BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chin...BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chinese medicine formulation,has demonstrated cardioprotective potential in preclinical studies,but clinical evidence in this population remains limited.AIM To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.METHODS A randomized,double-blind,placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy.Participants were allocated to:Intervention group:Conventional antipsychotics+Guanxinning tablets(0.38 g×4 tablets,ter in die);Control group:Conventional antipsychotics+identical placebo;Cardiac assessments at baseline and 12 months included:Electrocardiography(corrected QT interval),echocardiography(left ventricular ejection fraction,left ventricular end-diastolic diameter),serum biomarkers(cardiac troponin I,B-type natriuretic peptide,superoxide dismutase,malondialdehyde,high-sensitivity C-reactive protein).RESULTS Compared to controls,the Guanxinning group showed:Electrophysiological improvement:Corrected QT shortening(438±25 milliseconds vs 465±30 milliseconds,P<0.01).Functional enhancement:Left ventricular ejection fraction increase(58.5%±5.2%vs 53.8%±4.8%,P<0.05),left ventricular end-diastolic diameter reduction(49.8±3.5 mm vs 52.6±3.8 mm,P<0.05),Biochemical modulation:Reduced myocardial injury markers(cardiac troponin I:0.009 ng/mL vs 0.014 ng/mL;B-type natriuretic peptide:52 pg/mL vs 78 pg/mL,P<0.001),improved oxidative stress(superoxide dismutase:↑13.3 U/mL;malondialdehyde:↓0.9 nmol/mL,P<0.001),attenuated inflammation(high-sensitivity C-reactive protein:2.0 mg/L vs 3.2 mg/L,P<0.001).CONCLUSION Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients,demonstrating:Normalization of electrophysiological parameters,Preservation of systolic/diastolic function,suppression of oxidative stress and inflammation.These findings support its clinical application as an adjunctive cardioprotective therapy,potentially through inhibition of myocardial apoptosis and antioxidant upregulation.展开更多
Human cardiac organoids have revolutionized the study of cardiac development,disease modeling, drug discovery, and regenerative therapies. This review systematically discusses strategies and progress in the constructi...Human cardiac organoids have revolutionized the study of cardiac development,disease modeling, drug discovery, and regenerative therapies. This review systematically discusses strategies and progress in the construction of cardiac organoids, categorizing them into three main types:cardiac spheroids, self-organizing/assembloid organoids, and organoid-on-a-chip systems. This review uniquely integrates the advances in vascularization, organ-on-chip design, and environmental cardiotoxicity modeling within cardiac organoid platforms, offering a critical synthesis that is absent in the literature. In the context of escalating environmental threats to cardiovascular health, there is an urgent need for physiologically relevant models to accurately identify cardiac toxicants and elucidate their underlying mechanisms of action. This review highlights advances in cardiac organoid applications for disease modeling-including congenital heart defects and acquired cardiovascular diseases-drug development, toxicity screening, and the study of environmentally induced cardiovascular pathogenesis. In addition, it critically examines ongoing challenges and underscores opportunities brought by bioengineering approaches. Finally, we propose future directions for developing standardized cardiac organoid platforms with clinical predictability, aiming to expand the utility of this technology across broader research applications.展开更多
Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mecha...Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.展开更多
In this study,we developed a novel bilayered scaffold consisting of a bottom layer composed of the Decellularized Bovine Pericardium(DP)coated with Polyaniline Nanoparticles(PANINPs)and a top layer made of an electros...In this study,we developed a novel bilayered scaffold consisting of a bottom layer composed of the Decellularized Bovine Pericardium(DP)coated with Polyaniline Nanoparticles(PANINPs)and a top layer made of an electrospun Poly(lactic-co-glycolic acid)/Gelatin(PLGA/Gel)membrane incorporated with Vascular Endothelial Growth Fac-tor(VEGF)and hawthorn extract.Functionally,the DP supplies native Extracellular Matrix(ECM)components and mechanical support,while PANINPs provide conductivity.The electrospun PLGA/Gel layer mimics fibrous ECM.It incorporates bioactives,with VEGF promoting pro-angiogenic stimulation and hawthorn extract enhanc-ing anticoagulant activity,as well as increasing surface hydrophilicity.The tissue adhesive ensures the interfacial integrity between the two layers.Decellularization efficiency was confirmed histologically using 4',6-diamidino-2-phenylindole(DAPI)and Hematoxylin-Eosin(H&E)staining.The DP exhibited a DNA content of 115.9±47.8 ng/mg DNA,compared to 982.88±395.42 ng/mg in Native Pericardium(NP).The PANINPs had an average par-ticle size of 104.94±13.7 nm.The conductivity of PANINPs-coated decellularized pericardium was measured to be 9.093±8.6×10-4 S/cm using the four-point probe method.PLGA/Gel membranes containing hawthorn extract(1%,5%,10%,and 15%w/v)and VEGF(0.1μg/mL,0.5μg/mL,and 1μg/mL)were fabricated by electrospinning,result-ing in fiber diameters between 850 and 1200 nm and pore sizes between 14 and 20μm.The anticoagulant efficiency of the membranes containing hawthorn extract reached 430 s in the Activated Partial Thromboplastin Time Assay(aPTT).Mechanical testing revealed a tensile strength of 22.70±6.33 MPa,an elongation of 53.58±10.63%,and Young's modulus of 0.67±0.10 MPa.The scaffold also exhibited over 91%cell viability and excellent cardiomyo-cyte adhesion.The hemolysis ratio was determined to be 0.421±0.191%,which confirms its blood compatibility.Our results indicate that the proposed bilayered scaffold can be a promising candidate for cardiac patch applications.展开更多
BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to...BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.展开更多
Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and pr...Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.展开更多
Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low...Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low-dose curcumin(50 mg/kg),high-dose curcumin(200 mg/kg),high-dose curcumin plus a scrambled control antagomir,or high-dose curcumin plus anti-miR-29b treatments.Cardiac function was assessed by echocardiography.Fibrosis was evaluated by histology,collagen volume fraction,and hydroxyproline content.Expression of miR-29b,HDAC4,and fibrosis-related markers(Col1a1,Col3a1,TGF-β1)was measured by quantitative RT-PCR and Western blotting assays.Myocardial procollagen type I carboxy-terminal propeptide was determined by ELISA,and HDAC4-specific enzymatic activity was assayed using a fluorogenic kit.Results:Curcumin improved cardiac function,reduced fibrosis,restored miR-29b expression,and suppressed HDAC4 expression and activity in a dose-dependent manner.Furthermore,curcumin decreased myocardial procollagen type I carboxy-terminal propeptide levels,confirming reduced collagen synthesis.Anti-miR-29b administration partially abrogated the antifibrotic and cardioprotective effects of curcumin.Conclusions:Curcumin attenuates pressure overload-induced cardiac fibrosis and dysfunction in a TAC mouse model via modulation of the miR-29b/HDAC4 axis and suppression of collagen synthesis.展开更多
BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Scie...BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Science,and EMBASE from database inception through 10 June 2025.Studies that applied AI inboth in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA)populations acrossthe following domains were included:prediction of cardiac arrest occurrence,prognostication ofCA outcomes,applications of large language models(LLMs),and evaluation of cardiopulmonaryresuscitation(CPR)and other AI-driven interventions related to CA.RESULTS:The scoping review included 114 studies,encompassing data from 9,574,462patients in total.AI was most commonly applied to the prediction of CA(overall,n=40;IHCA,n=30;OHCA,n=4;and both,n=6),CPR-related decision support during CA(n=16),and post-arrestprognosis and rehabilitation outcomes(overall,n=38;OHCA,n=21;IHCA,n=3;and both,n=14).Additional application areas included LLM-based applications(n=8),emergency call handling(n=4),wearable device-based detection(n=3),heart rhythm identification(n=2),education(n=2),and extracorporeal cardiopulmonary resuscitation(ECPR)candidate identifi cation(n=1).Across allapplication scenarios,the highest area under the receiver operating characteristic curve(AUROC)value for pre-arrest CA prediction in IHCA patients was 0.998 using a multilayer perceptron(MLP)model,whereas the optimal AUROC for pre-arrest CA prediction in OHCA patients was 0.950 usingextreme gradient boosting(XGBoost)or random forest(RF)models.For CPR-related decisionsupport during CA,the highest AUROC achieved was 0.990 with a convolutional neural network(CNN)model.In prognostic prediction,the optimal AUROC for IHCA patients was 0.960 usingXGBoost,while for OHCA patients it reached 0.976 using an MLP model.CONCLUSION:This review shows that AI is most commonly used for the prediction of CA andCPR-related support,as well as post-arrest and rehabilitation outcomes.Future research directions includedrug discovery,post-resuscitation management,neurorehabilitation,and clinical trial innovation.Furtherstudies should prioritize multicenter clinical trials to evaluate AI models in real-world settings and validatetheir eff ectiveness across diverse patient populations.Overall,AI has signifi cant potential to improve clinicalpractice,and its role in CA application is increasingly important.展开更多
As the prevalence of obesity increases dramatically,obesity-associated cardiac dysfunction constitutes a considerable challenge to human health.This study aimed to identify more useful lipid/inflammatory markers to pr...As the prevalence of obesity increases dramatically,obesity-associated cardiac dysfunction constitutes a considerable challenge to human health.This study aimed to identify more useful lipid/inflammatory markers to predict the risk of obesity-associated cardiac dysfunction.By retrospectively analyzing the clinical characteristics of 5648 cardiac disease patients,we found that both the plasma level of high-density lipoprotein cholesterol(HDLC)and the blood monocyte count were significantly associated with impairment of the left ventricular ejection fraction(LVEF).Univariate and multivariate regression analyses revealed that the monocyte to HDL-C ratio(MHR)was a more powerful predictor of the risk of LVEF decline than either HDL-C or monocyte alone.Mediation analysis further revealed a mediating effect of a high MHR on the decline in obesity-associated cardiac systolic function.Collectively,our results demonstrate a superior role of MHR in predicting the risk of an obesityassociated decline in cardiac systolic function among routine metabolic/inflammatory markers.展开更多
BACKGROUND Postoperative atrial fibrillation(POAF)is a complication after cardiac surgeries associated with increased morbidity and hospital stay.Surgical cardiac dener-vation,which reduces autonomic input to the hear...BACKGROUND Postoperative atrial fibrillation(POAF)is a complication after cardiac surgeries associated with increased morbidity and hospital stay.Surgical cardiac dener-vation,which reduces autonomic input to the heart,has been proposed as a good preventive against POAF.However,evidence on its effectiveness remains incon-sistent.AIM To evaluate the impact of surgical cardiac denervation on the incidence of POAF and related clinical outcomes.METHODS This meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search was conducted across PubMed,Cochrane,ScienceDirect,and EMBASE up to April 2025 using a preformed search strategy using Medical Subject Headings terms and free-text keywords.Risk of bias assessment was done via Risk of Bias 2.0 and Risk Of Bias In Non-randomized Studies-of Interventions tools.Study analysis was performed using Review Manager version 5.4,with heterogeneity assessed via I^(2) values and appropriate fixed-or randomeffects models applied.RESULTS Five studies(N=1266)were included,with 627 patients undergoing cardiac denervation and 639 serving as controls.Denervation did not significantly reduce overall POAF[odds ratio=0.71;95%confidence interval(CI):0.32-1.58;P=0.40;I^(2)=83%],but was associated with a significant reduction in persistent atrial fibrillation(odds ratio=0.19;95%CI:0.10-0.36;P<0.00001;I^(2)=0%).Among secondary outcomes,only postoperative serum magnesium levels significantly reduced the denervation group(mean difference:-0.07 mmol/L;95%CI:-0.08 to-0.06;P<0.00001).Other outcomes,such as reoperation for bleeding,stroke/transient ischemic attack,length of hospital stay,30-day mortality,and postoperative drainage,did not show any significant difference.CONCLUSION Surgical cardiac denervation does not significantly reduce overall POAF but does lower the incidence of persistent atrial fibrillation.It is also shown to decrease serum magnesium levels.Other outcomes,such as stroke,reoperation,and hospital stay,showed no significant differences.展开更多
Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythm...Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythmia as the primary manifestation of cardiac metastasis of RCC with only two cases reported.[1,2]We add to the literature the third case,the diagnosis of which was only possible with cardiac magnetic resonance(CMR).展开更多
Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to impr...Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.展开更多
Astragali Radix(AR) and Notoginseng Radix et Rhizoma(NR) are frequently employed in cardiovascular disease treatment. However, the efficacy of the AR-NR medicine pair(AN) in improving cardiac remodeling and its underl...Astragali Radix(AR) and Notoginseng Radix et Rhizoma(NR) are frequently employed in cardiovascular disease treatment. However, the efficacy of the AR-NR medicine pair(AN) in improving cardiac remodeling and its underlying mechanism remains unclear. This study aimed to evaluate AN's cardioprotective effect and potential mechanism on cardiac remodeling using transverse aortic constriction(TAC) in mice and angiotensin II(Ang II)-induced neonatal rat cardiomyocytes(NRCMs) and fibroblasts in vitro. High-performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(HPLC-Q-TOF-MS/MS) characterized 23 main components of AN. AN significantly improved cardiac function in the TAC-induced mice. Furthermore, AN considerably reduced the serum levels of N-terminal pro-B-type natriuretic peptide(NT-pro BNP), cardiac troponin T(CTn-T), and interleukin-6(IL-6) and mitigated inflammatory cell infiltration. Post-AN treatment, TAC-induced heart size approached normal. AN decreased cardiomyocyte cross-sectional area and attenuated the upregulation of cardiac hypertrophy marker genes(ANP, BNP, and MYH7) in vivo and in vitro.Concurrently, AN alleviated collagen deposition in TAC-induced mice. AN also reduced the expression of fibrosis-related indicators(COL1A1 and COL3A1) and inhibited the activation of the transforming growth factor-β1(TGF-β1)/mothers against decapentaplegic homolog 3(Smad3) pathway. Thus, AN improved TAC-induced cardiac remodeling. Moreover, AN downregulated p-dynamin-related protein(Drp1)(Ser616) expression and upregulated mitogen 2(MFN-2) and optic atrophy 1(OPA1) expression in vivo and in vitro, thereby restoring mitochondrial fusion and fission balance. In conclusion, AN improves cardiac remodeling by regulating mitochondrial dynamic balance, providing experimental data for the rational application of Chinese medicine prescriptions with AN as the main component in clinical practice.展开更多
Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the inju...Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.展开更多
Cardiac sarcoidosis(CS)is a rare but serious manifestation of sarcoidosis that can lead to significant morbidity and mortality due to arrhythmias and heart failure.The inflammatory process in CS is characterized by th...Cardiac sarcoidosis(CS)is a rare but serious manifestation of sarcoidosis that can lead to significant morbidity and mortality due to arrhythmias and heart failure.The inflammatory process in CS is characterized by the formation of noncaseating granulomas in the myocardium,which can disrupt normal cardiac function and conduction.Corticosteroids are the primary therapeutic agents used to manage CS,particularly during the acute inflammatory phase,as they help reduce inflammation and improve cardiac function.However,the long-term use of steroids poses risks,including opportunistic infections and metabolic complications.Advanced imaging techniques,such as cardiac magnetic resonance imaging and positron emission tomography,play a crucial role in diagnosing CS and assessing myocardial involvement.These imaging modalities also aid in risk stratification for arrhythmic events,guiding therapeutic decisions such as the initiation of steroid therapy and the potential placement of implantable cardioverterdefibrillators.This review synthesizes current evidence regarding the role of steroid therapy in managing CS and its implications for cardiac arrhythmias,emphasizing the need for individualized treatment strategies to optimize patient outcomes.展开更多
Objective:To systematically evaluate the impact of phase I cardiac rehabilitation exercise prescriptions on cardiac function levels in patients after coronary intervention.Methods:Seven Chinese and English databases,i...Objective:To systematically evaluate the impact of phase I cardiac rehabilitation exercise prescriptions on cardiac function levels in patients after coronary intervention.Methods:Seven Chinese and English databases,including Cochrane Library,PubMed,Web of Science,ESC(European Society of Cardiology),and CNKI,as well as professional association websites,were searched using computers,with manual searching as a complement.Relevant literature published from the establishment of the database to February 2025 was retrieved.Two researchers independently screened the literature,extracted data,and evaluated the quality of the literature.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 8 articles were included,involving 843 patients.Meta-analysis results showed that compared with routine nursing,phase I cardiac rehabilitation exercise prescriptions helped increase the 6-minute walking distance in patients after coronary intervention[MD=0.84,95%CI(0.57,1.10),P<0.001],increase the level of left ventricular ejection fraction in patients after coronary intervention[MD=0.67,95%CI(0.33,1.00),P<0.001],and cardiac rehabilitation combined with respiratory rehabilitation exercise could improve the level of left ventricular ejection fraction in patients after coronary intervention[MD=0.58,95%CI(0.40,0.76),P<0.001].Conclusion:The implementation of phase I cardiac rehabilitation exercise prescriptions can help improve cardiac function levels in patients after coronary intervention.However,the standardization of outcome evaluation indicators needs to be improved,and the long-term effects of rehabilitation still require verification through a large number of high-quality studies.展开更多
Many studies have shown the negative relationship between long term exposure to PM_(2.5)and cardiac dysfunction.Recently,studies have shown that even a single exposure of PM_(2.5)from air sample in permissible range c...Many studies have shown the negative relationship between long term exposure to PM_(2.5)and cardiac dysfunction.Recently,studies have shown that even a single exposure of PM_(2.5)from air sample in permissible range can induce very mild cardiac pathological changes.In the present study,we revisited the toxic effect of PM_(2.5)on rat heart by adopting single and multiple exposure durations.FemaleWistar ratswere exposed to PM_(2.5)at a concentration of 250μg/m3 daily for 3 hr for single(1 day)and multiple(7,14,21 days)durations.The major pathological changes noted in 21 days exposed myocardium comprised of an elevated ST segment(the segment between the S wave and the T wave),development of cardiac fibrosis,hypertrophy,cardiac injury,tissue inflammation and declined cardiac function.With 14 days exposed heart,the electrocardiograms(ECG),data showed insignificantly declined heart rate and an increased QT(the time from the start of the Q wave to the end of the T wave)interval along with mild fibrosis,hypertrophy and lesser number of TUNEL positive cells.On the other hand,single-and 7-days exposure to PM_(2.5)did not impart any significant changes in the myocardium.To determine the reversibility potential of PM_(2.5)induced cardiotoxicity,a washout period of 24 hours was adopted and all observed changes in the myocardium were reversed till day 7,but not in 14-and 21-days exposed samples.Based on the above findings we concluded that PM_(2.5)associated cardiac dysfunction is the cumulative outcome of ineffective cardiac adaptive and repair process that accumulate additively over the time due to prolonged exposure durations.展开更多
BACKGROUND A key cardiac magnetic resonance(CMR)challenge is breath-holding duration,difficult for cardiac patients.AIM To evaluate whether artificial intelligence-assisted compressed sensing CINE(AICS-CINE)reduces im...BACKGROUND A key cardiac magnetic resonance(CMR)challenge is breath-holding duration,difficult for cardiac patients.AIM To evaluate whether artificial intelligence-assisted compressed sensing CINE(AICS-CINE)reduces image acquisition time of CMR compared to conventional CINE(C-CINE).METHODS Cardio-oncology patients(n=60)and healthy volunteers(n=29)underwent sequential C-CINE and AI-CS-CINE with a 1.5-T scanner.Acquisition time,visual image quality assessment,and biventricular metrics(end-diastolic volume,endsystolic volume,stroke volume,ejection fraction,left ventricular mass,and wall thickness)were analyzed and compared between C-CINE and AI-CS-CINE with Bland–Altman analysis,and calculation of intraclass coefficient(ICC).RESULTS In 89 participants(58.5±16.8 years,42 males,47 females),total AI-CS-CINE acquisition and reconstruction time(37 seconds)was 84%faster than C-CINE(238 seconds).C-CINE required repeats in 23%(20/89)of cases(approximately 8 minutes lost),while AI-CS-CINE only needed one repeat(1%;2 seconds lost).AICS-CINE had slightly lower contrast but preserved structural clarity.Bland-Altman plots and ICC(0.73≤r≤0.98)showed strong agreement for left ventricle(LV)and right ventricle(RV)metrics,including those in the cardiac amyloidosis subgroup(n=31).AI-CS-CINE enabled faster,easier imaging in patients with claustrophobia,dyspnea,arrhythmias,or restlessness.Motion-artifacted C-CINE images were reliably interpreted from AI-CS-CINE.CONCLUSION AI-CS-CINE accelerated CMR image acquisition and reconstruction,preserved anatomical detail,and diminished impact of patient-related motion.Quantitative AI-CS-CINE metrics agreed closely with C-CINE in cardio-oncology patients,including the cardiac amyloidosis cohort,as well as healthy volunteers regardless of left and right ventricular size and function.AI-CS-CINE significantly enhanced CMR workflow,particularly in challenging cases.The strong analytical concordance underscores reliability and robustness of AI-CS-CINE as a valuable tool.展开更多
BACKGROUND Cardiovascular diseases and cancer are leading causes of morbidity and mortality.Patients with malignancies are at increased risk for cardiovascular complications including acute coronary syndromes,chemothe...BACKGROUND Cardiovascular diseases and cancer are leading causes of morbidity and mortality.Patients with malignancies are at increased risk for cardiovascular complications including acute coronary syndromes,chemotherapy or radiation therapy related complications and cardiac metastasis.CASE SUMMARY We present a case of a 47-year-old female with metastatic cancer on immuno-therapy presented with anterior ST elevation myocardial infarction followed by emergent percutaneous coronary intervention in the left anterior descending artery.Echocardiography after 72 hours showed thickening of inferior wall and cardiac magnetic resonance depicted inflammation and necrosis attributable to either cardiac metastasis or immunotherapy induced myocarditis.Biopsy was not performed because of treatment with antiplatelet drugs and a definite diagnosis was achieved after probationary administration of high-dose intravenous methyl-prednisolone that led to recovery.CONCLUSION In patients with malignancy,chemotherapy-induced cardiovascular complications and cardiac metastasis are common concerns and may coexist with common acute cardiovascular diseases including acute coronary syndromes.In such cases clinical suspicion aided by multimodality imaging is crucial for the diagnosis.A multidisciplinary team approach is required for prompt initiation of the appro-priate treatment.展开更多
BACKGROUND Cardiac magnetic resonance(CMR)has been reported to identify myocardial damage inducing out-of-hospital cardiac arrest(OHCA).However,the usefulness of CMR may be affected by the medical institutions,patient...BACKGROUND Cardiac magnetic resonance(CMR)has been reported to identify myocardial damage inducing out-of-hospital cardiac arrest(OHCA).However,the usefulness of CMR may be affected by the medical institutions,patients’ages,and myocardial diseases.AIM To clarify the clinical usefulness and limitation of CMR for identifying myocardial damage in the survivors of OHCA in midtown.METHODS Nineteen patients underwent CMR to detect myocardial damage related to OHCA in the midtown of a capital city.Cine,T1 and T2 mapping,T2-weighted,and late gadolinium enhancement(LGE)imaging were acquired using a 1.5 T scanner.We described the clinical characteristics of the survivors of OHCA and evaluated usefulness of CMR for identifying myocardial damage related to OHCA.RESULTS Among 19 patients experiencing OHCA,7 experienced it in trains or on railway platforms,4 while practicing sports,and 4 during their daily work.Ten of the 19 survivors were diagnosed with coronary vasospasm(CVS),in whom CMR failed to depict its characteristic findings.CMR was useful for identifying myocardial damage associated with hypertrophic cardiomyopathy(HCM)or myocardial infarction(MI).LGE was related to serious ventricular arrhythmias after implantable cardioverter defibrillator(ICD)installation in 3 patients(CVS,2;HCM,1).CONCLUSION CMR is useful for identifying myocardial damage of HCM or MI inducing OHCA and predicting ventricular arrhythmias after ICD implantation but has limited capability for detecting myocardial damage of CVS.展开更多
基金Supported by the Special Project for Supporting the Development of Biomedicine and Health Industry in Hangzhou City,No.2022WJC123Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2022ZA143.
文摘BACKGROUND Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks,including QT interval prolongation,myocardial injury,and functional impairment.Guanxinning,a traditional Chinese medicine formulation,has demonstrated cardioprotective potential in preclinical studies,but clinical evidence in this population remains limited.AIM To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.METHODS A randomized,double-blind,placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy.Participants were allocated to:Intervention group:Conventional antipsychotics+Guanxinning tablets(0.38 g×4 tablets,ter in die);Control group:Conventional antipsychotics+identical placebo;Cardiac assessments at baseline and 12 months included:Electrocardiography(corrected QT interval),echocardiography(left ventricular ejection fraction,left ventricular end-diastolic diameter),serum biomarkers(cardiac troponin I,B-type natriuretic peptide,superoxide dismutase,malondialdehyde,high-sensitivity C-reactive protein).RESULTS Compared to controls,the Guanxinning group showed:Electrophysiological improvement:Corrected QT shortening(438±25 milliseconds vs 465±30 milliseconds,P<0.01).Functional enhancement:Left ventricular ejection fraction increase(58.5%±5.2%vs 53.8%±4.8%,P<0.05),left ventricular end-diastolic diameter reduction(49.8±3.5 mm vs 52.6±3.8 mm,P<0.05),Biochemical modulation:Reduced myocardial injury markers(cardiac troponin I:0.009 ng/mL vs 0.014 ng/mL;B-type natriuretic peptide:52 pg/mL vs 78 pg/mL,P<0.001),improved oxidative stress(superoxide dismutase:↑13.3 U/mL;malondialdehyde:↓0.9 nmol/mL,P<0.001),attenuated inflammation(high-sensitivity C-reactive protein:2.0 mg/L vs 3.2 mg/L,P<0.001).CONCLUSION Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients,demonstrating:Normalization of electrophysiological parameters,Preservation of systolic/diastolic function,suppression of oxidative stress and inflammation.These findings support its clinical application as an adjunctive cardioprotective therapy,potentially through inhibition of myocardial apoptosis and antioxidant upregulation.
基金supported by the Innovation Promotion Program of NHC and Shanghai Key Labs,SIBPT(grant number PT2025-01)。
文摘Human cardiac organoids have revolutionized the study of cardiac development,disease modeling, drug discovery, and regenerative therapies. This review systematically discusses strategies and progress in the construction of cardiac organoids, categorizing them into three main types:cardiac spheroids, self-organizing/assembloid organoids, and organoid-on-a-chip systems. This review uniquely integrates the advances in vascularization, organ-on-chip design, and environmental cardiotoxicity modeling within cardiac organoid platforms, offering a critical synthesis that is absent in the literature. In the context of escalating environmental threats to cardiovascular health, there is an urgent need for physiologically relevant models to accurately identify cardiac toxicants and elucidate their underlying mechanisms of action. This review highlights advances in cardiac organoid applications for disease modeling-including congenital heart defects and acquired cardiovascular diseases-drug development, toxicity screening, and the study of environmentally induced cardiovascular pathogenesis. In addition, it critically examines ongoing challenges and underscores opportunities brought by bioengineering approaches. Finally, we propose future directions for developing standardized cardiac organoid platforms with clinical predictability, aiming to expand the utility of this technology across broader research applications.
基金supported by the National Science Foundation of China,Nos.82325031(to FX),82030059(to YC),82102290(to YG),U23A20485(to YC)Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0505504(to FX),2023ZD0505500(to YC)the Key R&D Program of Shandong Province,No.2022ZLGX03(to YC).
文摘Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.
文摘In this study,we developed a novel bilayered scaffold consisting of a bottom layer composed of the Decellularized Bovine Pericardium(DP)coated with Polyaniline Nanoparticles(PANINPs)and a top layer made of an electrospun Poly(lactic-co-glycolic acid)/Gelatin(PLGA/Gel)membrane incorporated with Vascular Endothelial Growth Fac-tor(VEGF)and hawthorn extract.Functionally,the DP supplies native Extracellular Matrix(ECM)components and mechanical support,while PANINPs provide conductivity.The electrospun PLGA/Gel layer mimics fibrous ECM.It incorporates bioactives,with VEGF promoting pro-angiogenic stimulation and hawthorn extract enhanc-ing anticoagulant activity,as well as increasing surface hydrophilicity.The tissue adhesive ensures the interfacial integrity between the two layers.Decellularization efficiency was confirmed histologically using 4',6-diamidino-2-phenylindole(DAPI)and Hematoxylin-Eosin(H&E)staining.The DP exhibited a DNA content of 115.9±47.8 ng/mg DNA,compared to 982.88±395.42 ng/mg in Native Pericardium(NP).The PANINPs had an average par-ticle size of 104.94±13.7 nm.The conductivity of PANINPs-coated decellularized pericardium was measured to be 9.093±8.6×10-4 S/cm using the four-point probe method.PLGA/Gel membranes containing hawthorn extract(1%,5%,10%,and 15%w/v)and VEGF(0.1μg/mL,0.5μg/mL,and 1μg/mL)were fabricated by electrospinning,result-ing in fiber diameters between 850 and 1200 nm and pore sizes between 14 and 20μm.The anticoagulant efficiency of the membranes containing hawthorn extract reached 430 s in the Activated Partial Thromboplastin Time Assay(aPTT).Mechanical testing revealed a tensile strength of 22.70±6.33 MPa,an elongation of 53.58±10.63%,and Young's modulus of 0.67±0.10 MPa.The scaffold also exhibited over 91%cell viability and excellent cardiomyo-cyte adhesion.The hemolysis ratio was determined to be 0.421±0.191%,which confirms its blood compatibility.Our results indicate that the proposed bilayered scaffold can be a promising candidate for cardiac patch applications.
基金funded by the Shenzhen Science and Technology Program(JCYJ20230807112007014 to PG)the Shenzhen Key Medical Discipline Construction Fund(SZXK046 to PG).
文摘BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.
文摘Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.
基金supported by China International Medical Foundation(Z-2019-42-1908-4)Natural Science Basic Research Program of Shaanxi Province(2019JM-440).
文摘Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low-dose curcumin(50 mg/kg),high-dose curcumin(200 mg/kg),high-dose curcumin plus a scrambled control antagomir,or high-dose curcumin plus anti-miR-29b treatments.Cardiac function was assessed by echocardiography.Fibrosis was evaluated by histology,collagen volume fraction,and hydroxyproline content.Expression of miR-29b,HDAC4,and fibrosis-related markers(Col1a1,Col3a1,TGF-β1)was measured by quantitative RT-PCR and Western blotting assays.Myocardial procollagen type I carboxy-terminal propeptide was determined by ELISA,and HDAC4-specific enzymatic activity was assayed using a fluorogenic kit.Results:Curcumin improved cardiac function,reduced fibrosis,restored miR-29b expression,and suppressed HDAC4 expression and activity in a dose-dependent manner.Furthermore,curcumin decreased myocardial procollagen type I carboxy-terminal propeptide levels,confirming reduced collagen synthesis.Anti-miR-29b administration partially abrogated the antifibrotic and cardioprotective effects of curcumin.Conclusions:Curcumin attenuates pressure overload-induced cardiac fibrosis and dysfunction in a TAC mouse model via modulation of the miR-29b/HDAC4 axis and suppression of collagen synthesis.
基金supported by grant from the National Natural Science Foundation of China(82372207).
文摘BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Science,and EMBASE from database inception through 10 June 2025.Studies that applied AI inboth in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA)populations acrossthe following domains were included:prediction of cardiac arrest occurrence,prognostication ofCA outcomes,applications of large language models(LLMs),and evaluation of cardiopulmonaryresuscitation(CPR)and other AI-driven interventions related to CA.RESULTS:The scoping review included 114 studies,encompassing data from 9,574,462patients in total.AI was most commonly applied to the prediction of CA(overall,n=40;IHCA,n=30;OHCA,n=4;and both,n=6),CPR-related decision support during CA(n=16),and post-arrestprognosis and rehabilitation outcomes(overall,n=38;OHCA,n=21;IHCA,n=3;and both,n=14).Additional application areas included LLM-based applications(n=8),emergency call handling(n=4),wearable device-based detection(n=3),heart rhythm identification(n=2),education(n=2),and extracorporeal cardiopulmonary resuscitation(ECPR)candidate identifi cation(n=1).Across allapplication scenarios,the highest area under the receiver operating characteristic curve(AUROC)value for pre-arrest CA prediction in IHCA patients was 0.998 using a multilayer perceptron(MLP)model,whereas the optimal AUROC for pre-arrest CA prediction in OHCA patients was 0.950 usingextreme gradient boosting(XGBoost)or random forest(RF)models.For CPR-related decisionsupport during CA,the highest AUROC achieved was 0.990 with a convolutional neural network(CNN)model.In prognostic prediction,the optimal AUROC for IHCA patients was 0.960 usingXGBoost,while for OHCA patients it reached 0.976 using an MLP model.CONCLUSION:This review shows that AI is most commonly used for the prediction of CA andCPR-related support,as well as post-arrest and rehabilitation outcomes.Future research directions includedrug discovery,post-resuscitation management,neurorehabilitation,and clinical trial innovation.Furtherstudies should prioritize multicenter clinical trials to evaluate AI models in real-world settings and validatetheir eff ectiveness across diverse patient populations.Overall,AI has signifi cant potential to improve clinicalpractice,and its role in CA application is increasingly important.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82430018 to Q.C.,82270361 and 82570402 to H.Z.)the Nanjing Medical University Undergraduate Innovation and Entrepreneurship Training Program Fund(Grant No.202410312138Y to C.Z.)the Basic Sciences of Jiangsu Higher Education Institutions(Grant No.22KJA310002 to H.Z.)。
文摘As the prevalence of obesity increases dramatically,obesity-associated cardiac dysfunction constitutes a considerable challenge to human health.This study aimed to identify more useful lipid/inflammatory markers to predict the risk of obesity-associated cardiac dysfunction.By retrospectively analyzing the clinical characteristics of 5648 cardiac disease patients,we found that both the plasma level of high-density lipoprotein cholesterol(HDLC)and the blood monocyte count were significantly associated with impairment of the left ventricular ejection fraction(LVEF).Univariate and multivariate regression analyses revealed that the monocyte to HDL-C ratio(MHR)was a more powerful predictor of the risk of LVEF decline than either HDL-C or monocyte alone.Mediation analysis further revealed a mediating effect of a high MHR on the decline in obesity-associated cardiac systolic function.Collectively,our results demonstrate a superior role of MHR in predicting the risk of an obesityassociated decline in cardiac systolic function among routine metabolic/inflammatory markers.
文摘BACKGROUND Postoperative atrial fibrillation(POAF)is a complication after cardiac surgeries associated with increased morbidity and hospital stay.Surgical cardiac dener-vation,which reduces autonomic input to the heart,has been proposed as a good preventive against POAF.However,evidence on its effectiveness remains incon-sistent.AIM To evaluate the impact of surgical cardiac denervation on the incidence of POAF and related clinical outcomes.METHODS This meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search was conducted across PubMed,Cochrane,ScienceDirect,and EMBASE up to April 2025 using a preformed search strategy using Medical Subject Headings terms and free-text keywords.Risk of bias assessment was done via Risk of Bias 2.0 and Risk Of Bias In Non-randomized Studies-of Interventions tools.Study analysis was performed using Review Manager version 5.4,with heterogeneity assessed via I^(2) values and appropriate fixed-or randomeffects models applied.RESULTS Five studies(N=1266)were included,with 627 patients undergoing cardiac denervation and 639 serving as controls.Denervation did not significantly reduce overall POAF[odds ratio=0.71;95%confidence interval(CI):0.32-1.58;P=0.40;I^(2)=83%],but was associated with a significant reduction in persistent atrial fibrillation(odds ratio=0.19;95%CI:0.10-0.36;P<0.00001;I^(2)=0%).Among secondary outcomes,only postoperative serum magnesium levels significantly reduced the denervation group(mean difference:-0.07 mmol/L;95%CI:-0.08 to-0.06;P<0.00001).Other outcomes,such as reoperation for bleeding,stroke/transient ischemic attack,length of hospital stay,30-day mortality,and postoperative drainage,did not show any significant difference.CONCLUSION Surgical cardiac denervation does not significantly reduce overall POAF but does lower the incidence of persistent atrial fibrillation.It is also shown to decrease serum magnesium levels.Other outcomes,such as stroke,reoperation,and hospital stay,showed no significant differences.
文摘Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythmia as the primary manifestation of cardiac metastasis of RCC with only two cases reported.[1,2]We add to the literature the third case,the diagnosis of which was only possible with cardiac magnetic resonance(CMR).
基金supported by the Natural Science Fund of Fujian Province,No.2020J011058(to JK)the Project of Fujian Provincial Hospital for High-level Hospital Construction,No.2020HSJJ12(to JK)+1 种基金the Fujian Provincial Finance Department Special Fund,No.(2021)848(to FC)the Fujian Provincial Major Scientific and Technological Special Projects on Health,No.2022ZD01008(to FC).
文摘Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.
基金supported by the National Natural Science Foundation of China (Nos. 82274231 and 81973506)the State Key Laboratory for Chemistry and Molecular Engineering of Medicinal Resources (Guangxi Normal University, No.CMEMR2023-B12)+2 种基金the Fundamental Research Funds for the Central Universities (No. 2632023TD06)the Young Talent Support Project of Jiangsu Association for Science and Technology(No. TJ-2022-025)the Qinglan Project of Jiangsu Province。
文摘Astragali Radix(AR) and Notoginseng Radix et Rhizoma(NR) are frequently employed in cardiovascular disease treatment. However, the efficacy of the AR-NR medicine pair(AN) in improving cardiac remodeling and its underlying mechanism remains unclear. This study aimed to evaluate AN's cardioprotective effect and potential mechanism on cardiac remodeling using transverse aortic constriction(TAC) in mice and angiotensin II(Ang II)-induced neonatal rat cardiomyocytes(NRCMs) and fibroblasts in vitro. High-performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry(HPLC-Q-TOF-MS/MS) characterized 23 main components of AN. AN significantly improved cardiac function in the TAC-induced mice. Furthermore, AN considerably reduced the serum levels of N-terminal pro-B-type natriuretic peptide(NT-pro BNP), cardiac troponin T(CTn-T), and interleukin-6(IL-6) and mitigated inflammatory cell infiltration. Post-AN treatment, TAC-induced heart size approached normal. AN decreased cardiomyocyte cross-sectional area and attenuated the upregulation of cardiac hypertrophy marker genes(ANP, BNP, and MYH7) in vivo and in vitro.Concurrently, AN alleviated collagen deposition in TAC-induced mice. AN also reduced the expression of fibrosis-related indicators(COL1A1 and COL3A1) and inhibited the activation of the transforming growth factor-β1(TGF-β1)/mothers against decapentaplegic homolog 3(Smad3) pathway. Thus, AN improved TAC-induced cardiac remodeling. Moreover, AN downregulated p-dynamin-related protein(Drp1)(Ser616) expression and upregulated mitogen 2(MFN-2) and optic atrophy 1(OPA1) expression in vivo and in vitro, thereby restoring mitochondrial fusion and fission balance. In conclusion, AN improves cardiac remodeling by regulating mitochondrial dynamic balance, providing experimental data for the rational application of Chinese medicine prescriptions with AN as the main component in clinical practice.
基金supported by the National Key Research and Development Program(2021YFC3002205)the Postgraduate Research and Innovation Program of Tianjin Municipal Education Commission(2022BKY113),China.
文摘Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
文摘Cardiac sarcoidosis(CS)is a rare but serious manifestation of sarcoidosis that can lead to significant morbidity and mortality due to arrhythmias and heart failure.The inflammatory process in CS is characterized by the formation of noncaseating granulomas in the myocardium,which can disrupt normal cardiac function and conduction.Corticosteroids are the primary therapeutic agents used to manage CS,particularly during the acute inflammatory phase,as they help reduce inflammation and improve cardiac function.However,the long-term use of steroids poses risks,including opportunistic infections and metabolic complications.Advanced imaging techniques,such as cardiac magnetic resonance imaging and positron emission tomography,play a crucial role in diagnosing CS and assessing myocardial involvement.These imaging modalities also aid in risk stratification for arrhythmic events,guiding therapeutic decisions such as the initiation of steroid therapy and the potential placement of implantable cardioverterdefibrillators.This review synthesizes current evidence regarding the role of steroid therapy in managing CS and its implications for cardiac arrhythmias,emphasizing the need for individualized treatment strategies to optimize patient outcomes.
基金Science Research Fund Project of Yunnan Provincial Department of Education(Project No.:2024J0832)Science Research Fund Project of Yunnan Provincial Department of Education(Project No.:2025Y1186)。
文摘Objective:To systematically evaluate the impact of phase I cardiac rehabilitation exercise prescriptions on cardiac function levels in patients after coronary intervention.Methods:Seven Chinese and English databases,including Cochrane Library,PubMed,Web of Science,ESC(European Society of Cardiology),and CNKI,as well as professional association websites,were searched using computers,with manual searching as a complement.Relevant literature published from the establishment of the database to February 2025 was retrieved.Two researchers independently screened the literature,extracted data,and evaluated the quality of the literature.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 8 articles were included,involving 843 patients.Meta-analysis results showed that compared with routine nursing,phase I cardiac rehabilitation exercise prescriptions helped increase the 6-minute walking distance in patients after coronary intervention[MD=0.84,95%CI(0.57,1.10),P<0.001],increase the level of left ventricular ejection fraction in patients after coronary intervention[MD=0.67,95%CI(0.33,1.00),P<0.001],and cardiac rehabilitation combined with respiratory rehabilitation exercise could improve the level of left ventricular ejection fraction in patients after coronary intervention[MD=0.58,95%CI(0.40,0.76),P<0.001].Conclusion:The implementation of phase I cardiac rehabilitation exercise prescriptions can help improve cardiac function levels in patients after coronary intervention.However,the standardization of outcome evaluation indicators needs to be improved,and the long-term effects of rehabilitation still require verification through a large number of high-quality studies.
基金the Indian Council of Medical Research(No.3/1/2(22)/Env/2021-NCD-II)Department of science and technology,India(CRG/2021/000227)for funding this research.
文摘Many studies have shown the negative relationship between long term exposure to PM_(2.5)and cardiac dysfunction.Recently,studies have shown that even a single exposure of PM_(2.5)from air sample in permissible range can induce very mild cardiac pathological changes.In the present study,we revisited the toxic effect of PM_(2.5)on rat heart by adopting single and multiple exposure durations.FemaleWistar ratswere exposed to PM_(2.5)at a concentration of 250μg/m3 daily for 3 hr for single(1 day)and multiple(7,14,21 days)durations.The major pathological changes noted in 21 days exposed myocardium comprised of an elevated ST segment(the segment between the S wave and the T wave),development of cardiac fibrosis,hypertrophy,cardiac injury,tissue inflammation and declined cardiac function.With 14 days exposed heart,the electrocardiograms(ECG),data showed insignificantly declined heart rate and an increased QT(the time from the start of the Q wave to the end of the T wave)interval along with mild fibrosis,hypertrophy and lesser number of TUNEL positive cells.On the other hand,single-and 7-days exposure to PM_(2.5)did not impart any significant changes in the myocardium.To determine the reversibility potential of PM_(2.5)induced cardiotoxicity,a washout period of 24 hours was adopted and all observed changes in the myocardium were reversed till day 7,but not in 14-and 21-days exposed samples.Based on the above findings we concluded that PM_(2.5)associated cardiac dysfunction is the cumulative outcome of ineffective cardiac adaptive and repair process that accumulate additively over the time due to prolonged exposure durations.
基金Supported by James Russell Hornsby and Jun Xiong Fund and United Imaging Healthcare.
文摘BACKGROUND A key cardiac magnetic resonance(CMR)challenge is breath-holding duration,difficult for cardiac patients.AIM To evaluate whether artificial intelligence-assisted compressed sensing CINE(AICS-CINE)reduces image acquisition time of CMR compared to conventional CINE(C-CINE).METHODS Cardio-oncology patients(n=60)and healthy volunteers(n=29)underwent sequential C-CINE and AI-CS-CINE with a 1.5-T scanner.Acquisition time,visual image quality assessment,and biventricular metrics(end-diastolic volume,endsystolic volume,stroke volume,ejection fraction,left ventricular mass,and wall thickness)were analyzed and compared between C-CINE and AI-CS-CINE with Bland–Altman analysis,and calculation of intraclass coefficient(ICC).RESULTS In 89 participants(58.5±16.8 years,42 males,47 females),total AI-CS-CINE acquisition and reconstruction time(37 seconds)was 84%faster than C-CINE(238 seconds).C-CINE required repeats in 23%(20/89)of cases(approximately 8 minutes lost),while AI-CS-CINE only needed one repeat(1%;2 seconds lost).AICS-CINE had slightly lower contrast but preserved structural clarity.Bland-Altman plots and ICC(0.73≤r≤0.98)showed strong agreement for left ventricle(LV)and right ventricle(RV)metrics,including those in the cardiac amyloidosis subgroup(n=31).AI-CS-CINE enabled faster,easier imaging in patients with claustrophobia,dyspnea,arrhythmias,or restlessness.Motion-artifacted C-CINE images were reliably interpreted from AI-CS-CINE.CONCLUSION AI-CS-CINE accelerated CMR image acquisition and reconstruction,preserved anatomical detail,and diminished impact of patient-related motion.Quantitative AI-CS-CINE metrics agreed closely with C-CINE in cardio-oncology patients,including the cardiac amyloidosis cohort,as well as healthy volunteers regardless of left and right ventricular size and function.AI-CS-CINE significantly enhanced CMR workflow,particularly in challenging cases.The strong analytical concordance underscores reliability and robustness of AI-CS-CINE as a valuable tool.
文摘BACKGROUND Cardiovascular diseases and cancer are leading causes of morbidity and mortality.Patients with malignancies are at increased risk for cardiovascular complications including acute coronary syndromes,chemotherapy or radiation therapy related complications and cardiac metastasis.CASE SUMMARY We present a case of a 47-year-old female with metastatic cancer on immuno-therapy presented with anterior ST elevation myocardial infarction followed by emergent percutaneous coronary intervention in the left anterior descending artery.Echocardiography after 72 hours showed thickening of inferior wall and cardiac magnetic resonance depicted inflammation and necrosis attributable to either cardiac metastasis or immunotherapy induced myocarditis.Biopsy was not performed because of treatment with antiplatelet drugs and a definite diagnosis was achieved after probationary administration of high-dose intravenous methyl-prednisolone that led to recovery.CONCLUSION In patients with malignancy,chemotherapy-induced cardiovascular complications and cardiac metastasis are common concerns and may coexist with common acute cardiovascular diseases including acute coronary syndromes.In such cases clinical suspicion aided by multimodality imaging is crucial for the diagnosis.A multidisciplinary team approach is required for prompt initiation of the appro-priate treatment.
文摘BACKGROUND Cardiac magnetic resonance(CMR)has been reported to identify myocardial damage inducing out-of-hospital cardiac arrest(OHCA).However,the usefulness of CMR may be affected by the medical institutions,patients’ages,and myocardial diseases.AIM To clarify the clinical usefulness and limitation of CMR for identifying myocardial damage in the survivors of OHCA in midtown.METHODS Nineteen patients underwent CMR to detect myocardial damage related to OHCA in the midtown of a capital city.Cine,T1 and T2 mapping,T2-weighted,and late gadolinium enhancement(LGE)imaging were acquired using a 1.5 T scanner.We described the clinical characteristics of the survivors of OHCA and evaluated usefulness of CMR for identifying myocardial damage related to OHCA.RESULTS Among 19 patients experiencing OHCA,7 experienced it in trains or on railway platforms,4 while practicing sports,and 4 during their daily work.Ten of the 19 survivors were diagnosed with coronary vasospasm(CVS),in whom CMR failed to depict its characteristic findings.CMR was useful for identifying myocardial damage associated with hypertrophic cardiomyopathy(HCM)or myocardial infarction(MI).LGE was related to serious ventricular arrhythmias after implantable cardioverter defibrillator(ICD)installation in 3 patients(CVS,2;HCM,1).CONCLUSION CMR is useful for identifying myocardial damage of HCM or MI inducing OHCA and predicting ventricular arrhythmias after ICD implantation but has limited capability for detecting myocardial damage of CVS.
