Objective:To explore the therapeutic efficacy of L-carvone from Mentha spicata L.leaf extracts against isoproterenol-induced cardiac hypertrophy in rats.Methods:Isoproterenol(5 mg/kg)was injected intraperitoneally int...Objective:To explore the therapeutic efficacy of L-carvone from Mentha spicata L.leaf extracts against isoproterenol-induced cardiac hypertrophy in rats.Methods:Isoproterenol(5 mg/kg)was injected intraperitoneally into rats for one month to induce cardiac hypertrophy.L-carvone(25 and 100 mg/kg)was administered orally to treat cardiac hypertrophy.The cardioprotective activity of L-carvone was evaluated by electrocardiogram,histopathological analysis as well as determination of biochemical parameters and enzymatic markers.Results:L-carvone from Mentha spicata L.at 25 and 100 mg/kg ameliorated isoproterenol-induced cardiac hypertrophy,as evidenced by reduced QRS interval on electrocardiogram,and decreased heart weight and heart index.In addition,both doses of L-carvone markedly lowered the levels of glucose,total protein,low-density lipoprotein cholesterol,aspartate transaminase,alanine transaminase,lactate dehydrogenase,creatine kinase MB,troponin-Ⅰ,N-terminal pro-B type natriuretic peptide and triglycerides while increasing high-density lipoprotein cholesterol and lipase level(P<0.05).Moreover,L-carvone alleviated contraction band necrosis,and reorganized the myofibrils with normal striations and myocytes as well as normal nuclei in cardiac histoarchitecture of rats with isoproterenol-induced cardiac hypertrophy.Conclusions:L-carvone from Mentha spicata L.leaf extract can restore abnormal cardiac function and may be further explored as a therapeutic agent against the deleterious effects of cardiac hypertrophy after further evaluation.展开更多
Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
BACKGROUND Cold ischemia-reperfusion of the liver is an inevitable occurrence in liver trans-plantation that may also cause damage to the heart.Perioperative myocardial injury during liver transplantation can increase...BACKGROUND Cold ischemia-reperfusion of the liver is an inevitable occurrence in liver trans-plantation that may also cause damage to the heart.Perioperative myocardial injury during liver transplantation can increase the incidence of post-operative mortality,but there is little research on the incidence of myocardial injury in children who undergo living donor liver transplantation(LDLT).Therefore,this study mainly explores the independent risk factors for myocardial injury in children who undergo LDLT.factors for intraoperative myocardial injury.METHODS We retrospectively analyzed the inpatient records of pediatric patients who underwent LDLT in Tianjin First Central Hospital from January 1,2020,to January 31,2022.Recipient-related data and donor-related data were collected.The patients were divided into a myocardial injury group and a nonmyocardial injury group according to the value of the serum cardiac troponin I at the end of surgery for analysis.Univariate analysis and multivariate logistic regression were used to evaluate the risk factors for myocardial injury during LDLT in pediatric patients.RESULTS A total of 302 patients met the inclusion criteria.The myocardial injury group had 142 individuals(47%),and the nonmyocardial injury group included 160 patients(53%).Age,height,and weight were significantly lower in the myocardial injury group(P<0.001).The pediatric end-stage liver disease(PELD)score,total bilirubin,and interna-tional standardized ratio were significantly higher in the myocardial injury group(P<0.001).The mean arterial pressure,lactate,hemoglobin before reperfusion,duration of the anhepatic phase,cold ischemic time,incidence of postreperfusion syndrome(PRS),and fresh frozen plasma transfusion were significantly different between the two groups(P<0.05).The postoperative intensive care unit stay and peak total bilirubin values in the first 5 d after LDLT were significantly higher in the myocardial injury group(P<0.05).The pediatric patients with biliary atresia in the nonmyocardial injury group who underwent LDLT had a considerably higher one-year survival rate than those in the myocardial injury group(P=0.015).Multivariate logistic regression revealed the following independent risk factors for myocardial injury:a high PELD score[odds ratio(OR)=1.065,95%confidence interval(CI):1.013-1.121;P=0.014],a long duration of the anhepatic phase(OR=1.021,95%CI:1.003-1.040;P=0.025),and the occurrence of intraoperative PRS(OR=1.966,95%CI:1.111-3.480;P=0.020).CONCLUSION A high PELD score,a long anhepatic phase duration,and the occurrence of intraoperative PRS were independent risk factors for myocardial injury during LDLT in pediatric patients with biliary atresia.展开更多
Asprosin is a newly discovered protein hormone that promotes appetite,regulates glucose homeostasis,increases insulin resistance and has potential myocardial protection.Myocardium is vulnerable to oxidative stress inj...Asprosin is a newly discovered protein hormone that promotes appetite,regulates glucose homeostasis,increases insulin resistance and has potential myocardial protection.Myocardium is vulnerable to oxidative stress injury caused by factors such as high glucose,anti-tumor drugs,ischemia reperfusion and so on,and currently there is a lack of effective preventive measures.It has been reported in the literature that Asprosin has a unique protective effect on myocardium,but the protective mechanism of Asprosin is not clear.In this paper,the general situation and functions of Asprosin,as well as the protective mechanism of Asprosin on myocardium were reviewed,in order to provide reference for the application of Asprosin in the treatment of cardio-related diseases.展开更多
BACKGROUND Abdominal paracentesis drainage(APD)is a safe and effective strategy for severe acute pancreatitis(SAP)patients.However,the effects of APD treatment on SAPassociated cardiac injury remain unknown.AIM To inv...BACKGROUND Abdominal paracentesis drainage(APD)is a safe and effective strategy for severe acute pancreatitis(SAP)patients.However,the effects of APD treatment on SAPassociated cardiac injury remain unknown.AIM To investigate the protective effects of APD on SAP-associated cardiac injury and the underlying mechanisms.METHODS SAP was induced by 5%sodium taurocholate retrograde injection in Sprague-Dawley rats.APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after SAP induction.Morphological staining,serum amylase and inflammatory mediators,serum and ascites high mobility group box(HMGB)1,cardiac-related enzymes indexes and cardiac function,oxidative stress markers and apoptosis and associated proteins were assessed in the myocardium in SAP rats.Nicotinamide adenine dinucleotide phosphate oxidase activity and mRNA and protein expression were also examined.RESULTS APD treatment improved cardiac morphological changes,inhibited cardiac dysfunction,decreased cardiac enzymes and reduced cardiomyocyte apoptosis,proapoptotic Bax and cleaved caspase-3 protein levels.APD significantly decreased serum levels of HMGB1,inhibited nicotinamide adenine dinucleotide phosphate oxidase expression and ultimately alleviated cardiac oxidative injury.Furthermore,the activation of cardiac nicotinamide adenine dinucleotide phosphate oxidase by pancreatitis-associated ascitic fluid intraperitoneal injection was effectively inhibited by adding anti-HMGB1 neutralizing antibody in rats with mild acute pancreatitis.CONCLUSION APD treatment could exert cardioprotective effects on SAP-associated cardiac injury through suppressing HMGB1-mediated oxidative stress,which may be a novel mechanism behind the effectiveness of APD on SAP.展开更多
BACKGROUND:Sepsis-induced myocardial injury is one of the major predictors of morbidity and mortality of sepsis.The cytoprotective function of erythropoietin(EPO) has been discovered and extensively studied.However,th...BACKGROUND:Sepsis-induced myocardial injury is one of the major predictors of morbidity and mortality of sepsis.The cytoprotective function of erythropoietin(EPO) has been discovered and extensively studied.However,the cardioprotective effects of EPO on sepsis-induced myocardial injury in the rat sepsis model has not been reported.METHODS:The rat models of sepsis were produced by cecal ligation and perforation(CLP)surgery.Rats were randomly(random number) assigned to one of three groups(n=8 for each group):sham group,CLP group and EPO group(1000 lU/kg erythropoietin).Arterial blood was withdrawn at3,6,12,and 24 hours after CLP.cTnl,BNP,CK-MB,LDH,AST,TNF-a,IL-6,IL-10,and CRP were tested by the ELISA assay.Changes of hemodynamic parameters were recorded at 3,6,12,24 hours after the surgery.Histological diagnosis was made by hematoxylin and eosin.Flow cytometry was performed to examine cell apoptosis,myocardium mitochondrial inner membrane potential,and NF-κB(p65).Survival rate at 7 days after CLP was recorded.RESULTS:In the CLP group,myocardial enzyme index and inflammatory index increased at3,6,12 and 24 hours after CLP compared with the sham group,and EPO significantly blocked the increase.Compared with the CLP group,EPO significantly improved LVSP,LV +dpldt_(max) LV-dp/dt_(min),and decreased LVEDP at different time.EPO blocked the reduction of mitochondrial transmembrane potential,suppressed the cardiomyocyte apoptosis,inhibited the activation of NF-κB,and reduced the production of proinflmmatory cytokines.No difference in the survival rate at 7 days was observed between the CLP group and the EPO group.CONCLUSION:Exogenous EPO has cardioprotective effects on sepsis-induced myocardial injury.展开更多
Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients wit...Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.展开更多
Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’outcomes.Myocardial injury(MI)occurs in the context of coronav...Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’outcomes.Myocardial injury(MI)occurs in the context of coronavirus infectious disease 2019(COVID-19)and is associated with a higher risk of severe clinical outcome and mortality.COVID-19-related MI can have various clinical manifestations,of which the main ones are myocarditis,stress cardiomyopathy,acute coronary syndrome,and pulmonary embolism.The exact mechanisms of how MI occurs in these patients are not yet fully known.Direct injury,through direct viral myocardial invasion,and indirect injury,through interaction with angiotensin I converting enzyme 2,increased inflammation,and thrombocyte and endothelial dysfunction,could be involved in acute MI in patients with COVID-19.A better understanding of these multiple potential mechanisms may help to develop new targeted therapeutic strategies.The purpose of this review is to provide the current understanding of the potential mechanisms involved in MI induced by COVID-19 and to discuss the current progress in the therapeutic strategies.展开更多
Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation...Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation group(S group,n=6),ventricular fibrillation control group(VF-C group,n=8)and 654-1 intervention group(VF-I group,n=8).Hemodynamics was recorded at baseline,at recovery of spontaneous circulation(ROSC),and 1 h,2 h,4h and 6 h thereafter.Sidestream dark field(SDF)technology was used to evaluate and monitor the microcirculation flow index,total vessel density,perfusion vessel ratio,De-Backer score,and perfusion vessel density in animal viscera at various time points.Results After administration of 654-1 at 1.5 h post-ROSC,the hemodynamics in the VF-I group,as compared with the VF-C group,was significantly improved.The visceral microcirculation detected by SDF was also significantly improved in the VF-I group.As observed through electron microscopy,significantly less myocardial tissue injury was present in the VF-I group than the VF-C group.Conclusion Administration of 654-1 inhibited excessive inflammatory by improving the state of visceral microcirculation.展开更多
Objective:Keshan disease(KD)is a mitochondrial cardiomyopathy.The present study explored the roles of peroxisome proliferator-activated receptor(PPAR)-y coactivator-la(PGC-la),the key regulator of mitochondrial struct...Objective:Keshan disease(KD)is a mitochondrial cardiomyopathy.The present study explored the roles of peroxisome proliferator-activated receptor(PPAR)-y coactivator-la(PGC-la),the key regulator of mitochondrial structure and function,and its coactivators in myocardial injury in chronic KD.Furthermore,the usefulness of these molecules in the diagnosis of chronic KD was assessed.展开更多
Objective:To observe the effect of resveratrol on the injury of diabetic cardiomyocytes and its effect on HSF1 mediated iron death.Methods:the diabetic cardiomyopathy model was established by high glucose induced H9c2...Objective:To observe the effect of resveratrol on the injury of diabetic cardiomyocytes and its effect on HSF1 mediated iron death.Methods:the diabetic cardiomyopathy model was established by high glucose induced H9c2,and H9c2 was exposed to normal glucose concentration as a control.Then the intervention was performed with the corresponding drugs.The cell proliferation level was detected by CCK8 method,the concentrations of LDH,SOD,MDA and iron ions were detected by kit method,and the expression levels of HSF1,apoptotic proteins(Bax and Bcl-2)and iron death marker proteins(ACSL4,GPX4 and SLC7A11)were detected by Western blot;Results:compared with the blank group,the cell activity,SOD activity,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein in the model group decreased significantly,and the LDH activity,MDA content,Bax and ACSL4 protein expression,Bax/Bcl-2 ratio and Fe^(2+)content increased significantly(P<0.01).Compared with the model group,the activity of H9c2 cells,the activity of SOD,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein increased significantly,and the activity of LDH,the content of MDA,the expression of Bax and ACSL4 protein,the ratio of Bax/Bcl-2 and the content of Fe^(2+)decreased significantly in the resveratrol group(P<0.01).After the intervention,the activity of H9c2 cells,the activity of SOD,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein decreased significantly,and the activity of LDH,the content of MDA,the expression of Bax and ACSL4 protein,the ratio of Bax/Bcl-2 and the content of Fe^(2+)increased significantly in si-hsf1 group(P<0.01);Conclusion:resveratrol can inhibit cell iron death and improve high glucose induced cardiomyocyte injury by up regulating the expression of HSF1.展开更多
Objectives To investigate the effect of co-exposure of myocardial ischemia and cold stress on myocardial injury in rats and the relative mechanism.Methods Myocardial ischemia model was established by ligation of left ...Objectives To investigate the effect of co-exposure of myocardial ischemia and cold stress on myocardial injury in rats and the relative mechanism.Methods Myocardial ischemia model was established by ligation of left coronary artery.SD rats were randomly allocated to 4 groups; sham+normal temperature(S group),sham+cold stress(SC group),myocardial ischemia+ normal temperature(Ⅰgroup), myocardial ischemia+cold stress(IC group).On the condition of 26℃,SC and IC groups were keeped in a 4℃artificial chamber for 8h(8;00-16:00) for 4 consecu- tive days.Car diac function was assessed by echocardiography;pathological change was analyzed by HE staining;myocardial infarct size was determined by TTC staining;Bim,Caspase-3 expression in myocardium was determined by western blotting.Results It was demonstrated that co-exposure of myocardial ischemia and cold stress could significantly make the cardiac muscle in abnormal shape,increase the infarct size and the expression of Bim and Caspase-3.Conclusions Co-exposure of myocardial ischemia and cold stress may aggravate the cardiac injury,pro- apoptosis protein Bim is involved.展开更多
Objective: To investigate the expression of myocardium connexin 43(Cx43) in late exercise preconditioning(LEP) cardioprotection. Methods: Eight-week-old adult male Sprague Dawley rats were randomly assigned into four ...Objective: To investigate the expression of myocardium connexin 43(Cx43) in late exercise preconditioning(LEP) cardioprotection. Methods: Eight-week-old adult male Sprague Dawley rats were randomly assigned into four groups(n=8). Myocardial injury was judged in accordance with serum levels of c Tn and NT-pro BNP as well as hematoxylin basicfuchsin picric acid staining of myocardium. Cx43 m RNA was detected by in situ hybridization and qualified by real-time fluorescence quantitative PCR. Cx43 protein was localized by immunohistochemistry and its expression level was determined by western blotting. Results: The LEP obviously attenuated the myocardial ischemia/hypoxia injury caused by exhaustive exercise. There was no significant difference of Cx43 m RNA level between the four groups. Cx43 protein level was decreased significantly in group EE(P<0.05). However, LEP produced a significant increase in Cx43 protein level(P<0.05), and the decreased Cx43 protein level in exhaustive exercise was significantly up-regulated by LEP(P<0.05). Conclusions: LEP protects rat heart against exhaustive exercise-induced myocardial injury by up-regulating the expression of myocardial Cx43.展开更多
In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO ...In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO report,693,224 cases of COVID-19 were confirmed globally as of March 30,2020,with more than 33,000 deaths.[2]Because COVID-19 is highly contagious and harmful,it is crucial to determine the predictors of severe infection and death for risk stratification and guiding clinical treatment and intervention.展开更多
BACKGROUND Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes.However,the association between depression and myocardial injury on cardiac magnetic r...BACKGROUND Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes.However,the association between depression and myocardial injury on cardiac magnetic resonance(CMR)in patients with ST-segment elevation myocardial infarction(STEMI)has still not been assessed.AIM To assess the association between depression and myocardial injury on CMR in patients with STEMI.METHODS A total of 107 STEMI patients undergoing primary percutaneous coronary intervention(P-PCI)were analyzed in this prospectivecohort study.Each subject completed the Patient Health Questionnaire-9(PHQ-9)to assess the presence and severity of depressive symptoms.CMR was performed at a median of 3 d after PPCI for quantifying post-MI myocardial injury.Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.RESULTS In this study,19 patients(17.8%)were diagnosed with major depression identified by the PHQ-9≥10.PHQ-9 was analyzed both as a continuous variable and dichotomous variable.After multivariable adjustment,the proportion of patients with large infarction size was significantly higher in the major depression group(PHQ-9≥10)(OR:4.840,95%CI:1.122–20.868,P=0.034).When the PHQ-9 was evaluated as a continuous variable,after multivariable adjustment,an increased PHQ-9 score was associated with an increased risk of large infarction size(OR:1.226,95%CI:1.073–1.401,P=0.003).CONCLUSION In patients with STEMI undergoing PCI,depression was independently associated with a large infarction size.展开更多
BACKGROUND Acute chest pain(ACP)is very common among patients presenting to emergency departments.Nevertheless,ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man sufferi...BACKGROUND Acute chest pain(ACP)is very common among patients presenting to emergency departments.Nevertheless,ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man suffering from chest pain(increased pain for the last 9 h)was admitted to our hospital on October 25,2015.After undergoing physical examination and laboratory blood testing,he was diagnosed with acute anterior myocardial infarction.Consequently,the patient underwent emergency percutaneous coronary angiography;however,no myocardial infarction signs were observed.Later on,the patient experienced respiration failure and therefore was transferred to intensive care unit.Cardiac ultrasound showed pericardial effusion,which was considered as the cause of shock.He then underwent pericardium puncture drainage and the circulation temporarily improved.Nevertheless,persistent pericardial bleeding,unclear bleeding causes,and clot formation induced poor drainage led to worsening of cardiac tamponade symptoms.Consequently,the patient underwent emergency exploratory thoracotomy,which revealed a fish bone causing pericardial bleeding.The bone was removed,and the damaged blood vessels were mended.Eventually,the patient was discharged in good clinical condition.CONCLUSION For patients with chest pain,it is necessary to consider the possibility of foreign body in the esophagus or even in the heart.Careful history taking and the corresponding inspection can help to avoid unnecessary damage and safeguard patients from unnecessary pain.展开更多
Cardiac troponin-I(cTnI) and-T(cTnT) are sensitive and specific markers of myocardial injury.However,the role of increased cTnI and cTnT in percutaneous coronary intervention(PCI)-related myocardial injury remains con...Cardiac troponin-I(cTnI) and-T(cTnT) are sensitive and specific markers of myocardial injury.However,the role of increased cTnI and cTnT in percutaneous coronary intervention(PCI)-related myocardial injury remains controversial.In this prospective,single-center and double-blind study,we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT(cTns) in PCI-related myocardial injury in a Chinese population.A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited.The levels of cTnI and cTnT were examined before and after PCI.All patients were followed up for26±9 months to observe the incidence of major adverse cardiac events(MACEs).Our results showed that postPCI cTnI and/or cTnT levels were increased to more than the 99^(th) percentile upper reference limit(URL) in 133(13.2%) patients,among which 22(2.2%) were more than 5×99^(th) percentile URL.By univariate analysis,an elevation in cTns after PCI was not an independent predictor of increased MACEs,HR 1.35(P = 0.33,95%CI:0.74-2.46).In conclusion,our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.展开更多
BACKGROUND Extracellular vesicles(EVs)derived from hypoxia-preconditioned(HP)mesenchymal stem cells(MSCs)have better cardioprotective effects against myocardial infarction(MI)in the early stage than EVs isolated from ...BACKGROUND Extracellular vesicles(EVs)derived from hypoxia-preconditioned(HP)mesenchymal stem cells(MSCs)have better cardioprotective effects against myocardial infarction(MI)in the early stage than EVs isolated from normoxic(NC)-MSCs.However,the cardioprotective mechanisms of HP-EVs are not fully understood.AIM To explore the cardioprotective mechanism of EVs derived from HP MSCs.METHODS We evaluated the cardioprotective effects of HP-EVs or NC-EVs from mouse adipose-derived MSCs(ADSCs)following hypoxia in vitro or MI in vivo,in order to improve the survival of cardiomyocytes(CMs)and restore cardiac function.The degree of CM apoptosis in each group was assessed by the terminal deoxynucleotidyl transferase dUTP nick end-labeling and Annexin V/PI assays.MicroRNA(miRNA)sequencing was used to investigate the functional RNA diversity between HP-EVs and NC-EVs from mouse ADSCs.The molecular mechanism of EVs in mediating thioredoxin-interacting protein(TXNIP)was verified by the dual-luciferase reporter assay.Co-immunoprecipitation,western blotting,and immunofluorescence were performed to determine if TXNIP is involved in hypoxia-inducible factor-1 alpha(HIF-1α)ubiquitination and degradation via the chromosomal region maintenance-1(CRM-1)-dependent nuclear transport pathway.RESULTS HP-EVs derived from MSCs reduced both infarct size(necrosis area)and apoptotic degree to a greater extent than NC-EVs from CMs subjected to hypoxia in vitro and mice with MI in vivo.Sequencing of EV-associated miRNAs showed the upregulation of 10 miRNAs predicted to bind TXNIP,an oxidative stress-associated protein.We showed miRNA224-5p,the most upregulated miRNA in HP-EVs,directly combined the 3’untranslated region of TXNIP and demonstrated its critical protective role against hypoxia-mediated CM injury.Our results demonstrated that MI triggered TXNIP-mediated HIF-1αubiquitination and degradation in the CRM-1-mediated nuclear transport pathway in CMs,which led to aggravated injury and hypoxia tolerance in CMs in the early stage of MI.CONCLUSION The anti-apoptotic effects of HP-EVs in alleviating MI and the hypoxic conditions of CMs until reperfusion therapy may partly result from EV miR-224-5p targeting TXNIP.展开更多
This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phn...This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phnom Penh Hospital, Phnom Penh, Cambodia after electrical accident, in cardiopulmonary arrest status with no pulse, no breath. The cardiopulmonary resuscitation was done immediately as intra-tracheal ventilation, fluid replacement with NaCl 0.9%, urine alkalinization therapy with Natribicarbonate 4.2%, sympathomimetic agents as adrenaline and nor-adrenaline, and IV nutrition with glucose 30%. Cardiac biomarkers were repeated many times over 12 hours after admission. Troponin I increased 1000 times higher from 0.02 ng/mL on admission to 20.1 ng/mL within 12 hours. CK-MB increased from 55.4 to 227 U/L after 2 hours (normal value: <16 U/L). CPK (normal value: 90 - 140 U/L) changed quickly from 99 U/L on admission to a very high level as 9681 U/L after 12 hrs. The CK-MB/CPK index (defined as CK-MB × 100/CPK, unit as %) changed from 55.9% to 2.7%, respectively by time. In conclusion, the very quick dynamic change of cardiac biomarkers suggested the presence of serious myocardial injury among multiple organs injured in electric shock.展开更多
Objective:To explore the effects of mild hypothermia combined EPO therapy on cerebral injury, myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy. Methods: A total of 72 children with HI...Objective:To explore the effects of mild hypothermia combined EPO therapy on cerebral injury, myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy. Methods: A total of 72 children with HIE who were diagnosed and treated in the hospital between December 2015 and June 2017 were chosen as the study subjects and divided into control group (n=36) and EPO group (n=36) by random number table method. Control group received mild hypothermia therapy on the basis of conventional therapy, and EPO group received EPO therapy on the basis of the therapy for control group. The differences in serum levels of cerebral injury indexes, myocardial injury indexes and oxidative stress indexes were compared between the two groups before and after treatment.Results: The differences in serum levels of cerebral injury indexes, myocardial injury indexes and oxidative stress indexes were not statistically significant between the two groups before treatment. After the treatment ended, serum cerebral injury indexes VILIP-1, NPY and NSE levels of EPO group were lower than those of control group whereas IGF-1 level was higher than that of control group;myocardial injury indexes CT-1, Myo and cTnⅠ levels were lower than those of control group;oxidative stress indexes GSH-Px and SOD levels were higher than those of control group whereas AOPP and ROS levels were lower than those of control group.Conclusion: Mild hypothermia combined with EPO therapy can improve the cerebral injury, myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy.展开更多
文摘Objective:To explore the therapeutic efficacy of L-carvone from Mentha spicata L.leaf extracts against isoproterenol-induced cardiac hypertrophy in rats.Methods:Isoproterenol(5 mg/kg)was injected intraperitoneally into rats for one month to induce cardiac hypertrophy.L-carvone(25 and 100 mg/kg)was administered orally to treat cardiac hypertrophy.The cardioprotective activity of L-carvone was evaluated by electrocardiogram,histopathological analysis as well as determination of biochemical parameters and enzymatic markers.Results:L-carvone from Mentha spicata L.at 25 and 100 mg/kg ameliorated isoproterenol-induced cardiac hypertrophy,as evidenced by reduced QRS interval on electrocardiogram,and decreased heart weight and heart index.In addition,both doses of L-carvone markedly lowered the levels of glucose,total protein,low-density lipoprotein cholesterol,aspartate transaminase,alanine transaminase,lactate dehydrogenase,creatine kinase MB,troponin-Ⅰ,N-terminal pro-B type natriuretic peptide and triglycerides while increasing high-density lipoprotein cholesterol and lipase level(P<0.05).Moreover,L-carvone alleviated contraction band necrosis,and reorganized the myofibrils with normal striations and myocytes as well as normal nuclei in cardiac histoarchitecture of rats with isoproterenol-induced cardiac hypertrophy.Conclusions:L-carvone from Mentha spicata L.leaf extract can restore abnormal cardiac function and may be further explored as a therapeutic agent against the deleterious effects of cardiac hypertrophy after further evaluation.
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
基金Supported by Science and Technology Foundation of Tianjin Health Bureau,No.ZC20052Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-045A+2 种基金Tianjin Anesthesia Research Development Program of Bethune Charitable Foundation,No.TJMZ2022-005Natural Science Foundation of Tianjin,No.21JCQNJC01730Young Talent Program of Tianjin First Central Hospital.
文摘BACKGROUND Cold ischemia-reperfusion of the liver is an inevitable occurrence in liver trans-plantation that may also cause damage to the heart.Perioperative myocardial injury during liver transplantation can increase the incidence of post-operative mortality,but there is little research on the incidence of myocardial injury in children who undergo living donor liver transplantation(LDLT).Therefore,this study mainly explores the independent risk factors for myocardial injury in children who undergo LDLT.factors for intraoperative myocardial injury.METHODS We retrospectively analyzed the inpatient records of pediatric patients who underwent LDLT in Tianjin First Central Hospital from January 1,2020,to January 31,2022.Recipient-related data and donor-related data were collected.The patients were divided into a myocardial injury group and a nonmyocardial injury group according to the value of the serum cardiac troponin I at the end of surgery for analysis.Univariate analysis and multivariate logistic regression were used to evaluate the risk factors for myocardial injury during LDLT in pediatric patients.RESULTS A total of 302 patients met the inclusion criteria.The myocardial injury group had 142 individuals(47%),and the nonmyocardial injury group included 160 patients(53%).Age,height,and weight were significantly lower in the myocardial injury group(P<0.001).The pediatric end-stage liver disease(PELD)score,total bilirubin,and interna-tional standardized ratio were significantly higher in the myocardial injury group(P<0.001).The mean arterial pressure,lactate,hemoglobin before reperfusion,duration of the anhepatic phase,cold ischemic time,incidence of postreperfusion syndrome(PRS),and fresh frozen plasma transfusion were significantly different between the two groups(P<0.05).The postoperative intensive care unit stay and peak total bilirubin values in the first 5 d after LDLT were significantly higher in the myocardial injury group(P<0.05).The pediatric patients with biliary atresia in the nonmyocardial injury group who underwent LDLT had a considerably higher one-year survival rate than those in the myocardial injury group(P=0.015).Multivariate logistic regression revealed the following independent risk factors for myocardial injury:a high PELD score[odds ratio(OR)=1.065,95%confidence interval(CI):1.013-1.121;P=0.014],a long duration of the anhepatic phase(OR=1.021,95%CI:1.003-1.040;P=0.025),and the occurrence of intraoperative PRS(OR=1.966,95%CI:1.111-3.480;P=0.020).CONCLUSION A high PELD score,a long anhepatic phase duration,and the occurrence of intraoperative PRS were independent risk factors for myocardial injury during LDLT in pediatric patients with biliary atresia.
基金Scientific Research Foundation of Sichuan Science and Technology Department(Sichuan Science and Technology[2012]No.62012JY0068)。
文摘Asprosin is a newly discovered protein hormone that promotes appetite,regulates glucose homeostasis,increases insulin resistance and has potential myocardial protection.Myocardium is vulnerable to oxidative stress injury caused by factors such as high glucose,anti-tumor drugs,ischemia reperfusion and so on,and currently there is a lack of effective preventive measures.It has been reported in the literature that Asprosin has a unique protective effect on myocardium,but the protective mechanism of Asprosin is not clear.In this paper,the general situation and functions of Asprosin,as well as the protective mechanism of Asprosin on myocardium were reviewed,in order to provide reference for the application of Asprosin in the treatment of cardio-related diseases.
基金Supported by National Natural Science Foundation of China,No.81772001National Clinical Key Subject of China,No.41792113Technology Plan Program of Sichuan Provence,No.2015SZ0229,No.2016HH0067,No.2018JY0041and No.2019YJ0277
文摘BACKGROUND Abdominal paracentesis drainage(APD)is a safe and effective strategy for severe acute pancreatitis(SAP)patients.However,the effects of APD treatment on SAPassociated cardiac injury remain unknown.AIM To investigate the protective effects of APD on SAP-associated cardiac injury and the underlying mechanisms.METHODS SAP was induced by 5%sodium taurocholate retrograde injection in Sprague-Dawley rats.APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after SAP induction.Morphological staining,serum amylase and inflammatory mediators,serum and ascites high mobility group box(HMGB)1,cardiac-related enzymes indexes and cardiac function,oxidative stress markers and apoptosis and associated proteins were assessed in the myocardium in SAP rats.Nicotinamide adenine dinucleotide phosphate oxidase activity and mRNA and protein expression were also examined.RESULTS APD treatment improved cardiac morphological changes,inhibited cardiac dysfunction,decreased cardiac enzymes and reduced cardiomyocyte apoptosis,proapoptotic Bax and cleaved caspase-3 protein levels.APD significantly decreased serum levels of HMGB1,inhibited nicotinamide adenine dinucleotide phosphate oxidase expression and ultimately alleviated cardiac oxidative injury.Furthermore,the activation of cardiac nicotinamide adenine dinucleotide phosphate oxidase by pancreatitis-associated ascitic fluid intraperitoneal injection was effectively inhibited by adding anti-HMGB1 neutralizing antibody in rats with mild acute pancreatitis.CONCLUSION APD treatment could exert cardioprotective effects on SAP-associated cardiac injury through suppressing HMGB1-mediated oxidative stress,which may be a novel mechanism behind the effectiveness of APD on SAP.
基金supported by a grant from the National Natural Science Foundation of China(81070122)
文摘BACKGROUND:Sepsis-induced myocardial injury is one of the major predictors of morbidity and mortality of sepsis.The cytoprotective function of erythropoietin(EPO) has been discovered and extensively studied.However,the cardioprotective effects of EPO on sepsis-induced myocardial injury in the rat sepsis model has not been reported.METHODS:The rat models of sepsis were produced by cecal ligation and perforation(CLP)surgery.Rats were randomly(random number) assigned to one of three groups(n=8 for each group):sham group,CLP group and EPO group(1000 lU/kg erythropoietin).Arterial blood was withdrawn at3,6,12,and 24 hours after CLP.cTnl,BNP,CK-MB,LDH,AST,TNF-a,IL-6,IL-10,and CRP were tested by the ELISA assay.Changes of hemodynamic parameters were recorded at 3,6,12,24 hours after the surgery.Histological diagnosis was made by hematoxylin and eosin.Flow cytometry was performed to examine cell apoptosis,myocardium mitochondrial inner membrane potential,and NF-κB(p65).Survival rate at 7 days after CLP was recorded.RESULTS:In the CLP group,myocardial enzyme index and inflammatory index increased at3,6,12 and 24 hours after CLP compared with the sham group,and EPO significantly blocked the increase.Compared with the CLP group,EPO significantly improved LVSP,LV +dpldt_(max) LV-dp/dt_(min),and decreased LVEDP at different time.EPO blocked the reduction of mitochondrial transmembrane potential,suppressed the cardiomyocyte apoptosis,inhibited the activation of NF-κB,and reduced the production of proinflmmatory cytokines.No difference in the survival rate at 7 days was observed between the CLP group and the EPO group.CONCLUSION:Exogenous EPO has cardioprotective effects on sepsis-induced myocardial injury.
基金The report was supported by grants from the Beijing Nova Program(No.Z121107002512053)the Beijing Health System High Level Health Technology Talent Cultivation Plan(No.2013-3-013)+3 种基金Beijing Outstanding Talent Training Program(No.2014000021223ZK32)the National Natural Science Foundation of China(No.81100143)the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX 201303)and the National Key Clinical Speciality Construction Project.
文摘Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.
文摘Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’outcomes.Myocardial injury(MI)occurs in the context of coronavirus infectious disease 2019(COVID-19)and is associated with a higher risk of severe clinical outcome and mortality.COVID-19-related MI can have various clinical manifestations,of which the main ones are myocarditis,stress cardiomyopathy,acute coronary syndrome,and pulmonary embolism.The exact mechanisms of how MI occurs in these patients are not yet fully known.Direct injury,through direct viral myocardial invasion,and indirect injury,through interaction with angiotensin I converting enzyme 2,increased inflammation,and thrombocyte and endothelial dysfunction,could be involved in acute MI in patients with COVID-19.A better understanding of these multiple potential mechanisms may help to develop new targeted therapeutic strategies.The purpose of this review is to provide the current understanding of the potential mechanisms involved in MI induced by COVID-19 and to discuss the current progress in the therapeutic strategies.
文摘Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation group(S group,n=6),ventricular fibrillation control group(VF-C group,n=8)and 654-1 intervention group(VF-I group,n=8).Hemodynamics was recorded at baseline,at recovery of spontaneous circulation(ROSC),and 1 h,2 h,4h and 6 h thereafter.Sidestream dark field(SDF)technology was used to evaluate and monitor the microcirculation flow index,total vessel density,perfusion vessel ratio,De-Backer score,and perfusion vessel density in animal viscera at various time points.Results After administration of 654-1 at 1.5 h post-ROSC,the hemodynamics in the VF-I group,as compared with the VF-C group,was significantly improved.The visceral microcirculation detected by SDF was also significantly improved in the VF-I group.As observed through electron microscopy,significantly less myocardial tissue injury was present in the VF-I group than the VF-C group.Conclusion Administration of 654-1 inhibited excessive inflammatory by improving the state of visceral microcirculation.
基金This research was supported by the National Natural Science Foundation of China(No.81402637).
文摘Objective:Keshan disease(KD)is a mitochondrial cardiomyopathy.The present study explored the roles of peroxisome proliferator-activated receptor(PPAR)-y coactivator-la(PGC-la),the key regulator of mitochondrial structure and function,and its coactivators in myocardial injury in chronic KD.Furthermore,the usefulness of these molecules in the diagnosis of chronic KD was assessed.
基金Studio Construction Project of TCM School Heritage of National Administration of Traditional Chinese Medicine(No.LPGZS2012-14)。
文摘Objective:To observe the effect of resveratrol on the injury of diabetic cardiomyocytes and its effect on HSF1 mediated iron death.Methods:the diabetic cardiomyopathy model was established by high glucose induced H9c2,and H9c2 was exposed to normal glucose concentration as a control.Then the intervention was performed with the corresponding drugs.The cell proliferation level was detected by CCK8 method,the concentrations of LDH,SOD,MDA and iron ions were detected by kit method,and the expression levels of HSF1,apoptotic proteins(Bax and Bcl-2)and iron death marker proteins(ACSL4,GPX4 and SLC7A11)were detected by Western blot;Results:compared with the blank group,the cell activity,SOD activity,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein in the model group decreased significantly,and the LDH activity,MDA content,Bax and ACSL4 protein expression,Bax/Bcl-2 ratio and Fe^(2+)content increased significantly(P<0.01).Compared with the model group,the activity of H9c2 cells,the activity of SOD,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein increased significantly,and the activity of LDH,the content of MDA,the expression of Bax and ACSL4 protein,the ratio of Bax/Bcl-2 and the content of Fe^(2+)decreased significantly in the resveratrol group(P<0.01).After the intervention,the activity of H9c2 cells,the activity of SOD,the expression of HSF1,Bcl-2,GPX4 and SLC7A11 protein decreased significantly,and the activity of LDH,the content of MDA,the expression of Bax and ACSL4 protein,the ratio of Bax/Bcl-2 and the content of Fe^(2+)increased significantly in si-hsf1 group(P<0.01);Conclusion:resveratrol can inhibit cell iron death and improve high glucose induced cardiomyocyte injury by up regulating the expression of HSF1.
文摘Objectives To investigate the effect of co-exposure of myocardial ischemia and cold stress on myocardial injury in rats and the relative mechanism.Methods Myocardial ischemia model was established by ligation of left coronary artery.SD rats were randomly allocated to 4 groups; sham+normal temperature(S group),sham+cold stress(SC group),myocardial ischemia+ normal temperature(Ⅰgroup), myocardial ischemia+cold stress(IC group).On the condition of 26℃,SC and IC groups were keeped in a 4℃artificial chamber for 8h(8;00-16:00) for 4 consecu- tive days.Car diac function was assessed by echocardiography;pathological change was analyzed by HE staining;myocardial infarct size was determined by TTC staining;Bim,Caspase-3 expression in myocardium was determined by western blotting.Results It was demonstrated that co-exposure of myocardial ischemia and cold stress could significantly make the cardiac muscle in abnormal shape,increase the infarct size and the expression of Bim and Caspase-3.Conclusions Co-exposure of myocardial ischemia and cold stress may aggravate the cardiac injury,pro- apoptosis protein Bim is involved.
基金supported by Chinese Postdoctoral Science Foundation(No.2014N560538)Hainan Province Colleges and Universities Scientific Research Project(No.Hnky2015-34)Project of Natural Science Foundation of Hainan Province(314090)
文摘Objective: To investigate the expression of myocardium connexin 43(Cx43) in late exercise preconditioning(LEP) cardioprotection. Methods: Eight-week-old adult male Sprague Dawley rats were randomly assigned into four groups(n=8). Myocardial injury was judged in accordance with serum levels of c Tn and NT-pro BNP as well as hematoxylin basicfuchsin picric acid staining of myocardium. Cx43 m RNA was detected by in situ hybridization and qualified by real-time fluorescence quantitative PCR. Cx43 protein was localized by immunohistochemistry and its expression level was determined by western blotting. Results: The LEP obviously attenuated the myocardial ischemia/hypoxia injury caused by exhaustive exercise. There was no significant difference of Cx43 m RNA level between the four groups. Cx43 protein level was decreased significantly in group EE(P<0.05). However, LEP produced a significant increase in Cx43 protein level(P<0.05), and the decreased Cx43 protein level in exhaustive exercise was significantly up-regulated by LEP(P<0.05). Conclusions: LEP protects rat heart against exhaustive exercise-induced myocardial injury by up-regulating the expression of myocardial Cx43.
文摘In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO report,693,224 cases of COVID-19 were confirmed globally as of March 30,2020,with more than 33,000 deaths.[2]Because COVID-19 is highly contagious and harmful,it is crucial to determine the predictors of severe infection and death for risk stratification and guiding clinical treatment and intervention.
基金the National Key R&D Program of China,No.2018YFC1311600the Ethics Committee of the Shengjing Hospital of China Medical University Research Ethics Committee(No.2016PS373K).
文摘BACKGROUND Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes.However,the association between depression and myocardial injury on cardiac magnetic resonance(CMR)in patients with ST-segment elevation myocardial infarction(STEMI)has still not been assessed.AIM To assess the association between depression and myocardial injury on CMR in patients with STEMI.METHODS A total of 107 STEMI patients undergoing primary percutaneous coronary intervention(P-PCI)were analyzed in this prospectivecohort study.Each subject completed the Patient Health Questionnaire-9(PHQ-9)to assess the presence and severity of depressive symptoms.CMR was performed at a median of 3 d after PPCI for quantifying post-MI myocardial injury.Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.RESULTS In this study,19 patients(17.8%)were diagnosed with major depression identified by the PHQ-9≥10.PHQ-9 was analyzed both as a continuous variable and dichotomous variable.After multivariable adjustment,the proportion of patients with large infarction size was significantly higher in the major depression group(PHQ-9≥10)(OR:4.840,95%CI:1.122–20.868,P=0.034).When the PHQ-9 was evaluated as a continuous variable,after multivariable adjustment,an increased PHQ-9 score was associated with an increased risk of large infarction size(OR:1.226,95%CI:1.073–1.401,P=0.003).CONCLUSION In patients with STEMI undergoing PCI,depression was independently associated with a large infarction size.
基金Supported by The Key Medical Disciplines of Jiaxing-Critical Care Med(Supporting Subject),No.2019-zc-12
文摘BACKGROUND Acute chest pain(ACP)is very common among patients presenting to emergency departments.Nevertheless,ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man suffering from chest pain(increased pain for the last 9 h)was admitted to our hospital on October 25,2015.After undergoing physical examination and laboratory blood testing,he was diagnosed with acute anterior myocardial infarction.Consequently,the patient underwent emergency percutaneous coronary angiography;however,no myocardial infarction signs were observed.Later on,the patient experienced respiration failure and therefore was transferred to intensive care unit.Cardiac ultrasound showed pericardial effusion,which was considered as the cause of shock.He then underwent pericardium puncture drainage and the circulation temporarily improved.Nevertheless,persistent pericardial bleeding,unclear bleeding causes,and clot formation induced poor drainage led to worsening of cardiac tamponade symptoms.Consequently,the patient underwent emergency exploratory thoracotomy,which revealed a fish bone causing pericardial bleeding.The bone was removed,and the damaged blood vessels were mended.Eventually,the patient was discharged in good clinical condition.CONCLUSION For patients with chest pain,it is necessary to consider the possibility of foreign body in the esophagus or even in the heart.Careful history taking and the corresponding inspection can help to avoid unnecessary damage and safeguard patients from unnecessary pain.
基金supported by the Health Bureau of Jiangsu Province(No.K201104)the Scientific Support Plan of Jiangsu Province(No.BE2011803)+2 种基金the National Natural Science Foundation of China(No.81170102/H0203)the Priority Academic Program Development of Jiangsu Higher Education Institutions(No.BL2012011)the Fourth Period Project"333"of Jiangsu Province(No.BRA2012207),China
文摘Cardiac troponin-I(cTnI) and-T(cTnT) are sensitive and specific markers of myocardial injury.However,the role of increased cTnI and cTnT in percutaneous coronary intervention(PCI)-related myocardial injury remains controversial.In this prospective,single-center and double-blind study,we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT(cTns) in PCI-related myocardial injury in a Chinese population.A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited.The levels of cTnI and cTnT were examined before and after PCI.All patients were followed up for26±9 months to observe the incidence of major adverse cardiac events(MACEs).Our results showed that postPCI cTnI and/or cTnT levels were increased to more than the 99^(th) percentile upper reference limit(URL) in 133(13.2%) patients,among which 22(2.2%) were more than 5×99^(th) percentile URL.By univariate analysis,an elevation in cTns after PCI was not an independent predictor of increased MACEs,HR 1.35(P = 0.33,95%CI:0.74-2.46).In conclusion,our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.
基金Supported by National Natural Science Foundation of China,No. 81870264 and No. 81470546the Shanghai Committee of Science and Technology,No. 18411950500+1 种基金the Major Disease Joint Project of Shanghai Health System,No. 2014ZYJB0501Talent Cultivation Project of The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No. JC202005
文摘BACKGROUND Extracellular vesicles(EVs)derived from hypoxia-preconditioned(HP)mesenchymal stem cells(MSCs)have better cardioprotective effects against myocardial infarction(MI)in the early stage than EVs isolated from normoxic(NC)-MSCs.However,the cardioprotective mechanisms of HP-EVs are not fully understood.AIM To explore the cardioprotective mechanism of EVs derived from HP MSCs.METHODS We evaluated the cardioprotective effects of HP-EVs or NC-EVs from mouse adipose-derived MSCs(ADSCs)following hypoxia in vitro or MI in vivo,in order to improve the survival of cardiomyocytes(CMs)and restore cardiac function.The degree of CM apoptosis in each group was assessed by the terminal deoxynucleotidyl transferase dUTP nick end-labeling and Annexin V/PI assays.MicroRNA(miRNA)sequencing was used to investigate the functional RNA diversity between HP-EVs and NC-EVs from mouse ADSCs.The molecular mechanism of EVs in mediating thioredoxin-interacting protein(TXNIP)was verified by the dual-luciferase reporter assay.Co-immunoprecipitation,western blotting,and immunofluorescence were performed to determine if TXNIP is involved in hypoxia-inducible factor-1 alpha(HIF-1α)ubiquitination and degradation via the chromosomal region maintenance-1(CRM-1)-dependent nuclear transport pathway.RESULTS HP-EVs derived from MSCs reduced both infarct size(necrosis area)and apoptotic degree to a greater extent than NC-EVs from CMs subjected to hypoxia in vitro and mice with MI in vivo.Sequencing of EV-associated miRNAs showed the upregulation of 10 miRNAs predicted to bind TXNIP,an oxidative stress-associated protein.We showed miRNA224-5p,the most upregulated miRNA in HP-EVs,directly combined the 3’untranslated region of TXNIP and demonstrated its critical protective role against hypoxia-mediated CM injury.Our results demonstrated that MI triggered TXNIP-mediated HIF-1αubiquitination and degradation in the CRM-1-mediated nuclear transport pathway in CMs,which led to aggravated injury and hypoxia tolerance in CMs in the early stage of MI.CONCLUSION The anti-apoptotic effects of HP-EVs in alleviating MI and the hypoxic conditions of CMs until reperfusion therapy may partly result from EV miR-224-5p targeting TXNIP.
文摘This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phnom Penh Hospital, Phnom Penh, Cambodia after electrical accident, in cardiopulmonary arrest status with no pulse, no breath. The cardiopulmonary resuscitation was done immediately as intra-tracheal ventilation, fluid replacement with NaCl 0.9%, urine alkalinization therapy with Natribicarbonate 4.2%, sympathomimetic agents as adrenaline and nor-adrenaline, and IV nutrition with glucose 30%. Cardiac biomarkers were repeated many times over 12 hours after admission. Troponin I increased 1000 times higher from 0.02 ng/mL on admission to 20.1 ng/mL within 12 hours. CK-MB increased from 55.4 to 227 U/L after 2 hours (normal value: <16 U/L). CPK (normal value: 90 - 140 U/L) changed quickly from 99 U/L on admission to a very high level as 9681 U/L after 12 hrs. The CK-MB/CPK index (defined as CK-MB × 100/CPK, unit as %) changed from 55.9% to 2.7%, respectively by time. In conclusion, the very quick dynamic change of cardiac biomarkers suggested the presence of serious myocardial injury among multiple organs injured in electric shock.
文摘Objective:To explore the effects of mild hypothermia combined EPO therapy on cerebral injury, myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy. Methods: A total of 72 children with HIE who were diagnosed and treated in the hospital between December 2015 and June 2017 were chosen as the study subjects and divided into control group (n=36) and EPO group (n=36) by random number table method. Control group received mild hypothermia therapy on the basis of conventional therapy, and EPO group received EPO therapy on the basis of the therapy for control group. The differences in serum levels of cerebral injury indexes, myocardial injury indexes and oxidative stress indexes were compared between the two groups before and after treatment.Results: The differences in serum levels of cerebral injury indexes, myocardial injury indexes and oxidative stress indexes were not statistically significant between the two groups before treatment. After the treatment ended, serum cerebral injury indexes VILIP-1, NPY and NSE levels of EPO group were lower than those of control group whereas IGF-1 level was higher than that of control group;myocardial injury indexes CT-1, Myo and cTnⅠ levels were lower than those of control group;oxidative stress indexes GSH-Px and SOD levels were higher than those of control group whereas AOPP and ROS levels were lower than those of control group.Conclusion: Mild hypothermia combined with EPO therapy can improve the cerebral injury, myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy.
