ObjectiveTo explore the effect of Peplau's interpersonal relationship theory (PIRT) combined with case management (CM) on exercise-based cardiac rehabilitation (EBCR), self-efficacy of rehabilitation and risk factors in patients after primary percutaneous coronary intervention (PCI).MethodsThe convenience sampling method was used to select patients who were admitted to the Department of Cardiology in our hospital from January to October 2022 and received PCI for the first time. Patients were divided into a control group and an intervention group. The control group was given routine treatment and health guidance, including radial artery puncture site care, monitoring of vital signs, informing about medication and dietary precautions, etc. and the intervention group was given PIRT combined with CM. The study was conducted for 3 months. The effect of intervention in the two groups was evaluated by the coronary heart disease risk factor index, EBCR knowledge-attitude-behavior questionnaire and EBCR self-efficacy scale.ResultsThe rate of risk factors control including blood pressure (p < 0.001), low density lipoprotein cholesterol (p = 0.012), smoking cessation (p = 0.031) and exercises (p = 0.021), the scores of EBCR knowledge (p < 0.001), attitude (p = 0.001) and behavior (p < 0.001), and the score of EBCR self-efficacy scale (p < 0.001) in the intervention group were better than those in the control group at 3 months after intervention.ConclusionPeplau's interpersonal relationship theory combined with appropriate case management can effectively control cardiovascular disease in patients after primary PCI.

Objective: To observe the effects of cardiac rehabilitation guided by cardiopulmonary exercise testing (CPET) on cardiorespiratory reserve function, blood pressure, blood pressure variability, and lipid metabolism in patients with hypertension. Methods: A randomized trial enrolled 67 Grade 1 hypertensive patients on antihypertensive drugs, divided into conventional (n=35) and CPET (n=32) groups. Antihypertensive drugs were not adjusted in both groups during the study period. Blood pressure, cardiorespiratory indicators, lipid profile, and BMI were assessed pre/post 12 weeks. Results: Postintervention, the CPET group exhibited significantly lower blood pressure levels and improved cardiac indicators compared to the conventional group (p<0.05). CPET group showed greater improvements in cardiorespiratory endurance indicators (p<0.05). The cardiorespiratory endurance indicators showed significantly greater increases in the CPET group compared to the conventional group (p<0.05). Low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), and body mass index (BMI) were significantly lower in the CPET group (p<0.05). Conclusion: In addition to drug treatment, cardiac rehabilitation guided by CPET can effectively improve blood pressure control, reduce blood pressure variability, improve cardiorespiratory function and lipid metabolism, and increase exercise endurance in patients with Grade 1 hypertension. Its efficacy is clear and safe, with clinical value for promotion.

The modulation of vascular smooth muscle cell (VSMC) phenotype during cellular proliferation and migration may represent a potential therapeutic approach for vascular intimal hyperplasia prevention. However, the precise role of this process in VSMC biology and remodeling remains unclear. In the present study, western blotting, PCR, MTT and Transwell assays were used to analyze related protein and mRNA expression, cell viability and cell migration, respectively. It was demonstrated that miR-92a modulated VSMCs into a synthetic phenotype via the Kruppel-like factor 4 (KLF4) pathway. Targeting microRNA (miRNA/miR)-92a in VSMCs using a KLF4 inhibitor suppressed the synthetic phenotype and inhibited VSMC proliferation and migration. To further confirm this finding, the expression levels of miR-92a were measured in patients undergoing coronary artery intervention. The serum miR-92a expression levels were significantly higher in patients with in-stent restenosis (ISR) compared with those in patients without ISR, whereas KLF4 expression was significantly reduced in the non-ISR group. Bioinformatic analysis and promoter-luciferase reporter assays were used to examine the regulatory mechanisms underlying KLF4 expression. KLF4 was demonstrated to be transcriptionally upregulated by miR-92a in VSMCs. miRNA transfection was also performed to regulate the level of miR-92a expression. miR-92a overexpression inhibited VSMC proliferation and migration, and also increased the mRNA and protein expression levels of certain differentiated VSMC-related genes. Finally, miR-92a inhibition promoted the proliferation and migration of VSMCs, which could be reversed using a KLF4 inhibitor. Collectively, these results indicated that the local delivery of a KLF4 inhibitor may act as a novel therapeutic option for the prevention of ISR.

Cardiac hypertrophy is a current, major, global health challenge. Oxidative stress is an important mechanism that contributes to the pathogenesis of cardiac hypertrophy. Schisandra chinensis polysaccharides (SCP), the primary active constituent in Schisandra chinensis, have antioxidative properties. Here, we investigated the role played by SCP in a cardiac hypertrophy model mouse induced by transverse aortic constriction (TAC). We found that SCP treatment improved cardiac function by inhibiting myocardial hypertrophy and oxidative stress. Angiotensin II was used to induce cardiomyocyte hypertrophy and oxidative stress in vitro. We discovered that the antioxidant effects of SCP were mediated through the regulation of the thioredoxin-interacting protein (TXNIP)/Thioredoxin-1 (Trx-1) pathway. Using molecular docking, we found that SCP binds to Arg207, Ser169, Lys166, Lys286 and Ser285 in TXNIP through hydrogen bonds. TXNIP is an endogenous inhibitor of Trx-1, and the binding SCP with TXNIP may restrict or interfere with the binding between TXNIP and Trx-1, resulting in Trx-1 activation. In conclusion, our findings demonstrated that the potential use of SCP as a TXNIP inhibitor to attenuate oxidative stress, suggesting that TXNIP might represent a potential therapeutic target for the treatment of cardiac hypertrophy.