Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury...Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT （cTns） in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited. The levels of cTnI and cTnT were examined before and after PCI. All patients were followed up for 26± 9 months to observe the incidence of major adverse cardiac events （MACEs）. Our results showed that post- PCI cTnI and/or cTnT levels were increased to more than the 99^th percentile upper reference limit （URL） in 133 （13.2%） patients, among which 22 （2.2%） were more than 5 × 99^th percentile URL. By univariate analysis, an elevation in cTns after PCI was not an independent predictor of increased MACEs, HR 1.35 （P = 0.33, 95% CI： 0.74-2.46）. In conclusion, our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.展开更多
We aimed to investigate the effectiveness and safety of angiotensin-converting enzyme inhibitors （ACEIs） or angiotensin Ⅱ receptor blockers （ARBs） on preventing atrial fibrillation in essential hypertensive patie...We aimed to investigate the effectiveness and safety of angiotensin-converting enzyme inhibitors （ACEIs） or angiotensin Ⅱ receptor blockers （ARBs） on preventing atrial fibrillation in essential hypertensive patients. Systematic literature retrieval was carried out to obtain randomized controlled trials on the effects of ACEI/ ARBs on essential hypertensive patients before December, 2013. Data extraction and quality evaluation were performed. Meta-analysis was performed by Review Manager 5.2.3. Ten high quality studies （11 articles） with a total of 42,892 patients （20,491 patients in the ACEI/ARBs group and 22,401 patients in the β-blocker or the calcium antagonist group） met the inclusion criteria and were included in the meta-analysis. The results showed that ACEI/ARBs reduced the incidence of atrial fibrillation （AF） recurrence compared to calcium antagonists （RR=0.48; 95%CI, 0.40-0.58; P〈0.00001） or β-blockers （RR=0.39; 95%CI, 0.20-0.74; P=0.005） in long-term follow-up, respectively. Furthermore, ACEI/ARBs reduced the incidence of conges- tive heart failure （RR=0.86; 95%CI, 0.77-0.96; P=0.007）. However, no significant effects were observed on the incidence of new AF, cardiac death, myocardial infarction, and stroke. Our results suggest that ACEI/ ARBs may reduce the incidence of AF recurrence and congestive heart failure, with fewer serious adverse effects.展开更多
Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary inter- vention （PCI）. Contrast-induced acute kidney injury （CI-AKI） is a complex syndrome induced by exposure to in...Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary inter- vention （PCI）. Contrast-induced acute kidney injury （CI-AKI） is a complex syndrome induced by exposure to in- travascular contrast media （CM）. Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis （PMN） after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects un- dertaking elective PCI. The levels of cardiac troponins （cTns）, cTnl and cTnT, at baseline and on at least one occasion 18-24 h after PCI were measured. We also recorded serum levels of creatinine （SCr） and the urine albumin：creatinine ratio （ACR） before coronary angiography, and 24-48 h and 48-72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% （53/327） of subjects with cTns levels 〉99th to 5x99th percentile upper ref- erence limit （URL）. Twenty-seven patients （8.26%） developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN （20.8% versus 5.8%, respectively, /〉=-0.001）. Multiple logistic regression analysis revealed that pre-existing microalbuminuria （MA） was an important independent predictor of PMN （OR： 3.31; 95% CI： 1.26-8.65, P=0.01）. However, there was no correlation between the incidence of CI-AKI and PMN （OR： 2.38; 95% CI： 0.88-6.46, P=-0.09）. We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.展开更多
The potential of circular RNAs(circRNAs)as biomarkers and therapeutic targets is becoming increasingly evident,yet their roles in cardiac regeneration and myocardial renewal remain largely unexplored.Here,we investiga...The potential of circular RNAs(circRNAs)as biomarkers and therapeutic targets is becoming increasingly evident,yet their roles in cardiac regeneration and myocardial renewal remain largely unexplored.Here,we investigated the function of circlGF1R and related mechanisms in cardiac regeneration.Through analysis of circRNA sequencing data from neonatal and adult cardiomyocytes,circRNAs associated with regeneration were identified.Our data showed that circlGFiR expression was high in neonatal hearts,decreased with postnatal maturation,and up-regulated after cardiac injury.The elevation was validated in patients diagnosed with acute myocardial infarction(Ml)within 1 week.In human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)and myocardial tissue from mice after apical resection and Ml,we observed that circlGF1R overexpression enhanced cardiomyocyte proliferation,reduced apoptosis,and mitigated cardiac dysfunction and fibrosis,while circlGF1R knockdown impeded endogenous cardiac renewal.Mechanistically,we identified circIGF1R binding proteins through circRNA precipitation followed by mass spectrometry.RNA pull-down Western blot and RNA immunoprecipitation demonstrated that circlGF1R directly interacted with DDX5 and augmented its protein level by suppressing ubiquitin-dependent degradation.This subsequently triggered theβ-catenin signaling pathway,leading to the transcriptional activation of cyclin D1 and c-Myc.The roles of circlGF1R and DDX5 in cardiac regeneration were further substantiated through site-directed mutagenesis and rescue experiments.In conclusion,our study highlights the pivotal role of circlGFiR in facilitating heart regeneration and repair after ischemic insults.The circlGF1R/DDX5/β-catenin axis emerges as a novel therapeutic target for enhancing myocardial repair after Ml,offering promising avenues for the development of regenerative therapies.展开更多
基金supported by the Health Bureau of Jiangsu Province(No.K201104)the Scientific Support Plan of Jiangsu Province(No.BE2011803)+2 种基金the National Natural Science Foundation of China(No.81170102/H0203)the Priority Academic Program Development of Jiangsu Higher Education Institutions(No.BL2012011)the Fourth Period Project"333"of Jiangsu Province(No.BRA2012207),China
文摘Cardiac troponin-I （cTnI） and -T （cTnT） are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention （PCI）-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT （cTns） in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited. The levels of cTnI and cTnT were examined before and after PCI. All patients were followed up for 26± 9 months to observe the incidence of major adverse cardiac events （MACEs）. Our results showed that post- PCI cTnI and/or cTnT levels were increased to more than the 99^th percentile upper reference limit （URL） in 133 （13.2%） patients, among which 22 （2.2%） were more than 5 × 99^th percentile URL. By univariate analysis, an elevation in cTns after PCI was not an independent predictor of increased MACEs, HR 1.35 （P = 0.33, 95% CI： 0.74-2.46）. In conclusion, our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.
基金supported by grants from the National Natural Science Foundation of China(No.81270255 to L-SW)
文摘We aimed to investigate the effectiveness and safety of angiotensin-converting enzyme inhibitors （ACEIs） or angiotensin Ⅱ receptor blockers （ARBs） on preventing atrial fibrillation in essential hypertensive patients. Systematic literature retrieval was carried out to obtain randomized controlled trials on the effects of ACEI/ ARBs on essential hypertensive patients before December, 2013. Data extraction and quality evaluation were performed. Meta-analysis was performed by Review Manager 5.2.3. Ten high quality studies （11 articles） with a total of 42,892 patients （20,491 patients in the ACEI/ARBs group and 22,401 patients in the β-blocker or the calcium antagonist group） met the inclusion criteria and were included in the meta-analysis. The results showed that ACEI/ARBs reduced the incidence of atrial fibrillation （AF） recurrence compared to calcium antagonists （RR=0.48; 95%CI, 0.40-0.58; P〈0.00001） or β-blockers （RR=0.39; 95%CI, 0.20-0.74; P=0.005） in long-term follow-up, respectively. Furthermore, ACEI/ARBs reduced the incidence of conges- tive heart failure （RR=0.86; 95%CI, 0.77-0.96; P=0.007）. However, no significant effects were observed on the incidence of new AF, cardiac death, myocardial infarction, and stroke. Our results suggest that ACEI/ ARBs may reduce the incidence of AF recurrence and congestive heart failure, with fewer serious adverse effects.
基金Project supported by the National Natural Science Foundation of China (No. 81170102/H0203)the Priority Academic Program De-velopment of Jiangsu Higher Education Institutions (No. BL2012011)+1 种基金the Chinese Medical Association of the Sunlight Foundation (No. SCRFCMDA201217)the Fourth Period Progect "333" of Jiangsu Province (No. BRA2012207), China
文摘Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary inter- vention （PCI）. Contrast-induced acute kidney injury （CI-AKI） is a complex syndrome induced by exposure to in- travascular contrast media （CM）. Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis （PMN） after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects un- dertaking elective PCI. The levels of cardiac troponins （cTns）, cTnl and cTnT, at baseline and on at least one occasion 18-24 h after PCI were measured. We also recorded serum levels of creatinine （SCr） and the urine albumin：creatinine ratio （ACR） before coronary angiography, and 24-48 h and 48-72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% （53/327） of subjects with cTns levels 〉99th to 5x99th percentile upper ref- erence limit （URL）. Twenty-seven patients （8.26%） developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN （20.8% versus 5.8%, respectively, /〉=-0.001）. Multiple logistic regression analysis revealed that pre-existing microalbuminuria （MA） was an important independent predictor of PMN （OR： 3.31; 95% CI： 1.26-8.65, P=0.01）. However, there was no correlation between the incidence of CI-AKI and PMN （OR： 2.38; 95% CI： 0.88-6.46, P=-0.09）. We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.
基金support from various funding sources,including grants from Key Clinical Frontier Technology Project of Department of Science and Technology of Jiangsu Provincial(no.BE2022806)the National Natural Science Foundation of China Innovative Research Group Project(no.82121001)+1 种基金the National Natural Science Foundation of China(nos.82370344 and 82200382)the Scientific Research Innovation Projects of Graduate Students in Jiangsu Province(no.KYCX23_1940).
文摘The potential of circular RNAs(circRNAs)as biomarkers and therapeutic targets is becoming increasingly evident,yet their roles in cardiac regeneration and myocardial renewal remain largely unexplored.Here,we investigated the function of circlGF1R and related mechanisms in cardiac regeneration.Through analysis of circRNA sequencing data from neonatal and adult cardiomyocytes,circRNAs associated with regeneration were identified.Our data showed that circlGFiR expression was high in neonatal hearts,decreased with postnatal maturation,and up-regulated after cardiac injury.The elevation was validated in patients diagnosed with acute myocardial infarction(Ml)within 1 week.In human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)and myocardial tissue from mice after apical resection and Ml,we observed that circlGF1R overexpression enhanced cardiomyocyte proliferation,reduced apoptosis,and mitigated cardiac dysfunction and fibrosis,while circlGF1R knockdown impeded endogenous cardiac renewal.Mechanistically,we identified circIGF1R binding proteins through circRNA precipitation followed by mass spectrometry.RNA pull-down Western blot and RNA immunoprecipitation demonstrated that circlGF1R directly interacted with DDX5 and augmented its protein level by suppressing ubiquitin-dependent degradation.This subsequently triggered theβ-catenin signaling pathway,leading to the transcriptional activation of cyclin D1 and c-Myc.The roles of circlGF1R and DDX5 in cardiac regeneration were further substantiated through site-directed mutagenesis and rescue experiments.In conclusion,our study highlights the pivotal role of circlGFiR in facilitating heart regeneration and repair after ischemic insults.The circlGF1R/DDX5/β-catenin axis emerges as a novel therapeutic target for enhancing myocardial repair after Ml,offering promising avenues for the development of regenerative therapies.
