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124. Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19.

Author

Einstein, Andrew, Hirschfeld, Cole, Williams, Michelle, Vitola, Joao, Better, Nathan, Villines, Todd, Cerci, Rodrigo, Shaw, Leslee, Choi, Andrew, Dorbala, Sharmila, Karthikeyan, Ganesan, Lu, Bin, Sinitsyn, Valentin, Ansheles, Alexey, Kudo, Takashi, Bucciarelli-Ducci, Chiara, Nørgaard, Bjarne, Maurovich-Horvat, Pál, Campisi, Roxana, Milan, Elisa, Louw, Lizette, Allam, Adel, Bhatia, Mona, Sewanan, Lorenzo, Malkovskiy, Eli, Cohen, Yosef, Randazzo, Michael, Narula, Jagat, Morozova, Olga, Pascual, Thomas, Pynda, Yaroslav, Dondi, Maurizio, and Paez, Diana

Subjects
COVID-19, cardiac testing, cardiovascular disease, coronavirus, global health, COVID-19, Delivery of Health Care, Health Personnel, Humans, Pandemics, Surveys and Questionnaires
Abstract

BACKGROUND: The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown. OBJECTIVES: The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide. METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemics onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery. RESULTS: Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians psychological stress were significant in predicting recovery of cardiac testing. CONCLUSIONS: Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.

Published
2022

125. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification

Author

Yuan Xuesong, Bao Qing, Lu Bin, Xiang Chong, Hou Xiaoshan, and Wei Wenfeng

Subjects
intracranial aneurysms, circle of willis, m6a methylation, wtap, rbmvecs, Medicine
Abstract

Intracranial aneurysm (IA) is a type of cerebrovascular disease that mainly occurs in the circle of Willis. Abnormalities in RNA methylation at the N6-methyladenosine (m6A) site have been associated with numerous types of human diseases. WTAP recruits the m6A methyltransferase complexes to the mRNA targets, and its expression is positively correlated with m6A methylation levels. This research aimed to explore the potential mechanisms of m6A methylation in IA. A selective arterial ligation method was used to establish an IA rat model; thereafter, the m6A methylation level and m6A methylation-related genes were determined in blood and circle of Willis samples using a commercial kit and real-time quantitative PCR, respectively. Subsequently, rat brain microvascular endothelial cells (rBMVECs) were treated with TNF-α, and the expression of m6A methylation-related genes within the cells were assessed. Lastly, the effects of WTAP on TNF-α-induced rBMVECs were further investigated through in vitro experiments. In result, the m6A RNA methylation level evidently declined in the blood and circle of Willis’ samples of the IA rats, as compared to the corresponding samples from the control rats (P < 0.05). Compared to the results in the control rats/cells, WTAP expression was significantly downregulated, whereas ALKBH1 expression was evidently upregulated in the blood and circle of Willis samples of the TNF-α-induced rBMVECs of IA rats. Consequently, TNF-α-induced rBMVECs and rBMVECs with WTAP overexpression were successfully established. TNF-α inhibited the viability of the rBMVECs, promoted apoptosis, and significantly upregulated cleaved-caspase3 and downregulated WTAP expression. In contrast, WTAP overexpression significantly reversed these changes caused by TNF-α (P < 0.05). In conclusion, WTAP overexpression may modulate the growth of TNF-α-induced rBMVECs by enhancing WTAP expression and its m6A methylation.

Published
2023
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126. Effectiveness, Safety and Satisfaction of Distal Transradial Artery Approach in Cerebral Angiography

Author

LU Bin, XIANG Chong, YUAN Xuesong, CAI Gaojun, WEI Wenfeng, YAN Yongmin

Subjects
cerebrovascular diseases, cerebral angiography, radial artery, distal radial artery, treatment outcome, safety, Medicine
Abstract

Background Cerebral angiography is an important means for the assessment of cerebrovascular diseases. In recent years, distal transradial artery approach (dTRA) has gradually been used in cerebral angiography, but there are few reports on its effectiveness and safety. Objective To compare the effectiveness, patient safety and satisfaction between transradial artery approach (TRA) and dTRA in cerebral angiography. Methods Totally 135 patients who were hospitalized in Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University from January 2020 to June 2022 for cerebral angiography were selected. They were divided into TRA group (n=72) and dTRA group (n=63) by the approach used in cerebral angiography, and the puncture time, duration of cerebral angiography, puncture success rate, X-ray exposure time, incidence of puncture site complications and serious cardiovascular and cerebrovascular events within three days after cerebral angiography, and levels of pain and satisfaction within 24 hours after cerebral angiography were compared between the groups. Results The mean puncture time in dTRA group was much longer than that of TRA group (P0.05) . No serious cardiovascular and cerebrovascular events occurred in both groups within three days after cerebral angiography. dTRA group had much lighter pain level and significantly higher satisfaction within 24 hours after cerebral angiography than TRA group (P

Published
2023
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