This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,e...This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,emphasizing innovative strategies like bioabsorbable occluders and tissue engineering to reduce complications and improve prognosis.The integration of artificial intelligence and big data analytics for treatment decision-making and personalized surgical timing models is highlighted as transformative.Our analysis underscores the need for early diagnosis and tailored interventions,proposing future research directions in molecular mechanisms,multidisciplinary collaboration,and technology integration.These innovations promise to enhance VSR management and extend to other cardiovascular diseases,heralding a new era of precision and regenerative cardiovascular medicine.展开更多
Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequentl...Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequently augmenting urinary glucose excretion and attenuating blood glucose levels.Extensive clinical investigations have demonstrated their profound cardiovascular efficacy.Parallel basic science research has elucidated the mechanistic pathways through which diverse SGLT-2 inhibitors beneficially modulate pulmonary vascular cells and arterial remodeling.Specifically,these inhibitors exhibit promising potential in enhancing pulmonary vascular endothelial cell function,suppressing pulmonary smooth muscle cell proliferation and migration,reversing pulmonary arterial remodeling,and maintaining hemodynamic equilibrium.This comprehensive review synthesizes current literature to delineate the mechanisms by which SGLT-2 inhibitors enhance pulmonary vascular cell function and reverse pulmonary remodeling,thereby offering novel therapeutic perspectives for pulmonary vascular diseases.展开更多
Heart failure(HF)has emerged as one of the foremost global health threats due to its intricate pathophysiological mechanisms and multifactorial etiology.Adeno-sine triphosphate(ATP)-induced cell death represents a nov...Heart failure(HF)has emerged as one of the foremost global health threats due to its intricate pathophysiological mechanisms and multifactorial etiology.Adeno-sine triphosphate(ATP)-induced cell death represents a novel form of regulated cell deaths,marked by cellular energy depletion and metabolic dysregulation stemming from excessive ATP accumulation,identifying its uniqueness compared to other cell death processes modalities such as programmed cell death and necrosis.Growing evidence suggests that ATP-induced cell death(AICD)is predominantly governed by various biological pathways,including energy meta-bolism,redox homeostasis and intracellular calcium equilibrium.Recent research has shown that AICD is crucial in HF induced by pathological conditions like myocardial infarction,ischemia-reperfusion injury,and chemotherapy.Thus,it is essential to investigate the function of AICD in the pathogenesis of HF,as this may provide a foundation for the development of targeted therapies and novel treatment strategies.This review synthesizes current advancements in under-standing the link between AICD and HF,while further elucidating its invol-vement in cardiac remodeling and HF progression.展开更多
BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the p...BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the popularization of percutaneous coronary intervention.However,the risk is significantly increased for those who fail to undergo revascularization in time,and the mortality rate remains high.The current core contradiction in clinical practice lies in the selection of surgical timing,and the disparity in medical resources significantly affects prognosis.There is an urgent need to optimize the identification of high-risk populations and individualized treatment strategies.AIM To investigate the clinical features,determine the prognostic factors,and develop a predictive model for 30-day mortality in patients with acute myocardial infarction complicated by ventricular septal rupture(AMI-VSR)residing in high-altitude regions.METHODS This study retrospectively analyzed 48 AMI-VSR patients admitted to a Yunnan hospital from 2017 to 2024,with the establishment of survival(n=30)and mortality(n=18)groups based on patients’survival status.Risk factors were identified by univariate and multivariate logistic regression analyses.A nomogram model was developed using R software and validated via receiver operating characteristic(ROC)analysis and calibration curves.RESULTS Age,uric acid(UA),interleukin-6(IL-6),and low hemoglobin(Hb)were independent risk factors for 30-day mortality(odds ratios:1.147,1.006,1.034,and 0.941,respectively;P<0.05).The nomogram demonstrated excellent discrimination(area under the ROC curve=0.939)and calibration(Hosmer-Lemeshowχ²=2.268,P=0.971).In addition,patients’poor outcomes could be synergistically predicted by IL-6 and UA,advanced age,and reduced Hb.CONCLUSION This study highlights age,UA,IL-6,and Hb as critical predictors of mortality in AMI-VSR patients at high altitudes.The validated nomogram provides a practical tool for early risk stratification and tailored interventions,addressing gaps in managing this high-risk population in resource-limited settings.展开更多
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,China,No.202401AY070001-164Yunnan Provincial Department of Science and Technology Science and Technology Plan Project—Major Science and Technology Special Projects,No.202405AJ310003.
文摘This review comprehensively examines acute myocardial infarction with ventricular septal rupture(VSR),a rare yet lethal complication.We analyze its epidemiological,pathophysiological,clinical,and therapeutic aspects,emphasizing innovative strategies like bioabsorbable occluders and tissue engineering to reduce complications and improve prognosis.The integration of artificial intelligence and big data analytics for treatment decision-making and personalized surgical timing models is highlighted as transformative.Our analysis underscores the need for early diagnosis and tailored interventions,proposing future research directions in molecular mechanisms,multidisciplinary collaboration,and technology integration.These innovations promise to enhance VSR management and extend to other cardiovascular diseases,heralding a new era of precision and regenerative cardiovascular medicine.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,No.202401AY070001-164Yunnan Provincial Clinical Research Center Cardiovascular Diseases-New Technology Research for Development Project for Diagnosis and Treatment Cardiovascular Diseases,No.202102AA310002the Key Technology Research and Device Development Project for Innovative Diagnosis and Treatment of Structural Heart Disease in the Southwest Plateau Region,No.202302AA310045.
文摘Sodium-glucose cotransporter-2(SGLT-2)inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules,consequently augmenting urinary glucose excretion and attenuating blood glucose levels.Extensive clinical investigations have demonstrated their profound cardiovascular efficacy.Parallel basic science research has elucidated the mechanistic pathways through which diverse SGLT-2 inhibitors beneficially modulate pulmonary vascular cells and arterial remodeling.Specifically,these inhibitors exhibit promising potential in enhancing pulmonary vascular endothelial cell function,suppressing pulmonary smooth muscle cell proliferation and migration,reversing pulmonary arterial remodeling,and maintaining hemodynamic equilibrium.This comprehensive review synthesizes current literature to delineate the mechanisms by which SGLT-2 inhibitors enhance pulmonary vascular cell function and reverse pulmonary remodeling,thereby offering novel therapeutic perspectives for pulmonary vascular diseases.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,No.202401AY070001-164Yunnan Provincial Clinical Research Center Cardiovascular Diseases-New Technology Research for Development Project for Diagnosis and Treatment Cardiovascular Diseases,No.202102AA310002the Key Technology Research and Device Development Project for Innovative Diagnosis and Treatment of Structural Heart Disease in the Southwest Plateau Region,No.202302AA310045.
文摘Heart failure(HF)has emerged as one of the foremost global health threats due to its intricate pathophysiological mechanisms and multifactorial etiology.Adeno-sine triphosphate(ATP)-induced cell death represents a novel form of regulated cell deaths,marked by cellular energy depletion and metabolic dysregulation stemming from excessive ATP accumulation,identifying its uniqueness compared to other cell death processes modalities such as programmed cell death and necrosis.Growing evidence suggests that ATP-induced cell death(AICD)is predominantly governed by various biological pathways,including energy meta-bolism,redox homeostasis and intracellular calcium equilibrium.Recent research has shown that AICD is crucial in HF induced by pathological conditions like myocardial infarction,ischemia-reperfusion injury,and chemotherapy.Thus,it is essential to investigate the function of AICD in the pathogenesis of HF,as this may provide a foundation for the development of targeted therapies and novel treatment strategies.This review synthesizes current advancements in under-standing the link between AICD and HF,while further elucidating its invol-vement in cardiac remodeling and HF progression.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,No.202401AY070001-164Yunnan Provincial Department of Science and Technology Science and Technology Plan Project-Major Science and Technology Special Projects,No.202405AJ310003+1 种基金Yunnan Provincial Department of Science and Technology Science and Technology Plan Project-Key Research and Development Program,No.202103AC100004Yunnan Province Science and Technology Department Key Research and Development Plan,No.202103AC100002.
文摘BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the popularization of percutaneous coronary intervention.However,the risk is significantly increased for those who fail to undergo revascularization in time,and the mortality rate remains high.The current core contradiction in clinical practice lies in the selection of surgical timing,and the disparity in medical resources significantly affects prognosis.There is an urgent need to optimize the identification of high-risk populations and individualized treatment strategies.AIM To investigate the clinical features,determine the prognostic factors,and develop a predictive model for 30-day mortality in patients with acute myocardial infarction complicated by ventricular septal rupture(AMI-VSR)residing in high-altitude regions.METHODS This study retrospectively analyzed 48 AMI-VSR patients admitted to a Yunnan hospital from 2017 to 2024,with the establishment of survival(n=30)and mortality(n=18)groups based on patients’survival status.Risk factors were identified by univariate and multivariate logistic regression analyses.A nomogram model was developed using R software and validated via receiver operating characteristic(ROC)analysis and calibration curves.RESULTS Age,uric acid(UA),interleukin-6(IL-6),and low hemoglobin(Hb)were independent risk factors for 30-day mortality(odds ratios:1.147,1.006,1.034,and 0.941,respectively;P<0.05).The nomogram demonstrated excellent discrimination(area under the ROC curve=0.939)and calibration(Hosmer-Lemeshowχ²=2.268,P=0.971).In addition,patients’poor outcomes could be synergistically predicted by IL-6 and UA,advanced age,and reduced Hb.CONCLUSION This study highlights age,UA,IL-6,and Hb as critical predictors of mortality in AMI-VSR patients at high altitudes.The validated nomogram provides a practical tool for early risk stratification and tailored interventions,addressing gaps in managing this high-risk population in resource-limited settings.
