Abstract:Cholesterol homeostasis is critical for proper cellular function in the organism. Abnormal accumulation of cholesterol in the body caused by metabolic disorder can lead to hepatic steatosis and hypercholesterolemia, which is closely correlated to cardiac cerebrovascular disease such as arteriosclerosis. The liver plays a key role in maintaining cholesterol homeostasis through regulating its uptake, biosynthesis, conversion, and efflux. This paper reviews the progress in the regulation of cholesterol metabolic homeostasis by the liver.

Abstract:Atherosclerosis (As) is a pathological process which is tightly related to cardiovascular diseases. Because of its high risks to human health, Chinese scholars have carried out a large number of researches in recent 3 years, which focus on the model and the pathogenesis and risk factors of As, such as ferroptosis, pyroptosis, autophagy, gut microflora, exosomes, oxidative stress, low shear stress, non-coding RNA. Intensive and in-depth preclinical researches provide novel ideas for the selection of prevention and treatment strategies and drug research of As, in order to achieve clinical transformation. This paper reviews the preclinical researches on As conducted by Chinese scholars in recent 3 years.

Abstract:Atherosclerosis (As) is a chronic inflammatory disease of complex evolutionary caused by multiple factors. Lipid accumulation is one of the key pathological factors of As, which leads to the formation of As plaques by stimulating inflammatory cell infiltration, endothelial cell injury, foam cell formation and VSMC migration and proliferation. Lipophagy as a selective process of autophagy, it can selectively degradate intracellular lipid droplets via lysosome-mediated and reduce lipid deposition and maintain intracellular lipid homeostasis, which can be used as a new target for As research.This artical discusses the research progress on the role of lipophagy in As and related traditional Chinese medicine treatment to provide feasible ideas for traditional Chinese medicine preventing and treating As from the view of lipophagy.

Abstract:Aim To investigate the effect of miR-140-3p on hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury and its mechanism. Methods In vitro cardiomyocyte H/R model was constructed, and H9c2 cells were transfected with miR-140-3p mimics and chemokine receptor 4 (CXCR4) overexpression plasmids. Cell viability was detected by methyl thiazolyl tetrazolium method. Cell apoptosis was detected by flow cytometry. Reverse transcription polymerase chain reaction and Western blot were used to detect miR-140-3p, CXCR4, and the activation of Janus protein tyrosine kinase 2 (JAK2)/signal transducers and activators of transcription 3 (STAT3) pathway and the expressions of apoptosis-related proteins in cells. The targeting relationship between miR-140-3p and CXCR4 was verified by dual-luciferase reporter gene experiment. The activity of lactate dehydrogenase (LDH) and the levels of inflammatory factors and reactive oxygen species (ROS) were detected with corresponding kits. Results In vitro H/R could inhibit the expression of miR-140-3p, up-regulate the expression of CXCR4 and the phosphorylation of JAK2/STAT3 pathway, induce the apoptosis of H9c2 cells and inhibit the proliferation of H9c2 cells, promote the release of inflammatory factors and ROS, and up-regulate the activity of LDH. miR-140-3p could inhibit the expression of CXCR4 by targeting CXCR4 3′UTR, thereby inhibiting the phosphorylation activation of JAK2/STAT3 pathway, inhibiting the release of inflammatory factors and ROS, down-regulating the activity of LDH, promoting the proliferation of H9c2 cells and inhibiting their apoptosis. Conclusion miR-140-3p may inhibit the JAK2/STAT3 pathway through targeted inhibition of CXCR4, thereby attenuating ischemia/reperfusion-induced cardiomyocyte injury.

Abstract:Aim To study the anticoagulant effect of rivaroxaban, dabigatran etexilate and warfarin in patients with non-valvular atrial fibrillation. Methods 120 patients with non-valvular atrial fibrillation who were admitted to our department of cardiology or outpatient clinic from January 2016 to January 2018 were enrolled in this study. All patients were treated with a single anticoagulant and divided into warfarin group (40 cases), rivaroxaban group (40 cases), dabigatran group (40 cases), receiving drug treatment for 6 months, and comparing embolization events, bleeding events, blood routine, liver and kidney function and thromboelastography indicators during treatment. Results After 6 months of treatment, the incidence of embolization events in the rivaroxaban group and dabigatran group was significantly lower than that in the warfarin group (P＜0.05); There was no significant difference in the rivaroxaban group and dabigatran group (P＞0.05). It can be seen that rivaroxaban and dabigatran etexilate are more helpful in preventing embolism. There were no significant differences in bleading incidence rate, blood routine parameters (white blood cell count, platelet count, hemoglobin) and liver and kidney function indexes (SCr, ALT, BUN) among the three groups at pre-treatment and 6 months after treatment (P＞0.05). The R,Kü and MA values of thrombus elasticity index in rivaroxaban group and dabigatran group were significantly higher than those in warfarin group (P＜0.05); There was no significant difference in R value,Kü value and MA value between the rivaroxaban group and the dabigatran group after 6 months (P＞0.05). Conclusion Compared with warfarin, rivaroxaban and dabigatran etexilate have better anticoagulant effects in patients with non-valvular atrial fibrillation, which decrease embolization events but have no obvious effect on liver and kidney function and blood routine with high safety.

Abstract:Aim To systematically review the prognostic factors for major adverse cardiovascular events (MACE) in patients with chronic total occlusion (CTO) of coronary artery after percutaneous coronary intervention (PCI).Methods PubMed, EMBASE, the Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect cohort studies on the prognostic factors for MACE in patients with CTO after PCI from inception to October 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies.Then, Meta analysis was performed using R3.6.2 software. Results A total of 30 cohort studies were included, including 25 002 patients with CTO. The results of Meta analysis showed that there were 8 prognostic factors with statistical significance:age (RR＝1.6,5%CI was 1.01～1.10, P＝0.01), male (RR＝1.8,5%CI was 1.17～2.42, P＜0.01), coronary artery bypass grafting history (RR＝1.0,5%CI was 1.12～1.99, P＜0.01), diabetes history (RR＝1.1,5%CI was 1.15～1.99, P＜0.01), renal dysfunction (RR＝2.1,5%CI was 2.44～3.48, P＜0.01), in-stent CTO (RR＝2.5,5%CI was 1.08～4.31, P＝0.03), successful PCI (RR＝0.2,5%CI was 0.38～0.72, P＜0.01) and minimal lumen diameter (RR＝0.7,5%CI was 0.31～0.70, P＜0.01), respectively. Conclusions Current evidence shows that age, male, coronary artery bypass grafting history, diabetes history, renal dysfunction and in-stent CTO were the risk factors for MACE in patients with CTO after PCI. Successful PCI and minimal lumen diameter were the protective factors for MACE in patients with CTO after PCI.

Abstract:Aim To investigate the correlation between coronary artery stenosis, calcification score and coronary hemodynamics in patients with coronary heart disease based on the CT-fractional flow reserve (CT-FFR) of artificial intelligence. Methods The clinical and coronary CT angiography (CCTA) datas of 206 patients with suspected coronary heart disease in the Affiliated Hospital of Qinghai University from September 2020 to April 2021 were included in this study retrospectively. The CT-FFR, coronary artery calcification score and stenosis degree of coronary artery were analyzed by artificial intelligence software, including left anterior descending artery, left circumflex branch and right coronary artery. The patients were divided into two groups according to the CT-FFR value. The vessels with CT-FFR≤0.8 were divided into functional meaning group, and the rest are non-functional meaning group. The correlations between coronary artery stenosis and calcification score and coronary hemodynamics were analyzed. Results 365 blood vessels from 206 patients were included in the study,and there were 139 blood vessels in the functional meaning group and 226 blood vessels in the non-functional meaning group. Degree of coronary stenosis (r＝－0.473, P＜0.001) and calcification score (r＝－0.369, P＜0.001) were negatively correlated with CT-FFR, and the calcification score was weakly correlated with the degree of stenosis (r＝0.141,P＝0.007). Compared with non-functional meaning group, the age of onset was older, and the proportion of male patients, hypertension, smoking history were significantly higher than those in the non-functional meaning group. Conclusion Degree of coronary stenosis and calcification score are important factors affecting coronary hemodynamics, CT-FFR is helpful for the functional evaluation of CCTA in coronary artery disease.

Abstract:Aim To explore the changes of serum microRNA-590 (miR-590) level and its relationship with prognosis in patients with acute ischemic stroke (AIS). Methods 176 patients with AIS who received intravenous thrombolysis and arterial thrombectomy from February 2019 to October 2020 were selected as the research objects. According to the modified Rankin scale (mRS) score 90 days after treatment, the patients were divided into good prognosis group (n＝123; mRS score 0～2 points) and poor prognosis group (n＝53; mRS score 3～6 points). The level of serum miR-590 in patients with AIS was detected by real-time fluorescence quantitative PCR, the value of miR-590 in predicting the prognosis of AIS was evaluated by receiver operating characteristic (ROC) curve, and the risk factors of AIS prognosis were analyzed by Logistic regression. Results The age, male ratio, diabetes history, fasting plasma glucose (FPG), total cholesterol (TC), National Institute of Health Stroke Scale (NIHSS) score and door to needle time (DNT) in the poor prognosis group were higher than those in the good prognosis group (P＜0.05). After propensity score matching according to 1∶1, the relative level of miR-590 in the poor prognosis group was lower than that in the good prognosis group before treatment, the relative levels of miR-590 in the poor prognosis group and the good prognosis group after treatment were higher than those before treatment, after treatment the relative level increase degree of miR-590 in the poor prognosis group was higher than that in the good prognosis group, and the differences were statistically significant (P＜0.05). The area under the ROC curve of miR-590 predicting the prognosis of AIS before treatment was 0.793, which was higher than the difference of miR-590 (the difference between the relative levels of serum miR-590 before and after treatment) (P＜0.001). Logistic regression analysis showed that FPG, TC, NIHSS score and DNT were independent risk factors for the prognosis of AIS (P＜0.05), and the level of serum miR-590 before treatment was an independent protective factor for the prognosis of AIS (P＜0.001). Conclusion The low level of serum miR-590 before intravenous thrombolysis and arterial thrombectomy is related to poor prognosis in patients with AIS.

Abstract:Aim To investigate the predictive value of D-dimer/fibrinogen ratio (DFR) for slow flow/no-reflow (SF/NRF) during percutaneous coronary intervention (PCI) in elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A retrospective analysis of 240 elderly patients with STEMI who underwent emergency PCI was performed, and the patients were divided into SF/NRF group (42 cases) and non-SF/NRF group (198 cases) according to postoperative distal coronary blood flow. The baseline data, intervention-related indicators, DFR, etc. of the two groups of patients were compared. The influencing factors of SF/NRF and the predictive value of DFR for SF/NRF were analyzed. Results Cardiac function Killip grade 2～3, peak value of creatine kinase isoenzyme MB, peak value of cardiac troponin I, D-dimer, fibrinogen and DFR in SF/NRF group were significantly higher than those in non-SF/NRF group (P＜0.05). The time from symptom onset to first electrocardiogram in the SF/NRF group was significantly longer than that in the non-SF/NRF group, and the preoperative TIMI blood flow grade 0 proportion was significantly higher than that in the non-SF/NRF group (P＜0.05), while invasive systolic blood pressure, invasive diastolic blood pressure were significantly lower than those in the non-SF/NRF group (P＜0.05). Multivariate regression analysis showed that the time from symptom onset to first electrocardiogram and DFR were independent predictors of SF/NRF. ROC curve analysis showed that when DFR＞0.28, the predictive value of DFR for SF/NRF was higher, the area under curve was 0.818 (95%CI 0.763～0.864, P＜0.01), the sensitivity was 73.81%, and the specificity was 75.76%. Conclusion DFR has high predictive value for the occurrence of SF/NRF during PCI in elderly STEMI patients.

Abstract:Adipose tissue plays an important role in energy storage and metabolism, which is closely related to obesity, hyperlipidemia, atherosclerosis and other diseases. The metabolism of adipose tissue is regulated by the sympathetic nervous system. Thyroid hormone not only regulates the sympathetic nervous system, but also affects the metabolism of adipose tissue. The classical view is that the effect of thyroid hormone on adipose tissue is mostly in peripheral tissue, but recent studies have shown that thyroid hormone can also affect the metabolism of adipose tissue at the central nervous system. This paper reviews the effect of thyroid hormone on adipose tissue metabolism through sympathetic nerve, and discusses the regulation and mechanism of thyroid hormone on adipose tissue metabolism through sympathetic nerve.

Abstract:Monocytes are important innate immune cells of the body, which can phagocytose and remove injured and senescent cells and their fragments, and participate in the immune inflammatory response of the human body. Monocytes can further differentiate into macrophages and dendritic cells, both of which play an important role in establishing an effective immune response. Monocytes, macrophages and dendritic cells are widely used in related research in basic and clinical medicine. This article will introduce several different methods for isolating monocytes from peripheral blood, and compare and analyze their advantages and disadvantages, so as to help researchers choose a suitable separation method to efficiently obtain monocytes that meet the experimental requirements, and lay the foundation for subsequent research.

Abstract:Vascular plaque stability is a major factor contributing to the development of acute coronary syndrome, and optical coherence tomography (OCT) with ultra-high spatial resolution has a unique advantage in the identification of vulnerable plaques. This paper reviews the clinical progress of OCT in the identification of vulnerable plaques in patients with acute coronary syndrome in recent years.

Abstract:Ferroptosis is a novel form of programmed cell death, characterized by intracellular iron overload-induced production of lipid peroxides and massive accumulation in cells leading to cell death. Heart failure is a serious cardiac dysfunction, and the reduction of cardiomyocytes is the main reason for its occurrence and development. Recent studies have shown that ferroptosis occurs in heart failure and confirmed that ferroptosis plays a crucial role in its pathogenesis. This article intends to review the mechanism of ferroptosis and its impact on heart failure.