Objective To investigate the survival of different subgroups of pulmonary hypertension due to left heart disease(PH-LHD)in heart failure patients with reduced ejection fraction(HFrEF)and to detect possible hemodynamic...Objective To investigate the survival of different subgroups of pulmonary hypertension due to left heart disease(PH-LHD)in heart failure patients with reduced ejection fraction(HFrEF)and to detect possible hemodynamic variables associated with the prognosis of these patients.展开更多
目的:旨在研究血浆神经酰胺水平在射血分数减低型心力衰竭患者中的变化,以及神经酰胺与HFrEF患者心功能的相关性及预测价值。方法:采用1:1病例对照研究方法,收集了青岛大学附属医院心血管内科在2023年1月至2024年3月期间,门诊和住院的9...目的:旨在研究血浆神经酰胺水平在射血分数减低型心力衰竭患者中的变化,以及神经酰胺与HFrEF患者心功能的相关性及预测价值。方法:采用1:1病例对照研究方法,收集了青岛大学附属医院心血管内科在2023年1月至2024年3月期间,门诊和住院的98例射血分数减低型心力衰竭患者作为病例组,并选取了98例健康体检中心的患者作为对照组。检测血浆中6种神经酰胺(Cer16:0、Cer18:0、Cer20:0、Cer22:0、Cer24:0、Cer24:1)的水平,分析血浆神经酰胺对HFrEF的辅助诊断价值。结果:研究显示Cer16:0、Cer18:0、Cer20:0和Cer22:0在病例组表现出高表达,并且与NT-proBNP水平呈正相关;Cer24:0在HFrEF患者中的表达较低,并与NT-proBNP水平呈负相关,差异具有统计学意义(p 0.9,对HFrEF具有较高的诊断价值。结论:Cer16:0、Cer18:0、Cer20:0和Cer22:0水平变化可反映HFrEF心功能严重程度,可以考虑作为诊断HFrEF的生物标志物。Objective: The study aims to investigate the changes in plasma ceramide levels in patients with heart failure with reduced ejection fraction (HFrEF) and the correlation and predictive value of ceramides with cardiac function in HFrEF patients. Methods: Through a case-control study method, 98 patients with heart failure with reduced ejection fraction who visited and were hospitalized at the Department of Cardiology, Affiliated Hospital of Qingdao University, from January 2023 to March 2024 were collected as the case group, and 98 healthy individuals from the health examination center were selected as the control group. The levels of six types of ceramides (Cer16:0, Cer18:0, Cer20:0, Cer22:0, Cer24:0, Cer24:1) in the plasma were detected, and the auxiliary diagnostic value of plasma ceramides for HFrEF was analyzed. Results: Studies have shown that Cer16:0, Cer18:0, Cer20:0, and Cer22:0 exhibit high expression in the case group and are positively correlated with NT-proBNP levels;Cer24:0 expression is lower in HFrEF patients and is negatively correlated with NT-proBNP levels, with statistically significant differences (p < 0.05). ROC curve analysis results indicate that the AUC values for Cer16:0, Cer18:0, Cer20:0, and Cer22:0 are all greater than 0.9, indicating high diagnostic value for HFrEF. Conclusion: Changes in the levels of Cer16:0, Cer18:0, Cer20:0, and Cer22:0 can reflect the severity of heart function in HFrEF and may be considered as biomarkers for the diagnosis of HFrEF.展开更多
在射血分数降低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者中,部分患者的左室射血分数(left ventricular ejection fraction,LVEF)经治疗后在后续评估中出现明显改善。2022年美国心脏学会/美国心脏病协会/美...在射血分数降低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者中,部分患者的左室射血分数(left ventricular ejection fraction,LVEF)经治疗后在后续评估中出现明显改善。2022年美国心脏学会/美国心脏病协会/美国心衰学会(American Heart Association/American College of Cardiology/Heart Failure Society of America,AHA/ACC/HFSA)颁布的心力衰竭管理指南将既往LVEF≤40%且在随访过程中提升至40%以上的心力衰竭类型命名为射血分数改善型心力衰竭(heart failure with improved ejection fraction,HFimpEF)。研究表明,HFimpEF患者的全因死亡率、心力衰竭再住院率较低,预后明显优于HFrEF,可作为HFrEF患者的阶段性治疗目标。关于HFimpEF患者的热点讨论主要围绕2个方面,即HFimpEF的目标人群特征及LVEF提升的有效手段、HFimpEF患者心功能维持治疗方案;尤其是后者,尚无明确的临床指南推荐。因此,回顾现有研究,系统总结促使HFrEF向HFimpEF转归的治疗方案,以及有效针对HFimpEF的维持手段至关重要。该文对现有药物、器械、手术治疗的LVEF改善效果及HFimpEF患者的监测与治疗方法进行综述。对于HFrEF患者,现有临床研究提示β受体阻滞剂及心脏再同步治疗等能够显著改善LVEF并提升至40%以上;对于HFimpEF患者,钠-葡萄糖转运体2抑制剂及肾素-血管紧张素系统抑制剂能够有效维持患者LVEF及其心脏功能。此外,该文也提出HFimpEF现有研究的不足与未来的研究方向。展开更多
Dysfunctions of calcium cycling occur in heart failure wi+reduced and preserved ejection fraction(HFrEF and HFpEF).HFrEF and HFpEF showed Ca^(2+)leakage at diastole.the compensation of Na^(+)/Ca^(2+)exchanger andthe d...Dysfunctions of calcium cycling occur in heart failure wi+reduced and preserved ejection fraction(HFrEF and HFpEF).HFrEF and HFpEF showed Ca^(2+)leakage at diastole.the compensation of Na^(+)/Ca^(2+)exchanger andthe decrease of T-tubule density reduces cytoplasmic Ca^(2+)concentration in HFrEF and impairs systolic function.In contrast,HFpEF hasthe increase of cytoplasmic Ca^(2+)concentration and diastolic dysfunctions.the decrease of mitochondrial Ca^(2+)concentration weakens myocardial contractility in HFrEF while the increased concentration retainsthe contractility in HFpEF.Here,the changes of calcium cycling in HFrEF and HFpEF are summarized andthe possibility of relevanttherapeutic targets is discussed.展开更多
SGLT2抑制剂是近年来诞生的新型降糖药物,在糖尿病领域的几项大型临床研究中证实能减少心血管事件,但获益机制并不能完全归结于血糖的控制。近期ESC上公布的DAPA-HF研究(Dapagliflozin and Prevention of Adverse Outcomes in Heart Fai...SGLT2抑制剂是近年来诞生的新型降糖药物,在糖尿病领域的几项大型临床研究中证实能减少心血管事件,但获益机制并不能完全归结于血糖的控制。近期ESC上公布的DAPA-HF研究(Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure)证实了SGLT2抑制剂对于未患2型糖尿病的射血分数减低的心力衰竭(HFrEF)患者依然可以显著降低心血管死亡和心力衰竭住院风险,这一里程碑式的研究将开启心力衰竭治疗新的时代。展开更多
文摘Objective To investigate the survival of different subgroups of pulmonary hypertension due to left heart disease(PH-LHD)in heart failure patients with reduced ejection fraction(HFrEF)and to detect possible hemodynamic variables associated with the prognosis of these patients.
文摘目的:旨在研究血浆神经酰胺水平在射血分数减低型心力衰竭患者中的变化,以及神经酰胺与HFrEF患者心功能的相关性及预测价值。方法:采用1:1病例对照研究方法,收集了青岛大学附属医院心血管内科在2023年1月至2024年3月期间,门诊和住院的98例射血分数减低型心力衰竭患者作为病例组,并选取了98例健康体检中心的患者作为对照组。检测血浆中6种神经酰胺(Cer16:0、Cer18:0、Cer20:0、Cer22:0、Cer24:0、Cer24:1)的水平,分析血浆神经酰胺对HFrEF的辅助诊断价值。结果:研究显示Cer16:0、Cer18:0、Cer20:0和Cer22:0在病例组表现出高表达,并且与NT-proBNP水平呈正相关;Cer24:0在HFrEF患者中的表达较低,并与NT-proBNP水平呈负相关,差异具有统计学意义(p 0.9,对HFrEF具有较高的诊断价值。结论:Cer16:0、Cer18:0、Cer20:0和Cer22:0水平变化可反映HFrEF心功能严重程度,可以考虑作为诊断HFrEF的生物标志物。Objective: The study aims to investigate the changes in plasma ceramide levels in patients with heart failure with reduced ejection fraction (HFrEF) and the correlation and predictive value of ceramides with cardiac function in HFrEF patients. Methods: Through a case-control study method, 98 patients with heart failure with reduced ejection fraction who visited and were hospitalized at the Department of Cardiology, Affiliated Hospital of Qingdao University, from January 2023 to March 2024 were collected as the case group, and 98 healthy individuals from the health examination center were selected as the control group. The levels of six types of ceramides (Cer16:0, Cer18:0, Cer20:0, Cer22:0, Cer24:0, Cer24:1) in the plasma were detected, and the auxiliary diagnostic value of plasma ceramides for HFrEF was analyzed. Results: Studies have shown that Cer16:0, Cer18:0, Cer20:0, and Cer22:0 exhibit high expression in the case group and are positively correlated with NT-proBNP levels;Cer24:0 expression is lower in HFrEF patients and is negatively correlated with NT-proBNP levels, with statistically significant differences (p < 0.05). ROC curve analysis results indicate that the AUC values for Cer16:0, Cer18:0, Cer20:0, and Cer22:0 are all greater than 0.9, indicating high diagnostic value for HFrEF. Conclusion: Changes in the levels of Cer16:0, Cer18:0, Cer20:0, and Cer22:0 can reflect the severity of heart function in HFrEF and may be considered as biomarkers for the diagnosis of HFrEF.
文摘在射血分数降低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者中,部分患者的左室射血分数(left ventricular ejection fraction,LVEF)经治疗后在后续评估中出现明显改善。2022年美国心脏学会/美国心脏病协会/美国心衰学会(American Heart Association/American College of Cardiology/Heart Failure Society of America,AHA/ACC/HFSA)颁布的心力衰竭管理指南将既往LVEF≤40%且在随访过程中提升至40%以上的心力衰竭类型命名为射血分数改善型心力衰竭(heart failure with improved ejection fraction,HFimpEF)。研究表明,HFimpEF患者的全因死亡率、心力衰竭再住院率较低,预后明显优于HFrEF,可作为HFrEF患者的阶段性治疗目标。关于HFimpEF患者的热点讨论主要围绕2个方面,即HFimpEF的目标人群特征及LVEF提升的有效手段、HFimpEF患者心功能维持治疗方案;尤其是后者,尚无明确的临床指南推荐。因此,回顾现有研究,系统总结促使HFrEF向HFimpEF转归的治疗方案,以及有效针对HFimpEF的维持手段至关重要。该文对现有药物、器械、手术治疗的LVEF改善效果及HFimpEF患者的监测与治疗方法进行综述。对于HFrEF患者,现有临床研究提示β受体阻滞剂及心脏再同步治疗等能够显著改善LVEF并提升至40%以上;对于HFimpEF患者,钠-葡萄糖转运体2抑制剂及肾素-血管紧张素系统抑制剂能够有效维持患者LVEF及其心脏功能。此外,该文也提出HFimpEF现有研究的不足与未来的研究方向。
基金supported by the National Key Research and Development Program of China 2021YFA1000200 and 2021YFA1000203(Y.Huo)Shenzhen Science and Technology R&D Grant KQTD20180411143400981(Y.Huo).
文摘Dysfunctions of calcium cycling occur in heart failure wi+reduced and preserved ejection fraction(HFrEF and HFpEF).HFrEF and HFpEF showed Ca^(2+)leakage at diastole.the compensation of Na^(+)/Ca^(2+)exchanger andthe decrease of T-tubule density reduces cytoplasmic Ca^(2+)concentration in HFrEF and impairs systolic function.In contrast,HFpEF hasthe increase of cytoplasmic Ca^(2+)concentration and diastolic dysfunctions.the decrease of mitochondrial Ca^(2+)concentration weakens myocardial contractility in HFrEF while the increased concentration retainsthe contractility in HFpEF.Here,the changes of calcium cycling in HFrEF and HFpEF are summarized andthe possibility of relevanttherapeutic targets is discussed.
文摘SGLT2抑制剂是近年来诞生的新型降糖药物,在糖尿病领域的几项大型临床研究中证实能减少心血管事件,但获益机制并不能完全归结于血糖的控制。近期ESC上公布的DAPA-HF研究(Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure)证实了SGLT2抑制剂对于未患2型糖尿病的射血分数减低的心力衰竭(HFrEF)患者依然可以显著降低心血管死亡和心力衰竭住院风险,这一里程碑式的研究将开启心力衰竭治疗新的时代。
