Background Identifying patients at risk for new-onset atrial fibrillation (AF) during hospitalization for ST-segment elevation myocardial infarction (STEMI) is clinically challenging. We aimed to develop and internally validate a prediction model integrating cardiac magnetic resonance (CMR) and clinical data. Methods In this single-center retrospective study, 503 consecutive STEMI patients who underwent CMR were analyzed. Baseline clinical, laboratory, and imaging variables were entered into a ridge-penalized logistic regression model (70% training, 30% validation). Model discrimination was assessed with the area under the receiver operating characteristic curve (AUC), calibration with decile-based plots and bootstrapping, and clinical utility with decision curve analysis (DCA). Odds ratios (ORs) were derived from a conventional multivariable model, and a nomogram-style visualization was generated. Results New-onset AF occurred in 45 patients (8.9%). Left atrial (LA) reservoir strain was the only independent predictor (OR 0.913, 95% CI 0.863–0.964, p = 0.0009). Impaired LA strain reflects atrial remodeling and wall stress, which predispose to electrical instability and cause new-onset AF. Left ventricular global longitudinal strain (LVGLS) showed a similar trend but was not significant (OR 0.931, 95% CI 0.837–1.024, p = 0.147). The ridge model achieved moderate discrimination (AUC 0.765 training, 0.695 validation) with acceptable calibration (training Eavg ≈ 0.030, Brier ≈ 0.076; validation Eavg ≈ 0.023, Brier ≈ 0.079). DCA demonstrated limited incremental benefit compared with treat-all or treat-none strategies. Conclusion CMR-derived LA reservoir strain is central to predicting in-hospital AF after STEMI.

BACKGROUND:Radiofrequency catheter ablation (RFCA) is a first-line treatment for paroxysmal atrial fibrillation (PAF). Complications such as silent cerebral lesion (SCL) may occur during ablation. Pulsed field ablation (PFA) is a non-thermal method thatablates cardiac tissue via irreversible electroporation. Limited studies have reported the incidence of SCL during PFA, with highly variable results. However, randomized controlled trials (RCTs) remain scarce. The objective of this study was to compare perioperative SCL incidence between PFA and RFCA, and to identify risk factors for SCL during PFA. METHODS:In this prospective pilot RCT (ChiCTR2400088774), 62 patients with PAF were randomized 1:1 to undergo PFA or RFCA. Cerebral MRI (3.0 T) was performed preoperatively and 24-48h postoperatively. SCL was defined as a new acute brain lesion on MRI without neurological deficits. Baseline and surgical data of the patients were collected. RESULTS:SCL was detected post-procedure in 6.45% (2/31) in the RFCA group, 12.90% (4/31) in the PFA group. No statistically significant difference in the incidence of postoperative SCL was detected between the two groups (p = 0.67). Left atrium dimension (LAD), left atrial operation time (LAOT), left ventricular end-diastolic dimension (LVEDD), and total operation time (TOT) were significantly higher in SCL group than those in no-SCL group (p < 0.05) through univariate analyses. CONCLUSIONS:SCL incidence was 12.90% in the PFA group versus 6.45% in the RFCA group. While no statistically significant difference was detected between two groups, the numerically higher rate in the PFA group warrants larger studies to evaluate cerebral safety associated with PFA.

Purpose:To investigate the relationship between phenotypic age (PhenoAge) and accelerated phenotypic age (PhenoAgeAccel) and recurrence of atrial fibrillation (AF) in patients after radiofrequency catheter ablation (RFCA). Patients and Methods:Preoperative PhenoAge and PhenoAgeAccel were determined in AF patients undergoing RFCA. We used logistic regression models and subgroup analysis to study the relationship between PhenoAge and PhenoAgeAccel and the risk of AF recurrence. As for revealing the value of PhenoAgeAccel in predicting AF recurrence, the ROC curve analysis was performed. To further detect the enhancement role of in PhenoAgeAccel in the APPLE score and a model of established risk factors in predicting AF recurrence, C-statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) was conducted. Results:A total of 322 patients with AF who underwent RFCA in our hospital were included in the present study. The mean follow-up period was 21 months. The frequency of AF recurrence increased gradually as the PhenoAgeAccel index rose. The optimal cut-off value of the PhenoAgeAccel index was -0.338. Patients with PhenoAgeAccel ≥ -0.338 had a significantly greater likelihood of experiencing recurrent AF than those with PhenoAgeAccel <-0.338 (OR 3.989, 95% CI 2.006-7.933, p < 0.001). The association was also reflected in each subgroup. Incorporating the PhenoAgeAccel into the APPLE score and the existing model of established risk factors for recurrence may result in enhancements to the C-statistics, NRI and IDI (p<0.05), respectively. Conclusion:PhenoAgeAccel was positively and independently associated with AF recurrence following RFCA.

BACKGROUND:Current anticoagulation strategies of atrial fibrillation (AF) after radiofrequency ablation (RFCA) are still based on the CHA₂DS₂-VASc scoring system. The predictive value of the CHA2DS2-VASc score is limited and shows only moderate ability to assess risk.[1] Previous studies have shown that the left atrial substrate is associated with thrombosis.[2] Low-voltage areas(LVA) obtained in the left atrium (LA) are an accurate indicator to identify and measure atrial fibrosis. There are limited studies analyzing the association between low-voltage areas and clinical stroke post-RFCA. METHODS:This retrospective cohort study included 528 patients with non-valvular atrial fibrillation (NVAF) who underwent first-time AF ablation. Intraoperative left atrial voltage mapping was completed using ablation catheter in sinus rhythm after circumferential pulmonary vein isolation (CPVI). Patients were followed up postoperatively and divided into stroke-positive (n = 31) and stroke-negative groups(n = 497) based on clinical stroke occurrence. The association between LA-LVA% and other clinical factors with postoperative clinical stroke was analyzed. RESULTS:In the stroke-positive group, LVA was more prevalent than in the stroke-negative group [18/31 (58.0 %) vs. 82/497 (16.4 %), p < 0.001]. Multivariate logistic analysis showed a higher prevalence of CHA₂DS₂-VASc scores [OR: 1.34 95 % CI: (1.08-1.66), p = 0.008], LVA% [OR: 1.11 95 % CI: (1.02-1.20), p = 0.019] and LAD [OR: 1.05 95 % CI: (1.01-1.09), p = 0.010] were correlated with the occurrence of clinical stroke in patients after RFCA. In the patients who discontinued anticoagulation therapy (non-anticoagulation subgroup, n = 378), stratified analyses showed that the stroke rate in the low-risk group (0.00 %) was significantly lower than in the intermediate-risk group (4.5 %) and the high-risk group (27.3 %), with significant differences (p < 0.001). CONCLUSIONS:The LA-LVA% was significantly associated with postoperative clinical stroke. The combination of CHA₂DS₂-VASc score and LA-LVA% can identify low-risk patients.

Aims The current management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains a significant challenge. Catheter ablation (CA) has been shown to improve left ventricular ejection fraction (LVEF) in these patients, but which patients can benefit from CA is still poorly understood. The aim of our study was to determine the predictors of improved ejection fraction in patients with persistent atrial fibrillation (PeAF) complicated with HF undergoing CA. Methods and results A total of 435 patients with persistent AF underwent an initial CA between January 2019 and March 2023 in our hospital. We investigated consecutive patients with left ventricular systolic dysfunction (LVEF < 50%) measured by transthoracic echocardiography (TTE) within one month before CA. According to the LVEF changes at 6 months, these patients were divided into an improved group (fulfilling the ‘2021 Universal Definition of HF’ criteria for LVEF recovery) and a nonimproved group. Eighty patients were analyzed, and the improvement group consisted of 60 patients (75.0%). In the univariate analysis, left ventricular end-diastolic diameter ( P = 0.005) and low voltage zones in the left atrium ( P = 0.043) were associated with improvement of LVEF. A receiver operating characteristic analysis determined that the suitable cutoff value for left ventricular end-diastolic diameter (LVDd) was 59 mm (sensitivity: 85.0%, specificity: 55.0%, area under curve: 0.709). A multivariate analysis showed that LVDd (OR = 0.85; 95% CI: 0.76–0.95, P = 0.005) and low voltage zones (LVZs) (OR = 0.26; 95% CI: 0.07–0.96, P = 0.043) were significantly independently associated with the improvement of LVEF. Additionally, parameters were significantly improved regarding the left atrial diameter, LVDd and ventricular rate after radiofrequency catheter ablation (all p < 0.05). Conclusions The improvement of left ventricular ejection fraction (LVEF) occurred in 75.0% of patients. Our study provides additional evidence that LVDd < 59 mm and no low voltage zones in the left atrium can be used to jointly predict the improvement of LVEF after atrial fibrillation ablation.

Background It is widely known that the incidence rate and short-term mortality of acute myocardial infarctions (AMIs) are generally higher during the winter months. The goal of this study was to determine how the temperature of the environment influences fatal acute myocardial infarctions in Xuzhou. Methods This observational study used the daily meteorological data and the data on the cause of death from acute myocardial infarction in Xuzhou from January 1, 2018, to December 31, 2020. After controlling meteorological variables and pollutants, the distributed nonlinear lag model (DLNM) was used to estimate the correlation between temperature and lethal AMI. Results A total of 27712 patients with fatal AMI were enrolled. 82.4% were over the age of 65, and 50.9% were men. Relative to the reference temperature (15 ℃), the 30-day cumulative RRs of the extremely cold temperature (− 2 ℃) for the general population, women, and people aged 65 years and above were 4.66 (95% CI: 1.76, 12.30), 15.29 (95% CI: 3.94, 59.36), and 7.13 (95% CI: 2.50, 20.35), respectively. The 30-day cumulative RRs of the cold temperature (2 ℃) for the general population, women, and people aged 65 years and above were 2.55 (1.37, 4.75), 12.78 (2.24, 5.36), and 3.15 (1.61, 6.16), respectively. No statistically significant association was observed between high temperatures and the risk of fatal AMI. The influence of the cold effect (1st and 10th) was at its peak on that day, and the entire cold effect persisted for 30 days. Temperature extremes had an effect on the lag patterns of distinct age and gender stratifications. Conclusion According to this study, the risk of fatal AMI increases significantly in cold weather but not in hot weather. Women above the age of 65 are particularly sensitive to severe weather events. The influence of frigid weather on public health should also be considered.

Background: Atrial fibrillation (AF) is a common arrhythmia, with radiofrequency catheter ablation (RFCA) being first-line therapy. However, the high rate of post-ablation recurrence necessitates the identification of predictors for recurrence risk. Left atrial low-voltage areas (LA-LVASs), reflecting atrial fibrosis, have been confirmed to be related to recurrence of atrial fibrillation. Recently, epicardial adipose tissue (EAT) has been studied due to its role in initiating and maintaining atrial fibrillation. In this study, we try to evaluate the significance of the combined use of LA-EAT and percentage of LA-LVAs (LA-LVAs%) for predicting the recurrence of atrial fibrillation. Methods: A total of 387 patients with AF who had undergone RFCA for the first time were followed up for 3, 6, and 12 months. They were divided into two groups: the recurrence group (n=90) and the non-recurrence group (n=297). Before the ablation, all patients underwent computed tomography angiography (CTA) examination of the left atrium, and the left atrial epicardial adipose tissue (LA-EAT) was measured using medical software (Advantage Workstation 4.6, GE, USA). After circumferential pulmonary vein isolation， a three-dimensional mapping system was used to map the left atrial endocardium and evaluate the LA-LVAs in sinus rhythm. Results: After a median follow-up of 10.2 months, 90 patients developed AF recurrence after RFCA. Compared to patients without recurrence, the volume of LA-EAT (33.45±13.65 vs. 26.27±11.38; p<0.001) and the LA-LVAs% (1.60% (0%, 9.99%) vs. 0.00% (0%, 2.46%); p<0.001) were significantly higher. Multivariate analysis indicated that non-paroxysmal AF, LA-EAT volume, and LA-LVAs% were independent predictors. Compared to LA-EAT volume (AUC 0.655; specificity 0.675; sensitivity 0.586) or LA-LVAs% (AUC 0.659; specificity 0.836; sensitivity 0.437), the combined use of LA-EAT volume and LA-LVAs% offers higher accuracy for predicting AF recurrence after ablation (AUC 0.738; specificity 0.761; sensitivity 0.621). Conclusion: The combined LA-EAT and LA-LVAs% can effectively predict the risk of AF recurrence after radiofrequency ablation.

BackgroundThe objective of this study is to establish and validate a nomogram model for predicting the probability of silent cerebral infarction following ablation of atrial fibrillation.Methods and ResultsA retrospective observational study was conducted on the data of 238 patients with atrial fibrillation who underwent radiofrequency ablation in our hospital from October 2019 to December 2022. LASSO regression and multivariate logistics regression analysis were used to assess the independent risk factors for silent cerebral infarction after ablation. The AUC of the predictive model was 0.733 (95% CI, 0.649-0.816) and the internal validation (bootstrap = 1000) of the bootstrap method was 0.733 (95% CI 0.646-0.813). The Hosmer-Lemeshow test yields an insignificant p-value of X-squared = 10.212 and p-value = 0.2504, thus indicating an insignificant difference between predicted and observed values and good calibration results. The clinical impact curve (CIC) and clinical decision curve also prove that this graph is useful in the clinical setting.ConclusionWe developed an easy-to-use nomogram model to predict the probability of silent cerebral infarction following radiofrequency ablation of atrial fibrillation. This model can provide a valid assessment of the probability of postoperative silent cerebral infarction in patients undergoing radiofrequency ablation of atrial fibrillation.

ContextA nomogram model affecting the activated clotting time (ACT) targeting rate during radiofrequency ablation of atrial fibrillation (RFCA) in China.PurposeThe aim of this study is to develop and validate a nomogram model for predicting the activated clotting time targeting rate after the initial bolus heparin dosages during the radiofrequency catheter ablation of atrial fibrillation in China.Methods and ResultsA retrospective observational study was conducted on the data of 465 patients with atrial fibrillation who underwent radiofrequency catheter ablation (RFCA) from October 2019 to June 2022. All patients were randomized into a training cohort (70%; n = 325) and a validation cohort (30%; n = 140). Independent risk factors were identified using univariate and multifactorial logistic regression analysis. The predictive nomogram model was established using R software. The nomogram was developed and evaluated based on differentiation, calibration, and clinical efficacy using concordance statistic (C-statistic), calibration plots, and decision curve analysis (DCA), respectively. The nomogram was established using three variables, including sex (OR 1.01, 95% CI 0.29-1.76, P = 0.007), heparin dose (OR 0.04; 95%CI 0.02-0.05, P < 0.001), and the baseline ACT (OR 0.03; 95%CI 0.02-0.04, P < 0.001). The C-statistic of the nomogram was 0.736 (95%CI 0.675-0.732) in the training cohort and 0.700 (95%CI 0.622-0.721) in the validation cohort. The calibration plots showed good agreement between the predictions and observations in the training and validation cohorts. The clinical decision curve also proves that the map is useful in clinical settings.ConclusionThe nomogram model has good discrimination and accuracy, which can screen attainment groups intuitively and individually, and has a certain predictive value for the probability of ACT reaching the target after the adequate dosage of initial heparin in Chinese patients with atrial fibrillation.

患者男性,67岁.因陈旧性心肌梗死、持续性室性心动过速、低血压休克行埋藏式心脏转复除颤器植入,术后1个月反复出现胸痛,无发热等典型表现,诊断先后考虑肺动脉栓塞、心脏损伤后综合征,最终经心包、胸腔积液培养及血培养确诊肠炎沙门菌感染导致的化脓性心包炎、脓胸,经治疗痊愈出院.

BACKGROUND:A growing body of evidence supports that the left atrium epicardial adipose tissue (LA-EAT) is related to the occurrence and recurrence of atrial fibrillation (AF). The relationship between LA-EAT and the recurrence after radiofrequency catheter ablation (RFCA) in patients with different types of AF is still unclear. This study aims to evaluate the predictive value of LA-EAT on the recurrence of AF after RFCA in patients with different types of AF. METHODS:301 AF patients who underwent RFCA for the first time were divided into the paroxysmal atrial fibrillation (PAF) group (n = 181) and the persistent atrial fibrillation (PersAF) group(n = 120), which were followed up at 3, 6, and 12 months. All patients underwent left atrial computed tomography angiography (CTA) examination before the operation, and LA-EAT was measured using software (Advantage Workstation4.6, GE, USA). RESULTS:After a median follow-up of 10.7 months, 73/301 patients (24.25%) had a recurrence of AF, including 43 /120(35.83%) patients with PersAF and 30/181(16.57%) patients with PAF. In multivariable Cox regression analysis, LA-EAT volume (OR = 1.053;95%CI: 1.024-1.083, p < 0.001), attenuation (OR = 0.949;95%CI:0.911-0.988, p = 0.012) and left atrial diameter (LAD) (OR = 1.063;95%CI:1.002-1.127，p = 0.043) were independent risk factors for recurrence in patients with PersAF but not in patients with PAF. CONCLUSION:LA-EAT volume and attenuation are independent risk factors for recurrence after RFCA in patients with PersAF.

目的 探讨青年肥胖患者心外膜脂肪(EAT)与左心室功能的关系.方法 连续纳入 2021 年 3 月至 2022 年 3 月在徐州医科大学附属医院行减重手术、左心室收缩功能正常的 121 例青年肥胖患者,收集术前血液学检查资料,采用超声心动图测量EAT,EAT厚度为收缩末期右心室游离壁与心包脏层之间的无回声空间.通过二维斑点追踪成像技术(2D-STE)测量左心室整体纵向应变(GLS),利用HFA-PEFF评分表评估舒张功能.根据GLS分为两组:GLS≥18％(48 例)和GLS<18％(73 例),多因素线性回归分析GLS降低的影响因素.结果 与GLS≥18％组比较,GLS<18％组患者的腰臀比、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、糖化血红蛋白、高敏C反应蛋白、E/e'、左心房容积、左心房容积指数、EAT厚度和HFA-PEFF评分均较高(均为P<0.05).多因素线性回归分析显示,EAT厚度、低密度脂蛋白胆固醇、糖化血红蛋白和高敏C反应蛋白均与左心室GLS独立相关(均为P<0.05).结论 在青年肥胖群体中,EAT增厚与左心室功能的不良改变有一定程度的相关性.

目的 探讨消融指数(ablation index,AI)指导下单导管高功率射频消融在肺静脉隔离(pulmonary vein isolation,PVI)中的安全性和有效性.方法 回顾性纳入77例行房颤导管射频消融患者,分为单导管高功率消融组(HP组)和常规功率消融组(CP组),2组均以AI为参考.HP组应用单消融导管(SmartTouch Surrounding Flow,STSF)进行标测和消融;CP组应用消融导管(SmartTouch,ST)在环状标测导管指导下进行消融.所有患者AI目标值为前壁450～500,顶部400～450,后壁和底部350～400.消融终点为双侧肺静脉隔离即心房、肺静脉双向传导阻滞.比较2组患者一般基线资料、消融相关参数(每点消融时间、每点阻抗下降率、肺静脉隔离时间、总手术时间、左/右肺静脉单圈隔离率、盐水灌注量)、并发症以及随访6个月成功率.结果 与CP组相比,HP组肺静脉隔离时间、总手术时间均缩短(P<0.05),每点消融电阻抗下降率更低(P<0.01),盐水灌注量减少更明显(P<0.01);HP组的左/右肺静脉单圈隔离率更高,但差异无统计学意义(P>0.05).所有患者完成6个月随访,CP组术中发生1例股静脉穿刺处血肿.2组在维持窦性心律方面成功率差异无统计学意义(P>0.05);在持续性房颤中,HP组成功率高于CP组,但差异无统计学意义(P>0.05).结论 与常规功率环状标测导管指导下的肺静脉隔离相比,AI指导下的单消融导管高功率消融可以提高手术效率,缩短肺静脉隔离时间及总手术时间,是安全有效的.

目的 探讨非瓣膜病心房颤动(房颤)患者心外膜脂肪组织(EAT)与心房心肌纤维化的关系.方法 连续入选2020年1月至2021年4月于徐州医科大学附属医院心内科行首次射频消融手术的非瓣膜病房颤患者145例.术前进行左心房(LA)及肺静脉计算机断层摄影(CTA)检查,利用(Advandvage Workstation3.2,GE,USA)工作站软件分析测量总EAT和左心房EAT量、分布及放射密度.术中应用消融导管进行左房内电压标测LA低电压区(LVZ)以评估心房纤维化,根据有无低电压区将患者分为LVZ组和无LVZ组.结果 28例(19.31％)患者出现至少1个LVZ.LVZ组左心房心外膜脂肪(LA-EAT)量显著高于无LVZ组(37.03 cm3 vs.27.44 cm3,P=0.001).LVZ组的LA-EAT放射密度明显低于无LVZ组(-93.54±4.96 Hu vs.-90.31±5.84 Hu,P=0.006).多因素逻辑回归分析显示LA-EAT体积(OR=1.05,95％CI:1.001～1.096,P=0.047)及放射密度(OR=1.15,95％CI:1.104～1.209,P=0.021)是LA-LVZ的独立危险因素.结论 非瓣膜性房颤患者LA-EAT同左房纤维化密切相关,LA-EAT体积增加及放射密度降低是左房纤维化的独立危险因素.

目的 探究双腔起搏器置入后心房高频事件(atrial high rate episode,AHRE)的临床特征及其危险因素.方法 回顾性分析2016年1月至2021年6月在徐州医科大学附属医院心内科初次置入双腔起搏器患者119例.收集患者术前病史、心电图、超声心动图及起搏器随访报告等资料,根据有无AHRE将患者分为AHRE组与无AHRE组,探究双腔起搏器置入后AHRE的临床特征及其危险因素.结果 随访中位数16(9,32)个月,40例(33.6％)患者出现AHRE,27例(67.5％)AHRE心房频率>400次/min;大多数AHRE(28例,70.0％)持续时间集中在5 min～6 h;AHRE组患者病态窦房结综合征占比、心房起搏比例、P波离散度和左心房内径显著高于无AHRE组(P<0.05).多因素logistic回归分析显示病态窦房结综合征(OR=5.580,P=0.004)、P波离散度(OR=1.053,P=0.022)和左心房内径(OR=1.582,P<0.001)是AHRE的独立危险因素.Delong检验显示,左心房内径ROC曲线下面积比P波离散度更大,差异具有统计学意义(z=3.134,P=0.0017).结论 双腔起搏器置入患者AHRE发生率较高.病态窦房结综合征、P波离散度和左心房内径是AHRE的独立危险因素,左心房内径比P波离散度对AHRE的预测效能更高.

目的 探讨持续性心房颤动(房颤)射频导管消融术后复发的危险因素及其可能的风险预测评估方法.方法 本研究为单中心前瞻性观察性研究,连续选择2018年7月—2019年8月在徐州医科大学附属医院心内科首次行射频导管消融术的持续性房颤患者53例.记录患者相关临床资料,环肺静脉电隔离后行窦性心律下左房基质标测,平均随访16(12,21)个月,明确有无房颤复发,多因素回归分析探讨复发危险因素及预测复发风险.结果 14例(26.42％)患者房颤复发.复发组较成功组平均P波时限(mPWD)显著延长(P<0.01),左房平均电压(mLAV)显著降低(P<0.01).COX多因素回归分析显示mPWD及mLAV均为房颤复发的独立危险因素(P<0.05).联合mPWD及mLAV指标构建预测模型,绘制ROC曲线预测房颤复发风险,AUC=0.90(95％CI 0.80～0.99,P<0.01),预测P值截点值为0.41,其诊断的敏感度、特异度分别为0.786、0.949.结论 P波时限及左房电压可有效预测持续性房颤单次射频消融后的复发风险.

目的 探讨网络"互动"教学在临床医学专业心血管病教学中的应用效果.方法 以2016级临床医学专业学生56名为研究对象,随机分为对照组(n=28)和实验组(n=28),对照组采用传统网络教学方法,实验组采用网络"互动"教学方法,授课结束后,比较两组学生理论知识考试成绩,并对学生进行问卷调查以评估教学效果.结果 两组学生授课前心血管病学综合考试成绩得分相当,差异无统计学意义(P>0.05).在接受系统学习后,实验组成绩得分(86.18±18.46)分较对照组明显升高(71.81±16.47)分,差异有统计学意义(P<0.05).并且,实验组学生在教学形式、学习兴趣、网络学习能力、理论知识理解能力、分析能力、临床诊疗思维能力评价均较对照组明显要高,差异有统计学意义(P<0.05).结论 在心血管病学教学中开展网络"互动"教学,教学效果满意,具有较高的应用和推广价值.

Introduction: MicroRNAs (miRNAs) are considered as crucial modulators in myocardial ischemia and reperfusion (I/R) injury. The present study aimed to investigate the expression and biological functions of miR-214-5p via targeting Fas ligand (FASLG) in I/R injury.Material and methods: Lactate dehydrogenase, casein kinase, malondial-dehyde assay, reactive oxygen species (ROS) detection and cell apoptosis analysis measured cell damage and cell apoptosis in H9c2 cells under hypoxia/reperfusion (H/R) treatment. Bioinformatics and dual luciferase reporter assays demonstrated the molecular mechanism of miR-214-5p in cardiac cells. 2,3,5-Triphenyltetrazolium chloride (TTC) staining, hematoxylin-eosin (HE) staining and adenovirus injection were performed in I/R treated mice.Results: The expression of miR-214-5p was decreased in H/R injured H9c2 cells compared with control cells (p < 0.001). Overexpression of miR-214-5p reduced cell damage and apoptosis in H9c2 cells under H/R treatment (p < 0.001). Further study revealed that FASLG was a target of miR-214-5p. Enhanced expression of FASLG attenuated the protective function of miR-214-5p in H9c2 cells subjected to H/R injury (P < 0.001). Moreover, the elevated expression of miR-214-5p by adenovirus injection protected cardiac cells from I/R injury in mice (n = 6/per group).Conclusions: We found that miR-214-5p exerted a protective role in I/R injured cardiac cells by direct targeting FASLG in vitro and in vivo.

目的:研究白藜三醇(resveratrol,Res)对乳鼠心肌成纤维细胞(cardiac fibroblasts,CFs)增殖和胶原分泌的影响,并探讨其可能的机制.方法:采用胰酶、Ⅰ型胶原酶双酶消化法、差速贴壁法和免疫荧光法分离培养及鉴定乳鼠CFs;将2～3代CFs随机分为Con组(正常对照组)、DMSO组(溶剂对照组)、AngⅡ组(模型组)、AngⅡ+Res组(药物干预组).通过CCK-8及EdU染色法检测细胞增殖;羟脯氨酸法检测细胞胶原分泌水平;qRT-PCR检测AU碱基富集区RNA结合蛋白1(AU-rich element RNA-binding factor 1,AUF1)、转化生长因子β1(transforming growth factor-β1,TGF-β1)mRNA的表达;Western blot检测AUF1和TGF-β1蛋白表达.结果:成功提取新生大鼠原代CFs且波形蛋白(Vimentin)显著阳性;与Con组比,AngⅡ组细胞增殖和胶原分泌增加,AUF1、TGF-β1 mRNA及蛋白表达水平升高;经Res干预后,AngⅡ+Res组细胞增殖和胶原分泌水平较AngⅡ组降低,AUF1、TGF-β1 mRNA及蛋白表达减少;而DMSO组上述指标与Con组相比差异无统计学意义.结论:白藜三醇对AngⅡ诱导的乳鼠CFs的增殖和胶原分泌具有抑制作用,其机制可能与抑制了AUF1和TGF-β1的表达有关.