Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countrie...Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.展开更多
AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: ...AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD.Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.展开更多
1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of corona...1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.展开更多
Objective:A study was conducted to explore the level of illness perception,the level of cardiovascular health behaviour and the relationship between illness perception and cardiovascular health behaviour among persons...Objective:A study was conducted to explore the level of illness perception,the level of cardiovascular health behaviour and the relationship between illness perception and cardiovascular health behaviour among persons with ischemic heart disease(IHD)in a community setting.Method:The participants comprised 235 persons with IHD.The instruments used were as follows:1)Demographic Data and Health Information,2)The Brief Illness Perception Questionnaire(Brief IPQ),3)The Open-ended Questionnaire(OEQ),and 4)The Modified Cardiac Health Behaviour Scale(MCHBS).Findings from the OEQ are used to assess in-depth illness perception and to extend the information obtained from the Brief IPQ.The design of the study was descriptive correlational.The data were analysed using descriptive statistics to present the demographic data and health information.Inferential statistics was used to resolve the relationship between illness perception and cardiovascular health behaviour by using Pearson's Product Moment Correlation.Result:The mean score of illness perception was at a moderate level(M=43.65,SD=3.93),whereas the mean score of cardiovascular health behaviour was at a high level(M=80.29,SD=5.42).A significant positive relationship existed between illness perception and cardiovascular health behaviour among persons with IHD(r=0.38,P<0.01).Conclusion:Persons with higher illness perception showed a positive correlation with higher cardiovascular health behaviour at a significant level of 0.01.Results provided important information for nurses to develop an intervention program to promoting appropriate illness perception and cardiovascular health behaviour among persons with IHD.展开更多
To determine the reason for the different mortality trends of ischemic heart disease （IHD） for China between Global Burden of Disease （GBD） 2010 and GBD2013, and to improve garbage code （GC） redistribution. All ...To determine the reason for the different mortality trends of ischemic heart disease （IHD） for China between Global Burden of Disease （GBD） 2010 and GBD2013, and to improve garbage code （GC） redistribution. All data were obtained from the disease surveillance points system, and two proportions for assigning chronic pulmonary heart disease （PHD） as GC to IHD were from GBD2010 and GBD2013,展开更多
Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcom...Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD. The presence of unique risk factors such as exposure to menarche and pregnancy, more anemia, hypertension, and autoimmune disorders in women have recently received attention. Ischemic symptoms are more indefinite and vague in women compared to men as well as a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented. Without any correct diagnosis, treatment, and prevention, these problems are accumulated and continue up to older age. Accordingly, with the belief of longer life in women and the increased prevalence of IHD with aging, it will become an important public health problem and concern in the future. This narrative review aimed to provide an overview of some of the differences between the two genders in terms of IHD with paying more attention to practical points.展开更多
Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobi...Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group;and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.展开更多
Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100...Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100 patients with ischemic heart disease were selected as the research objects.Selecting the patients from May 2020 to May 2021 as a sample,the patients were divided into two groups,and different diagnostic methods were used to compare the clinical diagnosis effects.Results:In terms of the diagnostic accuracy of the two groups of patients,the maximum value was 92.00%(experimental group)and the minimum value was 80.00%(control group).There was a big difference in data between the two groups,P<0.05,which was statistically significant.The patient9s(experimental group)diagnosis accuracy rate is highe Conclusion:In the process of research work for patients with ischemic heart disease,it is particularly important to diagnose the patients.The combined application of and 64-slice spiral CT can improve the clinical diagnosis efficiency and achieve significant results.展开更多
To study the variation and significance of plasma coagulation factor Ⅶ （FⅦ） in different kinds of ischemia heart disease （IHD） and examine its relation with plasma lipid and gene polymorphism. FⅦa was determine...To study the variation and significance of plasma coagulation factor Ⅶ （FⅦ） in different kinds of ischemia heart disease （IHD） and examine its relation with plasma lipid and gene polymorphism. FⅦa was determined with one stage clotting assay by using a recombinant soluble tissue factor （rsTF）. FⅦc was measured with one stage clotting assay. FⅦag was quantified with an enzyme-linked immunosorbent assay （ELISA）. Polymorphism was analyzed with PCR-urea-polyacrylamide gel electrophoresis. Our results showed that FⅦa in stable angina （SA）, unstable angina （UA）, obsolete and acute myocardial infraction （OMI, AMI） patients was higher than those of normal group with the differences being significant within any two groups. FⅦag in UA, OMI and AMI was higher than those in SA and normal groups. There were positive correlations between FⅦa and serum triglycerides, FⅦa and FⅦc, FⅦc and FⅦag. FⅦ-323 0/10 bp polymorphism analysis was performed in 60 patients and 0/10 bp polymorphism was found in 5 cases. FⅦc and FⅦag were much lower in cases of 0/10 bp groups than those in cases of 0/0 bp groups. It is concluded that there was activation of extrinsic coagulation pathway in every kind of IHD to different extent. FⅦa was the risk factor in the development of IHD, and more sensitive in reflecting the severity of cardiovacutar disease than FⅦc or FⅦag. FⅦa was higher in OMI, which may be one of the risk factors of re-infraction. Serum triglyceride may indirectly lead to the development of IHD by increasing the level of FⅦa, FⅦ-323 0/10 bp polymorphism was present in Chinese patients with IHD and it was correlated with the level of FⅦc, FⅦag in plasma. 10 bp allelomorphic gene was a protective factor against thrombogenesis.展开更多
Ischemic heart disease has the characteristics of high morbidity and high mortality, which seriously endangers people's health. Mitophagy can selectively remove damaged organelles, and has a role in maintaining th...Ischemic heart disease has the characteristics of high morbidity and high mortality, which seriously endangers people's health. Mitophagy can selectively remove damaged organelles, and has a role in maintaining the homeostasis of myocardial cells and protecting ischemic myocardium. Significance. More and more studies have found that traditional Chinese medicine can improve ischemic damage of cardiomyocytes by regulating mitochondrial function and autophagy. Using mitochondria as the target of traditional Chinese medicine in cardiomyocytes to explore the treatment of ischemic Effective measures for heart disease have become a hotspot for related Chinese medicine workers. Based on the above background, this article outlines the main regulatory pathways of mitochondrial autophagy, and reviews related researches on traditional Chinese medicine of benefiting qi and activating blood and mitophagy in this field.展开更多
Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternu...Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.展开更多
The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of wea...The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.展开更多
The aim of this study was to present the prevalence of self-reported Ischemic Heart Disease (IHD) based on a national population-based survey and to characterize people with self-reported IHD with respect to health be...The aim of this study was to present the prevalence of self-reported Ischemic Heart Disease (IHD) based on a national population-based survey and to characterize people with self-reported IHD with respect to health behavior, risk factors, health-care services utilization and health-related HRQoL;further to compare people with self-reported IHD to those with other chronic illness and people without chronic illness. Based on the Danish Health Interview Survey 2005 (SUSY), a sample of 10,983 persons aged 35 years or older was examined. Data was collected through personal interviews (response rate = 66.7%) and self-administered questionnaires (51.5%). The sample was divided into three mutual exclusive groups: IHD;other chronic illnesses;and no chronic illness. The prevalence of IHD was 5.6% (5.2 - 6.0). The disease was more common in men than women, and the average age was 67.5 years. People with self-reported IHD were characterized as having poorer health behaviors;more risk factors: 40% smokers, 21% sedentary lifestyle, 26% obese;higher utilization of the health-care services;and poorer HRQoL. When compared to people with other chronic diseases, people with IHD continued to show the same characteristics. The IHD group had more problems affecting their daily lives than the other two groups. The issues that affected the people with IHD have also been shown to increase the load on the health-care system. Therefore, it is important to the patients, health-care, and society that the prevalence of IHD is reduced and the burden of disease is made a priority.展开更多
Ischemic heart disease(IHD)is one of the leading causes of death worldwide.However,different geographic regions show different variations of the risk factors of this disease based on the different lifestyles of people...Ischemic heart disease(IHD)is one of the leading causes of death worldwide.However,different geographic regions show different variations of the risk factors of this disease based on the different lifestyles of people.This study examines the current IHD condition in southern Bangladesh,a Southeast Asian middle-income country.The main approach to this research is an Al-based proposal of a reduced set of the greatest impact clinical traits that may cause IHD.This approach attempts to reduce IHD morbidity and mortality by early detection of risk factors using the reduced set of clinical data.Demographic,diagnostic,and symptomatic features were considered for analysing this clinical data.Data pre-processing utilizes several machine learning techniques to select significant features and make meaningful interpretations.A proposed voting mechanism ranked the selected 138 features by their impact factor.In this regard,diverse patterns in correlations with variables,including age,sex,career,family history,obesity,etc.,were calculated and explained in terms of voting scores.Among the 138 risk factors,three labels were categorized:high-risk,medium-risk,and low-risk features;19 features were regarded as high,25 were medium,and 94 were considered low impactful features.This research's technological methodology and practical goals provide an innovative and resilient framework for addressing IHD,especially in less developed cities and townships of Bangladesh,where the general population's socioeconomic conditions are often unexpected.The data collection,pre-processing,and use of this study's complete and comprehensive IHD patient dataset is another innovative addition.We believe that other relevant research initiatives will benefit from this work.展开更多
Yi-Qi-Huo-Xue Decoction(YQHX)is the recombination of Dang-Gui-Bu-Xue Decoction(DBD),which is one of the well-known traditional Chinese Medicine(TCM)prescription,and has long been shown to have significant protective e...Yi-Qi-Huo-Xue Decoction(YQHX)is the recombination of Dang-Gui-Bu-Xue Decoction(DBD),which is one of the well-known traditional Chinese Medicine(TCM)prescription,and has long been shown to have significant protective effects against myocardial ischemic injury.In previous studies,we found that YQHX could regulate lipid and glucose metabolism,promote angiogenesis,attenuate inflammatory response,and ameliorate left ventricular function in myocardial ischemia rat models.However,the underlying mechanism of how YQHX involves in lipid metabolism remains unclear so far.In this study,the underlying mechanism of YQHX in lipid metabolism disorders was elucidated in a myocardial ischemia rat model and a hypoxia-induced H9 c2 cell injury model.YQHX(8.2 g·kg-1)and positive-control drug trimetazidine(10 mg·kg-1)were administered daily on the second day after left anterior descending(LAD)operation.At 7 days and 28 days after surgery,changes of cardiac morphology,structure,and function were evaluated by H&E staining and echocardiography,respectively.The plasma lipid levels and mitochondrial ATP content were also evaluated.Western blot and RT-PCR were used to determine the protein and mRNA expressions of AMPK,PGC-1α,CPT-1α,and PPARα.YQHX improved cardiac function and ameliorated lipid metabolism disorders.Furthermore,YQHX increased the expression of p-AMPK,PGC-1α,and CPT-1αwithout changing PPARαin ischemic rat myocardium.In vitro,YQHX activated the protein and mRNA expression of PGC-1α,CPT-1α,and PPARαin hypoxia-induced H9 c2 cells injury,whereas AMPK inhibitor Compound c blocked the effects of YQHX.Taken together,the results suggest that YQHX reduces lipid metabolism disorders in myocardial ischemia via the AMPK-dependent signaling pathway.展开更多
Stenosis of the coronary artery has been considered as an essential component of ischemic heart disease(IHD). Consequently, revascularization [e.g., percutaneous coronary intervention(PCI) and coronary artery bypass] ...Stenosis of the coronary artery has been considered as an essential component of ischemic heart disease(IHD). Consequently, revascularization [e.g., percutaneous coronary intervention(PCI) and coronary artery bypass] has been the primary therapeutic approach to IHD. Such strategy has indeed revolutionized the management of IHD patients. However, not all patients with myocardial ischemia have visible coronary stenosis. Moreover, cardiovascular events occur in nearly 20% patients with stable coronary artery disease who have undergone PCI. The recently proposed 'solar system' hypothesis of IHD postulates that coronary stenosis is only one(albeit important) of its features. Mechanistic contribution and clinical implication of multiple pathophysiological processes beyond coronary stenosis are highlighted in this hypothesis. On the basis of a holistic regulation and individualized medicine, Chinese medicine(CM) has been used in the real-world setting to manage a variety of diseases, including IHD, for more than two thousands years. In this article, we summarize the evidence of CM that supports the 'solar system' IHD hypothesis, and argue for a comprehensive approach to IHD. At the theoretical level, the central features of this approach include a holistic view of disease and human subjects, as well as individualized medicine. At the practical level, this approach emphasizes anoxia-tolerance and self-healing.展开更多
Objective:Using network pharmacology to explore the mechanism of the'invigorating qi and promoting blood circulation'drug pair Ginseng-Danshen(Salvia miltiorrhiza)on treatment of ischemic heart disease(IHD).Me...Objective:Using network pharmacology to explore the mechanism of the'invigorating qi and promoting blood circulation'drug pair Ginseng-Danshen(Salvia miltiorrhiza)on treatment of ischemic heart disease(IHD).Methods:The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and the potential targets of the pair were identified.The pharmacodynamics of the pair was analyzed using network pharmacology.The targets of IHD were identified by database screening.Using protein-protein interaction network,the interaction targets of Ginseng-Danshen on IHD were constructed.A"constituent-target-disease"interaction network was constructed using Cytoscape software,Gene Ontology(GO)term enrichment analysis and biological pathway enrichment analysis were carried out,and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated.Results:Seventeen active constituents and 53 targets were identified from ginseng,53 active constituents and 61 targets were identified from Danshen,and 32 protein targets were shared by ginseng and Danshen.Twenty GO terms were analyzed,including cytokine receptor binding,cytokine activity,heme binding,and antioxidant activity.Sixty Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathways were analyzed,including phosphatidylinositol 3-kinase-serine-threonine kinase(PI3 K-AKT)signaling pathway,p53 signaling pathway,interleukin 17 signaling pathway,tumor necrosis factor signaling pathway,and the advanced glycation end product(AGE)-the receptor for AGE(RAGE)signaling pathway in diabetic complications.Conclusion:The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody,inhibiting the production of peroxides,removing the endogenous oxygen free radicals,regulating the expression of inflammatory factors,reducing myocardial cell apoptosis and promoting vascular regeneration.展开更多
Ischemic heart disease (IHD) is the leading cause of sudden cardiac death (SCD) and often non-thrombosed severe coronary stenoses with or without myocardial scars are detected.Left dominant arrhythmogenic cardiomyopat...Ischemic heart disease (IHD) is the leading cause of sudden cardiac death (SCD) and often non-thrombosed severe coronary stenoses with or without myocardial scars are detected.Left dominant arrhythmogenic cardiomyopathy (LDAC) is a life-threating rare disease which has been more thoroughly studied in the last 10years.The macroscopic study of an SCD victim was conducted and re-evaluated 9years later.The cardiological work-up in his firstdegree relatives initially comprised an electrocardiogram (ECG) and an echocardiogram.When they were re-evaluted 9years later,a cardiac magnetic resonance,an ECG-monitoring,an exercise testing and a genetic study were performed and the pedigree was extended accordingly.In 2008,an IHD was suspected in the sports-triggered SCD of a 37-year-old man upon the postmortem (75% stenosis of the left main and circumflex coronary arteries;the subepicardial left ventricular fibrofatty infiltration with mild myocardial degeneration was assumed to be a past myocardial infarction).No cardiomyopathy was identified in any of the two proband's sisters.Nine years thereafter,distant relatives were diagnosed with LDAC due to a pathogenic desmoplakin mutation.The reanalysis of the two sisters showed ventricular arrhythmias in one of them without structural heart involvement and the reviewed postmortem of the proband was reclassified as LDAC based on the fibrofatty infiltration;both were mutation carriers.The completion of the family study on 19 family members yielded one SCD due to LDAC (the proband),three living patients diagnosed with LDAC (two with a defibrillator),one mutation carrier without structural ventricular involvement,and 14 healthy relatives (who were discharged) with a very good co-segregation of the mutation.Although rare,LDAC exists and sometimes its differential diagnosis with iHD has to be faced.Modifying previous postmortem misdiagnoses can help family screening to further prevent SCDs.展开更多
Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden card...Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.展开更多
AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized ...AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized controlled study. One hundred and two patients were randomized to receive RIPC(3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC(control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group(P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.展开更多
文摘Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.
文摘AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD.Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.
文摘1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.
文摘Objective:A study was conducted to explore the level of illness perception,the level of cardiovascular health behaviour and the relationship between illness perception and cardiovascular health behaviour among persons with ischemic heart disease(IHD)in a community setting.Method:The participants comprised 235 persons with IHD.The instruments used were as follows:1)Demographic Data and Health Information,2)The Brief Illness Perception Questionnaire(Brief IPQ),3)The Open-ended Questionnaire(OEQ),and 4)The Modified Cardiac Health Behaviour Scale(MCHBS).Findings from the OEQ are used to assess in-depth illness perception and to extend the information obtained from the Brief IPQ.The design of the study was descriptive correlational.The data were analysed using descriptive statistics to present the demographic data and health information.Inferential statistics was used to resolve the relationship between illness perception and cardiovascular health behaviour by using Pearson's Product Moment Correlation.Result:The mean score of illness perception was at a moderate level(M=43.65,SD=3.93),whereas the mean score of cardiovascular health behaviour was at a high level(M=80.29,SD=5.42).A significant positive relationship existed between illness perception and cardiovascular health behaviour among persons with IHD(r=0.38,P<0.01).Conclusion:Persons with higher illness perception showed a positive correlation with higher cardiovascular health behaviour at a significant level of 0.01.Results provided important information for nurses to develop an intervention program to promoting appropriate illness perception and cardiovascular health behaviour among persons with IHD.
基金supported by the China Medical Board(grant No.12-107,15-208)China Medical Board Faculty Development Award(grant No.G16917561)China Scholarship Council(grant No.201408110083)
文摘To determine the reason for the different mortality trends of ischemic heart disease （IHD） for China between Global Burden of Disease （GBD） 2010 and GBD2013, and to improve garbage code （GC） redistribution. All data were obtained from the disease surveillance points system, and two proportions for assigning chronic pulmonary heart disease （PHD） as GC to IHD were from GBD2010 and GBD2013,
文摘Ischemic heart disease(IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD. The presence of unique risk factors such as exposure to menarche and pregnancy, more anemia, hypertension, and autoimmune disorders in women have recently received attention. Ischemic symptoms are more indefinite and vague in women compared to men as well as a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented. Without any correct diagnosis, treatment, and prevention, these problems are accumulated and continue up to older age. Accordingly, with the belief of longer life in women and the increased prevalence of IHD with aging, it will become an important public health problem and concern in the future. This narrative review aimed to provide an overview of some of the differences between the two genders in terms of IHD with paying more attention to practical points.
文摘Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group;and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.
文摘Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100 patients with ischemic heart disease were selected as the research objects.Selecting the patients from May 2020 to May 2021 as a sample,the patients were divided into two groups,and different diagnostic methods were used to compare the clinical diagnosis effects.Results:In terms of the diagnostic accuracy of the two groups of patients,the maximum value was 92.00%(experimental group)and the minimum value was 80.00%(control group).There was a big difference in data between the two groups,P<0.05,which was statistically significant.The patient9s(experimental group)diagnosis accuracy rate is highe Conclusion:In the process of research work for patients with ischemic heart disease,it is particularly important to diagnose the patients.The combined application of and 64-slice spiral CT can improve the clinical diagnosis efficiency and achieve significant results.
文摘To study the variation and significance of plasma coagulation factor Ⅶ （FⅦ） in different kinds of ischemia heart disease （IHD） and examine its relation with plasma lipid and gene polymorphism. FⅦa was determined with one stage clotting assay by using a recombinant soluble tissue factor （rsTF）. FⅦc was measured with one stage clotting assay. FⅦag was quantified with an enzyme-linked immunosorbent assay （ELISA）. Polymorphism was analyzed with PCR-urea-polyacrylamide gel electrophoresis. Our results showed that FⅦa in stable angina （SA）, unstable angina （UA）, obsolete and acute myocardial infraction （OMI, AMI） patients was higher than those of normal group with the differences being significant within any two groups. FⅦag in UA, OMI and AMI was higher than those in SA and normal groups. There were positive correlations between FⅦa and serum triglycerides, FⅦa and FⅦc, FⅦc and FⅦag. FⅦ-323 0/10 bp polymorphism analysis was performed in 60 patients and 0/10 bp polymorphism was found in 5 cases. FⅦc and FⅦag were much lower in cases of 0/10 bp groups than those in cases of 0/0 bp groups. It is concluded that there was activation of extrinsic coagulation pathway in every kind of IHD to different extent. FⅦa was the risk factor in the development of IHD, and more sensitive in reflecting the severity of cardiovacutar disease than FⅦc or FⅦag. FⅦa was higher in OMI, which may be one of the risk factors of re-infraction. Serum triglyceride may indirectly lead to the development of IHD by increasing the level of FⅦa, FⅦ-323 0/10 bp polymorphism was present in Chinese patients with IHD and it was correlated with the level of FⅦc, FⅦag in plasma. 10 bp allelomorphic gene was a protective factor against thrombogenesis.
基金National natural science foundation project (81673891)
文摘Ischemic heart disease has the characteristics of high morbidity and high mortality, which seriously endangers people's health. Mitophagy can selectively remove damaged organelles, and has a role in maintaining the homeostasis of myocardial cells and protecting ischemic myocardium. Significance. More and more studies have found that traditional Chinese medicine can improve ischemic damage of cardiomyocytes by regulating mitochondrial function and autophagy. Using mitochondria as the target of traditional Chinese medicine in cardiomyocytes to explore the treatment of ischemic Effective measures for heart disease have become a hotspot for related Chinese medicine workers. Based on the above background, this article outlines the main regulatory pathways of mitochondrial autophagy, and reviews related researches on traditional Chinese medicine of benefiting qi and activating blood and mitophagy in this field.
文摘Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.
文摘The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.
文摘The aim of this study was to present the prevalence of self-reported Ischemic Heart Disease (IHD) based on a national population-based survey and to characterize people with self-reported IHD with respect to health behavior, risk factors, health-care services utilization and health-related HRQoL;further to compare people with self-reported IHD to those with other chronic illness and people without chronic illness. Based on the Danish Health Interview Survey 2005 (SUSY), a sample of 10,983 persons aged 35 years or older was examined. Data was collected through personal interviews (response rate = 66.7%) and self-administered questionnaires (51.5%). The sample was divided into three mutual exclusive groups: IHD;other chronic illnesses;and no chronic illness. The prevalence of IHD was 5.6% (5.2 - 6.0). The disease was more common in men than women, and the average age was 67.5 years. People with self-reported IHD were characterized as having poorer health behaviors;more risk factors: 40% smokers, 21% sedentary lifestyle, 26% obese;higher utilization of the health-care services;and poorer HRQoL. When compared to people with other chronic diseases, people with IHD continued to show the same characteristics. The IHD group had more problems affecting their daily lives than the other two groups. The issues that affected the people with IHD have also been shown to increase the load on the health-care system. Therefore, it is important to the patients, health-care, and society that the prevalence of IHD is reduced and the burden of disease is made a priority.
文摘Ischemic heart disease(IHD)is one of the leading causes of death worldwide.However,different geographic regions show different variations of the risk factors of this disease based on the different lifestyles of people.This study examines the current IHD condition in southern Bangladesh,a Southeast Asian middle-income country.The main approach to this research is an Al-based proposal of a reduced set of the greatest impact clinical traits that may cause IHD.This approach attempts to reduce IHD morbidity and mortality by early detection of risk factors using the reduced set of clinical data.Demographic,diagnostic,and symptomatic features were considered for analysing this clinical data.Data pre-processing utilizes several machine learning techniques to select significant features and make meaningful interpretations.A proposed voting mechanism ranked the selected 138 features by their impact factor.In this regard,diverse patterns in correlations with variables,including age,sex,career,family history,obesity,etc.,were calculated and explained in terms of voting scores.Among the 138 risk factors,three labels were categorized:high-risk,medium-risk,and low-risk features;19 features were regarded as high,25 were medium,and 94 were considered low impactful features.This research's technological methodology and practical goals provide an innovative and resilient framework for addressing IHD,especially in less developed cities and townships of Bangladesh,where the general population's socioeconomic conditions are often unexpected.The data collection,pre-processing,and use of this study's complete and comprehensive IHD patient dataset is another innovative addition.We believe that other relevant research initiatives will benefit from this work.
基金the National Natural Science Foundation of China(No.81473552)the China Postdoctoral Science Foundation(No.2019TQ0043)。
文摘Yi-Qi-Huo-Xue Decoction(YQHX)is the recombination of Dang-Gui-Bu-Xue Decoction(DBD),which is one of the well-known traditional Chinese Medicine(TCM)prescription,and has long been shown to have significant protective effects against myocardial ischemic injury.In previous studies,we found that YQHX could regulate lipid and glucose metabolism,promote angiogenesis,attenuate inflammatory response,and ameliorate left ventricular function in myocardial ischemia rat models.However,the underlying mechanism of how YQHX involves in lipid metabolism remains unclear so far.In this study,the underlying mechanism of YQHX in lipid metabolism disorders was elucidated in a myocardial ischemia rat model and a hypoxia-induced H9 c2 cell injury model.YQHX(8.2 g·kg-1)and positive-control drug trimetazidine(10 mg·kg-1)were administered daily on the second day after left anterior descending(LAD)operation.At 7 days and 28 days after surgery,changes of cardiac morphology,structure,and function were evaluated by H&E staining and echocardiography,respectively.The plasma lipid levels and mitochondrial ATP content were also evaluated.Western blot and RT-PCR were used to determine the protein and mRNA expressions of AMPK,PGC-1α,CPT-1α,and PPARα.YQHX improved cardiac function and ameliorated lipid metabolism disorders.Furthermore,YQHX increased the expression of p-AMPK,PGC-1α,and CPT-1αwithout changing PPARαin ischemic rat myocardium.In vitro,YQHX activated the protein and mRNA expression of PGC-1α,CPT-1α,and PPARαin hypoxia-induced H9 c2 cells injury,whereas AMPK inhibitor Compound c blocked the effects of YQHX.Taken together,the results suggest that YQHX reduces lipid metabolism disorders in myocardial ischemia via the AMPK-dependent signaling pathway.
基金Supported by the Twelve Five-Year Plan of China(No.2013BAI02B01 and 2013BAI13B01)
文摘Stenosis of the coronary artery has been considered as an essential component of ischemic heart disease(IHD). Consequently, revascularization [e.g., percutaneous coronary intervention(PCI) and coronary artery bypass] has been the primary therapeutic approach to IHD. Such strategy has indeed revolutionized the management of IHD patients. However, not all patients with myocardial ischemia have visible coronary stenosis. Moreover, cardiovascular events occur in nearly 20% patients with stable coronary artery disease who have undergone PCI. The recently proposed 'solar system' hypothesis of IHD postulates that coronary stenosis is only one(albeit important) of its features. Mechanistic contribution and clinical implication of multiple pathophysiological processes beyond coronary stenosis are highlighted in this hypothesis. On the basis of a holistic regulation and individualized medicine, Chinese medicine(CM) has been used in the real-world setting to manage a variety of diseases, including IHD, for more than two thousands years. In this article, we summarize the evidence of CM that supports the 'solar system' IHD hypothesis, and argue for a comprehensive approach to IHD. At the theoretical level, the central features of this approach include a holistic view of disease and human subjects, as well as individualized medicine. At the practical level, this approach emphasizes anoxia-tolerance and self-healing.
基金Supported by the National Natural Science Foundation of China(No.81774145)Youth Program of National Natural Science Foundation of China(No.81503292)National Key Basic Research and Development Program(No.2015cb554406)。
文摘Objective:Using network pharmacology to explore the mechanism of the'invigorating qi and promoting blood circulation'drug pair Ginseng-Danshen(Salvia miltiorrhiza)on treatment of ischemic heart disease(IHD).Methods:The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and the potential targets of the pair were identified.The pharmacodynamics of the pair was analyzed using network pharmacology.The targets of IHD were identified by database screening.Using protein-protein interaction network,the interaction targets of Ginseng-Danshen on IHD were constructed.A"constituent-target-disease"interaction network was constructed using Cytoscape software,Gene Ontology(GO)term enrichment analysis and biological pathway enrichment analysis were carried out,and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated.Results:Seventeen active constituents and 53 targets were identified from ginseng,53 active constituents and 61 targets were identified from Danshen,and 32 protein targets were shared by ginseng and Danshen.Twenty GO terms were analyzed,including cytokine receptor binding,cytokine activity,heme binding,and antioxidant activity.Sixty Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathways were analyzed,including phosphatidylinositol 3-kinase-serine-threonine kinase(PI3 K-AKT)signaling pathway,p53 signaling pathway,interleukin 17 signaling pathway,tumor necrosis factor signaling pathway,and the advanced glycation end product(AGE)-the receptor for AGE(RAGE)signaling pathway in diabetic complications.Conclusion:The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody,inhibiting the production of peroxides,removing the endogenous oxygen free radicals,regulating the expression of inflammatory factors,reducing myocardial cell apoptosis and promoting vascular regeneration.
基金This work was supported by grants from the Ministerio de Economia y Competitividad[grant number DPI2015-70821-R]Instituto de Salud Carlos Ⅲ and FEDER UnionEuropea,Una forma de hacer Europa[grant numbersRD12/0042/0029,PI14/01477 and PI18/01582]La FeBiobank[grant number PT17/0015/0043].
文摘Ischemic heart disease (IHD) is the leading cause of sudden cardiac death (SCD) and often non-thrombosed severe coronary stenoses with or without myocardial scars are detected.Left dominant arrhythmogenic cardiomyopathy (LDAC) is a life-threating rare disease which has been more thoroughly studied in the last 10years.The macroscopic study of an SCD victim was conducted and re-evaluated 9years later.The cardiological work-up in his firstdegree relatives initially comprised an electrocardiogram (ECG) and an echocardiogram.When they were re-evaluted 9years later,a cardiac magnetic resonance,an ECG-monitoring,an exercise testing and a genetic study were performed and the pedigree was extended accordingly.In 2008,an IHD was suspected in the sports-triggered SCD of a 37-year-old man upon the postmortem (75% stenosis of the left main and circumflex coronary arteries;the subepicardial left ventricular fibrofatty infiltration with mild myocardial degeneration was assumed to be a past myocardial infarction).No cardiomyopathy was identified in any of the two proband's sisters.Nine years thereafter,distant relatives were diagnosed with LDAC due to a pathogenic desmoplakin mutation.The reanalysis of the two sisters showed ventricular arrhythmias in one of them without structural heart involvement and the reviewed postmortem of the proband was reclassified as LDAC based on the fibrofatty infiltration;both were mutation carriers.The completion of the family study on 19 family members yielded one SCD due to LDAC (the proband),three living patients diagnosed with LDAC (two with a defibrillator),one mutation carrier without structural ventricular involvement,and 14 healthy relatives (who were discharged) with a very good co-segregation of the mutation.Although rare,LDAC exists and sometimes its differential diagnosis with iHD has to be faced.Modifying previous postmortem misdiagnoses can help family screening to further prevent SCDs.
基金funded by the National Natural Science Foundation of China(Grant No.82002001).
文摘Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.
文摘AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized controlled study. One hundred and two patients were randomized to receive RIPC(3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC(control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group(P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.
