BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better...BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol（TCL）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）, and triglycerides（TG）]and right ventricle end diastolic diameter （RVEDD）, left ventricle end diastolic diameter （LVEDD）, right atrium diameter （RA）, left atrium diameter （LA）, or left ventricle ejection fraction （LVEF） were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD （r=-0.34,P〈0.001） and RA （r=-0.36,P〈0.001）. Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.展开更多
Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of ...Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of such patients in our hospital,to reduce the incidence of volume overload during this period.Methods:A total of 86 patients in the peri-dialysis period(glomerular filtration rate eGFR less than 15 mL/(min·1.73 m')to three months after dialysis)who received outpatient treatment,inpatient treatment,and hemodialysis in the hospital from June 2022 to December 2023 were selected as the research objects.General information,clinical symptoms,and laboratory data of the patients were collected.According to the disease evolution process of the patients,they were divided into the non-dialysis stage and the initial dialysis stage.The volume load index of the patients,namely the overhydration(OH)value,was measured by the multi-frequency bioelectrical impedance method.The relevant factors affecting the volume load of patients in the peri-dialysis period were compared and analyzed.Results:In the non-dialysis stage,68 patients(86%)had volume overload,and 21 patients(21%)had normal volume load.In the initial dialysis stage,53 patients(61%)had volume overload,and 33 patients(38%)had normal volume load.Among the patients with volume overload in the two stages combined,the primary diseases were diabetic nephropathy at 29%,hypertensive nephropathy at 29%,primary nephropathy at 34%,and other renal damage at 8%.Complications included heart failure at 29%,respiratory tract infection at 32%,coronary heart disease at 9%,and anemia at 21%.Among the patients with volume overload,69%were male,52%were over 60 years old,53%had no family member accompaniment,57%had insomnia,and 55%had an educational level of junior high school or below.Conclusion:More than half of the patients in the peri-dialysis period in the hospital are in a state of volume overload,which should arouse the attention of the department.For male patients,those with hypertension,diabetes,insomnia,respiratory tract infection,anemia,and without family member accompaniment,corresponding intervention measures should be taken to reduce the incidence of volume overload during the peri-dialysis period.展开更多
Background:The mechanisms underlying cardiac remodeling in aortic valvular(AoV)disease remain poorly understood,partially due to the insufficiency of appropriate preclinical animal models.Here,we present a novel murin...Background:The mechanisms underlying cardiac remodeling in aortic valvular(AoV)disease remain poorly understood,partially due to the insufficiency of appropriate preclinical animal models.Here,we present a novel murine model of aortic regurgitation(AR)generated by transapical wire destruction of the AoV.Methods:Directed by echocardiography,apical puncture of the left ventricle(LV)was performed in adult male C57BL/6 mice,and a metal guidewire was used to induce AoV destruction.Echocardiography,invasive LV hemodynamic and histological examination were conducted to assess the degree of AR,LV function and remodeling.Results:AR mice exhibited rapid aortic regurgitation velocity(424±15.22 mm/s)immediately following successful surgery.Four weeks post-surgery,echocardiography revealed a 54.6%increase in LV diastolic diameter and a 55.1%decrease in LV ejection fraction in AR mice compared to sham mice.Pressure-volume catheterization indicated that AR mice had significantly larger LV end-diastolic volumes(66.2±1.5μL vs.41.8±3.4μL),reduced LV contractility(lower dP/dt max and Ees),and diminished LV compliance(smaller dP/dt min and longer Tau)compared to sham mice.Histological examination demonstrated that AR mice had significantly larger cardiomyocyte area and more myocardial fibrosis in LV tissue,as well as a 107%and a 122%increase of heart weight/tibial length and lung weight/tibial length,respectively,relative to sham mice.Conclusions:The trans-apex wire-induced destruction of the AoV establishes a novel and efficient murine model to develop AR,characterized by significant eccentric LV hypertrophy,heart failure,and pulmonary congestion.展开更多
文摘BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol（TCL）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）, and triglycerides（TG）]and right ventricle end diastolic diameter （RVEDD）, left ventricle end diastolic diameter （LVEDD）, right atrium diameter （RA）, left atrium diameter （LA）, or left ventricle ejection fraction （LVEF） were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD （r=-0.34,P〈0.001） and RA （r=-0.36,P〈0.001）. Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.
文摘Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of such patients in our hospital,to reduce the incidence of volume overload during this period.Methods:A total of 86 patients in the peri-dialysis period(glomerular filtration rate eGFR less than 15 mL/(min·1.73 m')to three months after dialysis)who received outpatient treatment,inpatient treatment,and hemodialysis in the hospital from June 2022 to December 2023 were selected as the research objects.General information,clinical symptoms,and laboratory data of the patients were collected.According to the disease evolution process of the patients,they were divided into the non-dialysis stage and the initial dialysis stage.The volume load index of the patients,namely the overhydration(OH)value,was measured by the multi-frequency bioelectrical impedance method.The relevant factors affecting the volume load of patients in the peri-dialysis period were compared and analyzed.Results:In the non-dialysis stage,68 patients(86%)had volume overload,and 21 patients(21%)had normal volume load.In the initial dialysis stage,53 patients(61%)had volume overload,and 33 patients(38%)had normal volume load.Among the patients with volume overload in the two stages combined,the primary diseases were diabetic nephropathy at 29%,hypertensive nephropathy at 29%,primary nephropathy at 34%,and other renal damage at 8%.Complications included heart failure at 29%,respiratory tract infection at 32%,coronary heart disease at 9%,and anemia at 21%.Among the patients with volume overload,69%were male,52%were over 60 years old,53%had no family member accompaniment,57%had insomnia,and 55%had an educational level of junior high school or below.Conclusion:More than half of the patients in the peri-dialysis period in the hospital are in a state of volume overload,which should arouse the attention of the department.For male patients,those with hypertension,diabetes,insomnia,respiratory tract infection,anemia,and without family member accompaniment,corresponding intervention measures should be taken to reduce the incidence of volume overload during the peri-dialysis period.
基金Natural Science Foundation of Guangdong Province,Grant/Award Number:2023A1515110032 and 2022A1515220152Guangzhou Key Research and Development Program Foundation,Grant/Award Number:202206010199National Natural Science Foundation of China,Grant/Award Number:82100407,82272602 and 82370242。
文摘Background:The mechanisms underlying cardiac remodeling in aortic valvular(AoV)disease remain poorly understood,partially due to the insufficiency of appropriate preclinical animal models.Here,we present a novel murine model of aortic regurgitation(AR)generated by transapical wire destruction of the AoV.Methods:Directed by echocardiography,apical puncture of the left ventricle(LV)was performed in adult male C57BL/6 mice,and a metal guidewire was used to induce AoV destruction.Echocardiography,invasive LV hemodynamic and histological examination were conducted to assess the degree of AR,LV function and remodeling.Results:AR mice exhibited rapid aortic regurgitation velocity(424±15.22 mm/s)immediately following successful surgery.Four weeks post-surgery,echocardiography revealed a 54.6%increase in LV diastolic diameter and a 55.1%decrease in LV ejection fraction in AR mice compared to sham mice.Pressure-volume catheterization indicated that AR mice had significantly larger LV end-diastolic volumes(66.2±1.5μL vs.41.8±3.4μL),reduced LV contractility(lower dP/dt max and Ees),and diminished LV compliance(smaller dP/dt min and longer Tau)compared to sham mice.Histological examination demonstrated that AR mice had significantly larger cardiomyocyte area and more myocardial fibrosis in LV tissue,as well as a 107%and a 122%increase of heart weight/tibial length and lung weight/tibial length,respectively,relative to sham mice.Conclusions:The trans-apex wire-induced destruction of the AoV establishes a novel and efficient murine model to develop AR,characterized by significant eccentric LV hypertrophy,heart failure,and pulmonary congestion.
