Left ventricular hypertrophy (LVH) is a critical risk factor for cardiovascular diseases, yet the interplay between metabolic disorders and hypertension in its pathogenesis remains underexplored. This retrospective study investigated the independent and synergistic roles of epicardial adipose tissue (EAT) volume and hypertension in driving LVH among 253 preclinical heart failure patients with metabolic syndrome (MetS). EAT volume was measured via non-contrast computed tomography (CT). Analysis of covariance (ANCOVA) was employed to assess the contributions of metabolic factors and hypertension to LVH. Mediation analysis was conducted to evaluate whether the effect of EAT on LVH is mediated through blood pressure. Patients with LVH (median age 33 years) exhibited significantly higher prevalence of hypertension (70.9

BackgroundEpicardial adipose tissue (EAT) is closely associated with the pathophysiological processes of heart failure with preserved ejection fraction (HFpEF). However, it remains unknown whether EAT increases the risk of coronary artery disease (CAD) in patients with HFpEF.MethodsThis was a retrospective cohort study in 112 HFpEF patients hospitalized in the First Affiliated Hospital of Chongqing Medical University from September 2021 to May 2022, who undergoing at least once coronary artery examination. The thickness of EAT was measured by echocardiography. The correlation between EAT and CAD was analyzed by multifactorial binary logistic regression.ResultsCompared to patients without CAD, EAT thickness was noticeably higher in patients with CAD (P = 0.002). Spearman correlation analysis showed that CAD (r = 0.289, P = 0.002) and Gensini score (r = 0.334, P < 0.001) were positively correlated with EAT thickness. Furthermore, after adjusted for age, gender, body mass index, hypertension, type 2 diabetes mellitus, smoking history and a part of biochemical indexes, EAT thickness was associated with CAD (OR ranged from 1.450 to 1.472, all P values ＜0.05).ConclusionsEAT thickness was correlated with CAD in patients with HFpEF.

Tissue nonspecific alkaline phosphatase (TNAP) is expressed widely in different tissues, modulating functions of metabolism and inflammation. However, the effect of TNAP on cardiac fibrosis remains controversial and needs to be further studied. The present study aims to investigate the role of TNAP on myocardial infarction (MI)-induced fibrosis and its mechanism. TNAP was upregulated in patients with MI, both in serum and injured hearts, and predicted in-hospital mortality. TNAP was also significantly upregulated after MI in rats, mostly in the border zone of the infarcted hearts combined with collagen synthesis. Administration of TNAP inhibitor, tetramisole, markedly improved cardiac function and fibrosis after MI. In the primary cultures of neonatal rat cardiac fibroblasts (CFs), TNAP inhibition significantly attenuated migration, differentiation, and expression of collagen-related genes. The TGF-β1/Smads signaling suppression, and p-AMPK and p53 upregulation were involved in the process. When p53 inhibitor was administered, the antifibrotic effect of TNAP inhibition can be blocked. This study provides a direct evidence that inhibition of TNAP might be a novel regulator in cardiac fibrosis and exert an antifibrotic effect mainly through AMPK-TGF-β1/Smads and p53 signals.

Objective: The aim of this study is to clarify the association between subventricular zone (SVZ) involvement and velocity of diametric expansion(VDE) in patients with low-grade astrocytoma and also assessed the clinical outcome of those patients. Materials and Methods: A total of 168 adult patients with newly diagnosed supratentorial low-grade astrocytoma were studied retrospectively. Results: There were 73 patients had SVZ involvement. Patients with SVZ involvement(7.16 +/- 6.53 mm/y) had a higher VDE than patients without SVZ involvement(4.38 +/- 5.35 mm/y). VDE was modeled as a categorical variable(< 4, >= 4 and, < 8, >= 8 and, < 12, >= 12 mm/y). Logistic regression showed that SVZ involvement was associated with high VDE after adjusting by confounding variables. On the univariate analysis, the results showed that tumor involved with SVZ, VDE >= 4 mm/y, VDE >= 8 mm/y, and VDE >= 8 mm/y were significant predictors of a shorter OS, progression-free survival (PFS) and malignant progression-free survival (MFS)(all p < 0.05). The categorical variables of VDE (< 4 mm/y, >= 4 mm/y and, < 8 mm/y, >= 8 mm/y and, < 12 mm/y, >= 12 mm/y) were adjusted by confounding variables in multivariate analysis, respectively. The results indicated that VDE >= 8 mm/y, VDE >= 12 mm/y were worse prognostic factors for OS, while VDE >= 4 mm/y, VDE >= 8 mm/y and VDE >= 12 mm/y were related to shorter PFS and MFS. In addition, SVZ involvement was prognostic factors in predicting OS and PFS except MFS. Conclusion: Our results demonstrated that SVZ involvement predicted high VDE and worse clinical outcome, and high VDE was associated with poor prognosis in patients with low-grade astrocytoma.

Purpose: To explore the functional connectivity (FC) of bilateral amygdala in depression patients with hyposmia through the resting state fMRI. Methods: Major depression disorder group (MDD group) and normal control goup (NC group) included 37 subjects with depression and 38 healthy subjects respectively with matching gender, age and educational background. Both groups received 70％ isopropyl alcohol inhaled test. According to the test results, MDD group was subsequently divided into MDDa group of subjects with hyposmia and MDDb group of those without hyposmia. All patients were then examined by fMRI at resting state. Their bilateral amygdala was selected for FC analysis throughout their brains. Results: There was negative correlation between the severity of hyposmia and the score of HDRS-24 (r = -0.519, P= 0.033) of MD patients with hyposmia. Setting left amygdala as the seed region, MDD group showed lower functional connectivity than NC group at right fusiform,left inferior temporal gyrus,left postcentral gyrus, left precentral gyrus and bilateral medial cingulate gyrus, whereas MDDa group showed weakened functional connectivity at right thalamus, right medial cingulate gyrus, but enhanced connectivity at left calcarine, right insula, left superior temporal gyrus, right rolandic operculum, left cuneus, left medial cingulate gyrus, bilateral precentral gyrus, right middle frontal gyrus, left supplementary motor area, and right cerebellum crus. Setting right amygdala as the seed region, MDD group showed lower functional connectivity than the NC group at right inferior temporal gyrus, left superior temporal gyrus, left triangular inferior frontal gyri, left medial cingulate gyrus, left precentral gyrus, left postcentral gyrus, and right the paracentral lobule, but higher functional connectivity at left hippocampus. MDDa group showed enhanced functional connectivity at right medial cingulate gyrus. For MDDa group, the functional connectivity between left amygdala and other regions such as left superior temporal gyrus (r=-0.603,P=0.038), left cuneus(r=-0.671,P=0.017) and right cerebelum crus (r=-0.608,P=0.036) were negatively correlated with the distance recorded in olfactory test. Conclusion: There is a significant change of FC at bilateral amygdala of MD patients with hyposmia, which may reveal the relationship between olfactory dysfunction and emotional disorder of MD patients.

Objective To evaluate the clinical diagnostic value of prospective electrocardiograph (ECG)-gating of CT cardiac angiography in congenital heart diseases of Chinese population through a Meta-analysis.Methods The articles were searched to study CT prospective ECG-gating in diagnosis of congenital heart disease from January 1995 to February 2016 in domestic and foreign publications.The study quality was assessed by the Quality Assessment for Diagnostic Accuracy Studies and the data extraction was performed.The software of Meta-disc1.4 was used for heterogeneity test.Different effect models were choosen according to the results of heterogeneity analysis.Meanwhile,this soft was used to calculate the sensitivity,specificity,likelihood ratio and its 95％ confidence interval (CI),respectively.The forest maps and summary receiver operator characteristic (SROC) curve were drawn.In addition,the area under curve (AUC) was calculated.Results Twelve articles were included in the Meta-analysis.The study included 1 431 congenital heart malformations confirmed by surgery or cardiac catheterization angiography.CT prospective ECG-gating technique had no heterogeneity in sensitivity and specificity of congenital heart disease.The total sensitivity,the total specificity,positive likelihood ratios,negative likelihood ratios and its 95％ CI of CT cardiac angiography were 96％ (95％ CI 94％ to 97％),100％ (95％ CI 100％ to 100％),365.94(95％ CI 231.18 to 579.26),0.04(95％ CI 0.03 to 0.05) with fixed effect model,respectively.The AUC of the SROC was 99.86％,Q =0.987 9.Conclusions Prospectively ECG-gating of CT cardiac angiography has high sensitivity and specificity in the diagnosis of congenital heart diseases.Its AUC of the SROC is large.It has high diagnostic value in congenital heart diseases.

Objective To explore the application value of the second generation dual source CT in the diagnosis of congenital Tricuspid valve anomalies.Methods A total of 40 patients with congenital malformations of the Tricuspid valve confirmed by surgery were enrolled retrospectively and their echocardiographic and DSCT diagnoses were studied.Comparison of the accuracy of DSCT scan and real-time three-dimensional echocardiography (RT-3DE) in the diagnosis of congenital Tricuspid valve malformation and its associated malformations was evaluated.Using chi square test,P ＜ 0.05 was statistically significant in evaluating the image quality of the Tricuspid valve.Results In 40 patients,the total number of the congenital Tricuspid valve anomalies is 43,including of 32 cases of Ebstein anomaly,3 cases of Tricuspid valve atresia,5 cases of Tricuspid valve hypogenesis,3 cases Tricuspid valve leaflet number abnormality (two leaf malformation and leaflets most absent).The accuracy rate of diagnosis was 90.70％ (39/43) and 100％ (43/43) for the congenital Tricuspid valve malformation by DSCT and RT-3DE respectively.It is of no statistical significance(x2 =4.20,P ＞ 0.05).The accuracy rate of DSCT and RT-3 DE in cases complicated with intracardiac malformation is 82.86％ (29/35) and 100％ (35/35)respectively and there was statistical significance (x2 =6.56,P ＜ 0.05).But accuracy rates were 94.12％ (16/17) and 58.82％ (10/17) respectively.There were significant differences for the extracardiac malformations (x2 =5.89,P ＜ 0.05).The score of image quality for the Tricuspid valve is 3.82-± 0.73.Conclusion DSCT has a certain value in the diagnosis of congenital Tricuspid valve malformation and its associated malformations.

Objective To explore whether patients with first-episode depression have the comorbidity of olfactory dysfunction and investigate the correlation between white matter changes and the severity of depression in patients with concurrent olfactory disorder using diffusion tensor imaging (DTI).Methods Olfactory test was used to evaluate the olfactory function in 37 patients with first-episode depression who were admitted in our hospital from April 2016 to June 2017 and 38 gender-,age-and education-matched healthy control subjects.All the participants were examined using 24-item Hamilton depression rating scale (HDRS24).According to olfactory test results,the depressive patients were divided into group A with olfactory dysfunction (n =17) and group B without olfactory dysfunction (n =20).All the patients underwent DTI examination,and the fractional anisotropy (FA) acquired using tract-based spatial statistics (TBSS) were compared between groups A and B.Results Compared with the healthy controls,the patients with first episode depression had a significant deterioration of the olfactory function (P ＜ 0.01).Compared with those in group B,the depressive patients in group A showed significantly lower mean FA values in the left hippocanpus and in the genu of the corpus callosum (P ＜0.01,FDR corrected),but no brain regions with increased FA values were detected.In group A,an inverse correlation was noted between the olfactory test results and HDRS24 scores (r =-0.519,P =0.033),but no correlation was found between the decreased FA values in the white matter and HDRS24 scores (r =0.163 for the left hippocampus and r =-0.104 for the genu of the corpus callosum,P ＞ 0.05).Conclusion Patients with first-episode depression can have the co-morbidity of olfactory dysfunction possibly as a result of olfactory pathway impairments.The lower FA values in the white matters are not correlated with the severity of depression in such patients.

Objective To investigate the subtle changes of the brain function at olfactory region of MD patients with olfactory dysfunction at resting state, through the application of fMRI-BOLD. Methods This study enrolled 28 MD patients with olfactory dysfunction(Case group) who had been treated from February 2016 to March 2017, and 23 healthy volunteers (Control group) with matching gender, age and education background to the Case group.All subjects were examined by Symptoms Checklists-90(SCL-90), Hamilton Depression Rating Scale-24 (HAMD-24), 70% isopropyl alcohol inhalation test, and fMRI at resting state. The two independent samples t test was used to compare the two groups' educational years, psychological scales and olfactory test scores.Regional homogeneity(ReHo)analysis was conducted for the whole brain of subjects.The ReHo values at some brain regions of both groups were compared through two independent sample t-test.The ReHo values,extracted from the case group's brain regions with differences, were run through by Pearson correlation analysis.Results There was a negative correlation between the HAMD-24 score(r=-0.413,P=0.029)and the severity of olfactory decline in the MD patients with olfactory dysfunction.In addition,it was found by fMRI that Case group,as compared to Control group,demonstrate declined ReHo values at left orbital frontal gyrus(cluster=80,t=3.27),bilateral cingulate gyrus(right cluster=204,t=4.34,left cluster=204,t=3.63),bilateral middle frontal gyrus(right cluster=56,t=3.67,left cluster=28, t=3.50),rightinsular(cluster=40,t=3.53),bilateral amygdala(right cluster=76,t=3.66,left cluster=86,t=2.93),but increased ReHo values at bilateral inferior frontal gyrus(right cluster=44,t=3.62,left cluster=33,t=3.25), right thalamus(cluster=34, t=3.21)and bilateral gyri rectus(right cluster=45,t=3.78,left cluster=24,t=3.01)(AlphaSim correction,P<0.001).Moreover,there was a positive correlation between the ReHo value at left orbital frontal gyrus and the olfactory test distance(r=0.628,P<0.05).But the ReHo value at left orbital frontal gyruswas negatively correlated with HAMD-24 (r=-0.414,P=0.029). There was no correlation with other clinical data.Conclusion The abnormal brain functional activities of left orbital frontal gyrus at resting state might be related to the olfactory dysfunction of patients with depression.