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Zhang J, Chen X, Lv S, Hao Q. Dapagliflozin inhibits ferroptosis to improve chronic heart failure by regulating Nrf2/HO-1/GPX4 signaling pathway. PLoS One 2025; 20:e0317295. [PMID: 39874368 PMCID: PMC11774390 DOI: 10.1371/journal.pone.0317295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 12/24/2024] [Indexed: 01/30/2025] Open
Abstract
OBJECTIVE To study the effect of Dapagliflozin on ferroptosis in rabbits with chronic heart failure and to reveal its possible mechanism. METHODS Nine healthy adult male New Zealand white rabbits were randomly divided into Sham group (only thorax opening was performed in Sham group, no ascending aorta circumferential ligation was performed), Heart failure group (HF group, ascending aorta circumferential ligation was performed in HF group to establish the animal model of heart failure), and Dapagliflozin group (DAPA group, after the rabbit chronic heart failure model was successfully made in DAPA group). Dapagliflozin was given by force-feeding method. Echocardiography was used to assess cardiac function, HE staining to evaluate pathological changes in the heart, Prussia blue staining to observe iron ions in myocardial tissue, and enzyme-linked immunosorbent assay (ELISA) to determine serum levels of the inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) at the end of week 12 and/or the end of week 16. The oxidative stress related indexes of malondialdehyde (MDA), superoxide dismutase (SOD) and superoxide dismutase (GSH-Px) in serum were quantitatively analyzed by colorimetry. Protein expression levels of nuclear factor E2-related factor 2(Nrf2), heme oxygenase-1(HO-1), glutathione peroxidase 4(Gpx4) were detected by Western blot. RESULTS In animals with chronic heart failure, Dapagliflozin improved cardiomyocyte hypertrophy, degeneration and necrosis. Dapagliflozin increased serum GSH-Px and SOD levels and decreased IL-1β, IL-6, TNF-α and MDA levels (P < 0.05) in a rabbit model of heart failure. Dapagliflozin also decreased cardiac iron ion levels and increased Nrf2, HO-1 and GPX4 protein expression. CONCLUSION Dapagliflozin can improve heart failure by inhibiting oxidative stress and ferroptosis, and its mechanism may be related to the regulation of Nrf2/HO-1/GPX4 signaling pathway.
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Affiliation(s)
- Jing Zhang
- Hebei North University, Zhangjiakou City, Hebei Province, P.R. China
- Hebei General Hospital, Shijiazhuang City, Hebei Province, P.R. China
| | - Xuefeng Chen
- Hebei General Hospital, Shijiazhuang City, Hebei Province, P.R. China
| | - Shilin Lv
- Hebei Medical University, Shijiazhuang City, Hebei Province, P.R. China
| | - Qingqing Hao
- Hebei General Hospital, Shijiazhuang City, Hebei Province, P.R. China
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Huang Z, Chair SY. Development and pilot testing of a nurse-led common-sense model of self-regulation-based heart failure self-care program. BMC Nurs 2025; 24:85. [PMID: 39849430 PMCID: PMC11758749 DOI: 10.1186/s12912-025-02722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/13/2025] [Indexed: 01/25/2025] Open
Abstract
BACKGROUND Self-care practices among people with heart failure (HF) remain suboptimal. Nurse-led self-care interventions hold promise in managing this condition. The Common-Sense Model (CSM) of Self-Regulation is a widely adopted theoretical framework that promotes behavior change and improves disease prognosis among patients. Therefore, this study aimed to describe the development and pilot testing of a nurse-led CSM of Self-Regulation-based self-care intervention among people with HF. METHODS Intervention development was informed by a comprehensive review of the relevant literature, the CSM of self-regulation, international and national guidelines, and findings from our previous systematic reviews. The pilot study utilized a single-blinded, two-arm, parallel group, randomized controlled trial (RCT) design, adhering to the CONSORT Statement. Eligible participants were randomly assigned at a 1:1 ratio to either the intervention group or the control group. Data were collected at baseline and immediately after the intervention, with a focus on evaluating feasibility, acceptability, and potential effects. RESULTS We developed and validated a nurse-led, theory-driven, evidence-based, and need-oriented HF self-care program. A total of 26 participants were enrolled in the pilot study, achieving an eligibility of 79.4%, a recruitment rate of 96.3%, and a retention rate of 92.3%. Most participants (83.3%) recognized the benefits of the intervention. The intervention significantly improved illness perceptions, self-care self-efficacy, and self-care behaviors among people with HF. CONCLUSION The nurse-led CSM of Self-Regulation-based self-care intervention is feasible, acceptable, and potentially beneficial for people with HF. A full-scale mixed-method RCT is recommended to further examine the intervention's effectiveness. TRIAL REGISTRATION Chinese Clinical Trial Registry (No., ChiCTR2300068156; February 9, 2023).
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Affiliation(s)
- Zehao Huang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Horse Material Water, Shatin, New Territories, Hong Kong SAR, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Horse Material Water, Shatin, New Territories, Hong Kong SAR, China.
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Chen C, Sun X, Zhang Y, Xie H, Kou J, Zhang H. Fear of progression and quality of life in patients with heart failure: a cross-sectional study on the multiple mediation of psychological distress and resilience. BMC Nurs 2025; 24:60. [PMID: 39825270 PMCID: PMC11742502 DOI: 10.1186/s12912-025-02688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 01/03/2025] [Indexed: 01/20/2025] Open
Abstract
BACKGROUND Existing research indicates that fear of progression influences the quality of life of patients with various diseases. However, the influence of fear of progression on the quality of life of patients with heart failure and its underlying mechanisms remain unclear. This study aimed to identify the link between fear of progression and quality of life in patients with heart failure and explore the multiple mediating roles of psychological distress and resilience in this association. METHODS This multicenter, cross-sectional study was conducted between March and December 2023 across four tertiary hospitals in China. Data on fear of progression, psychological distress (anxiety and depression), resilience, and quality of life were collected. The PROCESS macro in SPSS was used to analyze the multiple mediation model. RESULTS The study involved 277 patients. The total indirect effect of fear of progression on quality of life was significant. Fear of progression influenced physical quality of life through two pathways: (i) resilience independently, and (ii) psychological distress-depression and resilience serially. Additionally, fear of progression influenced mental quality of life through three pathways: (i) psychological distress (anxiety and depression) independently, (ii) resilience independently, and (iii) psychological distress (anxiety and depression) and resilience serially. However, psychological distress-anxiety or resilience had no mediating effect on the relationship between fear of progression and physical quality of life in patients with heart failure. CONCLUSIONS Fear of progression had a negative association with quality of life in patients with heart failure. In addition, the relationship between fear of progression and quality of life was mediated by psychological distress and resilience. Interventions targeting the reduction of psychological distress and enhancement of resilience may mitigate the impact of fear of progression on quality of life in patients with heart failure.
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Affiliation(s)
- Cancan Chen
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Xiaofei Sun
- School of Humanities and Design, Zhengzhou Vocational University of Information and Technology, Zhengzhou, Henan, China
| | - Yanting Zhang
- School of Nursing, Zhengzhou Railway Vocational and Technical College, Zhengzhou, Henan, China
| | - Henan Xie
- Department of Geriatrics, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Jie Kou
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No7, Weiwu Road, Jinshui District, Zhengzhou, 450000, Henan, China.
| | - Hongmei Zhang
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No7, Weiwu Road, Jinshui District, Zhengzhou, 450000, Henan, China.
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Chen Z, Shi J, Huang X, Yang Y, Cheng Y, Qu Y, Gu N. Exosomal miRNAs in patients with chronic heart failure and hyperuricemia and the underlying mechanisms. Gene 2025; 933:148920. [PMID: 39241970 DOI: 10.1016/j.gene.2024.148920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/20/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024]
Abstract
Chronic heart failure (CHF) combined with hyperuricemia (HUA) is a comorbidity that is hard to diagnose by a single biomarker. Exosomal miRNAs are differentially expressed in cardiovascular diseases and are closely associated with regulating most biological functions. This study aimed to provide evidence for miRNA as a new molecular marker for precise diagnosis of the comorbidity of CHF with HUA and further analyze the potential targets of differentially expressed miRNA. This controlled study included 30 CHF patients combined with HUA (Group T) and 30 healthy volunteers (Group C). 6 peripheral blood samples from Group T and Group C were analyzed for exosomal miRNAs by high-throughput sequencing and then validated in the remaining 24 peripheral blood samples from Group T and Group C by applying real-time PCR (RT-PCR). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using R software to predict the differential miRNAs' action targets. 42 differentially expressed miRNAs were detected (18 upregulated and 24 downregulated), in which miR-27a-5p was significantly upregulated (P<0.01), and miR-139-3p was significantly downregulated (P<0.01) in Group T. The combination of miR-27a-5p and miR-139-3p predicted the development of CHF combined with HUA with a maximum area under the curve (AUC) of 0.899 (95 % CI: 0.812-0.987, SEN=79.2 %, SPE=91.7 %, J value = 0.709). GO and KEGG enrichment analysis revealed that the differentially expressed miRNAs had a role in activating the AMPK-mTOR signaling pathway to activate the autophagic response. Collectively, our findings suggest that upregulated exosomal miR-27a-5p combined with downregulated exosomal miR-139-3p can be used as a novel molecular marker for precise diagnosis of CHF combined with HUA and enhanced autophagy by AMPK-mTOR signaling pathway may be one pathogenesis of the differentially expressed miRNAs.
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Affiliation(s)
- Zhiliang Chen
- Department of Cardiology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China
| | - Jun Shi
- School of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, PR China
| | - Xia Huang
- Department of Cardiology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China
| | - Yonggang Yang
- Biochemical Labororatory, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China
| | - Yan Cheng
- Pharmaceutical Department, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China
| | - Yuan Qu
- Emergency Department, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China
| | - Ning Gu
- Department of Cardiology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, PR China.
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Yang M, Zhang X, Fang W, Zhang Y, Fan X. Trajectories and Predictors of Frailty in Patients With Heart Failure: A Longitudinal Study. J Clin Nurs 2025. [PMID: 39809597 DOI: 10.1111/jocn.17647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 12/20/2024] [Accepted: 01/02/2025] [Indexed: 01/16/2025]
Abstract
AIM This study aimed to identify the heterogeneous trajectories of frailty and determine the predictors of distinct trajectories in patients with heart failure. DESIGN A longitudinal study. METHODS A total of 253 patients with heart failure were recruited at the cardiology department of a tertiary hospital between February and December 2023. Frailty was assessed at baseline, 1 and 4 months after discharge. Patients' sociodemographic characteristics, physical symptoms, nutritional status, psychological distress, illness perception and social networks were obtained at baseline using a structured questionnaire. Group-based trajectory modelling was performed to identify the heterogeneity of the trajectories of frailty. Multiple logistic regression and decision tree models were used to explore the predictors of heterogeneous trajectories of frailty. RESULTS Three distinct trajectories of frailty were identified in patients with heart failure: low frailty with high-degree improvement group (46.2%), moderate frailty with high-degree improvement group (41.1%) and high frailty with low-degree improvement group (12.6%). Multiple logistic regression analysis showed that physical symptoms, nutritional status, illness perception and employment status were entered as independent predictors of heterogeneous trajectories of frailty. The decision tree model demonstrated that physical symptoms were the primary predictors, followed by nutritional status, illness perception and psychological distress. CONCLUSIONS Three distinct categories of frailty trajectories were identified in patients with heart failure. Physical symptoms, nutritional status, psychological distress, illness perception and employment status were independent predictors of heterogeneous trajectories of frailty, with physical symptoms being the most important predictor. IMPLICATION TO CLINICAL PRACTICE Dynamic frailty assessment is recommended. Interventions aimed at alleviating physical symptoms, psychological distress and negative illness perception, and improving nutritional status may be conducive to delaying or reversing frailty in patients with heart failure, particularly in unemployed individuals. REPORTING METHOD The reporting followed the STROBE guideline. PATIENT OR PUBLIC CONTRIBUTIONS No patient or public contribution.
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Affiliation(s)
- Mei Yang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiuting Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Wenjie Fang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Lv S, He ZP, Liu GM, Hu SS. Numerical simulation on the effect of impeller radial gap on hemodynamics and hemocompatibility of a centrifugal blood pump. Comput Methods Biomech Biomed Engin 2025:1-12. [PMID: 39797558 DOI: 10.1080/10255842.2024.2448299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 11/19/2024] [Accepted: 12/17/2024] [Indexed: 01/13/2025]
Abstract
Impeller radial gap is one of important parts within a blood pump, which may affect the hemodynamics and hemocompatibility. In this study, computational fluid dynamics method was performed to evaluate the impact of radial gap sizes. The volume of scalar shear stress decreased with radial gap sizes increasing. On the contrary, the residence time increased with radial gap sizes increasing, especially in the bottom gap. The hemolysis index and platelet activation status at three flow rates decreased with the increase of radial gap sizes. Compared with the hemolysis index when the radial gap size was 0.6 mm, the hemolysis index for the radial gap of 1.0 mm decreased by 27.6%, 25.4% and 21.1% from low flow rate to high flow rate, respectively. Similarly, the platelet activation status for the radial gap of 1.0 mm decreased by 13.0%, 11.5% and 9.1%, respectively. As a novelty, this study revealed that radial gap sizes can significantly influence the blood pump hemocompatibility, especially at low flow rate. In addition, the hemolysis performance can be more affected by radial gaps than that on thrombosis risk.
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Affiliation(s)
- Shen Lv
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
| | - Zhi-Peng He
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
| | - Guang-Mao Liu
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sheng-Shou Hu
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhang C, He J, Xiong D, Mei Y, Zhu Y, Deng P, Duan Y. Effect of miR-1285-3p as a diagnostic biomarker for chronic heart failure on vascular endothelial cells : (Effect of miR-1285-3p as a biomarker for CHF on HUVECs). J Cardiothorac Surg 2025; 20:53. [PMID: 39794868 PMCID: PMC11721593 DOI: 10.1186/s13019-024-03221-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 12/24/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) are closely related to cardiovascular diseases, including chronic heart failure (CHF). Endothelial dysfunction can lead to heart failure. The purpose of this study was to evaluate the clinical significance of miR-1285-3p in CHF patients, with the aim of identifying a novel and effective biomarker for CHF. At the same time, we investigated the effect of miR-1285-3p on vascular endothelial cells. METHODS Total RNA was extracted from plasma samples of 106 CHF patients and 106 healthy individuals. Quantitative Real-time PCR (qRT-PCR) was used to detect the expression of miR-1285-3p. The diagnostic accuracy of miR-1285-3p was tested by receiver operating characteristic (ROC) curve. Evaluated the related risk factors of CHF using logistic analysis. The proliferation and apoptosis of human umbilical vein endothelial cells (HUVECs) were detected by transfecting miR-1285-3p mimic or miR-1285-3p inhibitor in vitro using CCK8 and flow cytometry. Effect of miR-1285-3p on the angiogenesis of HUVECs were detected by in vitro angiogenesis assay. RESULTS miR-1285-3p is upregulated in CHF patients, demonstrating the ability to distinguish CHF patients from healthy individuals, with high sensitivity (83.0%) and specificity (93.4%). In vitro experiments revealed that transfection of miR-1285-3p mimic inhibited endothelial cell proliferation, accelerated apoptosis, and inhibited endothelial cell angiogenesis, which was reversed by transfection with miR-1285-3p inhibitor. CONCLUSION miR-1285-3p is upregulated in CHF and may serve as a new effective biomarker for CHF diagnosis, which can inhibit HUVECs angiogenesis.
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Affiliation(s)
- Chongyang Zhang
- Department of Cardiology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100043, China
| | - Jiazhen He
- Department of Cardiovascular, The Eighth Hospital of Wuhan, Wuhan, 430012, China
| | - Dan Xiong
- Senior Department of Cardiology, The Sixth Medical Center of PLA General Hospital, Beijing, 100084, China
| | - Yi Mei
- Cardiothoracic Vascular Surgery, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, 551705, China
| | - Yao Zhu
- Cardiology Department, Huzhou First People's Hospital, Huzhou, 313000, China
| | - Pan Deng
- Department of Cardiovascular Medicine, Xi 'an People's Hospital (Xi 'an Fourth Hospital), No. 155, Hangtian East Road, Chang 'an District, Xi 'an City, Shaanxi, 710004, China.
| | - Yang Duan
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, No.99 West Huaihai Road, Quanshan District, Xuzhou, 221000, China.
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You N, Liu G, Yu M, Chen W, Fei X, Sun T, Han M, Qin Z, Wei Z, Wang D. Reconceptualizing Endothelial-to-mesenchymal transition in atherosclerosis: Signaling pathways and prospective targeting strategies. J Adv Res 2025:S2090-1232(24)00627-1. [PMID: 39756576 DOI: 10.1016/j.jare.2024.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 12/27/2024] [Accepted: 12/28/2024] [Indexed: 01/07/2025] Open
Abstract
BACKGROUND The modification of endothelial cells (ECs) biological function under pathogenic conditions leads to the expression of mesenchymal stromal cells (MSCs) markers, defined as endothelial-to-mesenchymal transition (EndMT). Invisible in onset and slow in progression, atherosclerosis (AS) is a potential contributor to various atherosclerotic cardiovascular diseases (ASCVD). By triggering AS, EndMT, the "initiator" of AS, induces the progression of ASCVD such as coronary atherosclerotic heart disease (CHD) and ischemic cerebrovascular disease (ICD), with serious clinical complications such as myocardial infarction (MI) and stroke. In-depth research of the pathomechanisms of EndMT and identification of potential targeted therapeutic strategies hold considerable research value for the prevention and treatment of ASCVD-associated with delayed EndMT. Although previous studies have progressively unraveled the complexity of EndMT and its pathogenicity triggered by alterations in vascular microenvironmental factors, systematic descriptions of the most recent pathogenic roles of EndMT in the progression of AS, targeted therapeutic strategies, and their future research directions are scarce. AIM OF REVIEW We aim to provide new researchers with comprehensive knowledge of EndMT in AS. We exhaustively review the latest research advancements in the field and provide a theoretical basis for investigating EndMT, a biological process with sophisticated mechanisms. KEY SCIENTIFIC CONCEPTS OF REVIEW This review summarized that altered hemodynamics with microenvironmental crosstalk consisting of inflammatory responses or glycolysis, oxidative stress, lactate or acetyl-CoA (Ac-CoA), fatty acid oxidation (FAO), intracellular iron overload, and transcription factors, including ELK1 and STAT3, modulate the EndMT and affect AS progression. In addition, we provide new paradigms for the development of promising therapeutic agents against these disease-causing processes and indicate promising directions and challenges that need to be addressed to elucidate the EndMT process.
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Affiliation(s)
- Nanlin You
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
| | - Guohao Liu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Mengchen Yu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Wenbo Chen
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xiaoyao Fei
- Key Laboratory for Experimental Teratology of Ministry of Education, Shandong Key Laboratory of Infection and Immunology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Tao Sun
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Mengtao Han
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zhen Qin
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zhaosheng Wei
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Donghai Wang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute of Brain and Brain-Inspired Science, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, Shandong 253032, China.
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Liu C, Wang Y, Zhang H, Tong S. Dietary sodium intake restriction in patients with heart failure: an overview of systematic reviews. Heart Fail Rev 2025; 30:143-157. [PMID: 39424746 DOI: 10.1007/s10741-024-10452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2024] [Indexed: 10/21/2024]
Abstract
This study aimed to identify, assess, and summarize systematic reviews on dietary sodium intake restrictions for patients with heart failure. Literature searches were conducted on Pubmed, CINAHL, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure, and the Wanfang Database up to January 2024. The methodological quality of the included reviews was assessed using the quality assessment tool from the Australian JBI Center for Evidence-Based Healthcare (2016). The results of systematic reviews and meta-analyses were synthesized and presented according to different outcome indicators. Nine systematic reviews were included in this study. The current evidence does not support the fact that dietary sodium intake restrictions for patients with heart failure have a positive impact on mortality rates, rehospitalization rates, and quality of life. Conversely, strict dietary sodium intake restrictions (≤ 2000 mg/day) may increase the risk of death, rehospitalization, and symptom exacerbation. Dietary sodium intake restriction may not have a positive impact on clinical outcomes in patients with heart failure. Nevertheless, more evidence is required to explore the differences in the impact of various levels of dietary sodium restriction on the outcomes and symptom management indicators of patients with heart failure.
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Affiliation(s)
- Congying Liu
- Department of Cardiology, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Yating Wang
- Department of Cardiology, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Heli Zhang
- Department of Rehabilitation Medicine, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Sumei Tong
- Department of Cardiology, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China.
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Tian X, Zhang Y, Chen S, Xia X, Xu Q, Wang Y, Wu S, Wang A. Systolic blood pressure time in target range within 24 hours and incident heart failure: insights from the real-world setting. Hypertens Res 2025; 48:223-232. [PMID: 39138364 DOI: 10.1038/s41440-024-01840-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 06/29/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024]
Abstract
Systolic blood pressure (SBP) time in target (TTR) over months were associated with lower risk of adverse clinical outcomes in hypertensive patients, whether short-term of 24-h SBP TTR was effective in predicting heart failure (HF) risk in the general population remained unclear. This prospective study aimed to investigate the association of 24-h SBP TTR with HF in the real-world settings. Based on Kailuan study, 24-h SBP target range defined as 110-140 mmHg was calculated with linear interpolation. Among 5152 participants included in the analysis, 186 (3.61%) cases of incident HF occurred during a median follow-up of 6.96 years. Compared with participants with SBP TTR of 0 to <25%, those with TTR of 75% to 100% had 47% lower risk of HF (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.32-0.89). The restricted spline curve depicted an inverse relationship between SBP TTR and incident HF. Additionally, the addition of SBP TTR, rather than mean SBP and SBP variation, to a conventional risk model had an incremental effect on the predictive value for HF, with integrated discrimination improvement value of 0.31% (P = 0.0003) and category-free net reclassification improvement value of 19.79% (P = 0.0081). Higher SBP TTR was associated with a lower risk of incident HF. Efforts to attain SBP within 110 to 140 mmHg may be an effective strategy to prevent HF.
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Affiliation(s)
- Xue Tian
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yijun Zhang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Xia
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Qin Xu
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Yi Wang
- Department of Internal Medicine, Majiagou Hospital of Kailuan, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Anxin Wang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China.
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11
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Zhuo J, Zhong Y, Luo X, Qiu S, Li X, Liang Y, Wu Y, Zhang X. Heart Failure Is Closely Associated With the Expression Characteristics of Type I Interferon-Related Genes. Clin Cardiol 2025; 48:e70063. [PMID: 39704101 PMCID: PMC11659751 DOI: 10.1002/clc.70063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 11/06/2024] [Accepted: 11/27/2024] [Indexed: 12/21/2024] Open
Abstract
BACKGROUND The association between the expression of type I interferon related genes (TIIRGs) and EFrHF is not well understood. This study aimed to investigate the correlation between the expression patterns of TIIRGs and EFrHF using bioinformatics analysis. MATERIALS AND METHODS An analysis was conducted to examine the expression and distribution of TIIRGs in cardiomyocytes. Afterwards, GSE5406 was utilized as the validation set, including 16 without heart failure, 86 with idiopathic dilated cardiomyopathy (IDCM), and 108 individuals with ischemic cardiomyopathy (ICM). We conducted a comparative analysis of the variations in TIIRGs gene expression across various forms of heart failure. RESULTS There were eight genes that showed substantial changes between patients with EFrHF and those without heart failure. A risk model for EFrHF was developed utilizing JAK1 and EIF2AK2, with an area under the curve (AUC) of 0.909. Five genes exhibited notable disparities between IDCM and ICM. Through multivariate analysis, it was shown that JAK1 and IFNA16/IFNA14 were identified as independent risk variables for distinguishing between the two pathogenic categories. The model, utilizing JAK1 and IFNA16/IFNA14, successfully differentiated between IDCM and ICM with an area under the curve (AUC) of 0.722. In the validation set GSE5406, the expression of JAK1 was dramatically downregulated, while EIF2AK2 was significantly upregulated in heart failure (HF) tissues. The model utilizing JAK1 and EIF2AK2 successfully differentiated between those with an illness and those without (AUC = 0.877). CONCLUSIONS The expression of TIIRGs is strongly associated with the presence and specific subtypes of HF in a pathological context.
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Affiliation(s)
- Jianfeng Zhuo
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Yan Zhong
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xiaojuan Luo
- Department of EndocrinologyThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Sijie Qiu
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xinmei Li
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Yunyu Liang
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Yu Wu
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xiyu Zhang
- Department of GeriatricsThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
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12
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Li Z, Zhu S, Tang W, Zhang H, Le W, Luo S, Zhou C, Wang Y, Xu S, Hu W, Li S. Clinical features and two-year outcomes in systemic lupus erythematosus patients with heart failure and reduced, mid-range and preserved ejection fractions. Lupus 2025; 34:88-101. [PMID: 39658557 DOI: 10.1177/09612033241308105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2024]
Abstract
OBJECTIVE We retrospectively analyzed the clinical features and prognosis of SLE patients with HF. METHODS Patients with SLE and HF who were hospitalized in Jinling Hospital from January 2013 to May 2021 and followed up for 2 years after discharge were included. Risk factors for death and ESKD were analyzed. According to cardiac ultrasound, patients were subdivided into the HFrEF, HFmrEF and HFpEF groups, and differences in clinical features and prognosis among the three groups were analyzed. RESULTS Among 376 SLE patients with HF, the distribution was 13.30% HFrEF, 14.89% HFmrEF, and 71.81% HFpEF. Median ages at SLE and HF diagnosis were 29.00 (21.25, 42.00) and 35.25 (27.29, 49.31) years, with a median SLE duration of 49 (7, 120) months. The 2-year overall and renal survival rates were 86.97% and 63.56%, respectively. Multivariate COX analysis identified age, NPSLE, blood NT-proBNP, CD20+ B cells, Alb, and UA as death risk factors, and Scr, PCT, CD20+ B cells, urine RBP, and right kidney size as ESKD risk factors. The 2-year survival rates were 70% for HFrEF, 82.14% for HFmrEF, and 91.11% for HFpEF; renal survival rates were 46%, 58.93%, and 67.78%, respectively. HFrEF had lower survival rates than HFpEF, while HFmrEF showed intermediate rates and clinical features, with some significantly different from HFpEF but not HFrEF. No significant differences in SLE remission or relapse rates were found among non-ESKD survivors. CONCLUSIONS SLE patients with HF tend to have an early disease onset, high SLE activity and long course, with HFpEF being the predominant phenotype. HFrEF has a poorer prognosis compared to HFpEF, while HFmrEF has an intermediate prognosis and shares more clinical similarities with HFrEF.
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Affiliation(s)
- Zhe Li
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Shuhua Zhu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Wenjun Tang
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Haitao Zhang
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Weibo Le
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Song Luo
- Department of Medical Imaging, Jinling Hospital, Nanjing, China
| | - Chen Zhou
- Department of Ultrasound, Jinling Hospital, Nanjing, China
| | - Yang Wang
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Shutian Xu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Weixin Hu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
| | - Shijun Li
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing, China
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13
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Chen T, Su L, Yu J, Zhao H, Xiao H, Wang Y. Latent profile analysis of anticipatory grief in family caregivers of patients with chronic heart failure and its influencing factors. BMC Palliat Care 2024; 23:291. [PMID: 39707309 DOI: 10.1186/s12904-024-01621-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 12/11/2024] [Indexed: 12/23/2024] Open
Abstract
BACKGROUND Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. However, there is less research on the anticipatory grief of family caregivers with chronic heart failure. Therefore, the purpose of this study was to explore the profile of anticipatory grief among family caregivers of patients with chronic heart failure and to analyze the influencing factors of different profiles. METHODS A convenience sampling method was adopted to select 205 family caregivers of chronic heart failure patients hospitalized in a tertiary general hospital in Nanchong, China as the research subjects. A general information questionnaire, Anticipatory Grief Scale (AGS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) were used for the survey. Latent profile analysis was conducted on the anticipatory grief of family caregivers of chronic heart failure patients, and univariate analysis and multinomial logistic regression analysis were used to explore the influencing factors of anticipatory grief in each subgroup. RESULTS The anticipatory grief of family caregivers of chronic heart failure patients has been divided into three latent classes: low anticipatory grief class (16.4%), moderate anticipatory grief class (58.7%), and high anticipatory grief and loss class (24.8%). Gender, education, relationship with the patient, course of disease, and fear of progression were the influencing factors of the latent profile of anticipatory grief among family caregivers of chronic heart failure patients (all P < 0.05). CONCLUSION There were differences in the level of anticipatory grief among different subgroups of family caregivers of chronic heart failure patients. Medical staff can develop personalized intervention measures on the basis of the influencing factors of different categories to alleviate anticipatory grief of family caregivers and promote physical and mental health of caregivers in chronic heart failure patients.
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Affiliation(s)
- Ting Chen
- School of Nursing, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
- Department of Cardiac Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Li Su
- Department of nursing, Zi Yang Central Hospital, ZiYang, 641399, Sichuan, China
| | - Jiajie Yu
- School of Nursing, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
- Department of Cardiac Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Huiming Zhao
- Department of nursing, The Sixth People's Hospital of Yibin, Yibin, 644000, Sichuan, China
| | - Haoran Xiao
- Department of nursing, He Jiang People's Hospital, Luzhou, 646200, Sichuan, China
| | - Yali Wang
- School of Nursing, North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
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14
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Zhou H, Wang Q, Liu Z, Wu G, Zhou W, Yang D, Chen K. Subclinical hypothyroidism: a new predictor of heart failure with improved ejection fraction in HFrEF patients. Intern Emerg Med 2024:10.1007/s11739-024-03827-w. [PMID: 39688646 DOI: 10.1007/s11739-024-03827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Accepted: 11/23/2024] [Indexed: 12/18/2024]
Abstract
Heart failure (HF) with improved ejection fraction (HFimpEF) has gradually attracted widespread attention in recent years for its better clinical prognosis. In this study, we attempted to investigate the relationship between subclinical hypothyroidism (SCH) and HFimpEF. This study retrospectively collected clinical data on patients with HF with reduced ejection fraction (HFrEF) hospitalized at the First Affiliated Hospital of USTC from March 2015 to September 2023, and divided into two groups as euthyroidism or SCH according to the baseline thyroid function. Then patients were further categorized into HFimpEF (follow-up LVEF > 40% and absolute increase ≥ 10%) and persistent HFrEF based on their LVEF on the echocardiograms during the follow-up period. Afterward, logistic regression was used to estimate the effect of SCH on HFimpEF. A total of 916 patients with HFrEF met the inclusion and exclusion criteria, and 396 patients (43.2%) progressed to HFimpEF status during the follow-up period. Compared with HFrEF patients, the prevalence of SCH is lower in HFimpEF patients (9.3% vs. 14.4%, P = 0.020). Univariate logistic regression analysis indicates that SCH was a potential predictor for HFimpEF (OR: 0.612 [95% CI 0.403-0.928], P = 0.021). After adjusting for multiple factors in logistic regression, the odds ratios of HFrEF patients with SCH progressing to HFimpEF decreased by 37.8% (OR: 0.622 [95% CI 0.397-0.974], P = 0.038) compared with patients with euthyroidism. This study suggests that thyroid function affects the improvement of cardiac function in patients with HFrEF and SCH is an independent predictor for HFimpEF.
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Affiliation(s)
- Haiqing Zhou
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Qi Wang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Zhiquan Liu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Guohong Wu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Wenqing Zhou
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Dongmei Yang
- Department of Echocardiography, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Kangyu Chen
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
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15
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Wang L, Zhao Y, Han L, Zhang H, Chen H, Liu A, Yu J, Fu R, Duan L, An F, Guo Z, Lun Y, Chen C, Cheng F, Song C, Gao H, Zhou C. Pharmacist-Led Management Model and Medication Adherence Among Patients With Chronic Heart Failure: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2453976. [PMID: 39705029 PMCID: PMC11662253 DOI: 10.1001/jamanetworkopen.2024.53976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 11/05/2024] [Indexed: 12/21/2024] Open
Abstract
Importance Poor medication adherence is associated with high morbidity and mortality among patients with chronic heart failure (CHF), which is particularly concerning in China. Objective To assess the effect of a pharmacist-led management model incorporating a social media platform vs usual care on medication adherence in patients with CHF. Design, Setting, and Participants This prospective, multicenter randomized clinical trial was conducted from March 2021 to May 2023, with a follow-up duration of 52 weeks. The trial was conducted in the cardiology wards of 5 hospitals in China. Participants were 18 years or older, had a CHF diagnosis, and were receiving stable medication. They were randomly assigned to either the intervention group (pharmacist-led management) or the control group (usual care) in a 1:1 ratio using a computer-generated random number table with concealed allocation via opaque envelopes. Intention-to-treat data analysis was performed from June 2023 to July 2024. Intervention The intervention group received a multimodal pharmaceutical intervention, including WeChat application-based communication and education, and a standardized follow-up visit from a pharmacist every month. The control group received the standardized follow-up visit from nurses every month. Main Outcomes and Measures The primary outcome was the proportion of days covered (PDC) by heart failure medication at 52 weeks. Results Among the 445 participants analyzed, 223 were assigned to the intervention group and 222 to the control group. These patients had a mean (SD) age of 63.2 (13.3) years and included 263 males (59.1%). A total of 333 patients (74.8%) had a New York Heart Association class III or IV heart failure, indicating severe limitations in physical activity. At 52 weeks, the intervention group had a significantly higher PDC for heart failure medication (8.1%; 95% CI, 5.5%-10.7%; P < .001) and a greater proportion of patients with PDC of 80% or greater (odds ratio, 0.34; 95% CI, 0.21-0.54; P < .001) compared with the control group. Conclusions and Relevance This randomized clinical trial found a modest improvement in medication adherence among patients with CHF who received the pharmacist-led management intervention vs usual care. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2000040232.
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Affiliation(s)
- Lingjiao Wang
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Yuanyuan Zhao
- Department of Clinical Psychology, Key Laboratory for Neuroimmunological Regulation and Mental Health of Hebei Province, Hebei, China
- Department of Clinical Psychology, The First Hospital of Hebei Medical University, Hebei, China
| | - Liping Han
- Department of Clinical Pharmacy, Handan First Hospital, Hebei, China
| | - Huan Zhang
- Department of Pharmacy, Cangzhou Central Hospital, Hebei, China
| | - Hejun Chen
- Department of Pharmacy, Hengshui People’s Hospital, Hebei, China
| | - Aixia Liu
- Department of Pharmacy, the Fourth Hospital of Handan, Hebei, China
| | - Jing Yu
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
- Department of Clinical Pharmacy, The Technology Innovation Center for Artificial Intelligence in Clinical Pharmacy of Hebei Province, Hebei, China
| | - Ran Fu
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Liguang Duan
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Feiyue An
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Zhimin Guo
- Department of Pharmacy, Kanghui Hospital, Tianjin, China
| | - Yang Lun
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Chaoli Chen
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Fangfang Cheng
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Chaohui Song
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
| | - Haixia Gao
- Department of Pharmacology, Center for Innovative Drug Research and Evaluation, Institute of Medical Science and Health, The Hebei Collaboration Innovation Center for Mechanism, Diagnosis and Treatment of Neurological and Psychiatric Disease, The Key Laboratory of Neural and Vascular Biology, Ministry of Education, Hebei Medical University, Hebei, China
| | - Chunhua Zhou
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Hebei, China
- Department of Clinical Pharmacy, The Technology Innovation Center for Artificial Intelligence in Clinical Pharmacy of Hebei Province, Hebei, China
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16
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Jia Y, Zhang Y, Bai S, Liu J, Chen T, Liu X, Xu C, Zhang R, Du R. Triglyceride glucose index is a risk factor for heart failure: A prospective cohort study. ESC Heart Fail 2024; 11:3833-3841. [PMID: 39016168 PMCID: PMC11631298 DOI: 10.1002/ehf2.14963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 07/18/2024] Open
Abstract
AIMS This study aimed to investigate the relationship between the triglyceride glucose (TyG) index and all-cause mortality in patients with heart failure (HF). METHODS AND RESULTS A total of 1274 patients with HF diagnosed at Hebei General Hospital were enrolled in this study. The patients were divided into four groups by quartiles based on the TyG index. The endpoint was all-cause mortality during the follow-up period. The median follow-up period was 1079 days, with a total of 543 (42.7%) patients experiencing all-cause mortality. The survival curves showed no significant difference in endpoint events among the four groups (log-rank P = 0.329). The adjusted survival curves revealed that after adjusting for the variables in Model 3, the group with a higher TyG index exhibited a higher risk of death (log-rank P < 0.001). The multivariate-adjusted Cox proportional hazard models revealed a positive correlation between the TyG index and all-cause mortality. After complete adjustment, patients with the highest TyG index exhibited a higher risk of all-cause mortality than those in the lowest quartile [hazard ratio (HR) = 1.6, 95% confidence interval (CI): 1.22-2.09; P = 0.001]. Restricted cubic spline analysis showed that the risk of all-cause mortality increased linearly with the TyG index (P for non-linear = 0.207). Exploratory subgroup analyses revealed that, as a continuous variable, the TyG index was significantly associated with all-cause mortality in female patients (HR = 1.31, 95% CI: 1.08-1.58, P = 0.029) and older patients (HR = 1.25, 95% CI: 1.1-1.43, P = 0.027). CONCLUSIONS The TyG index was positively associated with increased all-cause mortality in hospitalized patients with HF. Subgroup analyses indicated that the TyG index was strongly associated with all-cause mortality in older and female patients.
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Affiliation(s)
- Yuan Jia
- Department of CardiologyHebei General HospitalShijiazhuangChina
| | - Yue Zhang
- Department of CardiologyHebei General HospitalShijiazhuangChina
| | - Shiru Bai
- Department of CardiologyHebei General HospitalShijiazhuangChina
| | - Jia Liu
- Department of CardiologyHebei General HospitalShijiazhuangChina
| | - Tianlei Chen
- Department of CardiologyHebei General HospitalShijiazhuangChina
| | - Xuda Liu
- Department of CardiologyHebei General HospitalShijiazhuangChina
- Department of CardiologyHebei Medical UniversityShijiazhuangChina
| | - Chao Xu
- Department of CardiologyHebei General HospitalShijiazhuangChina
- Department of CardiologyHebei North UniversityZhangjiakouChina
| | - Ruining Zhang
- Department of CardiologyHebei General HospitalShijiazhuangChina
- Department of CardiologyHebei Medical UniversityShijiazhuangChina
| | - Rongpin Du
- Department of CardiologyHebei General HospitalShijiazhuangChina
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17
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Zheng B, Liang T, Mei J, Shi X, Liu X, Li S, Wan Y, Zheng Y, Yang X, Huang Y. Prediction of 90 day readmission in heart failure with preserved ejection fraction by interpretable machine learning. ESC Heart Fail 2024; 11:4267-4276. [PMID: 39168476 PMCID: PMC11631356 DOI: 10.1002/ehf2.15033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/11/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024] Open
Abstract
AIMS Certain critical risk factors of heart failure with preserved ejection fraction (HFpEF) patients were significantly different from those of heart failure with reduced ejection fraction (HFrEF) patients, resulting in the limitations of existing predictive models in real-world situations. This study aimed to develop a machine learning model for predicting 90 day readmission for HFpEF patients. METHODS AND RESULTS Data were extracted from electronic health records from 1 August 2020 to 1 August 2021 and follow-up records of patients with HFpEF within 3 months after discharge. Feature extraction was performed by univariate analysis combined with the least absolute shrinkage and selection operator (LASSO) algorithms. Machine learning models like eXtreme Gradient Boosting (XGBoost), random forest, neural network and logistic regression were adopted to construct models. The discrimination and calibration of each model were compared, and the Shapley Additive exPlanations (SHAP) method was used to explore the interpretability of the model. The cohort included 746 patients, of whom 103 (13.8%) were readmitted within 90 days. XGBoost owned the best performance [area under the curve (AUC) = 0.896, precision-recall area under the curve (PR-AUC) = 0.868, sensitivity = 0.817, specificity = 0.837, balanced accuracy = 0.827]. The Kolmogorov-Smirnov (KS) statistic was 0.694 at 0.468 in the XGBoost model. SHAP identified the top 12 risk features, including activities of daily living (ADL), left atrial dimension (LAD), left ventricular end-diastolic diameter (LVDD), shortness, nitrates, length of stay, nutritional risk, fall risk, accompanied by other symptoms, educational level, anticoagulants and edema. CONCLUSIONS Our model could help medical agencies achieve the early identification of 90 day readmission risk in HFpEF patients and reveal risk factors that provide valuable insights for treatments.
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Affiliation(s)
- Baojia Zheng
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Tao Liang
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Jianping Mei
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Xiuru Shi
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Xiaohui Liu
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Sikai Li
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Yuting Wan
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Yifeng Zheng
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Xiaoyue Yang
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
| | - Yanxia Huang
- The Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhaiChina
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18
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Xu C, Zhang N, Rong W, Dong L, Gu W, Zou J, Zhu N, Shi T, Li H, Chen L. Clinical Prognostic Impact of the Serum C-reactive Protein-to-albumin Ratio (CAR) in Chronic Heart Failure Patients: A Retrospective Study. Rev Cardiovasc Med 2024; 25:461. [PMID: 39742221 PMCID: PMC11683722 DOI: 10.31083/j.rcm2512461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/26/2024] [Accepted: 08/02/2024] [Indexed: 01/03/2025] Open
Abstract
Background The serum C-reactive protein-to-albumin ratio (CAR) has been identified as an adverse prognostic indicator in a variety of diseases. Nevertheless, there have been not been any studies reporting a relationship between CAR and the prognosis of chronic heart failure (CHF). This study was designed to evaluate the association between CAR and all-cause mortality in CHF patients with different ejection fractions. Methods A total of 1221 heart failure (HF) patients were enrolled at the First Affiliated Hospital of Kunming Medical University due to acute exacerbation of chronic HF from January 2017 to October 2021. The main outcome was all-cause mortality. After collecting baseline characteristics and laboratory results from all patients, we classified all participants into four groups based on CAR quartile (G1-G4). Kaplan-Meier survival curves and multivariate Cox proportional hazard models were employed to investigate the association between CAR and all-cause mortality in the patients. Furthermore, receiver operating characteristic (ROC) curves were constructed for CARs, and the area under the curve (AUC) was calculated. Results After excluding ineligible patients, we ultimately included 1196 patients with CHF. The mean age was 66.38 ± 12.521 years, and 62% were male. According to the Kaplan‒Meier analysis, with different ejection fractions, the risk of all-cause mortality was always highest for G4 (CAR >63.27) and lowest for G1 (CAR ≤7.67). Cox multivariate regression analyses indicated that the CAR was an independent predictor of all-cause mortality in all HF patients and in patients with different HF subtypes. According to the ROC curves, the AUC for the CAR was 0.732 (p < 0.001), with a sensitivity of 66.2% and the specificity of 72.7%. CAR had a greater predictive value for all-cause mortality than did C-reactive protein (CRP). Conclusions An elevated serum CAR was independently associated with an increased risk of all-cause death, regardless of heart failure subtype.
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Affiliation(s)
- Chenggong Xu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Ningli Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Kunming Medical University, 650101 Kunming, Yunnan, China
| | - Wei Rong
- Department of Neurology, The Second Affiliated Hospital of Kunming Medical University, 650101 Kunming, Yunnan, China
| | - Ling Dong
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Wenyi Gu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Jie Zou
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Na Zhu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Tao Shi
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Hao Li
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Lixing Chen
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
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Gu Y, Liu B, Lin X, Chen J, Chen X, Jiang Y, Zhu Y, Li X, Lou S, Zhu J. Assessing the cost-effectiveness of replacing antimetabolites with mTOR inhibitors in heart transplant immunosuppression in China: a network meta-analysis-based economic evaluation. Int J Clin Pharm 2024; 46:1472-1481. [PMID: 39316305 DOI: 10.1007/s11096-024-01793-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/08/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Although several pharmacoeconomic studies have assessed the cost-effectiveness of maintenance immunosuppressive regimens for heart transplant recipients, economic comparisons between various combination drug therapies remain sparse. AIM This study used an economic evaluation based on network meta-analysis to assess the cost-effectiveness of four immunosuppressive regimens for adult heart transplant recipients in China. METHOD We conducted a systematic search for clinical trials in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. A validated Markov model was adapted to reflect the Chinese medical landscape. Four maintenance immunosuppression regimens were considered: tacrolimus/mycophenolate mofetil (TAC/MMF), cyclosporine/mycophenolate mofetil (CSA/MMF), everolimus/cyclosporine (EVL/CSA), and sirolimus/tacrolimus (SRL/TAC). The probabilities of health events were derived from a comprehensive literature review. Direct medical costs, adjusted for 2022 values, were from public documents and websites, while utilities for quality-adjusted life-years (QALYs) were taken from previous studies. Primary outcomes were mean lifetime cost, QALYs, and cost-effectiveness, with a willingness-to-pay (WTP) threshold set at three times China's GDP per capita in 2022. Sensitivity analyses were conducted to test the robustness of the results. RESULTS The base case analysis identified TAC/MMF as the most cost-effective regimen, producing a mean of 6.31 QALYs per patient at a cost of Chinese Yuan (CNY) 534,182.89. Sensitivity analyses consistently reinforced TAC/MMF as the most cost-effective and robust choice. CONCLUSION TAC/MMF is the most cost-effective maintenance immunosuppressive regimen for heart transplant recipients within the Chinese health system. The study findings are reinforced by sensitivity analyses, affirming their robustness amid various uncertainties.
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Affiliation(s)
- Yajie Gu
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Bing Liu
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Xiaonan Lin
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Jinjin Chen
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Xin Chen
- Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Yingshuo Jiang
- Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Yifan Zhu
- Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Xin Li
- School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Sheng Lou
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Junrong Zhu
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China.
- Department of Pharmacy, Nanjing First Hospital, Nanjing Hospital Afiliated to Nanjing Medical University, Nanjing, 210006, China.
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Wu Z, Huang Z, Sun L, Fu Y, Chen S, Wu S, Gao X. Neck circumference, waist-to-height ratio, Chinese visceral adiposity index and incident heart failure. Nutr J 2024; 23:149. [PMID: 39609796 PMCID: PMC11604003 DOI: 10.1186/s12937-024-01048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 11/13/2024] [Indexed: 11/30/2024] Open
Abstract
BACKGROUND The indicators of abdominal obesity have shown to be associated with a high risk of cardiovascular diseases (CVDs), even adjusted for body mass index (BMI). We aimed to investigate the association between neck circumference, waist-to-height ratio (WHtR), Chinese visceral adiposity index (CVAI) and incident heart failure (HF) in Chinese adults. METHODS The current study included 86,546 participants from two independent cohorts: the Kailuan I study established in 2006 and the Kailuan study II established in 2008. Participants aged 18-80 years who were free of CVDs or cancer were recruited at baseline. The values of neck circumference, WHtR and CVAI were available in 2014. The trajectory analysis was conducted using repeated measures of WHtR and CVAI in the 2008, 2010, 2012 and 2014 surveys. The incident HF cases were identified via reviewing medical records by cardiologists. RESULTS During a mean follow-up of 5.62 years, 724 incident HF cases were documented. The highest quartiles of neck circumference, WHtR and CVAI respectively, were significantly associated with a high risk of HF compared to the lowest quartiles of adiposity measures (neck circumference: HR:1.30, 95%CI: 1.03-1.65; WHtR: HR:1.49, 95%CI: 1.16-1.92; and CVAI: HR:1.98, 95%CI: 1.48-2.65). The combination of adiposity measures with BMI or metabolic abnormalities jointly predicted incident HF. Presence of hypertension and diabetes appeared to be the major mediators, accounting for ∼ 8.11-24.7% of the associations between three indicators of abdominal obesity and HF risk. CONCLUSION The new indices of abdominal adiposity could help to identify those who were at a high risk of HF, especially in the presence of high BMI or metabolic abnormalities.
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Affiliation(s)
- Zhijun Wu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, People's Republic of China
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, 130 Dongan Rd, Shanghai, 200032, People's Republic of China
| | - Yuang Fu
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, 130 Dongan Rd, Shanghai, 200032, People's Republic of China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, People's Republic of China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, People's Republic of China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, 130 Dongan Rd, Shanghai, 200032, People's Republic of China.
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Zhang Y, Liu R, Zhao Y, Wang Z, Wang C, Li Q, Han D, Anderson CS, Du X, Dong J. Influenza vaccination in patients with acute heart failure (PANDA II): study protocol for a hospital-based, parallel-group, cluster randomized controlled trial in China. Trials 2024; 25:792. [PMID: 39587669 PMCID: PMC11587674 DOI: 10.1186/s13063-024-08452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/04/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND Influenza vaccination confers broad benefits in the elderly and certain high-risk populations, but its effectiveness in patients with acute heart failure (HF) is uncertain. Rates of influenza vaccination are low in China due to poor awareness, cultural misunderstandings, and cost. AIMS To determine the effectiveness of influenza vaccination in patients with acute HF admitted to hospitals in China. METHODS The second Population Assessment of Influenza and Disease Activity (PANDA II) study is a two-arm, parallel-group, county-level hospital-based, cluster randomized controlled trial to determine the benefits and risks of full access to routine free influenza vaccination before hospital discharge, compared to routine limited use of influenza vaccination, on the primary endpoint of death or hospital readmission. Consecutive hospitalized patients at each site are enrolled to a target of 50 participants in each autumn-winter influenza outbreak period (October to March) over 3 consecutive years to reach the required sample size. Patients are centrally followed up at 1, 3, 6, and 12 months after hospital discharge (or death if earlier). Site numbers varied across year according to predicted influenza activity and logistical reasons. CONCLUSIONS This study offers a unique chance to clarify uncertainties surrounding the effectiveness of influenza vaccination in patients with HF and to lay the groundwork for future prevention strategies. TRIAL REGISTRATION This trial was registered with the acronym PANDA II (Population Assessment of Influenza and Disease Activity) at ChiCTR.org.cn (ChiCTR2100053264). Registered on 17 November 2021.
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Affiliation(s)
- Yiqun Zhang
- Heart Health Research Center (HHRC), Beijing, China
| | - Rong Liu
- The George Institute for Global Health, UNSW, Sydney, Australia
| | | | - Zhiyan Wang
- Beijing Anzhen Hospital, the Capital Medical University, Beijing, China
| | - Chi Wang
- Heart Health Research Center (HHRC), Beijing, China
| | - Qiang Li
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Dorothy Han
- Heart Health Research Center (HHRC), Beijing, China
| | - Craig S Anderson
- Heart Health Research Center (HHRC), Beijing, China.
- The George Institute for Global Health, UNSW, Sydney, Australia.
- Institute for Science and Technology for Brain-Inspired Research, Fudan University, Shanghai, China.
| | - Xin Du
- Heart Health Research Center (HHRC), Beijing, China.
- Beijing Anzhen Hospital, the Capital Medical University, Beijing, China.
| | - Jianzeng Dong
- Beijing Anzhen Hospital, the Capital Medical University, Beijing, China.
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
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22
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Song H, Qin WB, Yang FF, Tang WZ, He GX. Risk analysis and risk prediction of in-hospital heart failure in patients with acute myocardial infarction after emergency intervention surgery. BMC Cardiovasc Disord 2024; 24:673. [PMID: 39587472 PMCID: PMC11590280 DOI: 10.1186/s12872-024-04357-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 11/18/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) can rapidly open the culprit vessels of acute myocardial infarction (AMI) and save ischemic myocardium, but it is often accompanied by a variety of complications, including heart failure (HF).Please check if the article title is presented correctlyYes, it is presented correctly OBJECTIVE: We aimed to (i) analyze the possible risk factors affecting the occurrence of in-hospital HF after emergency PCI in patients with AMI through clinical data and (ii) establish a personalized risk prediction model for the occurrence of HF after emergency PCI in patients with AMI.Please check if the author names and affiliations are captured correctlyYes, they are captured correctly METHODS: Clinical data of 676 AMI patients who consecutively underwent emergency PCI between January 2020 and October 2023 at the First Affiliated Hospital of Guangxi University of Chinese Medicine were collected. Based on whether in-hospital HF occurred after PCI, the study subjects were divided into the HF group (91 cases) and the non-HF group (585 cases). Independent risk factors were screened using univariate and multivariate logistic regression. A nomogram model of the risk of HF was drawn using R, and the discriminative power was evaluated by calculating the area under the ROC curve and drawing the calibration curve and decision curve. RESULTS In this study, the incidence of in-hospital HF events in AMI patients after emergency PCI was 13.46%. The analysis showed that age, troponin levels, D-dimer levels, left ventricular ejection fraction (LVEF), and Gensini score were independent predictors of the occurrence of in-hospital HF in AMI patients after emergency PCI (P < 0.05). The AUC of the nomogram model were 0.87 (95% CI: 0. 82-0.91) and 0.85 (95% CI: 0. 76-0.93) in the training and validation sets, respectively. The Hosmer-Lemeshow goodness-of-fit test in the training set suggested that the difference between predicted and actual risks of the predictive model was not statistically significant (χ2 = 5.8185, P = 0.6676), and this was confirmed by the Hosmer-Lemeshow goodness-of-fit test in the validation set (χ2 = 9.4774, P = 0.3036). CONCLUSIONS The predictive model for the risk of in-hospital HF in AMI patients after emergency PCI includes age, troponin levels, D-dimer levels, LVEF, and Gensini score. It has a good differentiation ability and good accuracy, it can be used to intuitively and independently screen high-risk populations, and it has high predictive value for the occurrence of HF after PCI in AMI patients, so it can be used to assist clinicians in early screening, in identifying patients at high risk of postoperative HF, and in the implementation of targeted intervention therapy.Please check if "Strengths and limitations of this study" was captured and presented correctlyYes, it was captured and presented correctly.
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Affiliation(s)
- Hui Song
- Guangxi University of Chinese Medicine, Nanning, 530000, China
| | - Wei-Bin Qin
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530000, China
| | - Fei-Fei Yang
- Guangxi University of Chinese Medicine, Nanning, 530000, China
| | - Wei-Zhi Tang
- Guangxi University of Chinese Medicine, Nanning, 530000, China
| | - Gui-Xin He
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530000, China.
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23
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Guo L, Liu L, Li T, Cai L, Hu L, Zhou Y. Association between Serum Albumin-to-Creatinine Ratio and Readmission in Elderly Heart Failure Patients: A Retrospective Cohort Study. Gerontology 2024; 71:28-38. [PMID: 39557035 DOI: 10.1159/000542616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 11/08/2024] [Indexed: 11/20/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the relationship between the serum albumin-to-serum creatinine ratio (sACR) and readmission in elderly heart failure patients. METHODS We conducted a retrospective cohort study using data from the PhysioNet Restricted Health Data database. The exposure variable was sACR and the outcome variable readmission. Multivariate logistic regression and subgroup analyses were performed to assess the independent association between sACR and readmission. Smooth curve fits were applied to examine the nonlinear relationship. We employed multiple imputation and E-value sensitivity analyses to assess the robustness of our results. RESULTS Our study included 1,725 participants, of whom 40.6% were male, 59.2% were aged 60-79 years, and 40.8% were aged 80 years and older. After adjusting for potential confounders, we found that for each unit increase in sACR, the 28-day readmission rate decreased by 48% (odds ratio [OR] = 0.52, 95% CI: 0.29-0.95, p = 0.003). The 28-day readmission rate was significantly higher in the low sACR group (sACR <0.32) than in the high sACR group (sACR >0.51) (OR = 0.47, 95% CI: 0.3-0.76, p = 0.002). Similar results were observed for 3-month and 9-month readmission. Subgroup analysis showed no significant interactions. A nonlinear relationship was observed between the sACR and readmission. Sensitivity analyses have confirmed the robustness of our results. CONCLUSION There is a negative association between sACR and readmission in Chinese heart failure patients. Our study may offer novel insights into the management of heart failure readmissions.
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Affiliation(s)
- Leilei Guo
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
| | - Li Liu
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
| | - Tianwen Li
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
| | - Lina Cai
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
| | - Li Hu
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
| | - Yueshan Zhou
- Department of Cardiology, Jiang You People's Hospital, Mianyang, China
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Zhao Q, Sun X, Zhang Y, Zhang Y, Chen C. Network analysis of anxiety and depressive symptoms among patients with heart failure. BMC Psychiatry 2024; 24:803. [PMID: 39543555 PMCID: PMC11720705 DOI: 10.1186/s12888-024-06259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 11/05/2024] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND Anxiety and depressive symptoms are common among patients with heart failure (HF). Physical limitations, lifestyle changes, and uncertainties related to HF can result in the development or exacerbating of anxiety and depressive symptoms. However, the central and bridge symptoms of anxiety and depressive symptoms network among patients with HF remain unclear. Network analysis is a statistical method that can discover and visualize complex relationships between multiple variables. This study aimed to establish a network of anxiety and depressive symptoms and identify the central and bridge symptoms in this network among patients with HF. METHODS This study employed a cross-sectional study design and convenience sampling to recruit patients with HF. This study followed the Helsinki Declaration and was approved by the Research Ethics Committee of Hospital. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depressive symptoms among patients with HF, respectively. Network analysis of anxiety and depressive symptoms was performed using R. RESULTS In the anxiety and depressive symptoms network, PHQ2 (feeling down, depressed, or hopeless), PHQ7 (inability to concentrate), and GAD4 (difficulty relaxing) were the most central symptoms. Anxiety and depressive symptoms were linked by PHQ2 (feeling down, depressed, or hopeless), GAD6 (becoming easily annoyed or impatient), GAD5 (unable to sit still because of anxiety), GAD7 (feeling afraid that something terrible is about to happen), and PHQ6 (feeling bad or like a failure, or disappointing oneself or family). CONCLUSIONS This study identified the central and bridge symptoms in a network of anxiety and depressive symptoms. Targeting these symptoms can contribute to interventions for patients with HF at risk of-or suffering from-anxiety and depressive symptoms, which can be effective in reducing the comorbidity of anxiety and depression.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing, Shandong Second Medical University, 7166# Baotong Xi Road, Weifang, Shandong, 261053, P. R. China
| | - Xiaofei Sun
- School of Humanities and Design, Zhengzhou Vocational University of Information and Technology, Zhengzhou, Henan, China
| | - Yanting Zhang
- School of Nursing, Zhengzhou Railway Vocational and Technical College, Zhengzhou, Henan, China
| | - Yuzhen Zhang
- School of Nursing, Shandong Second Medical University, 7166# Baotong Xi Road, Weifang, Shandong, 261053, P. R. China
| | - Cancan Chen
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
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Wang X, Zhou X, Chen H, Du J, Qing P, Zou L, Chen Y, Duan F, Yuan S, Shi J, Ji B, Wu R, Zhang Y, Jin Y, Hu S. Long-term outcomes of a novel fully magnetically levitated ventricular assist device for the treatment of advanced heart failure in China. J Heart Lung Transplant 2024; 43:1806-1815. [PMID: 38740078 DOI: 10.1016/j.healun.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/28/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Left ventricular assist devices (LVADs) are well-established for treating end-stage heart failure, but this therapy is only available to Chinese patients in recent years. The CH-VAD is the first used fully magnetically levitated pump in China. This study reports the long-term outcomes of a cohort supported by the CH-VAD for the first time. METHODS From June 2017 to August 2023, 50 consecutive patients received CH-VAD implantation in Fuwai Hospital. Clinical data were collected and retrospectively analyzed. RESULTS Baseline characteristics included a mean age of 47.9 ± 13.9 years, 90% male, and 26% ischemic etiology. The Interagency Registry for Mechanically Assisted Circulatory Support profile revealed 12% profile 1, 56% profile 2, 26% profile 3, and 6% profile 4. The mean support duration was 868 ± 630 days (range 33 days-6.4 years). Kaplan-Meier survival rate was 93% (95% CI, 79-98) at 1 year, 93% (95% CI, 79-98) at 2 years, and 89% (95% CI, 71-96) at 3 years. Forty patients (80%) currently remain on support, 3 were bridged to recovery, 2 received transplants, and 5 expired during support. Major adverse events (AEs) included right heart failure (10%), surgical-related bleeding (8%), arrhythmia (8%), and driveline infection (16%). Major hemocompatibility-related AEs were limited to 3 nondisabling strokes and 1 gastrointestinal bleeding. No major device malfunction occurred during the follow-up period. CONCLUSIONS The largest single-center experience with the leading LVAD in China shows high survival with low complication rates, demonstrating that CH-VAD is safe and efficient in providing long-term support for patients with end-stage heart failure.
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Affiliation(s)
- Xianqiang Wang
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xingtong Zhou
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haibo Chen
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juan Du
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ping Qing
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zou
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Chen
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fujian Duan
- Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Su Yuan
- Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia Shi
- Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingyang Ji
- Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Wu
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanming Zhang
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Jin
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shengshou Hu
- Center of Cardiac Surgery in Adults, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Li A, Zhu C, Cheng M, Su Y, Ma T, Chi M, Wang N, Nie Y, Hou Y. The Impact of Inadequate Energy Intake on Readmission Burden of Patients With Heart Failure. J Cardiovasc Nurs 2024; 39:552-560. [PMID: 38019028 DOI: 10.1097/jcn.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Adequate energy intake is essential for good clinical outcomes. The association between energy intake and readmission burden of patients with heart failure (HF) still needs to be clarified. OBJECTIVE In this study, our aim was to determine the association between energy intake and readmission in patients with HF. METHODS A total of 311 inpatients with HF were recruited. Demographic and clinical information were collected during hospitalization; the daily diets of the participants were collected in the second week after discharge using the 3-day diet record, and the energy intake was calculated using a standardized nutrition calculator. The inadequate energy intake was defined as <70% × 25 kcal/kg of ideal body weight. The participants were followed up for 12 weeks after discharge. The number, reasons, and length of stay of unplanned readmissions were collected. Regression analyses were used to evaluate the associations between inadequate energy intake, and readmission rate and readmission days. RESULTS The median of the energy intake of participants was 1032 (interquartile range, 809-1266) kcal/d. The prevalence of inadequate energy intake was 40%. Patients with inadequate energy intake had a higher risk of unplanned readmission (odds ratio, 5.616; 95% confidence interval, 3.015-10.462; P < .001) and more readmission days (incidence rate ratio, 5.226; 95% confidence interval, 3.829-7.134, P < .001) after adjusting for potential confounders. CONCLUSIONS Patients with HF had a high incidence of inadequate dietary energy intake, and it increases the burden of readmission.
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Zhang G, Shi R, Li XM, Yan WF, Xu HY, Li Y, Guo YK, Shi K, Yang ZG. Impact of diabetes mellitus on right ventricular dysfunction and ventricular interdependence in hypertensive patients with heart failure with reduced ejection fraction assessed via 3.0 T cardiac MRI. Cardiovasc Diabetol 2024; 23:375. [PMID: 39443983 PMCID: PMC11515597 DOI: 10.1186/s12933-024-02472-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Accepted: 10/13/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Hypertension (HTN) and diabetes mellitus (DM) are two common comorbidities of heart failure with reduced ejection fraction (HFrEF), each of which can cause right ventricular (RV) dysfunction. The aim of this study was to investigate the impact of DM on RV dysfunction and ventricular interdependence in hypertensive HFrEF patients via cardiac magnetic resonance imaging (MRI) feature tracking. METHODS This study included 249 patients with HFrEF: 77 HFrEF controls, 97 with hypertensive HFrEF (HTN-HFrEF [DM-]) and 75 with hypertensive HFrEF and comorbid DM (HTN-HFrEF [DM+]). The cardiac MRI-derived biventricular global radial (GRS), circumferential (GCS) and longitudinal (GLS) peak strains were obtained and compared among the groups. Multivariable linear regression and mediation analyses were used to evaluate the effects of DM and left ventricular (LV) strain on RV strain. RESULTS The biventricular GLS and GLS of segments 8, 9 and 14 of the interventricular septum (IVS) decreased gradually from the HFrEF control group to the HTN-HFrEF (DM-) group to the HTN-HFrEF (DM+) group (all P < 0.05). Patients with DM had even lower biventricular GCS and IVS strains in all directions in specific segments than did those without DM and the HFrEF controls (all P < 0.05). DM was independently associated with impaired RVGLS and RVGCS (both P < 0.05) in hypertensive HFrEF patients. The difference in RVGLS between the hypertensive HFrEF subgroups was partly mediated by LVGLS [β = 0.80, 95% CI (0.39-1.31)], and that of RVGCS was partly mediated by LVGCS [β = 0.28, 95% CI (0.01-0.62)]. CONCLUSIONS In hypertensive HFrEF patients, comorbid DM may have aggravated RV dysfunction and was an independent determinant of impaired RV strain. RV dysfunction might be directly affected by DM and partially mediated by LV strain through unfavorable ventricular independence.
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Affiliation(s)
- Ge Zhang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Shi
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue-Ming Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Shi
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Zhi-Gang Yang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Zhao D, Zhang Y, Yong Y, Wang L, Liu J. Vericiguat combined with "new quadruple" therapy enhances cardiac function and life quality in patients with heart failure: a single-center prospective study. Front Cardiovasc Med 2024; 11:1476976. [PMID: 39465136 PMCID: PMC11502340 DOI: 10.3389/fcvm.2024.1476976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 09/27/2024] [Indexed: 10/29/2024] Open
Abstract
Objective To investigate the therapeutic effect of Vericiguat combined with "new quadruple" drugs on patients with heart failure (HF). Methods From December 1, 2022 to February 1, 2024, 103 patients with heart failure were consecutively enrolled from the cardiology clinic or ward of the First Affiliated Hospital of Nanjing Medical University. Before enrollment, the patients' left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), liver and kidney function electrolytes, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) and other indicators were measured. Patients diagnosed with reduced ejection fraction (HFrEF) and with heart failure with mildly reduced ejection fraction (HFmrEF) were treated with Vericiguat combined with "ARNI, BB, MRA, SGLT2i" therapy. Patients diagnosed with preserved ejection fraction (HFpEF) were treated with Vericiguat combined with "ARNI, BB, SGLT2i" therapy. The above indicators were rechecked after 1 month of treatment. Results For all patients, comparison after treatment: LVEF (38.1 ± 8.5% vs. 43.1 ± 8.5%, P < 0.01), LVEDD (60.5 ± 8.1 vs. 58.2 ± 7.3 mm, P < 0.01), NT-proBNP (4,567.8 ± 5,163.9 vs. 1,895.6 ± 2,702.1 ng/L, P < 0.01), MLHFQ (45.72 ± 11.09 vs. 32.29 ± 9.41, P < 0.01). Further subgroup analysis showed that Vericiguat combined with "ARNI, BB, SGLT2i or MRA" improved the LVEF and reduced NT-proBNP levels in patients with HFrEF, HFmrEF or HFpEF. and improved patients' quality of life scores. The intergroup comparison showed the therapeutic effect of the combination was equivalent in HF caused by myocardial Infarction (MI), dilated cardiomyopathy (DCM) or Valvular Heart Disease (VHD). Conclusion Vericiguat combined with the "new quadruple" therapy has a significant therapeutic effect on patients with heart failure caused by MI, DCM or VHD.
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Affiliation(s)
| | | | | | - Liansheng Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiabao Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Chen S, Xie JD, Xie MT, Yang LN, Lin YF, Chen JB, Chen TF, Zeng KF, Tan ZB, Lu SM, Wang HJ, Yang B, Jiang WH, Zhang SW, Deng B, Liu B, Zhang J. Przewaquinone A inhibits Angiotensin II-induced endothelial diastolic dysfunction activation of AMPK. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 133:155885. [PMID: 39096544 DOI: 10.1016/j.phymed.2024.155885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 06/02/2024] [Accepted: 07/14/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Endothelial dysfunction (ED), characterized by markedly reduced nitric oxide (NO) bioavailability, vasoconstriction, and a shift toward a proinflammatory and prothrombotic state, is an important contributor to hypertension, atherosclerosis, and other cardiovascular diseases. Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) is widely involved in cardiovascular development. Przewaquinone A (PA), a lipophilic diterpene quinone extracted from Salvia przewalskii Maxim, inhibits vascular contraction. PURPOSE Herein, the goal was to explore the protective effect of PA on ED in vivo and in vitro, as well as the underlying mechanisms. METHODS A human umbilical vein endothelial cell (HUVEC) model of ED induced by angiotensin II (AngII) was used for in vitro observations. Levels of AMPK, endothelial nitric oxide synthase (eNOS), vascular cell adhesion molecule-1 (VCAM-1), nitric oxide (NO), and endothelin-1 (ET-1) were detected by western blotting and ELISA. A mouse model of hypertension was established by continuous infusion of AngII (1000 ng/kg/min) for 4 weeks using osmotic pumps. Following PA and/or valsartan administration, NO and ET-1 levels were measured. The levels of AMPK signaling-related proteins in the thoracic aorta were evaluated by immunohistochemistry. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured using the tail cuff method. Isolated aortic vascular tone measurements were used to evaluate the vasodilatory function in mice. Molecular docking, molecular dynamics, and surface plasmon resonance imaging (SPRi) were used to confirm AMPK and PA interactions. RESULTS PA inhibited AngII-induced vasoconstriction and vascular adhesion as well as activated AMPK signaling in a dose-dependent manner. Moreover, PA markedly suppressed blood pressure, activated vasodilation in mice following AngII stimulation, and promoted the activation of AMPK signaling. Furthermore, molecular simulations and SPRi revealed that PA directly targeted AMPK. AMPK inhibition partly abolished the protective effects of PA against endothelial dysfunction. CONCLUSION PA activates AMPK and ameliorates endothelial dysfunction during hypertension.
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Affiliation(s)
- Si Chen
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China; School of Chinese medicine, Hong Kong Baptist University (HKBU), Kowloon Tong, Kowloon, Hong Kong, PR China
| | - Jun-di Xie
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Meng-Ting Xie
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Li-Ning Yang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Yu-Fang Lin
- The Second Clinical School of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Jun-Bang Chen
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Ting-Fang Chen
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Ke-Feng Zeng
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Zhang-Bin Tan
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Si-Min Lu
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Hui-Juan Wang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Bo Yang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Wei-Hao Jiang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Shuang-Wei Zhang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China
| | - Bo Deng
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China.
| | - Bin Liu
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China.
| | - Jingzhi Zhang
- Department of Traditional Chinese Medicine, Institute of Integration of Traditional and Western Medicine of Guangzhou Medical University, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510260, PR China.
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Khan MS, Shahid I, Bennis A, Rakisheva A, Metra M, Butler J. Global epidemiology of heart failure. Nat Rev Cardiol 2024; 21:717-734. [PMID: 38926611 DOI: 10.1038/s41569-024-01046-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Heart failure (HF) is a heterogeneous clinical syndrome marked by substantial morbidity and mortality. The natural history of HF is well established; however, epidemiological data are continually evolving owing to demographic shifts, advances in treatment and variations in access to health care. Although the incidence of HF has stabilized or declined in high-income countries over the past decade, its prevalence continues to increase, driven by an ageing population, an increase in risk factors, the effectiveness of novel therapies and improved survival. This rise in prevalence is increasingly noted among younger adults and is accompanied by a shift towards HF with preserved ejection fraction. However, disparities exist in our epidemiological understanding of HF burden and progression in low-income and middle-income countries owing to the lack of comprehensive data in these regions. Therefore, the current epidemiological landscape of HF highlights the need for periodic surveillance and resource allocation tailored to geographically vulnerable areas. In this Review, we highlight global trends in the burden of HF, focusing on the variations across the spectrum of left ventricular ejection fraction. We also discuss evolving population-based estimates of HF incidence and prevalence, the risk factors for and aetiologies of this disease, and outcomes in different geographical regions and populations.
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Affiliation(s)
| | - Izza Shahid
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Ahmed Bennis
- Department of Cardiology, The Ibn Rochd University Hospital Center, Casablanca, Morocco
| | | | - Marco Metra
- Cardiology Unit and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
- Baylor Scott and White Research Institute, Dallas, TX, USA.
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Zhang Z, Yang Z, Wang S, Wang X, Mao J. Overview of pyroptosis mechanism and in-depth analysis of cardiomyocyte pyroptosis mediated by NF-κB pathway in heart failure. Biomed Pharmacother 2024; 179:117367. [PMID: 39214011 DOI: 10.1016/j.biopha.2024.117367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/14/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
The pyroptosis of cardiomyocytes has become an essential topic in heart failure research. The abnormal accumulation of these biological factors, including angiotensin II, advanced glycation end products, and various growth factors (such as connective tissue growth factor, vascular endothelial growth factor, transforming growth factor beta, among others), activates the nuclear factor-κB (NF-κB) signaling pathway in cardiovascular diseases, ultimately leading to pyroptosis of cardiomyocytes. Therefore, exploring the underlying molecular biological mechanisms is essential for developing novel drugs and therapeutic strategies. However, our current understanding of the precise regulatory mechanism of this complex signaling pathway in cardiomyocyte pyroptosis is still limited. Given this, this study reviews the milestone discoveries in the field of pyroptosis research since 1986, analyzes in detail the similarities, differences, and interactions between pyroptosis and other cell death modes (such as apoptosis, necroptosis, autophagy, and ferroptosis), and explores the deep connection between pyroptosis and heart failure. At the same time, it depicts in detail the complete pathway of the activation, transmission, and eventual cardiomyocyte pyroptosis of the NF-κB signaling pathway in the process of heart failure. In addition, the study also systematically summarizes various therapeutic approaches that can inhibit NF-κB to reduce cardiomyocyte pyroptosis, including drugs, natural compounds, small molecule inhibitors, gene editing, and other cutting-edge technologies, aiming to provide solid scientific support and new research perspectives for the prevention and treatment of heart failure.
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Affiliation(s)
- Zeyu Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Zhihua Yang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shuai Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Xianliang Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Jingyuan Mao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
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Jia N, Zhao Y, Sun X, Wang M, Guo D. The effect of early initiation of self-management program based on multidisciplinary education in heart failure patients. BMC Cardiovasc Disord 2024; 24:503. [PMID: 39300340 DOI: 10.1186/s12872-024-04185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 09/11/2024] [Indexed: 09/22/2024] Open
Abstract
AIMS To explore the effect of early initiation of self-management based on multidisciplinary education in heart failure (HF) patients. METHODS HF patients in the Cardiology Department of Beijing Hospital were consecutively enrolled from June 2022 to February 2023. In-hospital HF patients from June 2022 to October 2022 were divided into the control group, and HF patients from November 2022 to February 2023 were divided into the cardiac rehabilitation (CR) group. A series of self-management education sessions with cardiologists, pharmacologists, nutritionists, and nurses was initiated early in the CR group. Continuous strengthening education was provided during the 3 months of discharge. Patients in the control group only received education twice during hospitalization. Minnesota Living with Heart Failure Questionnaire (MLHFQ), Pittsburgh sleep quality index (PSQI), anxiety Self-rating anxiety scale (SAS), and Self-rating depression scale (SDS) were compared between the two groups. Major cardiovascular adverse events (MACEs) were recorded during follow-up. RESULTS A total of 91 HF patients were enrolled. There were 44 patients in the CR group and 47 in the control group. Compared with before the program, the MLHFQ and SAS scores significantly decreased at 3 months after discharge in both groups. PSQI also showed mild improvement without significant differences in both groups. Furthermore, SDS showed a significant increase in the CR group but within the normal range. MACE occurrences did not show a significant difference. CONCLUSION Early initiation of self-management program based on multidisciplinary education may help improve quality of life, sleep quality, and reduce anxiety for hospitalized HF patients.
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Affiliation(s)
- Na Jia
- Cardiology Department, Beijing Hospital, National Center of Gerontology, National Health Commission Institute of Geriatric medicine, Chinese Academy of medical sciences, Beijing, China
| | - Yajie Zhao
- Cardiology Department, Beijing Hospital, National Center of Gerontology, National Health Commission Institute of Geriatric medicine, Chinese Academy of medical sciences, Beijing, China
| | - Xuelin Sun
- Pharmacology Department, Beijing Hospital, National Center of Gerontology, National Health Commission Institute of Geriatric medicine, Chinese Academy of medical sciences, Beijing, China
| | - Mingfang Wang
- Nutrition Department, Beijing Hospital, National Center of Gerontology, National Health Commission Institute of Geriatric medicine, Chinese Academy of medical sciences, Beijing, China
| | - Di Guo
- Cardiology Department, Beijing Hospital, National Center of Gerontology, National Health Commission Institute of Geriatric medicine, Chinese Academy of medical sciences, Beijing, China.
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Liu C, Guo X, Wang H, Zhou Y. Combination of Qi Benefiting and Blood Circulation Promoting Herbs with Dapagliflozin in the Treatment of Type 2 Diabetes Mellitus Combined with Heart Failure: A Systematic Evaluation and Meta-Analysis Based on a Randomized Controlled Trial. Complement Med Res 2024; 31:551-566. [PMID: 39293413 DOI: 10.1159/000541234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 08/30/2024] [Indexed: 09/20/2024]
Abstract
INTRODUCTION This systematic review examines the efficacy of a combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin in treating type 2 diabetes mellitus (T2DM) combined with heart failure (HF). METHODS Randomized controlled trials (RCTs) assessing the combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin for T2DM and CHF was conducted. The search, spanning from the database's establishment to June 2023, included seven databases: China Knowledge Network (CNKI), Wanfang Database, VIP Database, PubMed, Embase, Cochrane Library, and the Chinese Biomedical Literature Database. Two researchers screened and extracted data based on inclusion and exclusion criteria. The Cochrane Handbook version 5.1 guided the quality assessment of studies, and the meta-analysis was performed using RevMan 5.4 software. RESULTS Eleven articles, encompassing a sample size of 1,192 cases, were included. Meta-analysis results indicated that combining Qi benefiting and blood circulation promoting herbs with Dapagliflozin improved the clinical efficacy rate (OR = 4.35, 95% confidence interval [CI; 2.98, 6.35], p < 0.00001). It reduced blood glucose levels, evidenced by decreased fasting blood glucose (FBG) (mean difference [MD] = -1.19, 95% CI [-1.30, -1.09], p < 0.00001), 2-h postprandial blood glucose (2hPG) (MD = -1.95, 95% CI [-2.09, -1.80], p < 0.00001), and glycosylated hemoglobin (HbA1c) (MD = -1.40, 95% CI [-1.49, -1.31], p < 0.00001). Inflammatory factors also reduced, including C-reactive protein (CRP) (MD = -4.93, 95% CI [-5.38, -4.48], p < 0.00001), tumor necrosis factor (TNF-α) (MD = -2.91, 95% CI [-3.32, -2.49], p < 0.00001), and interleukin-6 (IL-6) (MD = -11.10, 95% CI [-12.43, -9.43], p < 0.00001). Additionally, left ventricular end-diastolic diameter (LVEDD) (standardized mean difference [SMD] = -1.25, 95% CI [-1.45, -1.05], p < 0.00001), left ventricular end-systolic diameter (LVESD) (SMD = -1.34, 95% CI [-1.51, -1.13], p < 0.00001), and improved left ventricular ejection fraction (LVEF) (SMD = 2.92, 95% CI [2.65, 3.19], p < 0.00001), 6-min walk test (6MWT) (MD = 35.59, 95% CI [29.72, 41.47], p < 0.00001), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores (MD = 35.59, 95% CI [29.72, 41.47], p < 0.00001) were observed. The incidence of adverse events also decreased (RR = 0.25, 95% CI [0.11, 0.56], p = 0.0007). CONCLUSION The combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin shows potential in treating patients with T2DM and HF, suggesting its use as adjunctive therapy in clinical practice. However, the limited number and quality of the included studies necessitate further high-quality research to confirm these findings.
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Affiliation(s)
- Changxing Liu
- First Clinical School of Medicine, Heilongjiang University of Chinese Medicine, Harbin, China,
| | - Xinyi Guo
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - He Wang
- Cardiovascular Division II, The First Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yabin Zhou
- Cardiovascular Division II, The First Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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Sang D, Tao J, Song W, Zhang Q, Wu S, Geng W. Comparison of the correlation of creatinine- and cystatin C-Based estimated GFR and their differences with new-onset heart failure in a community-based population with type 2 diabetes. Diabetol Metab Syndr 2024; 16:225. [PMID: 39267159 PMCID: PMC11391673 DOI: 10.1186/s13098-024-01461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 08/30/2024] [Indexed: 09/14/2024] Open
Abstract
AIMS This study aimed to investigate the impact of different estimated glomerular filtration rate (eGFR) values like cystatin C-based eGFR (eGFRcys), creatinine-based eGFR (eGFRcr), and their difference (eGFRdiff; eGFRcys -eGFRcr), on the incidence of heart failure (HF) in patients with type 2 diabetes(T2D). METHODS Being a prospective cohort study, it included 7,967 patients with T2D who underwent serum creatinine and cystatin C tests as part of the Kailuan Group's 6th annual health examination (2016). Subsequently, eGFRcys, eGFRcr, and eGFRdiff were calculated. Patients were categorized into three groups: negative (<-15 mL/min/1.73 m2), midrange (-15 to 15 mL/min/1.73 m2), and positive (> 15 mL/min/1.73 m2) eGFRdiff groups, respectively. Furthermore, the relationship between the various eGFR measurements and new-onset HF were studied using Cox proportional hazards regression, and the potential improvement in predictive capability was evaluated by adding these eGFR metrics to established HF risk models. RESULTS Among 7967 participants with mean age of 60.51 years, there were 20.92% women and 79.08% men. At baseline, eGFRcys and eGFRcr values differed by more than 15 mL/min/1.73m2 in 41.3% of participants. During a median follow-up period of 3.76 years, there were 172 (2.16%) new HF cases and 517 (6.49%) all-cause deaths. The cumulative incidence of HF in the midrange, negative, and positive eGFRdiff groups was 1.74%, 4.10%, and 0.61%, respectively (p < 0.001). In multivariable adjusted models, participants in the negative eGFRdiff group had higher risk of HF compared with the midrange eGFRdiff group (HR, 2.15; 95% CI, 1.57-2.94). Conversely, participants in the positive eGFRdiff group had lower risk for HF (HR, 0.40; 95% CI, 0.17-0.93). And each 15 mL/min/ 1.73 m2 higher eGFRdiff was associated with 34% (HR, 0.66; 95% CI, 0.58 - 0.47)lower risk of incident HF. The predictive capacity for HF risk in diabetic individuals was enhanced by adding eGFRcys or eGFRdiff to established HF risk models, with eGFRcys showing more significant additional predictive value. CONCLUSION These findings suggest that large differences between eGFRcys and eGFRcr were common in community-based population with T2D. Different eGFR metrics can independently predict HF incidence in patients with T2D. Additionally, metrics like eGFRcys and eGFRdiff provide significant predictive value for HF risks beyond traditional risk factors, with eGFRcys showing more pronounced benefits in such cases.
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Affiliation(s)
- Dasen Sang
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China.
| | - Jie Tao
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Wanqing Song
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Qi Zhang
- Department of Cardiology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, Hebei, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua Road(East), Tangshan, Hebei, China
| | - Wei Geng
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China.
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Cao Y, Sun Y, Miao B, Zhang X, Zhao Q, Qi L, Chen Y, Zhu L. Vericiguat on C-reactive Protein Level and Prognosis in Patients with Hypertensive Heart Failure. High Blood Press Cardiovasc Prev 2024; 31:485-492. [PMID: 39168957 DOI: 10.1007/s40292-024-00664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION Hypertensive heart failure (HHF) has a high incidence and poor prognosis. AIM This article evaluated the efficacy and safety of Vericiguat in HHF and analyzed the relationship between C-reactive protein (CRP) levels and patient prognosis. METHODS 110 HHF patients were divided into Placebo and Vericiguat groups. Cardiac function was assessed by echocardiography and 6-minute walk test (6MWT). Blood samples were collected to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), endothelin (ET-1), nitric oxide (NO), and CRP. RESULTS Left ventricular end systolic diameter (LVESD) and left ventricular end diastolic dimension (LVEDD) were reduced, the left ventricular ejection fraction (LVEF) and 6MWT were increased, and the serum levels of NT-proBNP, cTnI, ET-1, NO, and CRP were decreased in Vericiguat group as against Placebo group; The total effective rate was 76.4% in Placebo group and 92.7% in Vericiguat group (P < 0.05). The adverse reaction rate was 10.9% and 9.1% (P > 0.05). The proportion of persons with poor prognosis and no improvement of cardiac function in patients with highly expressed CRP before treatment was higher as against patients with low expression of CRP (P < 0.05). Highly expressed CRP is an independent risk factor for poor prognosis. CONCLUSION Vericiguat is safe and effective in improving cardiac function in HHF patients.
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Affiliation(s)
- Yabing Cao
- Department 1 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Yunjing Sun
- Department 2 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Bo Miao
- Department of Cardiovascular Intensive Care Unit, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Xiao Zhang
- Department 1 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Qingzhou Zhao
- Department 1 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Liping Qi
- Department of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Yaoqi Chen
- Department 1 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China
| | - Lingling Zhu
- Department 1 of Cardiology, Xingtai Third Hospital, Xingtai, Hebei Province, 054000, China.
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Zhang X, Fang W, Zhang Y, Yang M, Wang M, Fan X. The relationship between fatigue, exercise self-efficacy, fear of movement, and quality of life in patients with heart failure: A moderated mediation model. J Health Psychol 2024:13591053241273655. [PMID: 39175156 DOI: 10.1177/13591053241273655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
This study was aimed to examine the moderated mediating effects of exercise self-efficacy and fear of movement on the relationship between fatigue and quality of life in patients with heart failure. A total of 305 patients with heart failure were enrolled in this cross-sectional study. The results showed that fear of movement significantly mediated the relationship between fatigue and quality of life, indicating that relieving fear of movement may be beneficial to improve quality of life. Furthermore, exercise self-efficacy negatively moderated the mediating effect of fear of movement on the relationship between fatigue and physical health-related quality of life. It is suggesting that improving exercise self-efficacy may provide opportunities to buffer the negative effect of fear of movement on physical health-related quality of life in patients with heart failure, especially for those with fatigue. The findings provide additional strategies to optimize quality of life management in patients with heart failure.
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Affiliation(s)
- Xiuting Zhang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Wenjie Fang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Mei Yang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Mei Wang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Shandong University, P.R. China
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Zheng H, Wu K, Wu W, Huang Z, Wang X, Fu P, Wang Y, Chen Z, Cai Z, Cai Z, Lan Y, Wu S, Chen Y. Relationship of the trajectory of the triglyceride-glucose index with heart failure: the Kailuan study. Lipids Health Dis 2024; 23:257. [PMID: 39164722 PMCID: PMC11334604 DOI: 10.1186/s12944-024-02254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/13/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND A high triglyceride-glucose index (TyG) is associated with a higher risk of incident heart failure. However, the effects of longitudinal patterns of TyG index on the risk of heart failure remain to be characterized. Therefore, in the present study, we aimed to characterize the relationship between the trajectory of TyG index and the risk of heart failure. METHODS We performed a prospective study of 56,149 participants in the Kailuan study who attended three consecutive surveys in 2006-2007, 2008-2009, and 2010-2011 and had no history of heart failure or cancer before the third wave survey (2010-2011). The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2], and we used latent mixture modeling to characterize the trajectory of the TyG index over the period 2006-2010. Additionally, Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for incident heart failure for the various TyG index trajectory groups. RESULTS From 2006 to 2010, four different TyG trajectories were identified: low-stable (n = 13,554; range, 7.98-8.07), moderate low-stable (n = 29,435; range, 8.60-8.65), moderate high-stable (n = 11,262; range, 9.31-9.30), and elevated-stable (n = 1,898; range, 10.04-10.25). A total of 1,312 new heart failure events occurred during a median follow-up period of 10.04 years. After adjustment for potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident heart failure for the elevated-stable, moderate high-stable, and moderate low-stable groups were 1.55 (1.15, 2.08), 1.32 (1.08, 1.60), and 1.17 (0.99, 1.37), respectively, compared to the low-stable group. CONCLUSIONS Higher TyG index trajectories were associated with a higher risk of heart failure. This suggests that monitoring TyG index trajectory may help identify individuals at high risk for heart failure and highlights the importance of early control of blood glucose and lipids for the prevention of heart failure.
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Affiliation(s)
- Huancong Zheng
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Kuangyi Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zegui Huang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xianxuan Wang
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peng Fu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Yuxian Wang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zhiwei Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Yulong Lan
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Tangshan, 063000, China.
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China.
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Xu M, Ruan T, Huang X, Han B, Li Y, Ding Y, Zhu L. Care-seeking delay of patients with heart failure in China: a mixed-method study. ESC Heart Fail 2024; 11:2086-2099. [PMID: 38567397 PMCID: PMC11287340 DOI: 10.1002/ehf2.14757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
AIM This study aims to explore the duration and influencing factors of care-seeking delay among patients with heart failure (HF) in China. METHODS AND RESULTS A convergent mixed method containing a cross-sectional study and two parts of qualitative studies was designed, following the STROBE and COREQ guidelines. Convenience sampling was applied to recruit patients with HF from two general hospitals from December 2021 to December 2022. Purposive sampling was used to enrol healthcare professionals from two general hospitals and two community hospitals from June to November 2022. Among the 258 patients with HF in the cross-sectional study, the median duration of care-seeking delay was 7.5 days. The result integration indicated that the delay duration was influenced by the dyspnoea symptom burden, the oedema symptom burden, and the depression status. The lower dyspnoea symptom burden, the higher oedema symptom burden, and the higher depression score were related to the prolonged care-seeking delay duration. The duration was also affected by the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers. The COVID-19 pandemic, low level of support from medical system, and limited symptom management abilities of caregivers were related to the prolonged care-seeking delay duration. CONCLUSIONS Care-seeking delay among patients with HF needs attention in China. The duration of care-seeking delay of patients with HF was influenced by the dyspnoea symptom burden, the oedema symptom burden, and depression status, as well as the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers.
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Affiliation(s)
- Mengqi Xu
- Department of NursingShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Tiantian Ruan
- School of NursingShanghai Jiao Tong UniversityShanghaiChina
| | - Xiaoli Huang
- Department of CardiologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Beibei Han
- Department of CardiologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yingqi Li
- Department of CardiologyShanghai Eighth People's HospitalShanghaiChina
| | - Yuan Ding
- School of NursingShanghai Jiao Tong UniversityShanghaiChina
| | - Lingyan Zhu
- Department of NursingShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
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Qiu BY, Xu BR, Song YK, Hu YC, Ren HJ, Zheng J, Chen P, Wang YX. Effectiveness and mechanism of Huoxin pill on heart failure after percutaneous coronary intervention: Study protocol for a double-blind, randomised, placebo-controlled parallel trial. Contemp Clin Trials Commun 2024; 40:101328. [PMID: 39026569 PMCID: PMC11255501 DOI: 10.1016/j.conctc.2024.101328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
Background Coronary heart disease (CHD) is the most common cardiovascular disease facing human beings. Cardiac remodelling is an important pathological factor for the progression of heart failure (HF) after CHD. At present, Chinese medicine is widely used in the treatment of HF, but there are still some drugs lack of evidence-based and mechanism evidence. Multi-omics techniques can deep explore candidate pathogenic factors and construct gene regulatory networks.This trial is intended to evaluate the effect on Huoxin pill (HXP) in the treatment of HF after programmable communication interface (PCI). Meantime, multi-omics analysis technique will be used to target the fundamental pathological links of cardiac remodelling, so as to study the mechanism of HXP in the treatment of HF after PCI. Methods This study is a randomized, double-blind, placebo-controlled trial. Sixty patients with HF undergoing PCI are recruited from the First Affiliated Hospital of Henan University of CM. All selected patients will be randomly attributed to receive conventional treatment + HXP or placebo. The packaging, dosage and smell of placebo and heart activating pill were identical. The primary outcome is NYHA cardiac function grade, while the secondary outcomes included Lee's HF score, exercise tolerance test, and quality of life evaluation. Additional indicators include cardiac ultrasound, electrocardiogram, 24-h dynamic electrocardiogram, myocardial injury indicators, and energy metabolism indicators. Discussion This study may provide a new treatment option for patients with HF after PCI and provide evidence for the treatment of CHD and HF with HXP. Trial registration 2023-10-08 registered in China Clinical Trial Registry, registration number ChiCTR2300076402.
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Affiliation(s)
| | | | - Yan-kun Song
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Yu-cai Hu
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Hong-jie Ren
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Jia Zheng
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Peng Chen
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Yong-xia Wang
- Heart Center/National Regional (Traditional Chinese Mdicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
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Yao Y, Zhou Z, Geng T, Cai A, Li T, Yang J, Chen J, Li L. Long-term cost-effectiveness of transcatheter mitral valve repair in HF patients with secondary mitral regurgitation. ESC Heart Fail 2024; 11:2023-2032. [PMID: 38515335 PMCID: PMC11287354 DOI: 10.1002/ehf2.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 03/23/2024] Open
Abstract
AIMS The long-term cost-effectiveness of MitraClip in heart failure patients with secondary mitral regurgitation is still unclear. This study aimed to evaluate the long-term cost-effectiveness of MitraClip added to guideline-directed medical therapy vs. guideline-directed medical therapy alone in heart failure patients with secondary mitral regurgitation from the perspective of the healthcare systems of mainland China, the United Kingdom, Germany, and the United States. METHODS AND RESULTS A two-stage (decision + Markov) model was built. Health utilities were defined by the New York Heart Association class, heart failure re-hospitalization, and death and were calculated based on the 5 year follow-up results of the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation trial. Direct healthcare costs were derived from the nationally representative data. Future utilities and costs were discounted at country-specific rates. The primary outcome was the lifetime incremental cost-effectiveness ratio. The mean age of the base case in our model was 72.2 years. Over a lifetime horizon, treatment with MitraClip was associated with 829 fewer heart failure re-hospitalizations per 1000 treated patients. The MitraClip treatment was associated with incremental quality-adjusted life-year gains of 0.71, 0.76, 0.78, and 0.78, as well as incremental cost-effectiveness ratios of ¥468 462, £28 910, €26 045, and $71 199 per quality-adjusted life-year for a lifetime horizon in mainland China, the United Kingdom, Germany, and the United States, respectively. In probabilistic sensitivity analysis, 0.2%, 59.4%, 99.6%, and 84.7% of patients were cost-effective in mainland China, the United Kingdom, Germany, and the United States at the country-specific willingness-to-pay thresholds. CONCLUSIONS MitraClip + guideline-directed medical therapy was cost-effective in heart failure patients with secondary mitral regurgitation in the United Kingdom, Germany, and the United States, but not in mainland China from the perspective of the national healthcare system.
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Affiliation(s)
- Younan Yao
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
| | - Ziyou Zhou
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
- Department of Cardiology, School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Tian Geng
- Department of EmergencyGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouChina
| | - Anping Cai
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
| | - Tian Li
- Department of Cardiology and AngiologyMedical Center, University of FreiburgFreiburg im BreisgauGermany
| | - Junqing Yang
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
- Department of Cardiology, School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesNo. 106, Zhongshan 2nd Road, Yuexiu DistrictGuangzhou510080China
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Cheang I, Yao W, Zhou Y, Zhu X, Ni G, Lu X, Liao S, Gao R, Zhou F, Shen J, Leung AYL, Jiang M, Kong H, Bai L, Mahemuti A, Yuan H, Dong YG, Wong CK, Xu Q, Zhang G, Wu J, Lu Q, Zhang J, Cha C, Ren Q, Fu L, Wang B, Xu Y, Hu H, Dong J, Shang Z, Yu C, Li S, Yao C, Gao L, Zhang H, Rosenzweig A, Jia Z, Li X. The traditional Chinese medicine Qiliqiangxin in heart failure with reduced ejection fraction: a randomized, double-blind, placebo-controlled trial. Nat Med 2024; 30:2295-2302. [PMID: 39095596 PMCID: PMC11333273 DOI: 10.1038/s41591-024-03169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 07/01/2024] [Indexed: 08/04/2024]
Abstract
Previous findings have indicated the potential benefits of the Chinese traditional medicine Qiliqiangxin (QLQX) in heart failure. Here we performed a double-blind, randomized controlled trial to evaluate the efficacy and safety of QLQX in patients with heart failure and reduced ejection fraction (HFrEF). This multicenter trial, conducted in 133 hospitals in China, enrolled 3,110 patients with HFrEF with NT-proBNP levels of ≥450 pg ml-1 and left ventricular ejection fraction of ≤40%. Participants were randomized to receive either QLQX capsules or placebo (four capsules three times daily) alongside standard heart failure therapy. The trial met its primary outcome, which was a composite of hospitalization for heart failure and cardiovascular death: over a median follow-up of 18.3 months, the primary outcome occurred in 389 patients (25.02%) in the QLQX group and 467 patients (30.03%) in the placebo group (hazard ratio (HR), 0.78; 95% confidence interval (CI), 0.68-0.90; P < 0.001). In an analysis of secondary outcomes, the QLQX group showed reductions in both hospitalization for heart failure (15.63% versus 19.16%; HR, 0.76; 95% CI, 0.64-0.90; P = 0.002) and cardiovascular death (13.31% versus 15.95%; HR, 0.83; 95% CI, 0.68-0.996; P = 0.045) compared to the placebo group. All-cause mortality did not differ significantly between the two groups (HR, 0.84; 95% CI, 0.70-1.01; P = 0.058) and adverse events were also comparable between the groups. The results of this trial indicate that QLQX may improve clinical outcomes in patients with HFrEF when added to conventional therapy. ChiCTR registration: ChiCTR1900021929 .
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Affiliation(s)
- Iokfai Cheang
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Wenming Yao
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yanli Zhou
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Xu Zhu
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Gehui Ni
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Xinyi Lu
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Shengen Liao
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Rongrong Gao
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Fang Zhou
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Jiangang Shen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Meng Jiang
- Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hong Kong
- Sichuan Provincial People's Hospital, Chengdu, China
| | - Ling Bai
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ailiman Mahemuti
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | | | - Yu-Gang Dong
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun-Ka Wong
- Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Qinghua Xu
- Liaocheng People's Hospital, Liaocheng, China
| | | | - Jianhua Wu
- Xiuyan Manchu Autonomous County Central Peoples Hospital, Anshan, China
| | - Qi Lu
- Affiliated Hospital of Nantong University, Nantong, China
| | - Junhai Zhang
- Weixian Hospital of Traditional Chinese Medicine, Weixian, China
| | - Chunxi Cha
- Xinjiang Production and Construction Corps First Division Hospital, Aksu, China
| | - Qian Ren
- Sunsimiao Hospital of BUCM, Tongchuan, China
| | - Lu Fu
- The First Hospital of Harbin Medical University, Harbin, China
| | - Bing Wang
- Zouping People's Hospital, Zouping, China
| | - Yongshun Xu
- Workers' Hospital of Handan Iron and Steel Group Co., Handan, China
| | - Houxiang Hu
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing Dong
- The Second Affiliated Hospital of Shaanxi Medical University of Chinese Medicine, Xianyang, China
| | - Zhuo Shang
- The Second People's Hospital of Bengbu, Bengbu, China
| | - Chaoping Yu
- Pidu District People's Hospital, Chengdu, China
| | - Songsen Li
- Luoyang Central Hospital, Luoyang, China
| | - Chen Yao
- Peking University Clinical Research Institute, Beijing, China
| | - Lingling Gao
- Peking University Clinical Research Institute, Beijing, China
| | - Haifeng Zhang
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
| | - Anthony Rosenzweig
- Institute for Heart and Brain Health, University of Michigan Medical Center, Ann Arbor, MI, USA.
| | - Zhenhua Jia
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Hebei Clinical Research Center of Cardiovascular Disease of Traditional Chinese Medicine, Shijiazhuang, China.
| | - Xinli Li
- State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
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Lou Y, Hua Y, Yang J, Shi J, Jiang L, Yang Y. A nomogram for predicting CRT response based on multi-parameter features. BMC Cardiovasc Disord 2024; 24:376. [PMID: 39030503 PMCID: PMC11264749 DOI: 10.1186/s12872-024-04033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVE To construct a nomogram for predicting the responsiveness of cardiac resynchronization therapy (CRT) in patients with chronic heart failure and verify its predictive efficacy. METHOD A retrospective study was conducted including 109 patients with chronic heart failure who successfully received CRT from January 2018 to December 2022. According to patients after six months of the CRT preoperative improving acuity in the left ventricular ejection fraction is 5% or at least improve grade 1 NYHA heart function classification, divided into responsive group and non-responsive group. Clinical data of patients were collected, and LASSO regression analysis and multivariate logistic regression analysis were used to explore relative factors. A nomogram was constructed, and the predictive performance of the nomogram was evaluated using the calibration curve and decision curve analysis (DCA). RESULTS Among the 109 patients, 61 were assigned to the CRT-responsive group, while 48 were assigned to the non-responsive group. LASSO regression analysis showed that left ventricular end-systolic volume, diffuse fibrosis, and left bundle branch block (LBBB) were independent factors for CRT responsiveness in patients with heart failure (P < 0.05). Based on the above three predictive factors, a nomogram was constructed. The ROC curve analysis showed that the area under the curve (AUC) was 0.865 (95% CI 0.794-0.935). The calibration curve analysis showed that the predicted probability of the nomogram is consistent with the actual occurrence rate. DCA showed that the line graph model has an excellent clinical net benefit rate. CONCLUSION The nomogram constructed based on clinical features, laboratory, and imaging examinations in this study has high discrimination and calibration in predicting CRT responsiveness in patients with chronic heart failure.
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Affiliation(s)
- Yuxuan Lou
- Southeast University, Nanjing, 210009, Jiangsu, China
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yang Hua
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jiaming Yang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jing Shi
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Lei Jiang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yang Yang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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Huang J, Lin Y, Ding X, Lin S, Li X, Yan W, Chen M. Alteration of the gut microbiome in patients with heart failure: A systematic review and meta-analysis. Microb Pathog 2024; 192:106647. [PMID: 38788811 DOI: 10.1016/j.micpath.2024.106647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/02/2024] [Accepted: 04/13/2024] [Indexed: 05/26/2024]
Abstract
Recent research has revealed that alterations of the gut microbiome (GM) play a comprehensive role in the pathophysiology of HF. However, findings in this field remain controversial. In this study, we focus on differences in GM diversity and abundance between HF patients and non-HF people, based on previous 16 S ribosomal RNA (16rRNA) gene sequencing. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search of PubMed, Web of Science, Embase, Cochrane Library, and Ovid databases using the keyword "Heart failure" and "Gastrointestinal Microbiome". A significant decrease in alpha diversity was observed in the HF patients (Chao1, I2 = 87.5 %, p < 0.001; Shannon index, I2 = 62.8 %, p = 0.021). At the phylum level, the HF group exhibited higher abundances of Proteobacteria (I2 = 92.0 %, p = 0.004) and Actinobacteria (I2 = 82.5 %, p = 0.010), while Bacteroidetes (I2 = 45.1 %, p = 0.017) and F/B ratio (I2 = 0.0 %, p<0.001) were lower. The Firmicutes showed a decreasing trend but did not reach statistical significance (I2 = 82.3 %, p = 0.127). At the genus level, the relative abundances of Streptococcus, Bacteroides, Alistipes, Bifidobacterium, Escherichia-Shigella, Enterococcus and Klebsiella were increased in the HF group, whereas Ruminococcus, Faecalibacterium, Dorea and Megamona exhibited decreased relative abundances. Dialister, Blautia and Prevotella showed decreasing trends but without statistical significance. This observational meta-analysis suggests that GM changes are associated with HF, manifesting as alterations in GM abundance, disruptions in the production of short-chain fatty acids (SCFAs) bacteria, and an increase in trimethylamine N-oxide (TMAO) producing bacteria.
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Affiliation(s)
- Jiayi Huang
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China
| | - Yongping Lin
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China
| | - Xiangwei Ding
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China
| | - Song Lin
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China
| | - Xin Li
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China
| | - Wei Yan
- Department of Cardiology, Nanjing Pukou People's Hospital, Nanjing, 211800, China
| | - Minglong Chen
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, China; Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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HU SS. Heart failure in China: epidemiology and current management. J Geriatr Cardiol 2024; 21:631-641. [PMID: 38973826 PMCID: PMC11224652 DOI: 10.26599/1671-5411.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this sixth section of the report offers a comprehensive analysis of heart failure (HF) in China. HF is one of the most important cardiovascular disease in the 21st century. Its mortality is equivalent to that of cancer. It is an important public health problem that seriously affects the health of Chinese residents. In recent years, with the deepening of understanding, the change of treatment principles, the innovation of treatment methods and the update of treatment guidelines, the in-hospital mortality of HF patients has declined, and the long-term prognosis is also improving. However, there are still differences in the management level of HF among different hospitals in China. How to improve the standardized diagnosis and treatment level of HF in China remains an important challenge.
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Affiliation(s)
- Sheng-Shou HU
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Lu M, Li Y, Pan Y, Ding Y, Wang K, Xu D. Relationship between serum uric acid and sarcopenia in geriatric heart failure patients with preserved ejection fraction. Exp Gerontol 2024; 191:112445. [PMID: 38670208 DOI: 10.1016/j.exger.2024.112445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) presents a serious risk to human health. The increased prevalence of sarcopenia in the HFpEF population has a negative impact on patient prognosis. Uric acid (UA) is the byproduct of purine metabolism and is harmful to the cardiovascular system. This study aims to establish the potential relationship between sarcopenia and serum UA in HFpEF patients. METHODS Data were obtained from 180 individuals (aged ≥60 years) with HFpEF admitted to the Geriatric Department of Jiangsu Province Hospital between January 2021 and December 2022. The UA values were grouped into 4 quartiles (Q1-Q4). Logistic generalized linear models and restricted cubic spline (RCS) regression were used to analyze the relationship between sarcopenia and UA. Subgroups based on gender were utilised for further analysis. RESULTS After adjusting for covariates, odds ratios (ORs) and 95 % confidence intervals (CIs) for sarcopenia prevalence in the 2nd, 3rd, and 4th quartiles were 2.56 (0.57-12.65), 4.94 (1.10-24.49), and 6.95 (1.30-44.25), respectively, unlike the 1st quartile (P for trend = 0.022). The RCS plot demonstrated a positive linear relationship between serum UA levels and sarcopenia (P for non-linearity = 0.190). A sex-based subgroup analysis revealed a statistically significant relationship between UA and sarcopenia in males (P < 0.05). CONCLUSIONS In summary, the prevalence of sarcopenia is positively related to serum UA levels among the elderly diagnosed with HFpEF. Due to the cross-sectional nature of the study design, additional investigations are necessary to validate our findings and identify the optimal range for UA reduction.
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Affiliation(s)
- Miao Lu
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Yansong Li
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Yiting Pan
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Yinzhang Ding
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Kai Wang
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
| | - Di Xu
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
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Jiampo P, Tangkittikasem T, Boonyapiphat T, Senthong V, Torpongpun A. Real-World Heart Failure Burden in Thai Patients. Cardiol Ther 2024; 13:281-297. [PMID: 38326588 PMCID: PMC11093949 DOI: 10.1007/s40119-024-00355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Heart failure (HF) is one of the leading causes of hospitalization worldwide. In Thailand, data on HF burden remains limited. This study aimed to describe comprehensive evidence detailing the HF prevalence, hospital admission rates, in-hospital mortality, and overall mortality rates at the hospital level. METHOD All eligible adult patients' medical records from 2018 and 2019 were analyzed retrospectively at five hospitals in different regions. The patients were diagnosed with HF, as indicated by the International Classification of Diseases (ICD)-10 code I50. Descriptive statistics were used to examine the hospital burden as well as patients' clinical and outcome data. RESULTS A total of 7384 patients with HF were identified from five tertiary hospitals. Around half of the patients were male. The mean age was 67 years, and the main health insurance scheme was the Universal Coverage Scheme. The prevalence of HF was 0.1% in 2018 and 0.2% in 2019. Heart failure with preserved ejection fraction (HFpEF) was the most common type of HF in both visits, followed by heart failure with reduced ejection fraction (HFrEF) and heart failure with mildly reduced ejection fraction (HFmrEF). The proportion of HF hospitalizations was 1.2% in 2018 and 1.5% in 2019. The proportion of HF rehospitalizations versus hospitalizations in patients with HF was 22.7% in 2018 and 23.9% in 2019. The risk of rehospitalization was highest at 180 days after hospital discharge (87.8%). Among the patients with HF, the proportion of all-cause mortality was 9.1% in 2018 and 8.0% in 2019. Most of the deaths occurred within 30 days after hospitalization. CONCLUSION Our study demonstrated that the burden of HF in terms of hospitalization and in-hospital mortality was notably high when compared to similar studies conducted in Thailand and other countries.
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Affiliation(s)
- Panyapat Jiampo
- Bhumibol Adulyadej Hospital, Sai Mai District, Bangkok, Thailand
| | | | | | - Vichai Senthong
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Mueang, Khon Kaen, Thailand
| | - Artit Torpongpun
- Chonburi Hospital, 69 Moo 2, Sukhumvit Road, Ban Suan, Mueang Chon Buri, Chon Buri, 20000, Thailand.
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Zhao Q, Zhang Y, Dong X, Zhang X, Fan X. The effects of weight management on heart failure: A systematic review and meta-analysis of randomized controlled trials. Worldviews Evid Based Nurs 2024; 21:279-287. [PMID: 37368482 DOI: 10.1111/wvn.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 05/18/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Weight management is an important part of disease management in patients with heart failure. However, the effectiveness of reported weight management interventions is inconclusive. AIMS The aim of this systematic review and meta-analysis was to assess the effects of weight management on functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure. METHODS PubMed, Web of Science, Embase, and the Cochrane Library were searched on April 3, 2022. This study was registered with PROSPERO (CRD42021283817). Eligible studies assessed functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure. Two researchers independently screened the articles, extracted data, and evaluated the risk bias of each study. Dichotomous variables were presented as OR with a 95% confidence interval (CI). The data were analyzed using a fixed effect or random effect model, and heterogeneity was determined using I2 statistics. All statistical analyses were conducted using RevMan 5.3. RESULTS Among 4279 studies screened, seven randomized controlled trials were included in this study. The results showed that weight management significantly improved functional status (OR = 0.15, 95% CI [0.07, 0.35], I2 = 52%) and reduced the risk of all-cause mortality (OR = 0.54, 95% CI [0.34, 0.85], I2 = 0%), but had no significant effect on heart failure-related hospitalizations (OR = 0.72, 95% CI [0.20, 2.66]). LINKING EVIDENCE TO ACTION Weight management has effects on improved functional status and reduced all-cause mortality in patients with heart failure. It is necessary to strengthen the weight management interventions of patients with heart failure to improve patients' functional status and reduce all-cause mortality.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaoyu Dong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiuting Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Qiu B, Qiao S, Shi X, Shen L, Deng B, Ma Z, Zhou D, Wei Y. Shen'ge Formula Protects Cardiac Function in Rats with Pressure Overload-Induced Heart Failure. Drug Des Devel Ther 2024; 18:1875-1890. [PMID: 38831869 PMCID: PMC11146625 DOI: 10.2147/dddt.s451720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
Background In China, Shen'ge formula (SGF), a Traditional Chinese Medicine blend crafted from ginseng and gecko, holds a revered place in the treatment of cardiovascular diseases. However, despite its prevalent use, the precise cardioprotective mechanisms of SGF remain largely uncharted. This study aims to fill this gap by delving deeper into SGF's therapeutic potential and underlying action mechanism, thus giving its traditional use a solid scientific grounding. Methods In this study, rats were subjected to abdominal aortic constriction (AAC) to generate pressure overload. Following AAC, we administered SGF and bisoprolol intragastrically at specified doses for two distinct durations: 8 and 24 weeks. The cardiac function post-treatment was thoroughly analyzed using echocardiography and histological examinations, offering insights into SGF's influence on vital cardiovascular metrics, and signaling pathways central to cardiac health. Results SGF exhibited promising results, significantly enhanced cardiac functions over both 8 and 24-week periods, evidenced by improved ejection fraction and fractional shortening while moderating left ventricular parameters. Noteworthy was SGF's role in the significant mitigation of myocardial hypertrophy and in fostering the expression of vital proteins essential for heart health by the 24-week mark. This intervention markedly altered the dynamics of the Akt/HIF-1α/p53 pathway, inhibiting detrimental processes while promoting protective mechanisms. Conclusion Our research casts SGF in a promising light as a cardioprotective agent in heart failure conditions induced by pressure overload in rats. Central to this protective shield is the modulation of the Akt/HIF-1α/p53 pathway, pointing to a therapeutic trajectory that leverages HIF-1α promotion and p53 nuclear transport inhibition.
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Affiliation(s)
- Boyong Qiu
- Heart Center/National Regional (Traditional Chinese Medicine) Cardiovascular Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, People’s Republic of China
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Siyu Qiao
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Xiujuan Shi
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Lin Shen
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Bing Deng
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Zilin Ma
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Duan Zhou
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yihong Wei
- Cardiovascular Department, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Li Y, Zhu F, Ren D, Tong J, Xu Q, Zhong M, Zhao W, Duan X, Xu X. Establishment of in-hospital nutrition support program for middle-aged and elderly patients with acute decompendated heart failure. BMC Cardiovasc Disord 2024; 24:259. [PMID: 38762515 PMCID: PMC11102219 DOI: 10.1186/s12872-024-03887-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/11/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVE To construct a nutrition support program for middle-aged and elderly patients with acute decompensated heart failure (ADHF) during hospitalization. METHODS Based on the JBI Evidence-Based Health Care Model as the theoretical framework, the best evidence was extracted through literature analysis and a preliminary nutrition support plan for middle-aged and elderly ADHF patients during hospitalization was formed. Two rounds of expert opinion consultation were conducted using the Delphi method. The indicators were modified, supplemented and reduced according to the expert's scoring and feedback, and the expert scoring was calculated. RESULTS The response rates of the experts in the two rounds of consultation were 86.7% and 100%, respectively, and the coefficient of variation (CV) for each round was between 0.00% and 29.67% (all < 0.25). In the first round of expert consultation, 4 items were modified, 3 items were deleted, and 3 items were added. In the second round of the expert consultation, one item was deleted and one item was modified. Through two rounds of expert consultation, expert consensus was reached and a nutrition support plan for ADHF patients was finally formed, including 4 first-level indicators, 7 s-level indicators, and 24 third-level indicators. CONCLUSION The nutrition support program constructed in this study for middle-aged and elderly ADHF patients during hospitalization is authoritative, scientific and practical, and provides a theoretical basis for clinical development of nutrition support program for middle-aged and elderly ADHF patients during hospitalization.
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Affiliation(s)
- Yongliang Li
- CCU, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Fang Zhu
- CCU, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Dongmei Ren
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Jianping Tong
- Department of Cardiovascular Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201204, China
| | - Qin Xu
- Department of Emergency, Jiad-ing District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences, Shanghai, 201800, China
| | - Minhui Zhong
- Department of Nursing, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Wei Zhao
- Suzhou Science & Technology Town Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Xia Duan
- Department of Nursing, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
| | - Xiangdong Xu
- Department of Cardiovascular Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201204, China.
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Zhang X, Zhang Y, Li S, Liu M, Lu Y, He M, Sun Z, Ma M, Zheng L. Non-linear associations of serum spermidine with type 2 diabetes mellitus and fasting plasma glucose: a cross-sectional study. Front Nutr 2024; 11:1393552. [PMID: 38812932 PMCID: PMC11133730 DOI: 10.3389/fnut.2024.1393552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Background Previous animal experiments have demonstrated the potential of spermidine to mitigate glucose intolerance, insulin resistance, and hyperinsulinemia. However, there remains a scarcity of epidemiological evidence supporting these findings. Therefore, we aimed to elucidate the associations of serum spermidine with T2DM and FPG. Materials and methods The cross-sectional study was conducted from June to August 2019 in the rural areas of Fuxin County, Liaoning Province, China. A total of 4,437 participants were included in the study. The serum spermidine was detected using high-performance liquid chromatography with a fluorescence detector. FPG was measured using the hexokinase method. T2DM was defined as participants with a FPG level of 7.0 mmol/L or greater, or self-reported diagnosis of diabetes by a doctor. Restricted cubic spline model and piecewise linear regression model were used to explore the associations of serum spermidine with T2DM and FPG, respectively. Results The mean (SD) age of the participants was 59.3 (10.0) years, with 622 out of 4,437 participants being defined as T2DM. The serum spermidine in participants stratified by age and BMI categories was significantly different, with p values of 0.006 and 0.001, respectively. Among all the participants, the association of serum spermidine with T2DM was J-shaped. The log (spermidine) was negatively associated with T2DM (OR = 0.68, 95% CI: 0.52 to 0.92, p = 0.01) below the inflection point, while log (spermidine) was not significantly associated with T2DM (OR = 1.97, 95% CI: 0.93 to 4.15, p = 0.07) above the inflection point. Among the participants without T2DM, the association of serum spermidine with FPG was inverted J-shaped. The log (spermidine) was positively associated with FPG (β = 0.13, 95% CI: 0.05 to 0.21, p = 0.001) below the inflection point, while log (spermidine) was negatively associated with FPG (β = -0.29, 95% CI: -0.42 to -0.16, p < 0.001) above the inflection point. Conclusion In conclusion, non-linear associations of serum spermidine with T2DM and FPG were found in the cross-sectional study in Chinese rural adults. This provided insights into the use of spermidine for the prevention of T2DM, highlighting the potential role in public health prevention strategies of spermidine.
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Affiliation(s)
- Xiaohong Zhang
- Clinical Research Centre, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shaojie Li
- Department of Cardiovascular Medicine, Fenyang College of Shanxi Medical University, Fenyang Hospital Affiliated to Shanxi Medical University, Fenyang, Shanxi, China
| | - Min Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Ying Lu
- Department of Physical and Chemical, Shanghai Changning District Center for Disease Control and Prevention, Shanghai, China
| | - Mengyao He
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mingfeng Ma
- Department of Cardiovascular Medicine, Fenyang Hospital Affiliated to Shanxi Medical University, Fenyang, Shanxi, China
| | - Liqiang Zheng
- Clinical Research Centre, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
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