144 results on '"Rongchong Huang"'
Search Results
2. M2 macrophage-derived exosomes promote angiogenesis and improve cardiac function after myocardial infarction
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Hongzhou Guo, Zeya Li, Bin Xiao, and Rongchong Huang
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M2 macrophages ,Exosomes ,Angiogenesis ,Myocardial infarction ,Biology (General) ,QH301-705.5 - Abstract
Abstract Background Myocardial infarction (MI) is a major cause of mortality and morbidity worldwide. The intercellular communication in post-infarction angiogenesis remains unclear. Methods In this study, we explored the role and mechanism of action of M2 macrophage-derived exosomes (M2-exos) in angiogenesis after MI. M2-exos were harvested and injected intramyocardially at the onset of MI. Two distinct endothelial cells (ECs) were cultured with M2-exos to explore the direct effects on angiogenesis. Results We showed that M2-exos improved cardiac function, reduced infarct size, and enhanced angiogenesis after MI. Moreover, M2-exos promoted angiogenesis in vitro; the molecules loaded in the vesicles were responsible for its proangiogenic effects. We further validated that higher abundance of miR-132-3p in M2-exos, which recapitulate their functions, was required for the cardioprotective effects exerted by M2-exos. Mechanistically, miR-132-3p carried by M2-exos down-regulate the expression of THBS1 through direct binding to its 3´UTR and the proangiogenic effects of miR-132-3p were largely reversed by THBS1 overexpression. Conclusion Our findings demonstrate that M2-exos promote angiogenesis after MI by transporting miR-132-3p to ECs, and by binding to THBS1 mRNA directly and negatively regulating its expression. These findings highlight the role of M2-exos in cardiac repair and provide novel mechanistic understanding of intercellular communication in post-infarction angiogenesis.
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- 2024
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3. Association of blood pressure variability with target organ damage in older patients with essential hypertension
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Zhiquan Jing, Gang Wang, Zeya Li, Shanshan Wu, Xiang Qiu, and Rongchong Huang
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ambulatory blood pressure monitoring ,blood pressure variability ,hypertension ,target organ damage ,Medicine (General) ,R5-920 - Abstract
Abstract Background Although multiple measures of blood pressure variability (BPV) have been proposed, whether they are better than mean blood pressure in predicting target organs is unclear. We aimed to determine the relationship between short term BPV and target organ injury. Methods This study was a retrospective study, and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected. We divided participants into four groups on the basis of the quartiles of BPV. One‐way analysis of variance was used to compare the differences between the groups, and linear regression was used to analyze the relationship between BPV and target organ damage. Results The average age of 635 patients was 74.36 ± 6.50 years old. Among them, 354 of 627 patients had diminished renal function (56.5%), 221of 604 patients had associated left ventricular hypertrophy (36.6%), and 227 of 231 patients had carotid plaque formation (98.3%). The baseline data indicated significant differences in fasting glucose, total cholesterol, low‐density lipoprotein, creatinine, glomerular filtration rate, sex, calcium channel blocker use, and the rate of diminished renal function. Multiple linear regression analysis showed that BPV was negatively correlated with renal injury (creatinine: r = 0.306, p
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- 2023
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4. Global and national burden of atherosclerosis from 1990 to 2019: trend analysis based on the Global Burden of Disease Study 2019
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Weihua Chen, Zeya Li, Yu Zhao, Yitian Chen, Rongchong Huang, and Rongman Jia
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Medicine - Abstract
Abstract. Background:. Atherosclerosis-related diseases represent significant health issues among adults globally. Despite their widespread impact, comprehensive data concerning the global and national burden and trends of these diseases remain sparse. Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels. Methods:. We reported the average annual percentage changes (AAPCs) in prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of atherosclerosis-related diseases (ischemic heart disease [IHD], ischemic stroke, and peripheral arterial disease [PAD]) at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study (GBD) 2019. We further analyzed these global trends as a function of age, gender, and the social development index. We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends. Results:. Globally, the AAPC of IHD incidence rose from 1990 to 2019 (0.20; 95% confidence interval [CI], 0.12-0.28), with substantial surges in 1995, 2001, 2005, 2010, and 2017. Conversely, AAPC of IHD mortality rates exhibited a different trend until a rise in 2014. The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period, with respective 0.43 (95% CI, 0.39-0.48) and 0.13 (95% CI, 0.06-0.21). For ischemic stroke, both incidence and mortality soared in 2014, while PAD incidence declined in 1994 and 1998, then sharply climbed in 2016. Nationally, the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019. China saw a significant rise in ischemic stroke incidence, whereas the highest mortality rate increase occurred in Timor-Leste. By sociodemographic index (SDI) quintile, low-middle-, middle-, and high-middle-SDI countries all showed upward trends in IHD, ischemic stroke, and PAD incidence. Simultaneously, IHD and ischemic stroke mortality rates, as well as DALYs, dropped in the low-, high-middle-, and high-SDI nations. However, PAD mortality rates and DALYs saw an uptick across all SDI quintiles. Regarding age demographics, a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old, in contrast to an increase in the 20-55 age group during this period. AAPC of mortality rates for IHD, ischemic stroke, and PAD decreased across all ages. The AAPC showed an increase in IHD incidence in both genders. Conversely, IHD's DALYs saw a reduction in both males and females. Ischemic stroke patterns mirrored these trends, whereas all measures for PAD exhibited growth for both sexes. Conclusions:. From 1990 to 2019, there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis. Between 1990 and 2019, both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups. Overall, the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward. These findings strongly suggest that despite some progress made, efforts to control atherosclerosis diseases globally need to be intensified.
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- 2023
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5. Association between the insulin resistance marker TyG index and subsequent adverse long-term cardiovascular events in young and middle-aged US adults based on obesity status
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Weihua Chen, Shan Ding, Jiabin Tu, Guitao Xiao, Kaihong Chen, Yanbin Zhang, Rongchong Huang, and Ying Liao
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All-cause mortality ,Triglyceride-glucose index ,Obesity ,Cardiovascular events ,NHANES ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background A lthough the triglyceride-glucose (TyG) index has been shown to closely correlate with cardiometabolic outcomes and predict cardiovascular events in many groups, it remains unclear whether obese status in young and middle-aged adults is associated with long-term unfavorable cardiovascular events. This warrants further investigation. Methods This retrospective cohort study analyzed data from the National Health and Nutrition Examination Survey spanning the years 1999–2018, with follow-up for mortality status until December 31, 2019. To categorize participants based on the TyG level, the optimal critical value was determined through restricted cubic spline function analysis, dividing them into high and low TyG groups. The study assessed the relationship between TyG and cardiovascular events and all-cause mortality in young and middle-aged adults stratified by obesity status. Kaplan‒Meier and Cox proportional risk models were used to analyze the data. Results During a follow-up period of 123 months, a high TyG index increased the risk of cardiovascular events by 63% (P = 0.040) and the risk of all-cause mortality by 32% (P = 0.010) in individuals after adjusting for all covariates. High TyG was shown to be linked to cardiovascular events in obese people (Model 3: HR = 2.42, 95% CI = 1.13–5.12, P = 0.020); however, there was no significant difference in TyG groups for nonobese adults in Model 3 (P = 0.08). Conclusions TyG was independently associated with harmful long-term cardiovascular events in young and middle-aged US populations, with a stronger association observed in those who were obese.
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- 2023
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6. Effect of complete percutaneous revascularization on improving long-term outcomes of patients with chronic total occlusion and multi-vessel disease
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Zeya Li, Ziru Zhou, Lei Guo, Lei Zhong, Jingnan Xiao, Shaoke Meng, Yingdong Wang, Huaiyu Ding, Bo Zhang, Hao Zhu, Xuchen Zhou, Rongchong Huang, Rongman Jia, and Xiuyuan Hao
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Medicine - Abstract
Abstract. Background:. Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes. Methods:. A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group (n = 86), incomplete PCI group (n = 327), and complete PCI group (n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome. Results:. At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23–3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04–2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32–0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24–0.99; P = 0.046). Conclusions:. For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
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- 2023
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7. Good coronary collateral circulation is not associated with better prognosis in patients with chronic total occlusion, regardless of treatment strategy
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Zeya Li, Yingdong Wang, Shanshan Wu, Jingnan Xiao, Lei Guo, Shaoke Meng, Lei Zhong, Huaiyu Ding, Haichen Lv, Xuchen Zhou, and Rongchong Huang
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Chronic total occlusion ,coronary collateral circulation ,percutaneous coronary intervention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: This study aimed to assess the effects of coronary collateral circulation (CCC) on the prognosis of patients with chronic total occlusion (CTO) under different treatment strategies. Methods: We analyzed a total of 1124 patients who were diagnosed with CTO and divided them into groups with good CCC (grade 2 to 3, n = 539) or poor CCC (grade 0 to 1, n = 531). The primary outcome was cardiac death during follow-up; the secondary outcome was major adverse cardiovascular events (MACEs). We also performed subgroup analyses in groups with and without CTO revascularization (CTO-R and CTO-NR, respectively), and sensitivity analyses excluding patients who received failed CTO-PCI to further investigate the effect of CCC. Results: During a median follow-up duration of 23 months, we did not detect any significant differences between the good CCC group and the poor CCC group in terms of cardiac death (4.2% vs 4.1%; adjusted hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.56–1.83; p = 0.970) and MACEs (23.6% vs 23.2%; adjusted HR, 1.07; 95% CI, 0.84–1.37; p = 0.590). Subgroup analyses according to CTO revascularization showed similar results. In addition, we observed no differences in sensitivity analyses when patients who received failed CTO-PCI were excluded. Conclusion: Good CCC was not associated with a lower risk of cardiac death or MACEs among patients with CTO, regardless of whether the patients received CTO revascularization treatment.
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- 2023
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8. Nutrition-related diseases and cardiovascular mortality in American society: national health and nutrition examination study, 1999–2006
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Weihua Chen, Shanshan Shi, Jiabin Tu, Lihua Liao, Ying Liao, Kaihong Chen, Liling Chen, and Rongchong Huang
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Cardiovascular mortality ,Malnutrition-sarcopenia syndrome ,Nutrition-related diseases ,National Health and Nutrition Examination Survey ,Society ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Despite many significant advances in treatment and management, cardiovascular disease remains the main cause of the global disease burden. Nutrition-related disease is a modifiable cardiovascular risk factor. However, few studies have examined the relationship between nutrition-related diseases and cardiovascular mortality. Objective We aimed to investigate the association of nutrition-related diseases with cardiovascular mortality based on a large nationally representative community population. Design We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 with mortality follow-up through December 31, 2015. Finally, 12,469 participants were analyzed. Each participant was assigned to one of four groups: normal nutrition without sarcopenia, sarcopenia with normal nutrition, malnutrition without sarcopenia, and malnutrition-sarcopenia syndrome. Survival curves and Cox regressions based on the NHANES recommended weights were used to assess the association between nutrition-related diseases and cardiovascular mortality. Results Of the 12,469 patients included in the study and divided into four groups, malnutrition-sarcopenia syndrome had the highest 5- and 10-year cardiovascular mortality rates. After adjustment for related factors, sarcopenia with normal nutrition (hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.28–2.06; P
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- 2022
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9. QRS score: A simple marker to quantify the extent of myocardial scarring in patients with chronic total arterial occlusion
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Hongzhou Guo, Xuan Zhou, Jiaying Xu, Zhishuai Ye, Lei Guo, and Rongchong Huang
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chronic total occlusion ,late gadolinium enhancement cardiac magnetic resonance imaging ,myocardial scar ,Selvester QRS score ,Medicine (General) ,R5-920 - Abstract
Abstract Background Chronic total occlusion (CTO) is a critical and unique subgroup of coronary lesions. This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging (LGE‐CMRI) in quantifying myocardial scarring to provide a simple and feasible method for treating CTO. Methods The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1, 2014 and December 30, 2017 were retrospectively reviewed. All patients were grouped according to the CTO location (right coronary artery [RCA] CTO, left artery descending [LAD] CTO, left circumflex [LCX] CTO, and multivessel CTO groups). The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE‐CMRI. All patients were followed up for at least 12 months. Results Among the 62 CTO patients, 55 had occlusion of a single vessel and seven had occlusion of multiple vessels, of which 27 (43.55%) were in the RCA CTO group, 16 (25.81%) in the LAD CTO group, 12 (19.35%) in the LCX CTO group, and 7 (11.29%) in the multivessel CTO group. The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806, with a sensitivity and specificity of 94.7% and 42.1%, respectively. The Selvester QRS score and LGE‐CMRI measures of scar size were correlated in the RCA CTO, LCX CTO, and multivessel CTO groups (r = 0.466, 0.593, and 0.775, respectively). Conclusion The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.
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- 2022
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10. Pathophysiology and molecular mechanism of caveolin involved in myocardial protection strategies in ischemic conditioning
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Xin Zhao, Xueyao Yang, Ziyu An, Libo Liu, Jingwen Yong, Haoran Xing, Rongchong Huang, Jinfan Tian, and Xiantao Song
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Myocardial protection ,Caveolins ,Pathophysiology ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Multiple pathophysiological pathways are activated during the process of myocardial injury. Various cardioprotective strategies protect the myocardium from ischemia, infarction, and ischemia/reperfusion (I/R) injury through different targets, yet the clinical translation remains limited. Caveolae and its structure protein, caveolins, have been suggested as a bridge to transmit damage-preventing signals and mediate the protection of ultrastructure in cardiomyocytes under pathological conditions. In this review, we first briefly introduce caveolae and caveolins. Then we review the cardioprotective strategies mediated by caveolins through various pathophysiological pathways. Finally, some possible research directions are proposed to provide future experiments and clinical translation perspectives targeting caveolin based on the investigative evidence.
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- 2022
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11. Association of sarcopenia with ideal cardiovascular health metrics among US adults: a cross-sectional study of NHANES data from 2011 to 2018
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Kaihong Chen, Shanshan Shi, Kun Huang, Ying Liao, Weihua Chen, Yizhou Jiang, and Rongchong Huang
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Medicine - Abstract
Objective The American Heart Association (AHA) proposed the concept of ideal cardiovascular health (CVH) to reduce the risk of cardiovascular mortality. We attempted to broaden the impact of CVH and further contribute to AHA 2030 goals by identifying the relationship between CVH and non-cardiovascular diseases such as sarcopenia.Design Cross-sectional surveySetting National Health and Nutrition Examination Survey conducted in the USA from 2011 to 2018.Participants This study included participants with reliable first 24-hour dietary recall and ≥20 years of age and excluded those who could not diagnose sarcopenia or insufficient data to calculate the CVH scores.Primary and secondary outcome measures The prevalence of sarcopenia as measured by dual-energy X-ray absorptiometry.Results This cohort study involving 9326 adults≥20 years comprised 4733 females (50.0%). The number of intermediate or ideal and poor CVH participants was 5654 and 3672 with mean CVH score of 9.70±0.03 and 5.66±0.04, respectively. After adjusting for related confounding factors, intermediate or ideal CVH was associated with an odds reduction of sarcopenia than poor CVH (adjusted OR (aOR): 0.36, 95% CI 0.26 to 0.50, p5, the odds of sarcopenia decreased by up to 84% (aOR: 0.16, 95% CI 0.08 to 0.30).Conclusions Our findings suggest a relationship between the CVH and the prevalence of sarcopenia in adults. The results of our study can contribute to achieving the 2030 public health goal of achieving CVH for all, which may be supported by efforts to reduce the prevalence of sarcopenia.
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- 2022
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12. Long-term outcomes of medical therapy versus successful recanalisation for coronary chronic total occlusions in patients with and without type 2 diabetes mellitus
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Lei Guo, Junjie Wang, Huaiyu Ding, Shaoke Meng, Xiaoyan Zhang, Haichen Lv, Lei Zhong, Jian Wu, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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Chronic total occlusions ,Diabetes ,Percutaneous coronary intervention ,Medical therapy ,Outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background In this study, we compared the outcomes of medical therapy (MT) with successful percutaneous coronary intervention (PCI) in chronic total occlusions (CTO) patients with and without type 2 diabetes mellitus. Methods A total of 2015 patients with CTOs were stratified. Diabetic patients (n = 755, 37.5%) and non-diabetic patients (n = 1260, 62.5%) were subjected to medical therapy or successful CTO-PCI. We performed a propensity score matching (PSM) to balance the baseline characteristics. A comparison of the major adverse cardiac events (MACE) was done to evaluate long-term outcomes. Results The median follow-up duration was 2.6 years. Through multivariate analysis, the incidence of MACE was significantly higher among diabetic patients compared to the non-diabetic patients (adjusted hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.09–1.61, p = 0.005). Among the diabetic group, the rate of MACE (adjusted HR 0.61, 95% CI 0.42–0.87, p = 0.006) was significantly lower in the successful CTO-PCI group than in the MT group. Besides, in the non-diabetic group, the prevalence of MACE (adjusted HR 0.85, 95% CI 0.64–1.15, p = 0.294) and cardiac death (adjusted HR 0.94, 95% CI 0.51–1.70, p = 0.825) were comparable between the two groups. Similar results as with the early detection were obtained in propensity-matched diabetic and non-diabetic patients. Notably, there was a significant interaction between diabetic or non-diabetic with the therapeutic strategy on MACE (p for interaction = 0.036). Conclusions For treatment of CTO, successful CTO-PCI highly reduces the risk of MACE in diabetic patients when compared with medical therapy. However, this does not apply to non-diabetic patients.
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- 2020
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13. Two-year clinical outcomes of medical therapy vs. revascularization for patients with coronary chronic total occlusion
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Lei Guo, Jian Wu, Lei Zhong, Huaiyu Ding, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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Chronic total occlusions ,Revascularization ,Medical therapy ,Outcome ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: There are little data on the long-term clinical outcomes of medical therapy (MT) compared with revascularization in patients with chronic total occlusions (CTOs). Methods: Between January 2007 and December 2016, a total of 1655 patients with ≥1 CTO were enrolled in our center and were divided into the MT group (n = 800) and revascularization group (n = 855) according to the initial treatment strategy. Propensity score matching was also performed to adjust for baseline characteristics. The primary outcome was cardiac death. Results: After 2 years of follow-up, there was no significant difference between the two groups with regard to the prevalence of cardiac death (MT vs. revascularization: 6.6% vs. 4.2%, adjusted hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.60–1.49, p = 0.820). In the propensity-matched population (406 pairs), there were no significant differences in the prevalence of cardiac death (MT vs. revascularization: 5.4% vs. 4.7%, HR 0.88, 95% CI 0.48–1.63, p = 0.694), except for target vessel revascularization (TVR) (0.44, 0.31–0.63,
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- 2020
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14. Elevated Wnt2 and Wnt4 activate NF-κB signaling to promote cardiac fibrosis by cooperation of Fzd4/2 and LRP6 following myocardial infarction
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Chao Yin, Zhishuai Ye, Jian Wu, Chenxing Huang, Le Pan, Huaiyu Ding, Lei Zhong, Lei Guo, Yan Zou, Xiang Wang, Ying Wang, Pan Gao, Xuejuan Jin, Xiaoxiang Yan, Yunzeng Zou, Rongchong Huang, and Hui Gong
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Wnt ,Cardiac fibrosis ,Myocardial infarction ,Frizzled ,NF-κB ,Medicine ,Medicine (General) ,R5-920 - Abstract
Background: Acute myocardial infarction (AMI)-induced excessive myocardial fibrosis exaggerates cardiac dysfunction. However, serum Wnt2 or Wnt4 level in AMI patients, and the roles in cardiac fibrosis are largely unkown. Methods: AMI and non-AMI patients were enrolled to examine serum Wnt2 and Wnt4 levels by ELISA analysis. The AMI patients were followed-up for one year. MI mouse model was built by ligation of left anterior descending branch (LAD). Findings: Serum Wnt2 or Wnt4 level was increased in patients with AMI, and the elevated Wnt2 and Wnt4 were correlated to adverse outcome of these patients. Knockdown of Wnt2 and Wnt4 significantly attenuated myocardial remodeling and cardiac dysfunction following experimental MI. In vitro, hypoxia enhanced the secretion and expression of Wnt2 and Wnt4 in neonatal rat cardiac myocytes (NRCMs) or fibroblasts (NRCFs). Mechanistically, the elevated Wnt2 or Wnt4 activated β-catenin /NF-κB signaling to promote pro-fibrotic effects in cultured NRCFs. In addition, Wnt2 or Wnt4 upregulated the expression of these Wnt co-receptors, frizzled (Fzd) 2, Fzd4 and (low-density lipoprotein receptor-related protein 6 (LRP6). Further analysis revealed that Wnt2 or Wnt4 activated β-catenin /NF-κB by the co-operation of Fzd4 or Fzd2 and LRP6 signaling, respectively. Interpretation: Elevated Wnt2 and Wnt4 activate β-catenin/NF-κB signaling to promote cardiac fibrosis by cooperation of Fzd4/2 and LRP6 in fibroblasts, which contributes to adverse outcome of patients with AMI, suggesting that systemic inhibition of Wnt2 and Wnt4 may improve cardiac dysfunction after MI.
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- 2021
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15. Focus on HFpEF in heart failure
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Chunhui He, Rongchong Huang, and Ningning Wang
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Medicine - Published
- 2022
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16. Clinical Outcomes of Concomitant Use of Proton Pump Inhibitors and Dual Antiplatelet Therapy: A Systematic Review and Meta-Analysis
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Hongzhou Guo, Zhishuai Ye, and Rongchong Huang
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proton pump inhibitors ,coronary artery disease ,dual antiplatelet therapy ,medication interaction ,adverse cardiovascular events ,meta-analysis ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: The safety and efficacy associated with the use of proton pump inhibitors (PPIs) by patients with coronary artery disease receiving dual antiplatelet therapy (DAPT) remain unclear.Methods: The evaluated outcomes included combined major adverse cardiovascular events (MACEs), myocardial infarction (MI), all-cause mortality, and gastrointestinal (GI) bleeding. A random effects meta-analysis, stratified by study design, was performed and heterogeneity was assessed using the I2 statistic.Results: In total, 6 randomized controlled trials (RCTs) (6930 patients) and 16 observational studies (183,546 patients) were included. Analysis of RCTs showed that there were no significant differences in the incidences of MACEs (risk ratio [RR] = 0.89 [95% confidence interval (CI) = 0.75–1.05]), MI (RR = 0.93 [95% CI = 0.76–1.15]), and all-cause mortality (RR = 0.79 [95% CI = 0.50–1.23]) in the PPI groups vs. the non-PPI groups. Pooled data from observational studies revealed an inconsistent association between the use of each PPI subtype and the increased risks of MACEs during clopidogrel treatment. There was no increased risk of MACEs or all-cause mortality associated with the use of PPIs (as a class) and other P2Y12 inhibitors. Both the RCTs and observational studies revealed that the use of PPIs significantly reduced the risks of GI bleeding.Conclusion: The use of PPIs was associated with a reduced risk of GI bleeding in patients treated with DAPT after percutaneous coronary intervention or acute coronary syndrome. There was no clear evidence of an association between the use of PPIs and adverse cardiovascular events.Clinical Trial Registration: identifier [CRD42020190315]
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- 2021
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17. Agreement in Left Ventricular Function Measured by Echocardiography and Cardiac Magnetic Resonance in Patients With Chronic Coronary Total Occlusion
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Jiahui Li, Lijun Zhang, Yueli Wang, Huijuan Zuo, Rongchong Huang, Xueyao Yang, Ye Han, Yi He, and Xiantao Song
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magnetic resonance imaging ,transthoracic echocardiography ,left ventricular function ,chronic total occlusion ,agreement ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P < 0.001) and a moderately strong agreement (Kappa = 0.62, P < 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF
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- 2021
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18. Long-Term Outcomes of Successful Recanalization Compared With Optimal Medical Therapy for Coronary Chronic Total Occlusions in Patients With and Without Left Ventricular Systolic Dysfunction
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Lei Guo, Shaoke Meng, Haichen Lv, Lei Zhong, Jian Wu, Huaiyu Ding, Jiaying Xu, Xiaoyan Zhang, and Rongchong Huang
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chronic total occlusions ,percutaneous coronary intervention ,optimal medical therapy ,left ventricular systolic dysfunction ,LVEF ,outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: The number of coronary chronic total occlusion (CTO) patients with left ventricular (LV) systolic dysfunction is significant, but the clinical outcomes of these patients are rarely reported. The present retrospective cohort study aimed to investigate the long-term outcomes of successful recanalization vs. optimal medical therapy (MT) for CTOs in patients with preserved and impaired LV systolic function.Methods: A total of 1,895 patients with CTOs were stratified according to LV function. Of these, 1,420 patients (74.9%) with LV ejection fraction (LVEF) >45% and 475 patients (25.1%) with LVEF ≤45% were treated with optimal MT or successful CTO percutaneous coronary intervention (PCI). A 1:1 propensity score matching (PSM) was conducted to reduce the impact of potential confounding on the outcomes. The primary outcome was the frequency of major adverse cardiac events (MACEs).Results: Throughout a 2.6-year follow-up and after adjusting for confounders, among patients with preserved LV function, successful CTO PCI was associated with reduced incidence of MACE (14.2 vs. 23.9%, adjusted HR 0.63, 95% CI 0.48–0.83, p = 0.001) compared to MT. There was no significant difference in MACE occurrence (29.6 vs. 28.9%, adjusted HR 1.05, 95% CI: 0.71–1.56, p = 0.792) between successful recanalization and MT in patients with LV systolic dysfunction. The primary outcome among patients with impaired and preserved LV systolic function after PSM was similar to that from earlier findings before PSM was conducted. A significant interaction between LV function and therapeutic strategy for MACE was observed (interaction p = 0.038).Conclusions: Compared to MT alone for management of patients with CTOs, successful CTO PCI may reduce the risk of MACE in patients with preserved LV systolic function, but not in patients with LV dysfunction.
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- 2021
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19. Corrigendum: Long-Term Outcomes of Successful Revascularization for Patients With Coronary Chronic Total Occlusions: A Report of 1,655 Patients
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Lei Guo, Xiaoyan Zhang, Haichen Lv, Lei Zhong, Jian Wu, Huaiyu Ding, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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cardiac mortality ,coronary chronic total occlusions ,major adverse cardiac event ,medical therapy ,percutaneous coronary intervention ,successful revascularization ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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20. Corrigendum: Impact of Renal Function on Long-Term Clinical Outcomes in Patients With Coronary Chronic Total Occlusions: Results From an Observational Single-Center Cohort Study During the Last 12 Years
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Lei Guo, Huaiyu Ding, Haichen Lv, Xiaoyan Zhang, Lei Zhong, Jian Wu, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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chronic total occlusions ,medical therapy ,outcomes ,percutaneous coronary intervention ,renal function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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21. Impact of Renal Function on Long-Term Clinical Outcomes in Patients With Coronary Chronic Total Occlusions: Results From an Observational Single-Center Cohort Study During the Last 12 Years
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Lei Guo, Huaiyu Ding, Haichen Lv, Xiaoyan Zhang, Lei Zhong, Jian Wu, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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chronic total occlusions ,medical therapy ,outcomes ,percutaneous coronary intervention ,renal function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: The number of coronary chronic total occlusion (CTO) patients with renal insufficiency is huge, and limited data are available on the impact of renal insufficiency on long-term clinical outcomes in CTO patients. We aimed to investigate clinical outcomes of CTO percutaneous coronary intervention (PCI) vs. medical therapy (MT) in CTO patients according to baseline renal function.Methods: In the study population of 2,497, 1,220 patients underwent CTO PCI and 1,277 patients received MT. Patients were divided into four groups based on renal function: group 1 [estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2], group 2 (60 ≤ eGFR
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- 2020
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22. Long-Term Outcomes of Successful Revascularization for Patients With Coronary Chronic Total Occlusions: A Report of 1,655 Patients
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Lei Guo, Xiaoyan Zhang, Haichen Lv, Lei Zhong, Jian Wu, Huaiyu Ding, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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cardiac mortality ,coronary chronic total occlusions ,major adverse cardiac event ,medical therapy ,percutaneous coronary intervention ,successful revascularization ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: To date, the benefit of successful revascularization of chronic total occlusions (CTOs) on prognosis remains uncertain, and there is a paucity of data on the impact of successful revascularization for CTO patients on long-term cardiovascular survival. This study aimed to investigate the long-term cardiovascular survival for patients with successful and unsuccessful CTO revascularization in a large cohort of patients.Methods: There were 1,655 consecutive patients with at least one CTO included and were grouped into successful revascularization (n = 591) and unsuccessful revascularization (n = 1,064). Propensity score matching (PSM) was carried out to balance the clinical and the angiographic characteristics. Cardiac mortality was defined as the primary endpoint. Major adverse cardiac event (MACE) was assessed as a “secondary endpoint.”Results: After 3.6 years of follow-up, there was no significant difference between the successful and the unsuccessful revascularization groups in the rate of cardiac mortality [adjusted hazard ratio (HR) 0.96, 95% confidence interval (CI) 0.59–1.58, p = 0.865]. After the PSM analysis (371 pairs) between the two groups, the cardiac mortality rate values (HR 0.51, 95% CI 0.23–1.15, p = 0.104) were equivalent, whereas the adjusted risk of MACE (HR 0.43, 95% CI 0.32–0.58, p = 0.001) and target-vessel revascularization (HR 0.41, 95% CI 0.29–0.58, p < 0.001) were significantly higher in patients with unsuccessful revascularization.Conclusion: For the treatment of CTO patients, successful revascularization was not associated with a lesser risk for cardiac mortality as compared with unsuccessful revascularization. However, successful revascularization reduced MACE and target-vessel revascularization.
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- 2020
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23. A Peptide Analogue of Selectin Ligands Attenuated Atherosclerosis by Inhibiting Monocyte Activation
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Zhishuai Ye, Shanfeng Zhang, Yubo Liu, Shujing Wang, Jianing Zhang, and Rongchong Huang
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Pathology ,RB1-214 - Abstract
Background. Circulating monocytes play a critical role in the pathogenesis of atherosclerosis. Monocyte homing to sites of atherosclerosis is primarily initiated by selectin. Thus, blockade of the interaction of selectins and their ligands holds a significant role in monocyte homing which might be a potential approach to treat atherosclerosis. Here, we investigated the efficacy of a novel peptide analogue of selectin ligands IELLQAR in atherosclerosis. Methods and Results. In this study, we firstly measured the effect of the IELLQAR selectin-binding peptide on the inhibition of binding of selectins to monocytes by flow cytometry, which exhibited a dose-dependent inhibitory effect on the binding of the P-, E-, and L-selectins to monocytes, especially the inhibition of P-selectin binding to human peripheral blood monocytes (PBMCs) (half maximal inhibitory concentration (IC50~5 μM)) and THP-1 cells (IC50~10 μM). Furthermore, IELLQAR inhibited P-selectin-induced activation of CD11b on the surface of monocytes and decreased adhesion of monocytes to the endothelium. ApoE-/- mice with or without IELLQAR (1 or 3 mg/kg) fed a Western-type diet (WTD) or which had disturbed blood flow-induced shear stress underwent partial left carotid artery ligation (PLCA) to induce atherosclerosis. In the WTD- and PLCA-induced atherosclerosis models, atherosclerotic plaque formation and monocyte/macrophage infiltration of the arterial wall both decreased in ApoE-/- mice treated with the IELLQAR peptide. Our results also revealed that IELLQAR inhibited the differentiation of monocytes into macrophages through P-selectin-dependent activation of the nuclear factor- (NF-) κB and mammalian target of rapamycin (mTOR) pathways. Conclusion. Collectively, our results demonstrated that IELLQAR, a peptide analogue of selectin ligands, inhibited selectin binding to monocytes, which led to subsequent attenuation of atherosclerosis via inhibition of monocyte activation. Hence, use of the IELLQAR peptide provides a new approach and represents a promising candidate for the treatment of atherosclerosis in the early stage of disease.
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- 2019
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24. Gender Differences in Long-Term Outcomes of Medical Therapy and Successful Percutaneous Coronary Intervention for Coronary Chronic Total Occlusions
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Lei Guo, Haichen Lv, Lei Zhong, Jian Wu, Huaiyu Ding, Jiaying Xu, and Rongchong Huang
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background. There is a paucity of information about the gender differences in clinical outcomes of successful percutaneous coronary intervention (PCI) compared with medical therapy (MT) in patients with coronary chronic total occlusions (CTOs). Objectives. We aimed to investigate the impact of gender on long-term clinical outcomes associated with successful CTO-PCI versus MT in patients with CTOs. Methods. Between January 2007 and December 2016, a total of 1702 patients with ≥1 CTO were enrolled. After exclusion, 1294 patients with 1520 CTOs were analyzed and were divided into the female group (n = 304, 23.5%) and the male group (n = 990, 76.5%). The patients in the female or male group were assigned to a MT group or successful CTO-PCI group according to the treatment strategy. In the female group, they were divided into two groups: 177 patients in the MT group and 127 patients in the successful CTO-PCI group. In the male group, they were divided into two groups: 623 patients in the MT group and 367 patients in the successful CTO-PCI group. The primary outcome was cardiac death. The secondary outcome was major adverse cardiac event (MACE). Results. The median overall follow-up duration was 3.6 (IQR, 2.1–5.0) years, there were no significant differences between the MT and successful CTO-PCI groups with respect to the prevalence of cardiac death (MT vs. successful PCI: 6.8% vs. 3.9%, p=0.287) and MACE (20.9% vs. 21.3%, p=0.810) in female patients. In the male group, the occurrence of cardiac death (MT vs. successful PCI: 6.6% vs. 3.8%, p=0.066) was similar between the two groups. The MACE rate (30.0% vs. 18.5%, p
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- 2019
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25. Correction to: Long‑term outcomes of medical therapy versus successful recanalisation for coronary chronic total occlusions in patients with and without type 2 diabetes mellitus
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Lei Guo, Junjie Wang, Huaiyu Ding, Shaoke Meng, Xiaoyan Zhang, Haichen Lv, Lei Zhong, Jian Wu, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
An amendment to this paper has been published and can be accessed via the original article.
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- 2021
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26. Association between novel inflammatory markers and non-alcoholic fatty liver disease: a cross-sectional study.
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Gang Wang, Yu Zhao, Zeya Li, Dan Li, Feng Zhao, Jing Hao, Chunlei Yang, Jiashu Song, Xianzhong Gu, and Rongchong Huang
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- 2024
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27. Optimal antiplatelet therapy for patients after antiplatelet therapy induced gastrointestinal bleeding: timing
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Bin Xiao, Zhishuai Ye, Rui Cheng, Zhen Han, Shanshan Wu, Guoxing Wang, Zeya Li, Tuo Liang, Shutian Zhang, and Rongchong Huang
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Emergency Medicine ,Internal Medicine - Published
- 2023
28. Comparison of Clinical Outcomes Between Ticagrelor and Clopidogrel in Elderly Patients Undergoing Percutaneous Coronary Intervention: A Cohort Study
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Shaoke Meng, Lei Guo, Zhishuai Ye, Junjie Wang, Huaiyu Ding, Shanshan Wu, and Rongchong Huang
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Cohort Studies ,Ticagrelor ,Percutaneous Coronary Intervention ,Treatment Outcome ,Clinical Interventions in Aging ,Humans ,Hemorrhage ,General Medicine ,Acute Coronary Syndrome ,Geriatrics and Gerontology ,Platelet Aggregation Inhibitors ,Aged ,Clopidogrel - Abstract
Shaoke Meng,1,* Lei Guo,1,* Zhishuai Ye,2 Junjie Wang,1 Huaiyu Ding,1 Shanshan Wu,3 Rongchong Huang2 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Peopleâs Republic of China; 2Cardiac Center/Division of Cardiovascular Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing City, Peopleâs Republic of China; 3Department of Clinical Epidemiology and EBM, Beijing Friendship Hospital, Capital Medical University, Beijing City, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Rongchong Huang, Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongâan Road, Beijing City, 100053, Peopleâs Republic of China, Email rchuang@ccmu.edu.cnBackground: Age is a strong predictor of adverse outcomes due both to a higher risk of bleeding and ischemia. The purpose of this study was to evaluate the safety and efficacy of ticagrelor in elderly patients.Methods: Patients ⥠75 years of age admitted to our center from January, 2015 to December, 2019 who had undergone percutaneous coronary intervention (PCI) and received dual antiplatelet therapy (DAPT) were included in our study. Eligible patients were divided into clopidogrel and ticagrelor groups according to the P2Y12 receptor inhibitor and were followed up for 1 year. The primary safety endpoint was types 2, 3, and 5 bleeding, as defined by Bleeding Academic Research Consortium (BARC), and the primary efficacy endpoint was combined major adverse cardiovascular and cerebrovascular events (MACCEs). A Cox proportional hazard model and propensity score matching were used to correct confounding factors.Results: Of 1505 patients enrolled in this study, 442 were assigned to ticagrelor group and 1063 were assigned to clopidogrel group. The incidence of BARC 2, 3, and 5 bleeding (HR, 2.304; 95% CI, 1.540â 3.447), and any bleeding (HR, 2.476; 95% CI, 1.802â 3.403) in ticagrelor group was significantly higher than clopidogrel group. There were no significant difference between the two groups with respect to BARC 3 and 5 bleeding (HR, 1.566; 95% CI, 0.767â 3.198) and MACCEs (HR, 0.957; 95% CI, 0.702â 1.305).Conclusion: Compared with clopidogrel, DAPT with ticagrelor significantly increased the risk of BARC 2, 3, and 5 bleeding without reducing MACCEs in elderly patients who underwent PCI.Trial Registration: The study was retrospectively registered in clinicaltrials.gov (NCT 04999293).Keywords: ticagrelor, elderly, percutaneous coronary intervention, dual antiplatelet therapy
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- 2022
29. The redox activity of polychlorinated biphenyl quinone metabolite orchestrates its pro-atherosclerosis effect via CAV1 phosphorylation
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Bingwei Yang, Zhishuai Ye, Xiangyu Zhu, Rongchong Huang, Erqun Song, and Yang Song
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Environmental Engineering ,Health, Toxicology and Mutagenesis ,Environmental Chemistry ,Pollution ,Waste Management and Disposal - Published
- 2023
30. Assessment of late gadolinium enhancement-negative chronic total occlusion by longitudinal strain analysis using cardiac magnetic resonance imaging
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Zhiyong Li, Ailian Liu, Qingwei Song, Chen Zhang, RongChong Huang, Anna Mou, and Xin Li
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medicine.medical_specialty ,Longitudinal strain ,Diastole ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Gadolinium ,Strain (injury) ,Predictive Value of Tests ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Myocardium ,Heart ,General Medicine ,Strain rate ,medicine.disease ,Collateral circulation ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Cardiology ,business ,Perfusion ,Artery - Abstract
Background Strain analysis has become commonly used in clinical practice in various heart diseases. Purpose To explore whether late gadolinium enhancement (LGE)-negative areas with coronary artery chronic total occlusion (CTO) appear normal when analyzed for longitudinal strain using cardiac magnetic resonance (CMR) imaging. Material and Methods A total of 16 patients and 31 healthy controls who underwent 1.5-T MR at our hospital between January 2015 and July 2017 were included in the study. The LGE-CMR of patients with CTO was negative. Left ventricular functional parameters, segmental longitudinal strain/strain rate, and perfusion parameters were measured using CVI42 software. Results For myocardial segments supplied by CTO vessels, systolic longitudinal strain rate (SLSR)was significantly lower than that of healthy controls, and diastolic longitudinal strain rate (DLSR) was significantly higher (1.19 1/s vs. 1.02 1/s; P = 0.018). Moreover, longitudinal strain (LS), SLSR, and DLSR did not differ between good and poor collateral circulation. Perfusion index of CTO territory segments was lower than non-CTO territory segments (0.20 vs. 0.22; P = 0.027). No correlation was found between longitudinal strain parameters and perfusion parameters. Conclusion Although LGE-CMR was negative in patients with CTO, the myocardial SLSR of CTO territory segments was significantly lower than that of healthy controls.
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- 2021
31. Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary Intervention and Medical Therapy
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Lei Zhong, Huaiyu Ding, Le Yang, Xiaodong Liu, Xu-chen Zhou, Hao Zhu, Rongchong Huang, Haichen Lv, and Lei Guo
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,MACE ,Coronary Angiography ,Revascularization ,Risk Factors ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Myocardial infarction ,Adverse effect ,Original Research ,Heart Failure ,business.industry ,percutaneous coronary intervention ,Hazard ratio ,Percutaneous coronary intervention ,General Medicine ,coronary chronic total occlusions ,medicine.disease ,medical therapy ,Treatment Outcome ,predictors ,Coronary Occlusion ,Heart failure ,Chronic Disease ,Conventional PCI ,Cardiology ,Geriatrics and Gerontology ,business ,Mace - Abstract
Objective Limited data are available on the predictors of major adverse cardiac events (MACE) after a successful coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and medical therapy. This study aimed to identify predictors of MACE in CTO patients undergoing successful recanalization and medical therapy. Methods A total of 2015 patients with CTOs were enrolled. About 718 patients underwent successful CTO recanalization, and 1297 patients received medical therapy. The primary outcome was the frequency of MACE, defined as a composite of cardiac death, myocardial infarction, and target-vessel revascularization. Multivariate models were used to determine predictors of MACE. Results In successful CTO recanalization group, MACE occurred in 123 (17.1%) patients. In multivariate analysis, heart failure (hazard ratio [HR] 1.77, 95% confidence interval [CI]: 1.04–3.04, p = 0.036) was identified as independent predictors for MACE in successful CTO recanalization. Additionally, in medical therapy group, the significant predictors of MACE were male gender (HR 1.53, 95% CI: 1.13–2.05, p = 0.005), diabetes mellitus (HR 1.39, 95% CI: 1.11–1.74, p = 0.003), heart failure (HR 1.44, 95% CI: 1.10–1.87, p = 0.007), J-CTO score (HR 1.17, 95% CI: 1.07–1.28, p = 0.001) and multivessel disease (HR 2.20, 95% CI: 1.42–3.39, p < 0.001). Conclusion Heart failure was predictor for composite cardiovascular events in patients with CTO after successful recanalization. Male gender, diabetes mellitus, heart failure, J-CTO score and multivessel disease were predictors of MACE in CTO patients with medical therapy.
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- 2021
32. Association of sarcopenia with ideal cardiovascular health metrics among US adults: a cross-sectional study of NHANES data from 2011 to 2018
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Weihua Chen, Shanshan Shi, Yizhou Jiang, Kaihong Chen, Ying Liao, Rongchong Huang, and Kun Huang
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Adult ,Cohort Studies ,Sarcopenia ,Cross-Sectional Studies ,Risk Factors ,Health Status ,Humans ,Female ,General Medicine ,Nutrition Surveys ,United States ,Quality Indicators, Health Care - Abstract
ObjectiveThe American Heart Association (AHA) proposed the concept of ideal cardiovascular health (CVH) to reduce the risk of cardiovascular mortality. We attempted to broaden the impact of CVH and further contribute to AHA 2030 goals by identifying the relationship between CVH and non-cardiovascular diseases such as sarcopenia.DesignCross-sectional surveySettingNational Health and Nutrition Examination Survey conducted in the USA from 2011 to 2018.ParticipantsThis study included participants with reliable first 24-hour dietary recall and ≥20 years of age and excluded those who could not diagnose sarcopenia or insufficient data to calculate the CVH scores.Primary and secondary outcome measuresThe prevalence of sarcopenia as measured by dual-energy X-ray absorptiometry.ResultsThis cohort study involving 9326 adults≥20 years comprised 4733 females (50.0%). The number of intermediate or ideal and poor CVH participants was 5654 and 3672 with mean CVH score of 9.70±0.03 and 5.66±0.04, respectively. After adjusting for related confounding factors, intermediate or ideal CVH was associated with an odds reduction of sarcopenia than poor CVH (adjusted OR (aOR): 0.36, 95% CI 0.26 to 0.50, p5, the odds of sarcopenia decreased by up to 84% (aOR: 0.16, 95% CI 0.08 to 0.30).ConclusionsOur findings suggest a relationship between the CVH and the prevalence of sarcopenia in adults. The results of our study can contribute to achieving the 2030 public health goal of achieving CVH for all, which may be supported by efforts to reduce the prevalence of sarcopenia.
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- 2022
33. Good coronary collateral circulation is not associated with better prognosis in patients with chronic total occlusion, regardless of treatment strategy
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Zeya Li, Yingdong Wang, Shanshan Wu, Jingnan Xiao, Lei Guo, Shaoke Meng, Lei Zhong, Huaiyu Ding, Haichen Lv, Xuchen Zhou, and Rongchong Huang
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Cardiology and Cardiovascular Medicine - Abstract
Little is known regarding the effects of coronary collateral circulation (CCC) on the prognosis of patients with chronic total occlusion (CTO) under different treatment strategies.We analyzed a total of 1124 patients who had been diagnosed with CTO and divided them into groups with good CCC (grade 2 to 3, n = 539) or poor CCC (grade 0 to 1, n = 531). The primary outcome was cardiac death during follow-up; the secondary outcome was major adverse cardiovascular events (MACEs). We also performed subgroup analyses in groups with and without CTO revascularization (CTO-R and CTO-NR, respectively), and sensitivity analyses excluding patients who received failed CTO-PCI, to further investigate the effect of CCC.During a median follow-up duration of 23 months, we did not detect any significant differences between the good CCC group and the poor CCC group in terms of cardiac death (4.2% vs 4.1%; adjusted hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.56-1.83; p = 0.970) and MACEs (23.6% vs 23.2%; adjusted HR, 1.07; 95% CI, 0.84-1.37; p = 0.590). Subgroup analyses according to CTO revascularization showed similar results. In addition, we observed no differences in sensitivity analyses when patients who received failed CTO-PCI were excluded.Good CCC was not associated with a lower risk of cardiac death or MACEs among patients with CTO, regardless of whether the patients received CTO revascularization treatment.
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- 2022
34. Evaluation of Therapeutic Agents Targeting the Pathogenesis of Coronary Artery Spasm: A Mini Review
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Zhishuai Ye, Xiantao Song, Mingyue Xu, Xin Zhao, Jinfan Tian, and Rongchong Huang
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Pharmacology ,Vascular smooth muscle ,business.industry ,Myocardial Ischemia ,Coronary Vasospasm ,Disease ,medicine.disease ,Bioinformatics ,Sudden death ,eye diseases ,Angina ,Pathogenesis ,medicine.anatomical_structure ,embryonic structures ,medicine ,Humans ,Myocardial infarction ,Endothelial dysfunction ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Coronary artery spasm (CAS) plays an important role in the pathogenesis of ischemic heart disease. The clinical manifestations of CAS include variant angina, myocardial infarction and sudden death. Although endothelial dysfunction and hyperreactivity of vascular smooth muscle cells have been associated with CAS, the underlying mechanisms remain unclear. Thus, there is a long way to go to truly understand the pathogenesis of CAS to formulate effective treatments. This article discusses the pathophysiological mechanisms as well as downstream molecular pathways of CAS, with a focus on potential therapeutic targets.
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- 2021
35. Two‐year left ventricular systolic function of percutaneous coronary intervention vs optimal medical therapy for patients with single coronary chronic total occlusion
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Hui Wang, Rongchong Huang, Lin Qiu, Shuang Meng, and Jian Wu
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medicine.medical_specialty ,medicine.medical_treatment ,Echocardiography, Three-Dimensional ,Speckle tracking echocardiography ,Systolic function ,030204 cardiovascular system & hematology ,Revascularization ,Total occlusion ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,030212 general & internal medicine ,Aged ,Ejection fraction ,business.industry ,Percutaneous coronary intervention ,Stroke Volume ,Middle Aged ,Coronary Occlusion ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Medical therapy - Abstract
In this study, two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (RT-3DE) were applied to compare the changes of left ventricular systolic function associated with percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with single chronic total occlusion (CTO). 63 single CTO patients (age 61.88 ± 8.86 years) were examined by echocardiography and were divided into the PCI group (n = 27) and OMT group (n = 36) according to the initial treatment strategy. Two-dimensional left ventricular ejection fraction (2D-LVEF), two-dimensional indexed left ventricular end-systolic volume (2D-LVESVI), and two-dimensional indexed left ventricular end-diastolic volume (2D-LVEDVI) were measured using two-dimensional echocardiography (2DE). Three-dimensional left ventricular ejection fraction (3D-LVEF), three-dimensional indexed left ventricular end-systolic volume (3D-LVESVI), and three-dimensional indexed left ventricular end-diastolic volume (3D-LVEDVI) were measured using RT-3DE. Global circumferential strain (GCS) and global longitudinal strain (GLS) were measured using 2D-STE. After 2 years of follow-up, there were no significant differences in the 2D-LVEF, 2D-LVESVI, 3D-LVEF, 3D-LVESVI, 3D-LVEDVI, and GCS, except for GLS (P = .001) between the CTO-PCI and CTO-OMT groups. GLS decreased significantly in OMT group (P = .016) in contrast with PCI group in which GLS increased significantly (P = .007). Left ventricular systolic function assessment using 2D-STE showed a significant difference in GLS between CTO-PCI and CTO-OMT. And the patients who chose PCI revascularization at the 2-year follow-up had better left ventricular systolic function improvement than those who were conservatively treated with OMT.
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- 2021
36. Evaluation of Early Biomarkers of Atherosclerosis Associated with Polychlorinated Biphenyl Exposure: An
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Bingwei, Yang, Zhishuai, Ye, Yawen, Wang, Hongzhou, Guo, Hans-Joachim, Lehmler, Rongchong, Huang, Erqun, Song, and Yang, Song
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Mice ,Human Umbilical Vein Endothelial Cells ,Animals ,Humans ,RNA, Long Noncoding ,Atherosclerosis ,Polychlorinated Biphenyls ,Biomarkers - Abstract
Miscellaneous cardiovascular risk factors have been defined, but the contribution of environmental pollutants exposure on cardiovascular disease (CVD) remains underappreciated.We investigated the potential impact of typical environmental pollutant exposure on atherogenesis and its underlying mechanisms.We used human umbilical vein endothelial cells (HUVECs) and apolipoprotein E knockout (Our data indicate that lncRNAThese findings demonstrated that a mechanism-based, integrated-omics approach enabled the identification of potentially clinically relevant diagnostic indicators and therapeutic targets of CHD mediated by environmental contaminants using
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- 2022
37. Long-term outcomes of medical therapy versus successful recanalisation for coronary chronic total occlusions in patients with and without type 2 diabetes mellitus
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Jun-Jie Wang, Huaiyu Ding, Rongchong Huang, Lei Guo, Jian Wu, Jiaying Xu, Shaoke Meng, Xuchen Zhou, Haichen Lv, Xiaoyan Zhang, and Lei Zhong
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Medical therapy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Outcomes ,Percutaneous coronary intervention ,Diabetes mellitus ,Internal medicine ,medicine ,cardiovascular diseases ,Chronic total occlusions ,Original Investigation ,business.industry ,Incidence (epidemiology) ,Hazard ratio ,Diabetes ,medicine.disease ,Confidence interval ,lcsh:RC666-701 ,Propensity score matching ,Conventional PCI ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Background In this study, we compared the outcomes of medical therapy (MT) with successful percutaneous coronary intervention (PCI) in chronic total occlusions (CTO) patients with and without type 2 diabetes mellitus. Methods A total of 2015 patients with CTOs were stratified. Diabetic patients (n = 755, 37.5%) and non-diabetic patients (n = 1260, 62.5%) were subjected to medical therapy or successful CTO-PCI. We performed a propensity score matching (PSM) to balance the baseline characteristics. A comparison of the major adverse cardiac events (MACE) was done to evaluate long-term outcomes. Results The median follow-up duration was 2.6 years. Through multivariate analysis, the incidence of MACE was significantly higher among diabetic patients compared to the non-diabetic patients (adjusted hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.09–1.61, p = 0.005). Among the diabetic group, the rate of MACE (adjusted HR 0.61, 95% CI 0.42–0.87, p = 0.006) was significantly lower in the successful CTO-PCI group than in the MT group. Besides, in the non-diabetic group, the prevalence of MACE (adjusted HR 0.85, 95% CI 0.64–1.15, p = 0.294) and cardiac death (adjusted HR 0.94, 95% CI 0.51–1.70, p = 0.825) were comparable between the two groups. Similar results as with the early detection were obtained in propensity-matched diabetic and non-diabetic patients. Notably, there was a significant interaction between diabetic or non-diabetic with the therapeutic strategy on MACE (p for interaction = 0.036). Conclusions For treatment of CTO, successful CTO-PCI highly reduces the risk of MACE in diabetic patients when compared with medical therapy. However, this does not apply to non-diabetic patients.
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- 2020
38. Percutaneous Coronary Intervention in Elderly Patients with Coronary Chronic Total Occlusions: Current Evidence and Future Perspectives
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Rongchong Huang, Haichen Lv, and Lei Guo
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High rate ,education.field_of_study ,medicine.medical_specialty ,business.industry ,health care facilities, manpower, and services ,medicine.medical_treatment ,Population ,Percutaneous coronary intervention ,General Medicine ,Guideline ,Total population ,medicine.disease ,Coronary revascularization ,humanities ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Conventional PCI ,medicine ,030212 general & internal medicine ,Geriatrics and Gerontology ,education ,Intensive care medicine ,business ,030217 neurology & neurosurgery - Abstract
The proportion of the elderly in the total population of the world is growing, and the number of elderly patients with coronary chronic total occlusions (CTO) is huge. The elderly patients often have more extensive coronary artery disease, more severe ischemic burden and higher risk of cardiovascular events, as compared to younger patients, and thereby they might greatly benefit from coronary revascularization, even though they may have higher risk of operative complications. Most interventional cardiologists are more likely to be reluctant to operate complex percutaneous coronary intervention (PCI) in elderly patients. The latest refinements in dedicated CTO-PCI equipment and techniques have led to high rates of success and low complications rates and have made the CTO-PCI procedures safe and effective among the elderly patients. However, up to now, there is no widely recognized consensus or guideline on treatment strategy of elderly CTO patients, and the prognosis in this population is unknown. In this review, we aim to provide an overview of the current evidence and future perspectives on PCI in elderly patients with CTOs.
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- 2020
39. Caveolin as a Novel Potential Therapeutic Target in Cardiac and Vascular Diseases: A Mini Review
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Rongchong Huang, Jinfan Tian, Xin Zhao, Min Zhang, Mohammad Sharif Popal, Xiantao Song, and Mingduo Zhang
- Subjects
0301 basic medicine ,autophagy ,Caveolin ,Review Article ,Pathology and Forensic Medicine ,Nitric oxide ,target ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,cardiovascular disease ,Caveolae ,Medicine ,business.industry ,Autophagy ,Cell Biology ,Cell biology ,Crosstalk (biology) ,030104 developmental biology ,chemistry ,role ,Neurology (clinical) ,Geriatrics and Gerontology ,Signal transduction ,business ,030217 neurology & neurosurgery ,Biogenesis ,Homeostasis - Abstract
Caveolin, a structural protein of caveolae, play roles in the regulation of endothelial function, cellular lipid homeostasis, and cardiac function by affecting the activity and biogenesis of nitric oxide, and by modulating signal transduction pathways that mediate inflammatory responses and oxidative stress. In this review, we present the role of caveolin in cardiac and vascular diseases and the relevant signaling pathways involved. Furthermore, we discuss a novel therapeutic perspective comprising crosstalk between caveolin and autophagy.
- Published
- 2020
40. Human umbilical cord blood mesenchymal stem cells conditioned media inhibits hypoxia-induced apoptosis in H9c2 cells by activation of the survival protein Akt
- Author
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Xuhe Gong, Guangpu Fan, Si-Jia Wang, Hui Liu, and Rongchong Huang
- Subjects
medicine.anatomical_structure ,Apoptosis ,business.industry ,Mesenchymal stem cell ,Cancer research ,medicine ,General Medicine ,Hypoxia (medical) ,medicine.symptom ,business ,Protein kinase B ,Umbilical cord - Published
- 2020
41. Comparison of long-term outcomes of medical therapy and successful recanalisation for coronary chronic total occlusions in elderly patients: a report of 1,294 patients
- Author
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Haichen Lv, Lei Zhong, Jian Wu, Rongchong Huang, Lei Guo, Jiaying Xu, and Huaiyu Ding
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Percutaneous coronary intervention ,030204 cardiovascular system & hematology ,medicine.disease ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Right coronary artery ,medicine.artery ,Propensity score matching ,Conventional PCI ,medicine ,Original Article ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Background: Little is known about the long-term outcomes of medical therapy (MT) versus successful percutaneous coronary intervention (PCI) in elderly patients with coronary chronic total occlusions (CTOs). Methods: There were 1,294 consecutive patients with 1,520 CTOs included (2007 to 2016) and were divided into the younger group (age
- Published
- 2019
42. Safety of low-dose dobutamine stress test in coronary slow flow phenomenon
- Author
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Jian Wu, Rongchong Huang, Shuang Meng, and Yanzong Yang
- Subjects
Pharmaceutical Science ,Pharmacology (medical) ,cardiovascular diseases ,Coronary slow flow phenomenon, Dobutamine stress test, Echocardiography, Tachycardia, Malignant arrhythmia, Ventricular fibrillation - Abstract
Purpose: To investigate the feasibility and safety of a low-dose dobutamine stress test in coronary slow flow phenomenon (CSFP) patients.Methods: One hundred and forty-two CSFP patients, and forty-four patients without CSFP or significant epicardial coronary stenosis who served as the control group, were retrospectively reviewed. All patients were infused intravenously with dobutamine at an initial infusion rate of 5 μg/kg/min which was then increased at 8-min intervals to 10, 15, and 20 μg/kg/min. Symptoms and echocardiography were monitored simultaneously.Results: Patient tolerance decreased as the doses of dobutamine increased. No termination of the test occurred without dobutamine or at the infusion rate of 5 μg/kg/min. Nonetheless, when the infusion rates were adjusted to 15 and 20 μg/kg/min, the incident of side effects reached up to 30.9 %, and a few patients experienced ST-segment depression in precordial electrocardiographic leads. There were no induced arrhythmias without dobutamine, while the incidence of arrhythmias was highest at the infusion rate of 20 μg/kg/min. Malignant arrhythmias such as ventricular fibrillation and sustained ventricular tachycardia, were not detected. No significant differences were showed in echocardiogram result for left ventricular ejection fraction (LVEF) between CSFP and control group (63.7±7.9 in the CSFP group, versus 64.3±7.2 in the control group; p = 0.63).Conclusion: A low-dose dobutamine stress test is safe and feasible in CSFP patients.
- Published
- 2021
43. Evaluation of Left Ventricular Function in Patients with Coronary Slow Flow by the Dobutamine Stress Echocardiography
- Author
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Yanzong Yang, Rongchong Huang, Jian Wu, Shuang Meng, and Hui Wang
- Subjects
Ventricular Dysfunction, Left ,Echocardiography ,Dobutamine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ventricular Function, Left ,Echocardiography, Stress - Abstract
Background: The study aims to assess the changes to left ventricular (LV) function of patients with the coronary slow flow (CSF) in response to stress induced by low dose dobutamine. Methods: Based on coronary angiography (CAG) results, a total of 186 patients undergoing CAG for chest pain and suspected coronary heart disease were assigned to the CSF group (n = 142) and control group (n = 44). Patients in the CSF group underwent two-dimensional speckle-tracking echocardiography (STE) during the dobutamine stress test to evaluate LV systolic and diastolic functions. Results: At rest, there were no statistically significant differences in LV peak systolic longitudinal strain (LS), LV peak systolic longitudinal strain rate (LSRs), LV peak early diastolic longitudinal strain rate (LSRed), LV circumferential strain (CS), or LV circumferential strain rate (CSRed) between the CSF and control groups. In the CSF group, LS and LSRs first increased as the infusion rate was increased to 10 μg/kg/min (all, p < 0.05), before decreasing at infusion rates of 15 and 20 μg/kg/min (all, p < 0.05). CS and CSRed increased in the CSF group at infusion rates of 5, 10, and 15 μg/kg/min, (all, p < 0.05), but decreased significantly at 20 μg/kg/min (all, p < 0.05). Conclusions: At rest, LV systolic and diastolic functions were comparable between the CSF and control groups. However, when blood flow to the heart muscles was insufficient, LSRed decreased first, followed by LS. In terms of sensitivity to myocardial ischemia, LS is a better strain parameter than CS.
- Published
- 2021
44. GALNT4 primes monocytes adhesion and transmigration by regulating O-Glycosylation of PSGL-1 in atherosclerosis
- Author
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Zhishuai Ye, Hongzhou Guo, Liping Wang, Yan Li, Mingyue Xu, Xin Zhao, Xiantao Song, Zhaoyang Chen, and Rongchong Huang
- Subjects
Glycosylation ,TOR Serine-Threonine Kinases ,Atherosclerosis ,Monocytes ,Plaque, Atherosclerotic ,Mice ,P-Selectin ,Apolipoproteins E ,NF-KappaB Inhibitor alpha ,Cell Adhesion ,Animals ,N-Acetylgalactosaminyltransferases ,Cardiology and Cardiovascular Medicine ,Molecular Biology ,Proto-Oncogene Proteins c-akt ,Genome-Wide Association Study - Abstract
Atherosclerosis is a major underlying cause of cardiovascular disease. Genome wide association studies have predicted that GalNAc-T4 (GALNT4), which responsible for initiating step of mucin-type O-glycosylation, plays a causal role in the susceptibility to cardiovascular diseases, whereas the precise mechanism remains obscure. Thus, we sought to determine the role and mechanism of GALNT4 in atherosclerosis. Firstly, we found the expression of GALNT4 and protein O-glycosylation were both increased in plaque as atherosclerosis progressed in ApoE
- Published
- 2021
45. Serum apolipoprotein A-I depletion is causative to silica nanoparticles–induced cardiovascular damage
- Author
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Erqun Song, Wei Wei, Pu Chun Ke, Rongchong Huang, Jianlin Lou, Zixuan Liu, Lingfang Feng, Xuting Liu, Yang Song, and Chunying Chen
- Subjects
Male ,Apolipoprotein B ,Protein Corona ,Pharmacology ,Cardiovascular System ,Proinflammatory cytokine ,Lesion ,Mice ,Silicosis ,medicine ,Animals ,Nanotechnology ,Particle Size ,Respiratory system ,Lung ,Mice, Knockout ,Multidisciplinary ,Apolipoprotein A-I ,biology ,Chemistry ,Environmental exposure ,Biological Sciences ,Silicon Dioxide ,medicine.disease ,Mice, Inbred C57BL ,Oxidative Stress ,medicine.anatomical_structure ,Cardiovascular Diseases ,biology.protein ,Nanoparticles ,Adsorption ,medicine.symptom ,Signal Transduction - Abstract
The rapid development of nanotechnology has greatly benefited modern science and engineering and also led to an increased environmental exposure to nanoparticles (NPs). While recent research has established a correlation between the exposure of NPs and cardiovascular diseases, the intrinsic mechanisms of such a connection remain unclear. Inhaled NPs can penetrate the air-blood barrier from the lung to systemic circulation, thereby intruding the cardiovascular system and generating cardiotoxic effects. In this study, on-site cardiovascular damage was observed in mice upon respiratory exposure of silica nanoparticles (SiNPs), and the corresponding mechanism was investigated by focusing on the interaction of SiNPs and their encountered biomacromolecules en route. SiNPs were found to collect a significant amount of apolipoprotein A-I (Apo A-I) from the blood, in particular when the SiNPs were preadsorbed with pulmonary surfactants. While the adsorbed Apo A-I ameliorated the cytotoxic and proinflammatory effects of SiNPs, the protein was eliminated from the blood upon clearance of the NPs. However, supplementation of Apo A-I mimic peptide mitigated the atherosclerotic lesion induced by SiNPs. In addition, we found a further declined plasma Apo A-I level in clinical silicosis patients than coronary heart disease patients, suggesting clearance of SiNPs sequestered Apo A-I to compromise the coronal protein's regular biological functions. Together, this study has provided evidence that the protein corona of SiNPs acquired in the blood depletes Apo A-I, a biomarker for prediction of cardiovascular diseases, which gives rise to unexpected toxic effects of the nanoparticles.
- Published
- 2021
46. TLR4-Myd88 pathway upregulated caveolin-1 expression contributes to coronary artery spasm
- Author
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Jinfan Tian, Yue Liu, Xin Zhao, Mingyue Xu, Zhishuai Ye, Xiantao Song, and Rongchong Huang
- Subjects
Lipopolysaccharides ,Spasm ,Physiology ,Caveolin 1 ,Mice ,Downregulation and upregulation ,In vivo ,Human Umbilical Vein Endothelial Cells ,Medicine ,Animals ,Humans ,Endothelial dysfunction ,Receptor ,Pharmacology ,business.industry ,Vasospasm ,medicine.disease ,Coronary Vessels ,Endothelial stem cell ,Toll-Like Receptor 4 ,Myeloid Differentiation Factor 88 ,cardiovascular system ,Cancer research ,TLR4 ,Molecular Medicine ,business - Abstract
Aim To study the role of toll-like receptors 4-myeloid differentiation factor 88 (TLR4-Myd88) dependent caveolin-1 (Cav-1) expression modulation in coronary artery spasm (CAS) and explore the underlying pathogenic mechanisms. Methods and results Lipopolysaccharide (LPS) and acetylcholine (Ach) were used to develop the in vitro and in vivo models mimicking the physiological CAS microenvironment. LPS-induced upregulation of Cav-1 expression in mouse coronary and aorta endothelial cells was shown by western blot and immunofluorescence (IF) staining (p Conclusion These findings suggested that Cav-1, which was upregulated by TLR4-Myd88, served as an important modulator of CAS microenvironment establishment in vivo and in vitro, making it a potential pharmacologic target for the treatment of vasospasm via reduced endothelial cell inflammation.
- Published
- 2021
47. Agreement in Left Ventricular Function Measured by Echocardiography and Cardiac Magnetic Resonance in Patients With Chronic Coronary Total Occlusion
- Author
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Lijun Zhang, Xueyao Yang, Xiantao Song, Rongchong Huang, Huijuan Zuo, Yi He, Ye Han, Jiahui Li, and Yueli Wang
- Subjects
medicine.medical_specialty ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Total occlusion ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,transthoracic echocardiography ,left ventricular function ,0302 clinical medicine ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,magnetic resonance imaging ,In patient ,Wall motion ,cardiovascular diseases ,chronic total occlusion ,Original Research ,Ejection fraction ,medicine.diagnostic_test ,Ventricular function ,business.industry ,Magnetic resonance imaging ,RC666-701 ,Cardiology ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance ,agreement ,Kappa - Abstract
Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P < 0.001) and a moderately strong agreement (Kappa = 0.62, P < 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF r = 0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF
- Published
- 2021
48. Long-Term Outcomes of Successful Recanalization Compared With Optimal Medical Therapy for Coronary Chronic Total Occlusions in Patients With and Without Left Ventricular Systolic Dysfunction
- Author
-
Huaiyu Ding, Shaoke Meng, Lei Zhong, Haichen Lv, Xiaoyan Zhang, Lei Guo, Jiaying Xu, Jian Wu, and Rongchong Huang
- Subjects
medicine.medical_specialty ,LVEF ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,outcomes ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,030212 general & internal medicine ,cardiovascular diseases ,Original Research ,Ejection fraction ,business.industry ,Incidence (epidemiology) ,Confounding ,percutaneous coronary intervention ,Percutaneous coronary intervention ,Retrospective cohort study ,optimal medical therapy ,RC666-701 ,chronic total occlusions ,Conventional PCI ,Propensity score matching ,Cardiology ,business ,Cardiology and Cardiovascular Medicine ,Mace ,left ventricular systolic dysfunction - Abstract
Background: The number of coronary chronic total occlusion (CTO) patients with left ventricular (LV) systolic dysfunction is significant, but the clinical outcomes of these patients are rarely reported. The present retrospective cohort study aimed to investigate the long-term outcomes of successful recanalization vs. optimal medical therapy (MT) for CTOs in patients with preserved and impaired LV systolic function.Methods: A total of 1,895 patients with CTOs were stratified according to LV function. Of these, 1,420 patients (74.9%) with LV ejection fraction (LVEF) >45% and 475 patients (25.1%) with LVEF ≤45% were treated with optimal MT or successful CTO percutaneous coronary intervention (PCI). A 1:1 propensity score matching (PSM) was conducted to reduce the impact of potential confounding on the outcomes. The primary outcome was the frequency of major adverse cardiac events (MACEs).Results: Throughout a 2.6-year follow-up and after adjusting for confounders, among patients with preserved LV function, successful CTO PCI was associated with reduced incidence of MACE (14.2 vs. 23.9%, adjusted HR 0.63, 95% CI 0.48–0.83, p = 0.001) compared to MT. There was no significant difference in MACE occurrence (29.6 vs. 28.9%, adjusted HR 1.05, 95% CI: 0.71–1.56, p = 0.792) between successful recanalization and MT in patients with LV systolic dysfunction. The primary outcome among patients with impaired and preserved LV systolic function after PSM was similar to that from earlier findings before PSM was conducted. A significant interaction between LV function and therapeutic strategy for MACE was observed (interaction p = 0.038).Conclusions: Compared to MT alone for management of patients with CTOs, successful CTO PCI may reduce the risk of MACE in patients with preserved LV systolic function, but not in patients with LV dysfunction.
- Published
- 2021
49. Successful recanalisation of coronary chronic total occlusions is not associated with improved cardiovascular survival compared with initial medical therapy
- Author
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Jian Wu, Shanfeng Zhang, Lei Zhong, Huaiyu Ding, Lei Guo, Jiaying Xu, Xuchen Zhou, and Rongchong Huang
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Risk Assessment ,Total occlusion ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Aged ,business.industry ,Percutaneous coronary intervention ,Cardiovascular Agents ,Middle Aged ,Treatment Outcome ,Coronary Occlusion ,Chronic Disease ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Medical therapy - Abstract
Objective. To compare the clinical outcomes associated with successful percutaneous coronary intervention (PCI) versus initial medical therapy (MT) in patients with coronary chronic total occlusion...
- Published
- 2019
50. The P-selectin and PSGL-1 axis accelerates atherosclerosis via activation of dendritic cells by the TLR4 signaling pathway
- Author
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Lei Zhong, Jie Zheng, Shujing Wang, Rongchong Huang, Zhishuai Ye, Jianing Zhang, Shengnan Zhu, and Yinuo Wang
- Subjects
Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,P-selectin ,Immunology ,Stimulation ,030204 cardiovascular system & hematology ,Article ,Proinflammatory cytokine ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Apolipoproteins E ,0302 clinical medicine ,In vivo ,Internal medicine ,Cell death and immune response ,medicine ,Animals ,Humans ,lcsh:QH573-671 ,Receptor ,Aged ,Mice, Knockout ,Membrane Glycoproteins ,Chemistry ,lcsh:Cytology ,Dendritic Cells ,Cell Biology ,Middle Aged ,Atherosclerosis ,Toll-Like Receptor 4 ,P-Selectin ,030104 developmental biology ,Endocrinology ,Myeloid Differentiation Factor 88 ,Knockout mouse ,TLR4 ,Female ,B7-2 Antigen ,Signal transduction ,Signal Transduction - Abstract
P-selectin and dendritic cells (DCs) are associated with atherosclerosis. However, their interactions in this setting are undefined. Herein, we investigated the role of P-selectin and its receptor P-selectin glycoprotein ligand (PSGL)-1 on atherosclerosis via activation of DCs. In the current study, a total of 34 patients with ST elevation myocardial infarction (STEMI) and 34 healthy control subjects were enrolled. Serum concentration of P-selectin was higher and the myeloid DC/plasmacytoid DC (mDC/pDC) ratio was lower in STEMI patients than in normal individuals. Interestingly, in STEMI patients, P-selectin was decreased and the mDC/pDC ratio was increased at 5–7 days after successful percutaneous coronary intervention, as compared with values on admission. Serum P-selectin was inversely correlated with the mDC/pDC ratio. Moreover, ApoE−/−P−/− and ApoE−/−PSGL-1−/− mice developed small atherosclerotic plaques after feeding of a western diet for 12 weeks and DC infiltration was significantly reduced. P-selectin stimulation markedly induced phenotypic maturation, enhanced secretion of inflammatory cytokines, communication with T cells, and the adhesion and migration of DCs. In vivo, DC maturation was significantly attenuated in P-selectin and PSGL1 knockout mice under hypercholesterolemic and inflammatory conditions. These effects were associated with the activation of myeloid differentiation primary response 88 (MYD88)-dependent and MyD88-independent Toll-like receptor 4 (TLR4) signaling pathways. Taken together, binding of P-selectin to PSGL-1 on DCs contributes to atherosclerosis progression via DC activation via the TLR4 signaling pathway.
- Published
- 2019
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