Cross sectional study of familial hypercholesterolemia in dyslipidemia patients receiving lipid-lowering therapy: DYSIS-China subgroup analysis / 中华心血管病杂志

Objectives: To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China. Methods: Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of "Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version". DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HF, possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gender, lipids levels, drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification. Results: A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) years, 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%), possible FH was 3294 (13.7%), and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups. Conclusion: The detection rate of FH in Chinese patients with dyslipidemia is not low, the blood lipid level is poorly controlled, and the risk of cardiovascular disease is high in Chinses FH patients.

Extracts of red yolk from duck eggs inhibit metastasis of human mammary carcinoma (4T1) cells in mice

The aim of the present study was to investigate the in vivo anti-metastatic activity of the red pigments of red yolk eggs laid by the ducks dieting on Potamogeton cripus L on the mammary carcinoma (4T1). The pigments were extracted with petroleum ether and acetone (2:1, v/v). BALB/c mice were divided into three groups (n=6), fed with the extracts at 150 mg/kg body weight (BW)/day (DEYE-H) or at 50 mg/kg BW/day (DEYE-L) and identical buffer without the extract (control group). The extracts were administered for 34 days. The treatment significantly inhibited the growth of orthotopical 4T1 tumour (DEYE-H vs control, 1:2; DEYE-L vs control, 2:3) and reduced the metastasis of tumour in the lungs (DEYE-H vs control, 4:7; DEYE-L vs control, 5:7), without statistical difference of body weight among the three groups.

Cardiovascular manifestations in Chinese patients with hypereosinophilic syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the cardiovascular involvements in Chinese patients with hypereosinophilic syndrome.</p><p><b>METHOD</b>We respectively reviewed 149 inpatients with hypereosinophilic syndrome admitted to Peking Union Medical College Hospital and analyzed the cardiovascular involvements in these patients.</p><p><b>RESULTS</b>Cardiac abnormalities was evidenced in 32.9% patients (49/149). The ratio of male vs female was 34:15. The average age of the patients was (41.3 ± 16.9) years and course of disease was (26.4 ± 72.3) months. Cardiovascular involvements included ST segment and/or T wave (ST-T) ischemic changes, arrhythmia, myocardial injury, cardiac thrombosis, pericardial effusion, pulmonary hypertension, valve disorder, vein or artery thrombosis. After glucocorticoid and/or chemotherapeutic agents and treatment for symptoms, 11 (22.4%) patients achieved remission but have recurrent attacks and 3 (6.1%) patients died from failure in treatment. The prognosis in patients with echocardiogram abnormalities were poorer than those only with electrocardiogram abnormalities (P < 0.05).</p><p><b>CONCLUSIONS</b>Cardiovascular involvements are common in patients with hypereosinophilic syndrome and the manifestation of these involvement is various. Cardiovascular complications of HES are a major source of morbidity and mortality in these disorders.</p>

Clinical manifestations of premenopausal women with coronary arterial disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare clinical characteristics among premenopausal women with coronary arterial disease (CAD) with or without atherosclerosis (AS) and postmenopausal women with CAD.</p><p><b>METHODS</b>The clinical and coronary angiographic data, traditional risk factors (age, smoking, blood pressure, lipid profile, blood glucose, BMI, family history) were compared among premenopause (Pre-M, n=42) and post-menopause (Post-M, n=172) women with CAD as well as Pre-M patients with non-AS CAD (non-AS CAD, n=8).</p><p><b>RESULTS</b>Compared with the Post-M patients with CAD, Pre-M CAD patients had significantly fewer traditional risk factors, such as hypertension, diabetes and hypercholesterolemia, significantly more acute coronary syndrome and fewer previous history of chest pain, significantly more single vessel lesion and lower Gessini score (all P < 0. 01). The logistic regression results showed that obesity is an independent risk factor for the development of CAD in premenopausal women (OR = 3. 655, 95% CI: 1. 5-11.59, P = 0.028). Hypertension (OR = 4.73, 95% CI: 0.991-22.589, P = 0.051) and hypercholesterolemia (OR = 4.68, 95% CI: 0.971-22.564, P = 0.055) might also contribute to the development of CAD in these patients. Clinical characteristics were similar between Pre-M and non-AS CAD patients (P > 0.05).</p><p><b>CONCLUSIONS</b>Pre-M CAD patients had less traditional risk factors and lower coronary lesion score compared to post-M CAD patients. Obesity is an independent risk factor for Pre-M CAD. Non-AS coronary artery disease is also an important reason for the development of coronary arterial events in premenopausal women.</p>

A randomized, double-blind, double-dummy study comparing a fixed dose combination of telmisartan 80 mg plus hydrochlorothiazide 12.5 mg to telmisartan 80 mg in Chinese hypertensive patients who failed to respond adequately to telmisartan 80 mg / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of a fixed dose combination of telmisartan 80 mg plus hydrochlorothiazide (HCTZ) 12.5 mg (TH) to telmisartan 80 mg (T) in Chinese patients who failed to respond adequately to treatment with T.</p><p><b>METHOD</b>This is a multi-center, randomized, double-blind, double-dummy clinical study. A total of 699 eligible hypertensive patients entered a one-week screening phase prior to the eight-week open-label T period. At the end of eight weeks, 345 patients who failed to respond to T (DBP > or = 90 mm Hg, 1 mm Hg = 0.133 kPa) were randomized to receive either TH (175 patients) or T (170 patients) for another eight weeks. Sitting and standing BP were taken 24 hours post-dose and adverse events were documented at visit with 4 weeks interval. Laboratory, ECG and physical examination were performed at screening, at baseline and at the final visit.</p><p><b>RESULTS</b>After 8 weeks treatment, (1) The mean trough reduction in sitting diastolic blood pressure (SiDBP) from baseline in TH group was greater than that in T group (10.1 mm Hg vs 7.7 mm Hg, P = 0.0017). The mean trough reduction in sitting systolic blood pressure (SiSBP) from baseline was 14.2 mm Hg in TH group and 7.4 mm Hg in T group (P < 0.0001). (2) The mean trough reduction in standing DBP and standing SBP from baseline were significantly greater in TH group (8.7 mm Hg and 12.9 mm Hg) compared those in T group (7.3 mm Hg and 7.0 mmHg, P = 0.0350, P < 0.0001). (3) The number and percentage of responders in TH group (129, 74.6%) were significantly higher than in T group (100, 59.2%, P = 0.0016). (4) The incidence of the study drug-related adverse events was similar between TH and T group (3.5% vs. 3.6%, P > 0.05).</p><p><b>CONCLUSION</b>TH was more effective than T in patients not responded adequately to T in Chinese hypertensive patients.</p>

Myocardial involvement in 2494 patients with systemic lupus erythematosus / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and related pathogenetic factors in systemic lupus erythematosus (SLE) patients with myocardial involvement.</p><p><b>METHODS</b>Clinic data and myocardial involvements were analyzed in 2494 SLE patients who admitted to our hospital from 1997 to 2007.</p><p><b>RESULTS</b>Myocardial involvements were seen in 13 out of 2494 SLE patients (0.52%). Dyspnea of various degrees and left ventricular systolic dysfunction are frequently found in these patients with myocardial involvements. Glucocorticoid therapy significantly increased left ventricular ejection fraction (LVEF, 37.7% +/- 5.8% vs. 40.9% +/- 7.1%, P = 0.002). Significant associations were found between anti-rRNP antibody and LVEF (r = 0.843, P = 0.001) as well as between cardiac troponin I (cTnI) and left ventricular end diastolic diameter (LVEDD) (r = 0.656, P = 0.036).</p><p><b>CONCLUSIONS</b>Myocardium is rarely affected in patients with SLE in this cohort. Echocardiography is a valuable method for detecting cardiac abnormalities in patients with SLE. Glucocorticoid therapy could improve cardiac function in SLE patients with cardiac involvement and serological factors are related to cardiac functions.</p>

Risk factors for coronary artery disease stimulate urokinase receptor expression on monocytes / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the effect of risk factors for coronary artery disease (CAD) on urokinase receptor (uPAR) expression on monocytes.</p><p><b>METHODS</b>A total of 106 patients were enrolled and divided into five risk-factor groups: sixteen with hypertension, twenty-four with dyslipidemia, eighteen with hypertension + obesity, eighteen with dyslipidemia + obesity and thirty with hypertension + dyslipidemia + obesity. Seventeen healthy volunteers were recruited as control group. Monocyte expression of uPAR and mean fluorescence intensity index (MFI Index) of uPAR were measured by flow cytometer (FACSCalibur).</p><p><b>RESULTS</b>No difference in monocyte uPAR expression was detected between hypertension and control group [(4.9 +/- 12.5)% vs. (7.7 +/- 10.3)%, P=0.74]. However, the uPAR expression was raised to (23.7 +/- 22.5)% in hyperlipidemia group, a 3.9- and a 2.1-fold increase compared with those in hypertension (P<0.01) and control group (P<0.05), respectively. When combined with obesity, uPAR expression was elevated further to (32.9 +/- 30.8)% in hypertension + obesity group, (37.4 +/- 31.4)% in dyslipidemia + obesity group and (23.8 +/- 20.5)% in hypertension + dyslipidemia + obesity group, all having statistical significance compared with control group or hypertension group (P<0.01). The results were the same when corrected by age, BMI and hs-CRP. uPAR MFI Index was increased from 0.78 +/- 0.86 in control group to 1.91 +/- 1.97 and 3.33 +/- 2.52 in dyslipidemia group and hypertension + obesity group, respectively, P<0.05. Linear regression analysis revealed a significant correlation between uPAR expression and FBG concentration in dyslipidemia group, r=0.72, P=0.04.</p><p><b>CONCLUSIONS</b>uPAR expression was elevated on monocytes in patients with risk factors for CAD. Dyslipidemia and obesity may contribute to the increase of uPAR expression.</p>

Porcine MSC-derived CLC induced by rabbit's cardiomyocytes extract did not induce immune reaction in vivo / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the in vivo immune reaction of transplanting porcine MSC-derived CLC with rabbit cardiomyocytes extracts induced differentiation or in vitro cultured porcine MSC.</p><p><b>METHODS</b>After injecting the MSC-derived CLC or MSC to the original porcines, the number of CD4+, CD8+ T cells were determined by flow cytometry. The serum concentrations of IL-2, IL-4 were measured by ELISA, and the porcine spleen lymphocyte CTL cytotoxicity was determined by Cell Counting Kit-8 Assay.</p><p><b>RESULTS</b>The numbers of CD4+ and CD8+ T cells, the serum concentrations of IL-2, IL-4 and spleen lymphocyte CTL cytotoxicity were all similar in porcines received MSC-derived CLC induced by rabbit's CMs extract or MSC transplantation.</p><p><b>CONCLUSION</b>The porcine MSC-derived CLC induced by rabbit's CMs extract did not induce extra immune reaction when injected back to the original porcine.</p>

Clinical significance of adenosine 99mTc-MIBI myocardial perfusion single photon emission computed tomography for patients in percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical significance of adenosine (99m)Tc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) for percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Coronary angiography and adenosine (99m)Tc-MIBI myocardial perfusion SPECT were performed for all patients. Adenosine myocardial perfusion was performed after PCI. Adenosine was infused intravenously at a rate of 140 microg.kg(-1).min(-1) for 6 minutes, and 925MBq (99m)Tc-MIBI was injected intravenously at 3 minutes after adenosine infusion. SPECT myocardial imaging acquisition was obtained in 1.5 hours after adenosine infusion. If the result was abnormal, rest (99m)Tc-MIBI myocardial perfusion SPECT would be performed next day. There were 17 segments of left ventricle, and four degrees of myocardial perfusion.</p><p><b>RESULTS</b>There were 63 cases (63 +/- 10 years old) with CAD, in which 40 patients got PCI. Twenty eight cases after PCI.</p><p><b>CONCLUSION</b>Adenosine myocardial perfusion imaging will be useful in detecting regional myocardial perfusion abnormalities for patients with PCI.</p>

Differentiation of mesenchymal stem cells into cardio myogenic cells under the induction of myocardial cell lysate / 中华心血管病杂志

<p><b>OBJECTIVE</b>In order to understand the effects of cardiac microenvironment on the differentiation of bone marrow mesenchymal stem cells (MSCs) into myocardial-like cells, we simulated the cardiac microenvironment in vitro by adding myocardial cell lysate into the culture system of MSCs, and compared the differentiation promoting effect of myocardial cell lysate with that of well-established inducer 5-azacytidine (5-aza).</p><p><b>METHODS</b>Myocardial cells isolated from newly born rats were lysed by repeat freezing and defrosting. MSCs isolated from adult rat were cultured in four different systems. Medium A: medium with myocardial cell lysate; medium B: medium with 5-aza; medium C: medium with 5-aza and myocardial cell lysate; and control medium: ordinary medium without any addition reagent. The dynamic changes of MSCs morphology in different media were observed within 7 days after introduction of MSCs. Immunohistochemical staining against alpha-actin, cTnT, Connexin43 and CD31 were performed at the end of cultivation.</p><p><b>RESULTS</b>MSCs in both medium A and B were differentiated into myocardial-like cells expressing alpha-actin and cTnT after 7-day cultivation. Cells in medium A developed more myofilaments than those in medium B, and expressed CD31, whereas cells in medium B did not. MSCs in control medium only expressed alpha-actin.</p><p><b>CONCLUSIONS</b>Myocardial cell lysate is an ideal inducer to differentiate MSCs into myocardial-like cells in vitro. The differentiation promoting effect of myocardial cell lysate is more predominant than that of 5-aza.</p>