- Signature-oriented investigation of the efficacy of multicomponent drugs against heart failure. [Journal Article]
- FJFASEB J 2018 Sep 19; :fj201800673RR
- Increasing attention has been paid to the application of precision medicine in heart failure (HF), and biomarker-based personalized medical care has shown great progress in HF management. Additionall...
Increasing attention has been paid to the application of precision medicine in heart failure (HF), and biomarker-based personalized medical care has shown great progress in HF management. Additionally, multicomponent drugs represented by traditional Chinese medicine (TCM) are demonstrating safety and efficacy in the management of HF. However, the potential mechanism is unclear, and the ambiguous clinical locations of TCM remain a hindrance to its extensive application. To meet this requirement, a precise investigation on the efficacy of multicomponent drugs against HF using the signature biomarkers-oriented approach was developed and applied to a conventional drug for cardiac disease, YiXinShu (YXS). On the basis of in vitro and in vivo efficacy evaluation of YXS against HF, and with the aid of proteomics and network pharmacology approaches, specific signatures regulated by YXS against HF were identified. YXS may show distinctive treatment features for those HF patients showing the elevation of fatty acid-binding protein 3 and cytoskeleton-associated protein 5, as well as other classic HF biomarkers. This study provides the first precise investigation of the efficacy of multicomponent drugs against HF and offers a practicable and low-cost approach for personalized management of HF.-Wei, J., Guo, F., Zhang, M., Xian, M., Wang, T., Gao, J., Wu, H., Song, L., Zhang, Y., Li, D., Yang, H., Huang, L. Signature-oriented investigation of the efficacy of multicomponent drugs against heart failure.
- Acute molecular effects of pressure-controlled intermittent coronary sinus occlusion in patients with advanced heart failure. [Journal Article]
- EHESC Heart Fail 2018 Sep 19
- CONCLUSIONS: Here, we show for the first time that PICSO, a trans-coronary sinus catheter intervention, is associated with an increase in morphogens secreted into cardiac veins, normally present during cardiac development, and a significant induction of cell proliferation. Present findings support the notion that epigenetic modifications, that is, haemodynamic stimuli on venous vascular cells, may reverse myocardial deterioration. Further investigations are needed to decipher the maze of complex interacting molecular pathways in failing myocardium and the potential role of PICSO to reinitiate developmental processes to prevent further myocardial decay eventually reaching clinical significance.
- Telemedical Interventional Management in Heart Failure II (TIM-HF2), a randomised, controlled trial investigating the impact of telemedicine on unplanned cardiovascular hospitalisations and mortality in heart failure patients: study design and description of the intervention. [Journal Article]
- EJEur J Heart Fail 2018 Sep 19
- CONCLUSIONS: The TIM-HF2 trial will provide important prospective data on the potential beneficial effect of telemedical monitoring and RPM on unplanned cardiovascular hospitalisations and mortality in HF patients.
- Congenital coronary artery fistula: Presentation in the neonatal period and transcatheter closure. [Journal Article]
- CHCongenit Heart Dis 2018 Sep 19
- CONCLUSIONS: We hereby describe the rare presentation of symptomatic coronary artery fistulae in the neonatal period and their successful transcatheter management. This is also the first description of left anterior descending and circumflex coronary artery atresia in the setting of a large left main coronary artery to left ventricle fistula.
- Hospital resource utilization and presence of advance directives at the end of life for adults with congenital heart disease. [Journal Article]
- CHCongenit Heart Dis 2018 Sep 19
- CONCLUSIONS: Adults with congenital heart disease have significant hospital resource utilization near the end of life compared to patients with cancer, notable for more hospitalizations and a higher likelihood of death in the hospital. This population represents an important opportunity for the application of palliative and supportive care.
- Short-term effects of levosimendan on strain/strain rate markers in patients with nonischemic dilated cardiomyopathy. [Journal Article]
- JCJ Clin Ultrasound 2018 Sep 19
- CONCLUSIONS: STE can successfully completed conventional echocardiography in the evaluation of patients with decompensated heart failure who were treated with levosimendan.
- Right Ventricular Function in Left Heart Disease: Relevance to the Mitral Valve. [Journal Article]
- SCSemin Cardiothorac Vasc Anesth 2018 Sep 19; :1089253218799345
- Right ventricular (RV) function is an independent prognostic factor for short- and long-term outcomes in cardiac surgical patients. Patients with mitral valve (MV) disease are at increased risk of RV...
Right ventricular (RV) function is an independent prognostic factor for short- and long-term outcomes in cardiac surgical patients. Patients with mitral valve (MV) disease are at increased risk of RV dysfunction before and after MV operations. Yet RV function is not part of criteria for decision making or risk stratification in this setting. The role of MV disease in the development of pulmonary hypertension (PHTN) and the ultimate impact of PHTN on RV function have been well described. Nonetheless, there are other mechanisms by which MV disease and MV surgery affect RV performance. Research suggests that PHTN may not be the most important determinant of RV dysfunction. Both RV dysfunction and PHTN have independent prognostic significance. This review explores the unique anatomic and functional features of the RV and the pathophysiologic and prognostic implications of RV dysfunction in patients with MV disease in the perioperative period.
- Left ventricular remodeling after the first myocardial infarction in association with LGALS-3 neighbouring variants rs2274273 and rs17128183 and its relative mRNA expression: a prospective study. [Journal Article]
- MBMol Biol Rep 2018 Sep 18
- Post-infarct left ventricular remodeling (LVR) process increases the risk of heart failure (HF). Circulating galectin-3 has been associated with fibrosis, inflammation and cardiac dysfunction during ...
Post-infarct left ventricular remodeling (LVR) process increases the risk of heart failure (HF). Circulating galectin-3 has been associated with fibrosis, inflammation and cardiac dysfunction during the remodeling process after myocardial infarction (MI). The aims of this prospective case study were to investigate the association of potentially functional variants in the vicinity of LGALS-3 locus, rs2274273 and rs17128183 with maladaptive LVR and whether these variants could affect LGALS-3 mRNA expression in peripheral blood mononuclear cells of patients 6 months after the first MI. This study encompassed 167 patients with acute MI that were followed up for 6 months. Evidence of LVR was obtained by repeated 2D Doppler echocardiography. Rs2274273, rs17128183 and LGALS-3 mRNA expression were detected by TaqMan® technology. Rs2274273 and rs17128183 rare allele bearing genotypes, according to the dominant model (CT+TT vs. CC and AG+GG vs. AA, respectively), were significantly and independently associated with maladaptive LVR (adjusted OR = 3.02, P = 0.016; adjusted OR = 3.14, P = 0.019, respectively) and higher LGALS-3 mRNA expression (fold induction 1.203, P = 0.03 and 1.214, P = 0.03, respectively). Our exploratory results suggest that rs2274273 and rs17128183 variants affect LGALS-3 mRNA and bear the risk for maladaptive LVR post-MI remodeling. Further replication and validation in a larger group of patients is inevitable.
- Interrelationship in the prognostic efficacy of regional coronary flow reserve, fractional flow reserve, high-sensitivity cardiac troponin-I and NT-proBNP in patients with stable coronary artery disease. [Journal Article]
- HVHeart Vessels 2018 Sep 18
- This study aimed to investigate the combined efficacy in prediction of major adverse cardiac events (MACE) by coronary regional physiological indices including coronary flow reserve (CFR) or fraction...
This study aimed to investigate the combined efficacy in prediction of major adverse cardiac events (MACE) by coronary regional physiological indices including coronary flow reserve (CFR) or fractional flow reserve (FFR) and high-sensitivity cardiac troponin-I (hs-cTnI) or N-terminal pro brain natriuretic peptide (NT-proBNP). Impaired CFR, decreased FFR, elevated cardiac troponin, and NT-proBNP are all associated with increased MACE, while these interaction or collinearity remains uncertain. The study included 429 patients with stable coronary artery disease (CAD) evaluated hs-cTnI and NT-proBNP levels before regional physiological measurement during coronary angiography. Patients were followed up for MACE including all-cause death, myocardial infarction, hospital admission for heart failure and target vessel remote revascularization. Median hs-cTnI and NT-proBNP values were 4 ng/L and 85 ng/L, respectively. Regional CFR was significantly albeit weakly correlated with hs-cTnI and NT-proBNP, while fractional flow reserve (FFR) was only linked to hs-cTnI. The addition of hs-cTnI and NT-proBNP on clinical backgrounds and angiographic score significantly improved predictive accuracy for MACE incidence, and further consideration of FFR and CFR could refine the model. The combined stratification using hs-cTnI, NT-proBNP, FFR and CFR could efficiently stratify patient risk for MACE. In patients with stable CAD, integrated assessment of cardiac biomarkers and physiological indices could be useful for predicting future cardiovascular events.
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- Dose-dependent effect of smoking on risk of coronary heart disease, heart failure and stroke in individuals with type 1 diabetes. [Journal Article]
- DDiabetologia 2018 Sep 18
- CONCLUSIONS: There is a dose-dependent association between smoking and cardiovascular disease in individuals with type 1 diabetes. In men in particular, the risk of incident stroke remains high even after smoking cessation and is increased in current and former smokers independently of other risk factors.