS. Heart 2012. [DOI: 10.1136/heartjnl-2012-302920a.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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