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FMO3--TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection

《医学前沿（英文）》 2022年 第16卷 第2期   页码 295-305 doi: 10.1007/s11684-021-0857-2

摘要： The association among plasma trimethylamine-N-oxide (TMAO), FMO3 polymorphisms, and chronic heart failure (CHF) remains to be elucidated. TMAO is a microbiota-dependent metabolite from dietary choline and carnitine. A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction, with the longest follow-up of 7 years. The concentrations of plasma TMAO and its precursors, namely, choline and carnitine, were determined by liquid chromatography-mass spectrometry, and the FMO3 E158K polymorphisms (rs2266782) were genotyped. The top tertile of plasma TMAO was associated with a significant increment in hazard ratio (HR) for the composite outcome of cardiovascular death or heart transplantation (HR=1.47, 95% CI=1.13–1.91, P=0.004) compared with the lowest tertile. After adjustments of the potential confounders, higher TMAO could still be used to predict the risk of the primary endpoint (adjusted HR=1.33, 95% CI=1.01–1.74, P=0.039). This result was also obtained after further adjustment for carnitine (adjusted HR=1.33, 95% CI=1.01–1.74, P=0.039). The FMO3 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort, and lower TMAO levels were found in the AA-genotype. Thus, higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders, and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.

关键词： chronic heart failure     trimethylamine-N-oxide     flavin monooxygenase 3     single nucleotide polymorphism    

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Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction

Hui Wang, Yang Zhang, Zhujun Shen, Ligang Fang, Zhenyu Liu, Shuyang Zhang

《医学前沿（英文）》 2021年 第15卷 第1期   页码 70-78 doi: 10.1007/s11684-020-0749-x

摘要： Recent studies have shown that acute blood glucose elevation in patients with ST-segment elevation myocardial infarction (STEMI) suggests a poor prognosis. To investigate the effect of fasting blood glucose (FBG) on the risk of heart failure (HF) and left ventricular systolic dysfunction (LVSD) in non-diabetic patients undergoing primary percutaneous coronary intervention (PCI) for acute STEMI, we retrospectively recruited consecutive non-diabetic patients who underwent primary PCI for STEMI in our hospital from February 2003 to March 2015. The patients were divided into two groups according to the FBG level. A total of 623 patients were recruited with an age of 61.3±12.9 years, of whom 514 (82.5%) were male. The HF risk (odds ratio 3.401, 95% confidence interval (CI) 2.144–5.395, <0.001) was significantly increased in patients with elevated FBG than those with normal FBG. Elevated FBG was also independently related to LVSD (β 1.513, 95%CI 1.282–1.785, <0.001) in a multiple logistics regression analysis. In conclusion, elevated FBG was independently associated with 30-day HF and LVSD risk in non-diabetic patients undergoing primary PCI for STEMI.

关键词： myocardial infarction     percutaneous coronary intervention     diabetes mellitus     fasting glucose     heart failure    

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The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

《医学前沿（英文）》 2023年 第17卷 第3期   页码 527-533 doi: 10.1007/s11684-022-0967-5

摘要： In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984−2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age: 50 years, males: 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR: 1.07, 95% CI (1.02–1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

关键词： orthotopic heart transplant     tricuspid regurgitation     clinical impact     biatrial heart transplantation    

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A rare chronic constrictive pericarditis with localized adherent visceral pericardium and normal parietal pericardium: a case report

null

《医学前沿（英文）》 2016年 第10卷 第3期   页码 356-359 doi: 10.1007/s11684-016-0467-6

摘要：

Classic constrictive pericarditis (CP) is characterized by fibrous scarring and adhesion of both the visceral pericardium and the parietal pericardium, which leads to restricted cardiac filling. However, diagnosing CP with normal thickness pericardium and without calcification is still a challenge. The predominant cause in the developed world is idiopathic or viral pericarditis， followed by post-cardiac surgery and post-radiation. Tuberculosis still remains a common cause of CP in developing countries. In this report, we describe a rare case of idiopathic localized constrictive visceral pericardium with normal thickness of the parietal pericardium in a middle-aged man. The patient presented with unexplained right heart failure and echocardiography showed moderate bi-atrial enlargement which should be?identified with the restrictive cardiomyopathy.?After 10 months of conservative treatment, the progression of right heart failure was remaining. A pericardiectomy was performed and the patient recovered. This case serves as a reminder to consider CP in patients with unexplained right heart failure, so that timely investigation and treatment can be initiated.

关键词： constrictive pericarditis     heart failure     pericardiectomy    

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Integrated management of cardiac failure: the cardiac failure clinic

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《医学前沿（英文）》 2011年 第5卷 第1期   页码 20-25 doi: 10.1007/s11684-011-0106-1

摘要：

The prevalence of the risk factors and the risk of cardiac failure are both increasing in China. This might be the consequence of the changes of the life conditions (emigration to the urban areas, changes in the diet and life style, lack of physical exercise, etc.). The wide range of clinical presentations of cardiac failure (acute or chronic) and of therapeutic approaches (medical or surgical) makes necessary the integration within the same structure of the various experts involved in the diagnosis and the treatment of cardiac diseases. Technologic and human resources required to offer all the options represent a multifaceted commitment which should be focused optimally in dedicated centers. In these centers, collaboration should replace competition between the medical and the surgical cardiac specialists. Development of team work should permit to optimize the cost efficacy of the treatments. Most of all, such a structure will facilitate the translation of innovative therapies between the research centers and clinical facilities.

关键词： cardiac failure     cardiac transplantation     mechanical circulatory support    

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The role of natriuretic peptide precursor A gene polymorphism in the development of coronary heart disease

Ripen NSENGA MD, Longxian CHENG PhD, Mei’an HE PhD, Tangchun WU PhD,

《医学前沿（英文）》 2009年 第3卷 第4期   页码 437-442 doi: 10.1007/s11684-009-0074-x

摘要： Natriuretic peptide precursor A (NPPA) is synthesized, stored, and released by atrial myocytes. Previous studies have shown that NPPA plays a significant role in the regulation of coronary circulation and in atherosclerosis. Rs5065 NPPA gene polymorphism leads to the translation of NPPA with two additional arginines and has been suggested to be associated with salt-sensitive hypertension. The purpose of the present study was to investigate the relationship between the rs5065 NPPA gene polymorphism and the risk of coronary heart disease (CHD) in Chinese Han population. We genotyped the single nucleotide polymorphism (SNP) rs5065 NPPA in the human NPPA gene in 1861 sex- and age-matched subjects, comprising of 904 CHD cases and 957 controls of Chinese Han population. Genotyping of SNP was performed with Taqman SNP allelic discrimination assays by means of an ABI 7900HT. Our study showed that the frequencies of rs5065 NPPA C allele in the case and the control groups were 0.012 and 0.005, respectively. There was significant difference in C allele frequency distribution between the two groups (OR=2.607, 95% CI: 1.197−5.678, =0.012). In the case group, there was significant difference between smokers and nonsmokers with subjects carrying C allele (=0.037), and no significant difference in gender, age, fasting total cholesterol (TC), triglycerides (TG), fasting plasma glucose (FPG), body mass index (BMI), and blood pressure (BP) between the cases and the controls (>0.05). Our results suggest that the C allele of rs5065 NPPA gene polymorphism may be associated with the risk of CHD.

关键词： natriuretic peptide precursor A     coronary heart disease     gene polymorphism     allelic discrimination     polymorphism     single nucleotide    

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Applications of traditional pump design theory to artificial heart and CFD simulation

WANG Yingpeng, SONG Xinwei, YING Chuntong

《能源前沿（英文）》 2008年 第2卷 第4期   页码 504-507 doi: 10.1007/s11708-008-0059-5

摘要： A novel heart pump model was obtained by improving the traditional axial pump design theory with the consideration of working and hydraulic situations for artificial hearts. The pump head range and the velocity triangle were introduced and an iterative approach was utilized for the initial model. Moreover, computational fluid dynamics (CFD) simulations were performed to determine relevant model parameters. The results show that this procedure can be used for designing a series of high-efficiency artificial heart pumps.

关键词： computational     high-efficiency artificial     iterative approach     artificial     traditional    

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Progressive failure analysis of notched composite plate by utilizing macro mechanics approach

《结构与土木工程前沿（英文）》 2021年 第15卷 第3期   页码 623-642 doi: 10.1007/s11709-021-0726-8

摘要： In this study, gradual and sudden reduction methods were combined to simulate a progressive failure in notched composite plates using a macro mechanics approach. Using the presented method, a progressive failure is simulated based on a linear softening law prior to a catastrophic failure, and thereafter, sudden reduction methods are employed for modeling a progressive failure. This combination method significantly reduces the computational cost and is also capable of simultaneously predicting the first and last ply failures (LPFs) in composite plates. The proposed method is intended to predict the first ply failure (FPF), LPF, and dominant failure modes of carbon/epoxy and glass/epoxy notched composite plates. In addition, the effects of mechanical properties and different stacking sequences on the propagation of damage in notched composite plates were studied. The results of the presented method were compared with experimental data previously reported in the literature. By comparing the numerical and experimental data, it is revealed that the proposed method can accurately simulate the failure propagation in notched composite plates at a low computational cost.

关键词： progressive failure     notched composite plate     Hashin failure criterion     macro mechanics approach     finite element method    

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Adiponectin: mechanisms and new therapeutic approaches for restoring diabetic heart sensitivity to ischemic

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 301-305 doi: 10.1007/s11684-013-0283-1

摘要：

Systemic inflammatory response following myocardial ischemia-reperfusion injury (IRI) to a specific organ may cause injuries. Ischemic post-conditioning (IPostC) has emerged as a promising method for myocardial protection against IRI both in experimental and in clinical settings. Enhancement of endogenous nitric oxide (NO) is one of the major mechanisms by which IPostC confers cardioprotection. However, the sensitivity of the diabetic heart to IPostC is impaired and the underlying mechanism is unknown. Adiponectin (APN) is an adipocyte-derived plasma protein with anti-diabetic and anti-inflammatory properties. Plasma levels of APN are decreased in obese subjects and in patients with type 2 diabetes. APN supplementation has been shown to increase NO production and attenuate myocardial IRI in normal (non-diabetic) animals. However, the effect of APN on myocardial injury in diabetic subjects, especially its potential in restoring the sensitivity of the diabetic heart to IPostC has not been investigated. In the current paper, we discussed the possible reasons why the myocardium of diabetic subjects loses sensitivity to IPostC and also highlighted the potential effectiveness and mechanism of APN in restoring IPostC cardioprotection in diabetes. This review proposes to conduct studies that may facilitate the development of novel and optimal therapies to enhance cardioprotection in patients with severe diseases such as diabetes.

关键词： adiponectin     ischemic post-conditioning     ischemia reperfusion injury     diabetes    

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Setting up a heart rate alarm limit to decrease oculocardiac reflex during strabismus surgery in children

ZHANG Kangkang, GU Enhua, LU Junjie

《医学前沿（英文）》 2008年 第2卷 第3期   页码 295-297 doi: 10.1007/s11684-008-0056-4

摘要： The aim of this paper is to investigate a method which may decrease the incidence and severity of oculocardiac reflex (OCR) without drugs. One hundred and sixty children undergoing strabismus surgery were allocated to two groups using double-blind randomization. OCR was defined as a decrease of more than 10% from the baseline heart rate during operation. An alarm sounded and a lamp flashed as soon as OCR occurred in group I, and neither of the above happened in group II. OCR occurred (1.151 ± 0.858) times in group I and (2.287 ± 1.371) times in group II ( < 0.05). Heart rate decreased by (23 ± 19) bpm in group I and (35 ± 28) bpm in group II ( < 0.05). The duration of OCR in group I and group II was (4.36 ± 4.26)s and (7.62 ± 6.41)s, respectively ( < 0.05). The recovery time for group I and group II was (15.36 ± 13.28)s and (32.36 ± 19.57)s, respectively ( < 0.05). The numbers of times of interruption were 8 in group I (10%) and 26 in group II (32%) ( < 0.01). This method significantly decreased the incidence and severity of OCR during strabismus surgery in children.
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Current progress on scaffolds of tissue engineering heart valves

DONG Nianguo, SHI Jiawei, CHEN Si, HONG Hao, HU Ping

《医学前沿（英文）》 2008年 第2卷 第3期   页码 229-234 doi: 10.1007/s11684-008-0043-9

摘要： Tissue engineering heart valves (TEHV) may be the most promising valve substitute, but the study has been relatively stagnant in the recent five years due to the special position, function and mechanical property of heart valves. It is one of the key factors to select an ideal scaffold material in the construction of TEHV. And this article will briefly review the current research and progress on the scaffolds of TEHV, especially based on Chinese works.

关键词： function     scaffold     promising     research     engineering    

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Bending failure performance of a shield tunnel segment based on full-scale test and numerical analysis

《结构与土木工程前沿（英文）》   页码 1033-1046 doi: 10.1007/s11709-023-0973-y

摘要： This study focuses on the bending failure performance of a shield tunnel segment. A full-scale test was conducted to investigate deformation and failure characteristics. During the loading, the bending failure process can be divided into four stages: the elastic stage, working stage with cracks, failure stage, and ultimate stage. The characteristic loads between contiguous stages are the cracking, failure, and ultimate loads. A numerical model corresponding to the test was established using the elastoplastic damage constitutive model of concrete. After a comparative analysis of the simulation and test results, parametric studies were performed to discuss the influence of the reinforcement ratio and proportion of tensile longitudinal reinforcement on the bearing capacity. The results indicated that the change in the reinforcement ratio and the proportion of tensile longitudinal reinforcement had little effect on the cracking load but significantly influenced the failure and ultimate loads of the segment. It is suggested that in the reinforcement design of the subway segment, the reinforcement ratio and the proportion of tensile longitudinal reinforcement can be chosen in the range of 0.7%–1.2% and 49%–55%, respectively, allowing the segment to effectively use the reinforcement and exert the design strength, thereby improving the bearing capacity of the segment.

关键词： shield tunnel     bearing capacity     failure mechanism     segment reinforcement    

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Cluster analysis for syndromes of real-world coronary heart disease with angina pectoris

Yufeng Zhao, Xueyun Yu, Xinyu Cao, Lin Luo, Liyun He, Shusong Mao, Li Ma, Peijing Rong, Yuxue Zhao, Guozheng Li, Baoyan Liu

《医学前沿（英文）》 2018年 第12卷 第5期   页码 566-571 doi: 10.1007/s11684-017-0556-1

摘要：

Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.

关键词： syndrome differentiation     real-world study     coronary heart disease with angina pectoris     cluster analysis    

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Overview on acute-on-chronic liver failure

null

《医学前沿（英文）》 2016年 第10卷 第1期   页码 1-17 doi: 10.1007/s11684-016-0439-x

摘要：

Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.

关键词： liver failure     chronic liver failure     acute-on-chronic liver failure     diagnosis     prognosis     treatment    

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serum leptin and its relationship with platelet membrane glycoprotein Ib in patients with coronary heart

XIA Dasheng, SONG Yanqiu, LI Chao, ZHANG Feng, WEI Minxin

《医学前沿（英文）》 2007年 第1卷 第4期   页码 352-355 doi: 10.1007/s11684-007-0067-6

摘要： The aim of this paper was to investigate the change of serum leptin and its relationship with platelet membrane glycoprotein Ib (GP Ib) in patients with coronary heart disease (CHD). The enrolled included 50 patients with CHD (CHD group) and 30 patients without CHD (control group) who were diagnosed by coronary angiography. The positive percentage and the average fluorescence intensity of platelet membrane GP Ib were detected by full-blood flow cytometry. Serum leptin was detected by enzyme linked immunosorbent assay. The positive percentage and the average fluorescence intensity of platelet membrane GP Ib in the CHD group were significantly lower than those in the control group (<0.05). After correcting the differences of systolic blood pressure, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting glucose, PPBS, fasting insulin and quantitative insulin sensitive index, serum leptin level in the CHD group was significantly higher than that in the control group (<0.05). Single factor correlative analysis revealed that serum leptin in CHD patients was negatively correlated with the average fluorescence intensity of platelet membrane GP Ib (<0.05). Multifactorial stepwise regression analysis showed that serum leptin in CHD patients was independently negatively correlated with the average fluorescence intensity of platelet membrane GP Ib (<0.05). Logistic analysis demonstrated that serum leptin was independently correlated with the risk of CHD (<0.05). Hyperleptinemia was verified in CHD patients. The increase of serum leptin could affect blood platelet activation. Hyperleptinemia may play an important role in the pathogenesis of CHD.
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标题 作者 时间 类型 操作

FMO3--TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection

期刊论文

Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction

Hui Wang, Yang Zhang, Zhujun Shen, Ligang Fang, Zhenyu Liu, Shuyang Zhang

期刊论文

The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

期刊论文

A rare chronic constrictive pericarditis with localized adherent visceral pericardium and normal parietal pericardium: a case report

null

期刊论文

Integrated management of cardiac failure: the cardiac failure clinic

null

期刊论文

The role of natriuretic peptide precursor A gene polymorphism in the development of coronary heart disease

Ripen NSENGA MD, Longxian CHENG PhD, Mei’an HE PhD, Tangchun WU PhD,

期刊论文

Applications of traditional pump design theory to artificial heart and CFD simulation

WANG Yingpeng, SONG Xinwei, YING Chuntong

期刊论文

Progressive failure analysis of notched composite plate by utilizing macro mechanics approach

期刊论文

Adiponectin: mechanisms and new therapeutic approaches for restoring diabetic heart sensitivity to ischemic

null

期刊论文

Setting up a heart rate alarm limit to decrease oculocardiac reflex during strabismus surgery in children

ZHANG Kangkang, GU Enhua, LU Junjie

期刊论文

Current progress on scaffolds of tissue engineering heart valves

DONG Nianguo, SHI Jiawei, CHEN Si, HONG Hao, HU Ping

期刊论文

Bending failure performance of a shield tunnel segment based on full-scale test and numerical analysis

期刊论文

Cluster analysis for syndromes of real-world coronary heart disease with angina pectoris

Yufeng Zhao, Xueyun Yu, Xinyu Cao, Lin Luo, Liyun He, Shusong Mao, Li Ma, Peijing Rong, Yuxue Zhao, Guozheng Li, Baoyan Liu

期刊论文

Overview on acute-on-chronic liver failure

null

期刊论文

serum leptin and its relationship with platelet membrane glycoprotein Ib in patients with coronary heart

XIA Dasheng, SONG Yanqiu, LI Chao, ZHANG Feng, WEI Minxin

期刊论文