ObjectiveTo investigate the association of arterial stiffness with cardiovascular risk factors.
MethodsFrom July 2014 to August 2015, 1 599 participants aged over 65 years old were recruited from 10 communities located in the northern Shanghai. Carotid-femoral pulse wave velocity (cf-PWV) was measured by SphygmoCor device. Cardiovascular risk factors were assessed by questionnaire, anthropometry or conventional biochemical measurements. SPSS 20.0 was applied for data management and statistical analysis.
ResultsCf-PWV was significantly associated with cardiovascular risk factors (P<0.001). Moreover, with the accumulating cardiovascular risk factors, cf-PWV increased gradually and significantly (P<0.001). The increasing trend remained significant in all participants, in men and in women, respectively.
ConclusionArterial stiffness is significantly associated with cardiovascular risk factors and their accumulation.
ObjectivesTo systematically review the efficacy of Nordic walking on prognosis of cardiovascular diseases. MethodsPubMed, Web of Science, EMbase, The Cochrane Library, CBM, CNKI and VIP databases were electronically searched to collect intervention studies on the efficacy of Nordic walking on prognosis of cardiovascular diseases from inception to June, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 studies involving 328 patients were included. The results of meta-analysis showed that: compared with control group, there were an obvious decrease in the values of LDL (MD=–11.38, 95%CI –17.51 to –5.25, P=0.000 3), TG (MD=–21.14, 95%CI –32.33 to–9.96, P=0.000 2), SBP (MD=–7.96, 95%CI ?11.45 to –4.46, P<0.000 01) and TC, DBP, BMI (P<0.05). However, there were no obvious differences between two groups in HDL. ConclusionsNordic walking can improve the prognosis of patients with cardiovascular diseases, yet the long-term effect is unclear. Due to limited quality and quantity of the included studies, more higher quality studies are required to verify above conclusions.
Abstract: The amniotic fluidderived stem cells (AFSC) possess considerable advantageous characteristics including high proliferation potential, easy availability, low immunogenicity and oncogenicity，and accordance with medical ethnics. Moreover, they do not require the sacrifice of human embryos for their isolation and the cells can differentiate into all three kinds of germs. Accordingly，they initiate a new and very promising field in stem cell research and they will be a potential source of stem cells for therapies related to regeneration medicine of cardiovascular diseases. The research about the AFSC utilization in cardiovascular diseases is just started. Though there were some exciting breakthroughs, there still remain many challenges. In the article，we will discuss AFSC characteristics, influence of amniotic fluid harvesting time on stem cells, isolation and purification, emphasizing mainly on the potential of AFSC differentiation into cardiovascular cells, current situation and problems in this field.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
Objective To summarize treatment experience and evaluate clinical outcomes of surgical therapy for Stanford type A aortic dissection （AD）. Methods Clinical data of 48 patients with Stanford type A AD who underwent surgical treatment in General Hospital of Lanzhou Military Region from October 2006 to March 2013 were retrospectively analyzed. There were 41 males and 7 females with their age of 26-72 （47.6±9.2） years. There were 43 patients with acute Stanford type A AD （interval between symptom onset and diagnosis＜14 days） and 5 patients with chronic AD. There were 19 patients with moderate to severe aortic insufficiency and 6 patients with Marfan symdrome but good aortic valve function，who all received Bentall procedure，total arch replacement and stented elephant trunk implantation. There were 8 patients with AD involving the aortic root but good aortic valve function who underwent modified David procedure，total arch replacement and stented elephant trunk implantation. There were 10 patients with AD involving the ascending aorta who received ascending aorta replacement，total arch replacement and stented elephant trunk implantation. There were 5 patients with AD involving partial aortic arch who underwent ascending aorta and hemiarch replacement. Patients were followed up in the 3rd，6th and 12th month after discharge then once every year. Follow-up evaluation included general patient conditions，blood pressure control，chest pain recurrence，mobility and computerized tomography arteriography （CTA）. ResultsCardiopulmonary bypass time was 121-500 （191.4±50.6） minutes，aortic cross-clamp time was 58-212 （112.3±31.7） minutes，and circulatory arrest and selective cerebral perfusion time was 26-56 （34.8±8.7） minutes. Postoperative mechanicalventilation time was 32-250 （76.2±35.6） hours，and ICU stay was 3-20 （7.1±3.4） days. Thoracic drainage within 24 hours postoperatively was 680-1 600 （1 092.5±236.3） ml. Seven patients （14.5%） died perioperatively including 2 patients with multiple organ dysfunction syndrome，2 patients with low cardiac output syndrome，1 patient with renal failure，1patient with delayed refractory hemorrhage，and 1 patient with coma. Twenty patients had other postoperative complicationsand were cured or improved after treatment. A total of 38 patients ［92.7% （38/41）］ were followed up for 3-48 （13.0±8.9） months，and 3 patients were lost during follow-up. During follow-up，there were 36 patients alive and 2 patients who died of other chronic diseases. There was no AD-related death during follow-up. None of the patients required reoperation for AD or false-lumen expansion. CTA at 6th month after discharge showed no anastomotic leakage，graft distortion or obstruction.Conclusion According to aortic intimal tear locations，ascending aorta diameter and AD involving scopes，appropriate surgical strategies，timing and organ protection are the key strategies to achieve optimal surgical results for Stanford type A AD. Combined axillary and femoral artery perfusion and increased lowest intraoperative temperature are good methods for satisfactory surgical outcomes of Stanford type A AD.
Objective To explore the difference of cardiovascular risk factors and coronary artery lesion between Hui nationality and Han nationality patients with premature coronary heart disease. Methods A total of 316 patients with premature coronary heart disease were divided into two groups, including the Hui group (78 cases) and the Han group (238 cases). Eight risk factors for premature coronary heart disease (including age, gender, body mass index, familial heredity, diabetes, hypertension, dyslipidemia and smoking history) and coronary artery lesion characteristics were compared between the two groups. Results Compared with the Han group, the Hui group had a higher prevalence of smoking history and myocardial infarction, but a lower prevalence of angina (Plt;0.05). Type A disease was the major type in both Hui and Han groups. Compared with the Han group, the rate of type C were higher. Single-vessel lesion was the major lesion in both Hui and Han groups. The incidence of three-vessel lesion in the Han group was significantly lower than that in the Hui group. Gensini score in the Hui group was higher than that in the Han group, with a significant difference (Plt;0.05). Conclusion Hui patients with premature coronary artery disease are more than Han patients with premature coronary artery disease in proportions of smoking, diabetes, and the lesions of the left anterior descending artery, the right coronary artery disease, three-vessel disease rate, and C-type lesions. The coronary artery disease of the Hui group is more serious.
ObjectiveTo systematically evaluate the efficacy and safety of Polypill on cardiovascular risk factors.
MethodSuch databases as Embase, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastracture, WanFang, and China Biology Medicine Disc were searched from their establishment to May 2015 for randomized controlled trials on the efficacy and safety of Polypillon on cardiovascular risk factors. Meta-analyses were performed by using the RevMan 5.2 software.
ResultsSix studies were included which all came from overseas including 1 155 patients treated with Polypill and 1 149 treated with placebo or single or combined medicaiton. The meta-analysis showed that:when compared with the controls, Polypills could significantly reduce systolic blood pressure[WMD=-9.39 mm Hg (1 mm Hg=0.133 kPa), 95%CI (-14.44, -4.33) mm Hg, P=0.0003], diastolic blood pressure[WMD=-5.32 mm Hg, 95%CI (-8.10, -2.55) mm Hg, P=0.0002], total cholesterol[WMD=-1.11 mmol/L, 95%CI (-1.48, -0.74) mmol/L, P<0.00001], and low density lipoprotein[WMD=-0.91 mmol/L, 95%CI (-1.25, -0.57) mmol/L, P<0.00001]. However, those who took Polypill were easier to discontinue medication [OR=1.49, 95%CI (1.19, 1.87), P=0.0005]. In the respect of adverse effects, there was no significant difference between the two groups[OR=1.47, 95%CI (0.67, 3.25), P=0.34].
ConclusionsThe efficacy of Polypill on cardiovascular risk factors is obvious. Polypills can significantly reduce blood pressure and lipids. Tolerability is lower in those taking Polypills, but the difference is minor. There is no significant difference in the respect of adverse effects.
Objective To introduce a novel approach using parallel placement of another oxygenator in the recirculation line as oxygen supply for oxygenator failure without circulatory arrest in cardiopulmonary bypass （CPB），and confirm its outcomes in an animal experiment. Methods A traditional piglet CPB model was established. Oxygenator failure model was established by reducing fraction of inspired oxygen （FiO2） from 80% to 21% after aortic cross-clamp and cardiac arrest in CPB. Another oxygenator was then parallel placed in the recirculation line to supply 100% oxygen.Dynamic changes in partial pressure of oxygen （PaO2），mixed venous oxygen saturation （SvO2），arterial oxygen saturation（SaO2） and blood pH of blood samples from the arterial perfusion duct were monitored with different blood flow of400 ml/min，800 ml/min and 1 100 ml/min. Results When FiO2 was reduced to 21%，PaO2 decreased to 64-67 mm Hg（P＜0.001），SaO2 decreased significantly to 88%-90% （P＜0.001），SvO2 decreased to 69%-72% （P＜0.001），and blood pH decreased too，all indicating oxygenator failure. After parallel placement of another oxygenator in the recirculation line was performed，PaO2，SaO2 and SvO2 all significantly increased，as well as blood pH. When the blood flow in the recirculation line achieved 33% or above of overall arterial perfusion flow，clinical oxygen demand was generally satisfied. Conclusion Parallel placement of another oxygenator in the recirculation line may be utilized as a treatment strategy for oxygenator failure without circulatory arrest and changeover of failed oxygenator.
ObjectiveTo explore the causal association between venous thromboembolism (VTE) and cardiovascular disease (CVD) risks using a two-sample bidirectional Mendelian randomization (MR) study. MethodsThe single-nucleotide polymorphism (SNP) data associated with VTE and CVD from genome-wide association studies were obtained as instrumental variables. Inverse variance weighted (IVW) was used as the main MR method and other methods were used as supplementary methods. Cochran's Q test, the intercept term of MR-Egger, and MR-PRESSO were used to assess pleiotropy and heterogeneity to ensure the robustness of the results. ResultsThe IVW method suggested a causal association between VTE and atrial fibrillation (OR=1.033, 95%CI 1.009 to 1.058, P=0.008), but no association was identified between VTE and coronary artery disease (OR=0.994, 95%CI 0.974 to 1.023, P = 0.551), heart failure (OR=1.021, 95%CI 0.992 to 1.050, P=0.159) and myocardial infarction (OR=1.012, 95%CI 0.971 to 1.055, P=0.568). The results of Cochran's Q test showed that there was no heterogeneity in the MR analyses of VTE and CVD. The MR-Egger intercept analysis and the MR-PRESSO global testing did not detect potential horizontal pleiotropy, and the results were robust. Reverse MR analysis was used to verify the presence of reverse causal associations. The reverse MR analysis demonstrated that reverse causal associations between VTE and CVD were not evidenced. ConclusionThe results of the MR study demonstrated a causal association between VTE and atrial fibrillation, but not with coronary artery disease, heart failure or myocardial infarction.
To investigate the value of plasma placental growth factor (PlGF) in percutaneous coronary angioplasty and stent implantation. Methods From May 2006 to March 2007, 61 patients (53 males and 8 females, mean age61 years) and 28 normal controls were included. All patients present with acute chest pain and underwent coronary angiography, the lesion severity of coronary arteries was assessed by Gensini coronary scoring system. Of them, 26 patients having serious coronary lesion underwent (percutaneous transluminal coronary angioplasty, PTCA) and stent implantation. Cardiovascular events were recorded after 30 days. Plasma PlGF was determined by ELISA. Results According to the angiography, the patients could be divided into CAD group (n=45) and Non- CAD group (n=16). Plasma PlGF level in CAD group was significantly higher than that in Non-CAD group and control group [(10.70 ± 0.49) ng/L vs (4.53 ± 0.64) ng/L vs (3.64 ± 0.36) ng/L, P lt; 0.001)], and there was no significant difference between the non-CAD group and control group (P gt; 0.05). A significant positive correlation was found between Gensini coronary score and plasma PlGF level (r=0.918, P lt; 0.01). Moreover, patients with cardiovascular events had a higher PlGF level than those without cardiovascular events after PTCA and stent implantation [(13.98 ± 3.39) ng/L vs (7.25 ± 2.96) ng/L, P lt; 0.01)]. Conclusion PlGF level has diagnostic value in patients with acute chest pain. The measurement of plasma PlGF might be helpful for early diagnosis of coronary artery disease. Patients with higher plasma PlGF level may have more severe coronary lesion. PlGF may be one of predictors for cardiovascular events after PCI.
