With the widespread application of percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD),the mortality of patients with CHD has gradually decreased.However,there is an increased risk of major adverse cardiovascular events after PCI.Therefore,early and accurate risk stratification is crucial for the postoperative management of CHD patients after PCI.Age,creatinine and ejection fraction(ACEF)score includes age,creatinine,and left ventricular ejection fraction,the data are easy to obtain,and its accurate predictive ability has been widely verified in a variety of clinical practices.This article will review the application of the ACEF score and its derivative scores in patients with CHD after PCI.
Absent in melanoma 2(AIM2)recognizes double-stranded DNA from pathogenic microorganisms or the host itself,causing activated caspase-1 to shear pro-interleukin(IL)-1 β and pro-IL-18 and mediating the maturation and secretion of the inflammatory factors IL-1β and IL-18 to elicit an intrinsic immune response.In addition,AIM2 inflammasome can convert Gasdermin D(GSDMD)to GSDMD-N,which promotes the release of cytokines and various cytoplasmic contents,causing cell membrane rupture and leading to pyroptosis.An increasing number of studies have shown that the development process of cardiovascular diseases,such as atherosclerosis,myocardial infarction and heart failure,is associated with AIM2 inflammasome,IL-1[3 and pyroptosis.This paper reviews the possible mechanisms of the role of AIM2 inflammasome in the development of cardiovascular diseases based on the current available studies,with the aim of providing new ideas for the targeted therapy of cardiovascular diseases.
Patient-reported outcomes(PROs)are any reports on the patient's health status that comes directly from the patient,providing the most direct and realistic efficacy evaluation indicators for clinical research and practice from the patient's perspective.With the development of individualized medicine model and the promotion of patient-centered medicine concept,PROs are receiving increasing attention and have been promoted by more and more researchers.Understanding the application of PROs in clinical trials is a necessary step to further improve the quality of clinical research.Taking the cardiovascular field as an example,this paper elaborates and summarizes the application status of PROs in clinical trials,in order to provide reference and suggestions for the application and development of PROs in domestic clinical trials.
Acute myocardial infarction is a serious type of coronary heart disease,which is the main cause of death and disability.In recent years,nanomaterials,as a new therapeutic method,have shown great potential in the diagnosis and treatment of clinical diseases.This article describes the progress of nanomaterials in the treatment of myocardial infarction from the aspects of reactive oxygen species scavenging,inflammatory reaction,myocardial cell apoptosis,myocardial fibrosis,cardiac vascular regeneration,and anti-myocardial infarction related arrhythmia,aiming to provide new ideas for the treatment of myocardial infarction.
Myosin phosphatase targeting subunit(MYPT)family includes five members.They can influence the activity of myosin light chain phosphatase(MLCP)and cell function,regulating Rho/ROCK pathway and NO/cGMP/PKG pathway through their own phosphorylation,thus playing an important role in the occurrence and development of cardiovascular disease.This article reviews the structure of MYPT family members,their relationship with cell function and signaling pathways,and their mechanism of action in cardiovascular disease,so as to provide a theoretical basis for the research and treatment of cardiovascular disease.
The incidence of sudden cardiac arrest caused by aging population and other reasons is increasing year by year,due to the limitations of traditional cardiopulmonary resuscitation treatment,extracorporeal cardiopulmonary resuscitation with extracorporeal membrane oxygenation as the core has been developed,and it is a supplementary means when traditional cardiopulmonary resuscitation fails.This direction is the application hotspot of cardiopulmonary resuscitation abroad in recent years.This article reviews the application and research status of extracorporeal cardiopulmonary resuscitation.
Atherosclerotic cardiovascular disease(ASCVD)is the leading cause of death and disability in the worldwide.At present,the research of traditional cardiovascular risk factors including hyperlipidemia,hypertension and unhealthy lifestyles have been studied in depth and made great strides.Although traditional risk factors have been fully popularized and effectively prevented,the residual cardiovascular risk that may lead to recurrent adverse cardiovascular events in some patients remains to be fully studied.Percutaneous coronary intervention is the cornerstone therapy for ASCVD,but its related complications should not be underestimated,which leads to a decrease of the long-term survival rate for patients.How to make ASCVD patients get a better prognosis after treatment has always been a hot and difficult point of research in the cardiovascular field.This review systematically summarizes the relationship between residual cardiovascular risk and coronary stent failure,aiming to provide new ideas for the long-term prognosis and prevention of recurrent events in patients with stent implantation.
Ketone bodies are endogenously synthetized metabolites that become significant contributors to energy metabolism in human organs.The heart is metabolically flexible and can readily shift between different energy substrates to maintain energy production.The consumption and utilization of myocardial ketone bodies is increased during pathological and physiological conditions.In addition,it was found that ketone bodies play multiple protective roles in cardiovascular system,such as inhibiting oxidative stress,alleviating inflammation,promoting vascular endothelial cell proliferation and improving cardiac remodeling.Therefore,there is potential clinical application prospect for increasing blood ketone body levels moderately in treatment of heart diseases.Especially chronic and long-term elevation of blood ketone body level may provide clinical benefits for patients with cardiovascular diseases such as heart failure.
Aortic stenosis(AS)is the most common valvular disease in the middle-aged and elderly.Transcatheter aortic valve implantation(TAVI)has become a minimally invasive procedure for the treatment of severe symptomatic AS patients,which greatly improves the survival rate and quality of life of AS patients.However,cerebrovascular events(CVE)remain one of the serious complications of TAVI,which seriously affects the prognosis of patients.This article reviews the mechanism and prevention strategies of postoperative CVE,so as to provide reference for improving the management quality of CVE after TAVI.
Objective To compare the hemostatic effect and incidence of complication of Angio-Seal vascular closure device and manual compression after intra-aortic balloon pump(IABP)extraction.Methods A total of 220 patients with IABP over 12 h were randomised into the Angio-Seal group and the manual compression group based on whether using Angio-Seal closure device after removing IABP.The outcome events included the occurrence rates of bleeding,hematoma,pseudoaneurysm,retroperitoneal hematoma,vasovagal nerve reflex and lumbodorsal discomfort were observed after removing IABP.Results There was no significant difference between the two groups in the rates of bleeding and complications such as hematoma,pseudoaneurysm and retroperitoneal hematoma(P＞0.05),while there existed a lower rate of vasovagal reflex and lumbodorsal discomfort in Angio-Seal group(P＜0.05).Conclusion For patients with IABP over 12 h,the Angio-Seal vascular closure device did not increase the risk of bleeding and related complications compared to manual compression,while also improving patient discomfort.
Objective To investigate the mechanism of large conductance calcium-activated potassium channel(BKCa)in angiotensin Ⅱ(Ang Ⅱ)-induced atrial fibrosis.Methods Primary human atrial fibroblasts were obtained by tissue block attachment method and identified by immunofluorescence staining.Human atrial fibroblasts were treated with Ang Ⅱ(500 nmol/L)for 24 h.Real-time fluorescent quantitative PCR and Western blot were used to detect the mRNA and protein expression levels of fibrosis marker genes α-SMA,collagen Ⅰ and collagen Ⅲ,as well as α and β subunits of BKCa channels before and after treatment.And whole cell patch clamp technique was used to detect the current changes of BKCa channels before and after Ang Ⅱ treatment.Results(1)After Ang Ⅱ treatment of human atrial fibroblasts,the mRNA and protein expression levels of α-SMA,collagen Ⅰ and collagen Ⅲ increased;(2)After Ang Ⅱ treatment,the mRNA and protein expression of BKCa channel α and β subunits decreased;(3)Human atrial fibroblasts exist normal BKCa channel,which are voltage dependent;(4)Macro current amplitude of BKCa channel in human atrial fibroblasts decreased after Ang Ⅱ treatment;(5)After overexpression of BKCa channel α subunit on human atrial fibroblasts,the mRNA and protein expression levels of fibrosis marker α-SMA,collagen Ⅰ and collagen Ⅲ decreased significantly.Conclusion Ang Ⅱ may induce fibrosis in human atrial fibroblasts by inhibiting the expression and function of BKCa channel,and finally induce atrial fibrosis.
Epicardial adipose tissue(EAT)is a visceral fat depot located on the surface of myocardium.Studies have shown that EAT can mediate the occurrence and development of heart failure through a variety of mechanisms.This article mainly summarizes the anatomy and physiological functions of EAT,its role and pathogenesis in heart failure,and the relevant treatment methods that use EAT as a therapeutic target.
Sarcopenia is a kind of senile syndrome related to aging,which is characterized by progressive decline in skeletal muscle volume and muscle strength and dysfunction.Chronic heart failure(CHF)is the terminal manifestation of various cardiovascular diseases.Its symptoms are related to the decline of skeletal muscle function and changes in skeletal muscle cell,and are closely related to the occurrence and development of sarcopenia.Exercise intervention is an important means of treating sarcopenia.Among them,resistance training is closely related to reducing the readmission rate and improving the life quality of CHF patients.This article reviews the pathogenesis of CHF complicated with sarcopenia,the effect of resistance training on it and related mechanisms,in order to provide scientific basis for clinical diagnosis and treatment of CHF patients with sarcopenia.
CYP2C19 enzyme is a part of CYP450 cytochrome oxidase superfamily.It completes the metabolism of many clinical drugs,and clopidogrel,an antiplatelet drug,is one of them.The effect of CYP2C19 gene polymorphism on clopidogrel activity in vivo has been confirmed.Different genotypes lead to different metabolic degrees of clopidogrel in the body,and clopidogrel resistance in the slow metabolism populations will lead to treatment failure and adverse outcomes of patients.Individualized therapy with new drugs such as ticagrelor and prasugrel seems to be effective in reducing adverse events.
The heart is innervated and regulated by the autonomic nervous system,and excessive activation of the sympathetic nervous system is a key trigger factor for the progression of cardiovascular disease.Cardiovascular autonomic central nuclei in the hypothalamus can regulate cardiac physiological functions and improve the prognosis of cardiovascular diseases by regulating the activity and function of the peripheral autonomic nervous system.Ventromedial hypothalamic nucleus(VMH)is one of the most important nuclei that regulate metabolism and emotion.It is closely related to the cardiovascular central nucleus and the autonomic nervous system in the hypothalamus.Understanding the relationship between the three can help to understand the pathogenesis of cardiovascular diseases related to brain-heart crosstalk,and clarify the signaling pathways and neurotransmitters of the VMH in regulating cardiac autonomic nervous system.This article reviews the regulatory role of VMH on the cardiac autonomic nervous system,the possible involved neural projections,molecular signaling pathways and regulatory strategies.
Atherosclerosis is a chronic inflammatory response with lipid metabolism disorder.NOD-like receptor protein 3(NLRP3)inflammasome,as a multi-protein inflammatory complex,is closely related to cell activity,vascular inflammatory,and the progression of plaque.Trimethylamine oxide,as a major metabolite of intestinal flora,can initiate the activation of NLRP3 inflammasome and participate in the pathophysiological mechanism of atherosclerotic plaque formation and plaque rupture.The paper reviews the role of NLRP3 inflammasome and trimethylamine oxide in atherosclerosis to provide a new perspective for the mechanism research and clinical prevention and treatment of atherosclerosis.
Neuraminidase(NEU)is a group of enzymes that break down sialic acid on the cell surface.In mammals,NEU can be divided into four types:NEU 1,NEU2,NEU3 and NEU4.Among which NEU1 has the most extensive functions,and it has been proved that it plays an important role in the occurrence and development of diseases such as nervous system disease,respiratory disease and cancer.In recent years,the role of NEU1 in cardiovascular system has been paid more and more attention,especially in cardiovascular disease such as atherosclerosis,ischemia reperfusion injury,heart failure and cardiomyopathy.This article reviews the role of NEU1 in cardiovascular disease.
As the prevalence of diabetes increases year by year,the prevalence of diabetic cardiomyopathy(DCM)is also increasing.The main manifestation of DCM in the early stage is myocardial diastolic and systolic dysfunction,which ultimately leads to clinical heart failure.Its pathogenesis is complex and multiple,and further clinical research is needed.In recent years,glucagon-like peptide-1(GLP-1)receptor agonist has been widely used in clinical practice.In addition to the hypoglycemic effect,it also regulates a variety of cardiovascular risk factors,thereby inhibiting the process of atherosclerosis,reducing coronary events,and reducing the incidence of cardiovascular death.However,the effect of GLP-1 receptor agonist on DCM is still unclear.This article reviews the research in related fields.
Heart failure is the end stage of several cardiovascular diseases and is a complex clinical syndrome.In heart failure,there is an imbalance of autonomic nervous system and immune regulation disorder,which interact with each other.Immune cells can express neurotransmitters,and after activation of autonomic nervous system,neurotransmitters act on immune cells to regulate the release of cellular inflammatory factors.Neuroimmune crosstalk participates in and maintain the occurrence and development of heart failure.This review summarizes the existing knowledge and clinical application progress of neuroimmune crosstalk in heart failure,and provides a supportive and rational background for further research.
High levels of low-density lipoprotein cholesterol(LDL-C)is an important risk factor for atherosclerotic cardiovascular disease(ASCVD).Effective reduction of LDL-C is of great significance for prevention and treatment of ASCVD.However,with the gradual reduction of LDL-C target value,the potential risks begin to emerge and deserve our attention.We reviewed the evidence for the potential risks associated with excessively low levels of LDL-C.
