Abstract:With the development of multi-omics detection technology, researchers have more understanding of the metabolic changes in the process of cardiac remodeling. On the one hand, the process of cardiac remodeling involves not only the metabolism of fatty acids, glucose and amino acids, but more and more new metabolites are concerned; on the other hand, highly attention has been paid for the interaction between different organs and the heart. This review plans to explain the interaction between cardiac remodeling and metabolism.

Abstract:Aim Through simulating the ischemia/reperfusion of cardiomyocytes in vivo by constructing a model of cardiomyocyte hypoxia and reoxygenation in vitro, to verify the effect of Aliskiren on improving the myocardial ischemia/reperfusion injury and to explore its mechanism in regulating apoptosis. Methods Cell experiments were divided into four groups:normal oxygen supply group (Control), hypoxia/reoxygenation group (H/R), Aliskiren+H/R group, NF-κB P65 specific inhibitor (bay11-7082)+H/R group. CCK-8 was used to detect the survival rate of cardiomyocytes pretreated with different concentrations of Aliskiren, and ELISA was performed to determine the levels of inflammatory factors (TNF-α, IL-6) in each experimental group. Hoechst33258 staining and Annexin V/PI dual staining flow cytometry were conducted to evaluate the myocardial cell apoptosis ratio in each group. The JC-1 kit was used to measure mitochondrial membrane potential and cardiomyocyte ATP content. Meanwhile, the Caspase-3 activity kit was performed to detect the activity of apoptotic proteases in each group. Results When the concentration of Aliskiren was less than 20 mmol/L, a positive correlation with cardiomyocyte activity was showed, and when between 40 mmol/L and 80 mmol/L, there was a negative correlation. The optimal concentration of Aliskiren was 20 mmol/L at which the myocardial cell activity is the highest. Compared with the H/R group, Aliskiren can decrease the expression of TNF-α and IL-6 ((129.33±5.86) ng/L vs (319.00±4.58) ng/L, P＜0.05; (29.67±1.53) ng/L vs (64.67±2.08) ng/L, P＜0.05), and significantly reduce the apoptosis rate of cardiomyocytes ((7.23%±1.14%) vs (32.25%±3.15%), P＜0.05), and reduced the proportion of cardiomyocytes with energy disorders ((6.9%±1.6%) vs (13.5%±1.7%), P＜0.05), what’s more, Aliskiren can gain the function of stabilizing mitochondrial membrane potential ((3.90±0.60) vs (1.80±0.16), P＜0.05) and inhibit the activity of apoptotic protease Caspase-3 ((2.26±0.35) vs (3.26±0.62), P＜0.05). It is of great importance that there was no statistical difference in the experimental results between Aliskiren+H/R group and bay11-7082+H/R group.Conclusion Aliskiren can improve myocardial ischemia/reperfusion injury by inhibiting inflammatory response and regulating mitochondrial receptor-mediated apoptosis. Based on the experimental results, it can be speculated that the role of Aliskiren in regulating apoptosis may be related to inhibition of NF-κB expression.

Abstract:Aim To investigate the effect of-94 ATTG insertion/deletion mutation at the promoter region of nuclear factor of kappa light polypeptide gene enhancer in B-cell 1 (NFKB1) gene on injury of human umbilical vein endothelial cell (HUVEC) induced by high glucose and high fat microenvironment and its potential mechanism. MethodsHigh glucose and high fat model of primary HUVEC cells with different genotypes of NFKB1 was established. Cellular apoptosis was detected by Annexin-V-FLUOS staining. Morphology of mitochondria was observed by laser confocal microscopy after Mito Tracker staining. Western blot was used to detect p50 and p65 proteins in nuclear factor-κB (NF-κB) signaling pathway, mitochondrial fission related proteins Drp1, Drp1-s637, Drp1-s616 and Fis1, mitochondrial fusion related proteins Mfn1, Mfn2 and Opa1, and apoptosis related protein cytochrome C (CytC). Results The apoptotic rate of primary HUVEC induced by high glucose and high fat was higher than control group, and the apoptotic rate of mutant type cells (DD genotype) was more than that of wild type cells (Ⅱ genotype). Mitochondria was over-fission into fragments.The expression of p50, a key protein in NF-κB pathway, was significantly decreased in DD genotype cells. Expression of mitochondrial fusion related protein Mfn2 was decreased. The phosphorylation of mitochondrial fission dynamic related protein Drp1-s616 was increased, and the expression of CytC was increased. Conclusion NFKB1 gene deletion mutation may be an important reason for the vulnerable damage of DD genotype HUVEC during high glucose and high fat microenvironment, and its potential mechanism may be related to mitochondrial over-fission.

Abstract:Aim To investigate the effect of miR-200c-3p on apoptosis of cardiomyocytes with hypoxia/reoxygenation and its mechanism. Methods H9c2 cells hypoxia/reoxygenation (H/R)model was constructed by treatment in hypoxia/reoxygenation incubator for 12 hours. The expression levels of miR-200c-3p and X-linked inhibitor of apoptosis protein(XIAP) mRNA were detected by Real-time fluorescent quantitative reverse transcription polymerase chain reaction(qRT-PCR). H/R+anti-miR-NC group (transfected with anti-miR-NC), H/R+anti-miR-200c-3p group (transfected with anti-miR-200c-3p), H/R+pcDNA group (transfected with pcDNA), H/R+pcDNA-XIAP group (transfected with pcDNA-XIAP), H/R+anti-miR-200c-3p+si-NC group (co-transfected with anti-miR-200c-3p and si-NC), H/R+anti-miR-200c-3p+si-XIAP group (co-transfected with anti-miR-200c-3p and si-XIAP) were transfected into H9c2 cells by liposome method and subjected to hypoxia-reoxygenation treatment. Western blotting(western blot), methyl thiazolyl tetrazolium (MTT) and flow cytometry were used to detect the expression of XIAP, Cysteine aspartic protease(Caspase-3), cleaved Caspase-3,Bü cell lymphoma/leukemia-2 X protein(Bax) and B cell lymphoma/leukemia-2(Bcl-2), cell proliferation and apoptosis respectively. The dual luciferase reporter gene assay was used to detect the binding of miR-200c-3pto XIAP in cells. Results Hypoxia-reoxygenation H9c2 cells were successfully constructed. Compared with the control group, the expression of miR-200c-3p was up-regulated, and the expression of XIAP was down-regulated in H9c2 cells with H/R. The inhibition of miR-200c-3p and overexpression of XIAP inhibited cell apoptosis, down-regulation of cleaved Caspase-3, Bax, up-regulation of Bcl-2 in H/R H9c2 cells; miR-200c-3p inhibits the fluorescence activity of wild-type XIAP cells and negatively regulates the expression of XIAP; Knockdown XIAP could reverse the inhibition of miR-200c-3p on the apoptosis of H/R H9c2 cells. Conclusion miR-200c-3p can promote the apoptosis of cardiomyocytes with hypoxia-reoxygenation treatment, and its intracellular mechanism is related to the regulation of XIAP, which will provide a new target for the treatment of ischemic myocardial injury.

Abstract:Aim To investigate the correlation between circulating microRNA-204 levels and coronary CT angiography (CTA) calcification score(CACS) in patients with diabetes. Methods Clinical data from 179 patients diagnosed with diabetes who underwent coronary CT angiography in our hospital from January 2017 to December 2018, were cross-section analyzed. Patients were divided into moderate to severe calcification group(CACS＞0,9 cases) and non-or minimal calcification group (CACS≤0,0 cases). Five patients with coronary artery calcification (CAC) (CACS＞10) and 5 patients with non-CAC (CACS≤10) were selected for microRNA microarray analysis of plasma microRNAs. Two groups of microRNA-204 were quantified by using qRT-PCR and univariate linear regression was performed to assess the potential correlation between microRNA-204 levels and CACS. The potential diagnostic ability of microRNA-204 was assessed by ROC curve analysis. Results There was significant difference in fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) between two groups (P＜0.05). MicroRNA microarray analysis showed a significant decrease in microRNA-204 expression levels in the CAC group compared with the non-CAC group. MicroRNA-204 was significantly down-regulated in the moderate-to-severe calcification group by qRT-PCR (P＜0.05). Univariate linear regression analysis showed that circulating microRNA-204 levels in moderate to severe calcification group were negatively correlated with CACS, which reflected the severity of coronary artery calcification. The ROC curve showed that the area under the curve of microRNA-204 levels predicting vascular calcification of patients with diabetes was 0.948 7(0.919 1～0.978 2, P＜0.0001) and the diagnostic threshold was 21.3, the sensitivity was 96.3%, the specificity was 79.6%. Conclusion The expression level of microRNA-204 in plasma of CAC patients decreased significantly, but there was a negative correlation between the severity of CAC and microRNA-204, which may be of great significance to further verify that the level of microRNA-204 in human plasma macroscopically reflects the severity of CAC in patients with diabetes mellitus. MicroRNA-204 may be a new biomarker for the diagnosis of coronary artery calcification.

Abstract:Aim To explore the correlation between lipid deposition index and atherosclerosis of coronary heart disease (CHD) and optimize the best index to provide reference for clinical diagnosis and treatment. Methods 231 patients who underwent coronary angiography from January 2018 to February 2019 were selected. According to the results of coronary angiography, the patients were divided into three groups:non-CHD group (n＝75), CHD non-intervention group (n＝80), and CHD intervention group (n＝76). Routine biochemistry and full set of blood lipid indexes were detected by automatic biochemical analyzer. The correlation between lipid deposition index and the degree of atherosclerosis was analyzed. ROC curve was used to analyze the specificity and sensitivity of lipid deposition index in predicting CHD.Results There were significant differences in age, body mass index, total cholesterol, low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol, apolipoprotein B, apolipoprotein A1, homocysteine (Hcy), C-reactive protein (CRP) and cardiac troponin I among the three groups (P＜0.05). Logistic regression analysis showed that lipid deposition index A,Dü and E were positively correlated with the degree of atherosclerosis in CHD (P＜0.05), among which the correlation of lipid deposition index E composed of LDLC×age×Hcy×CRP was the highest. ROC curve analysis showed that the area under curve of lipid deposition index E was 0.618, the specificity was 0.911, and the sensitivity was 0.767, which was the highest in predicting CHD. Conclusion There is a significant positive correlation between lipid deposition index E and the degree of atherosclerosis in CHD. Lipid deposition index E can highly predict the degree of coronary artery lesions.

Abstract:Aim To investigate the level of serum tp53-induced glycolysis and apoptotic and regulator (TIGAR) mRNA in patients with acute ischemic stroke and its relationship with prognosis. Methods 247 patients with acute ischemic stroke were selected as the study object. The age, sex, body mass index, hypertension, hyperlipidemia, diabetes, coronary heart disease, smoking, stroke distribution, stroke onset time, toast etiology, severity, stroke focus number, hemorrhage transformation, homocysteine (Hcy), C-reactive protein (CRP), D-Dimer (D-D), hemoglobin A1c (HbA1c), angiopoietin-1 (Ang-1) of patients were collected. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the relative expression of serum TIGAR mRNA, and its relationship with prognosis was analyzed. Results The incidence of poor prognosis in 247 patients with acute ischemic stroke was 47.77% within 90 days. The relative expression of TIGAR mRNA in the prognosis group was significantly higher than that in the poor prognosis group, and the difference was statistically significant (P＜0.05). The area under the curve AUC, sensitivity and specificity of TIGAR mRNA in evaluating the prognosis of patients with acute ischemic stroke were 0.6,8.14% and 80.62%, respectively.Logistic multivariate regression analysis showed that the onset time of stroke, TOAST etiology classification, severity, hemorrhagic transformation and TIGAR mRNA were closely related to the prognosis of patients with acute ischemic stroke. Conclusion The higher the relative expression of TIGAR mRNA in serum, the better the prognosis of patients with acute ischemic stroke. Detection of relative expression of TIGAR mRNA is helpful to assess the prognosis of patients.

Abstract:Aim To analyse the prognosis of non-valvular atrial fibrillation patients after PCI with hyperhomocysteinemia and CHA2DS2-VASc in Beijing. Methods A total of 1 688 NVAF-PCI patients with CHA2DS2-VASc=0 or 1 was selected to evaluate the risk and influencing factors of major adverse cardiac events (MACE) within 1 year. Patients were divided into two groups according to their plasma homocysteine(Hcy)levels before catheterization:the normal group (1 135 patients, Hcy<15 μmol/L) and the HHcy group (553 patients, Hcy≥15 μmol/L). The primary endpoint was the occurrence of MACE. Results After 1 year of follow-up, HHcy patients had a higher rate of MACE(P=0.017). The main differences between the two groups were ischemic stroke (P=0.009), cardiac death (P=0.046) and non-fatal myocardial infarction (MI)(P=0.044). Conclusion Elevated Hcy levels were independently associated with an increased risk of MACE in non-valvular AF patients with low CHA2DS2-VASc scores after coronary artery stent implantation, and to receive anticoagulant may be effective.

Abstract:Aim To study the effect of mean platelet volume (MPV) on the short-term prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods 100 patients with ACS who underwent PCI in Xinyang Central Hospital from March 2015 to March 2018 were selected as the study subjects. According to whether adverse cardiovascular events occurred within one year after PCI, the patients were divided into two groups:the poor prognosis group and the control group. Then the differences of general clinical data, laboratory indexes, ultrasound indexes and PCI treatment between the two groups were analyzed. The influencing factors of prognosis were analyzed by COX model, and the predictive value of MPV on prognosis was analyzed by ROC curve. Results The rates of hypertension, diabetes mellitus, smoking and MPV, C-reactive protein (CRP) and low density lipoprotein cholesterol in the poor prognosis group were higher than those in the control group, and the proportions of thrombus aspiration and tirofiban use were lower than those in the control group (P＜0.05). COX regression analysis showed that smoking, elevated MPV and CRP were independent risk factors for poor prognosis (P＜0.05). By ROC curve analysis, MPV had a good predictive value for adverse cardiovascular events in ACS patients within one year after PCI, and the best cutoff point was 10.68 fL, the sensitivity of prediction was 70.73%, and the specificity was 72.22%. Kaplan-Meier curve analysis showed that the incidence of adverse cardiovascular events in ACS patients with increased MPV was higher than that in ACS patients with normal MPV (P＜0.05). Conclusions The increase of MPV is an independent risk factor for adverse cardiovascular events in ACS patients within one year after PCI. The MPV of more than 10.68 fL has a good predictive value for adverse cardiovascular events.

Abstract:Aim To study the relationship between vascular cognitive impairment (VCI) degree and serum inflammatory factors in patients with cognitive dysfunction of hypertensive cerebral small vessel disease (CSVD). Methods The clinical data of 141 patients with hypertension CSVD who were treated in Affiliated Hospital of Chengde Medical College from January 2016 to October 2018 were retrospectively analyzed. Patients were divided into non-VCI (WVCI) group (n＝45), vascular cognitive impairment no dementia (VCIND) group (n＝56) and vascular dementia (VD) group (n＝40) according to the degree of VCI. The levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1) and plasma homocysteine (Hcy) were compared among the three groups, and the above indexes before and after treatment were compared in VCIND group and VD group. Furthermore, taking whether CSVD merges VCI as dependent variable, indicators with statistical differences in univariate analysis as independent variables, multivariate Logistic regression analysis was performed. Results The levels of serum hs-CRP, IL-6, IL-1β and TNF-α in the VCIND group and the VD group were significantly higher than those in the WVCI group (P＜0.05), and the levels of above serum indexes in the VD group were significantly higher than those in the VCIND group (P＜0.05). Compared with before treatment, the levels of serum hs-CRP, IL-6, IL-1β and TNF-α in VCIND group and VD group decreased significantly after treatment (P＜0.05 or P＜0.01). The levels of serum ICAM-1 and plasma Hcy in the VCIND group and the VD group were significantly higher than those in the WVCI group (P＜0.01), while the levels of serum ICAM-1 and plasma Hcy in the VD group were significantly higher than those in the VCIND group (P＜0.05). Compared with before treatment, the levels of serum ICAM-1 and plasma Hcy in VCIND group and VD group significantly decreased after treatment (P＜0.01). The levels of serum IL-6, IL-1β, TNF-α, ICAM-1 and plasma Hcy were negatively correlated with Montreal Cognitive Assessment Score (P＜0.05). Logistic regression analysis showed that serum IL-6, IL-1β, TNF-α, ICAM-1 and plasma Hcy were independent risk factors for VCI. Conclusion Inflammatory factors such as IL-6, IL-1β and TNF-α are involved in the occurrence of cognitive dysfunction in patients with hypertension CSVD, and the higher the levels, the more serious the degree of VCI.

Abstract:Aim Tissue Doppler imaging (TDI) and two-dimensional speckle tracking imaging (2D-STI) were used to evaluate the changes of left atrial pressure and function and their relationship with left ventricular function in patients with coronary heart disease (CHD) before and after percutaneous coronary intervention (PCI), so as to provide more effective information for clinical treatment of CHD. Methods Maximal left atrial volume (LAV_max), minimal left atrial volume (LAV_min), pre-atrial contraction left atrial volume (LAV_pre), left atrial passive emptying fraction (LAPEF), left atrial active emptying fraction (LAAEF), left ventricular ejection fraction (LVEF), early velocity of mitral valve (E), atrial contractile velocity of mitral valve (A) were measured and calculated by echocardiography before PCI, 1 week after PCI and 3 months after PCI in 30 CHD patients. Early diastole velocity of mitral valve annulus (e’), left atrial mean pressure (mLAP), E/A and E/e’ were measured and calculated by TDI. Left ventricular systolic global longitudinal strain (GLS), mean systolic peak strain rate (mSRs), mean early diastolic peak strain rate (mSRe), mean late diastolic peak strain rate (mSRa) were measured and calculated by 2D-STI. Another 30 cases with coronary artery stenosis rate less than 30% measured by coronary angiography were selected as the control group. Results Compared with the control group, LVEF, LAPEF, E, E/A, e’, mSRs, mSRe and GLS decreased, A, E/e’, mLAP, LAV_min, LAV_max, LAV_pre, LAAEF and mSRa increased at different time in the CHD group (P＜0.05). In the CHD group, there were no significant difference in all the indexes between 1 week after PCI and before PCI (P＞0.05); Compared with before PCI and 1 week after PCI, E, e’, E/A, mSRs, mSRe, GLS, LVEF and LAPEF increased, while A, E/e’, mLAP, LAV_min, LAV_max, LAV_pre, LAAEF and mSRa decreased at 3 months after PCI (P＜0.05). At 3 months after PCI in the CHD group, mLAP was positively correlated with GLS, mSRe, LAV_min, LAV_max and LAV_pre (r＝0.8,0.1,0.1,0.8,0.857, P＜0.01), and negatively correlated with LVEF, E/A, mSRa, mSRs and LAPEF (r＝－0.800, －0.884, －0.898, －0.829, －0.427, P＜0.05). Conclusions The function of left atrium and left ventricle in CHD patients is improved significantly in 3 months after PCI compared with that in 1 week after PCI and before PCI. The changes of left atrial pressure and function can comprehensively reflect the changes of left atrial and left ventricular function in CHD patients after PCI, which are closely related to each other.

Abstract:Aim To explore the current situation, hotspots and trends of blood lipid research in Chinese population from 2009 to 2019. Methods From 2009 to 2019, literatures related to blood lipid research were retrieved on China National Knowledge Infrastructure (CNKI). Bibliographic item co-occurrence matrix builder (BICOMB) and graphical clustering toolkit (gCLUTO) were used for word frequency analysis and clustering analysis. Results A total of 3 022 literatures were searched, with 47 high-frequency words and with frequency greater than or equal to 31. The results of cluster analysis showed that from 2009 to 2019, the research hotspots of blood lipid in China mainly focused on five aspects:the epidemiology of hyperlipidemia in Chinese population, the chronic diseases related to lipids or atherosclerosis, the theory of oxidized low density lipoprotein cholesterol fat, lipid regulating drugs, and Chinese characteristic lipid regulating therapy. Conclusion Many scholars are committed to the study of disease mechanism, lipid-lowering treatment strategy and new drug research and development, but the study of non-drug intervention in lipid management is very rare, so it is urgent to carry out health education in nursing and promote intervention, so as to improve the awareness rate, treatment rate and standard-reaching rate of lipid management.

Abstract:Exosomes are nano-level matrix vesicles from cellular endocrine to extracellular level. They have a bilayer structure of phospholipids and contain a variety of cell-specific lipids, nucleic acids and proteins. They are mainly involved in the processes of cellular communication, immune regulation and cellular signal pathway regulation. In recent years, studies have found that exosomes play an important role in the occurrence and development of vascular smooth muscle cells in vascular calcification. Understanding the mechanism by which exosomes regulate vascular smooth muscle cell calcification plays an important role in preventing vascular calcification and reducing the risk of cardiovascular disease in the future.

Abstract:Adiponectin (APN) is a cardioprotective polypeptide secreted by adipose tissue. Its gene is polymorphic. Three polymorphic loci, located in promoter region (rs266729), exon region (rs2241766) and intron region (rs1501299) respectively, are widely reported to be significantly associated with coronary heart disease (CHD). Other polymorphisms such as rs12495941, rs822395, rs182052, rs3774261 and rs17366568 were also reported to be significantly associated with CHD. In mechanisms, the polymorphisms of APN gene increased the risk of CHD mainly by reducing plasma APN level, causing lipid disorders, elevating blood pressure and promoting obesity. This article reviews the relationship between the polymorphisms of APN gene and CHD, as well as the underlying mechanisms.

Abstract:Atrial fibrillation (AF) is the most common sustained arrhythmia after non-cardiac thoracic surgery and is associated with a significant increase in perioperative morbidity, intensive care unit (ICU) admission, and mortality. Practical guidance is needed to assist clinicians in managing this critical issue and direct further research.

Abstract:In order to reduce the risk of recurrent atherothrombotic thrombus, domestic and international guidelines recommend that patients receive aspirin combined with P2Y12 inhibitor dual antiplatelet therapy (DAPT) for at least 12 months after the occurrence of acute coronary syndrome (ACS). However, the existing evidence suggests that the risk of residual ischemia in ACS patients will last for more than 12 months, and the benefits of prolonging DAPT treatment in patients with special ACS (with high risk of bleeding) are still controversial. The purpose of this review is to provide an individualized and accurate treatment plan for the patients based on the pathophysiological mechanism of ACS, combined with stent type and risk stratification system to fully evaluate the bleeding risk and anti-ischemic event benefit of DAPT, and maximize the benefit/risk ratio.