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1.
Rev. colomb. cardiol ; 31(3): 128-133, mayo-jun. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1576244

ABSTRACT

Resumen Introducción: La amiodarona es un fármaco antiarrítmico ampliamente utilizado para la prevención y el tratamiento de arritmias supraventriculares y ventriculares. Sin embargo, se puede asociar a diversos eventos adversos. En Colombia son pocos los estudios sobre eventos adversos relacionados con este medicamento. Objetivo: Determinar las características demográficas, clínicas y farmacológicas asociadas a eventos adversos en pacientes con uso de amiodarona en una clínica cardiovascular de la ciudad de Medellín. Materiales y método: Estudio observacional analítico de cohorte retrospectivo, basado en la revisión de historias clínicas de pacientes tratados con amiodarona durante el periodo 2008 a 2021. Se realizó un análisis univariado, bivariado y multivariado mediante regresión logística binomial. Resultados: Se revisaron 553 historias clínicas, de las cuales 221 cumplieron los criterios de elegibilidad. La edad promedio fue 63 años, con predominio del sexo masculino (57.5%). La mayoría presentó multimorbilidad (73.3%) y el diagnóstico más común para la prescripción de amiodarona fue la fibrilación auricular (84.4%). Se reportaron 71 (32.1%) eventos adversos relacionados con amiodarona, de los cuales los más frecuentes fueron los de origen cardiovascular (43.7%), seguidos por los tiroideos (29.6%) y por los oftalmológicos (10%). La variable que explicó la presencia evento adverso por amiodarona fue multimorbilidad (riesgo relativo -RR- ajustado 1.65; IC 95%: 1.02-2.25; p = 0.039). Conclusiones: Los eventos adversos por amiodarona fueron frecuentes. La característica que explica el 16.8% R²N (Nagelkerke’s R2) de los eventos adversos fue multimorbilidad y la mayoría de los pacientes requirieron la suspensión del tratamiento.


Abstract Introduction: Amiodarone is an antiarrhythmic drug widely used to treat and prevent supraventricular and ventricular arrhythmias. However, it can be associated with various adverse events. In Colombia there are few studies conducted on adverse events with amiodarone. Objective: To determine the demographic, clinical and pharmacological characteristics associated with the presence of adverse events in patients with amiodarone use in a cardiovascular clinic in the city of Medellín. Materials and method: Retrospective observational analytical cohort study, was conducted by means a review of the clinical records of patients treated with amiodarone during the period from 2008 to 2021. An univariate, bivariate and multivariate analysis was performed through binomial logistic regression. Results: A total of 553 medical records were reviewed, of which 221 met the eligibility criteria. The mean age was 63 years and the male sex predominated (57.5%). The majority presented multimorbidity (73.3%), the most common diagnosis for the prescription of amiodarone was atrial fibrillation (84.4%). 71 (32.1%) of adverse events related to amiodarone were reported; being more frequent those of cardiovascular origin (43.7%), followed by thyroid (29.6%) and ophthalmological (10%). The variable that was associated with an adverse event due to amiodarone was multimorbidity (adjusted relative risk [RR] 1.65; IC 95%: 1.02-2.25; p = 0.039). Conclusions: Amiodarone adverse events were common. The characteristic that explains 16.8% R²N (Nagelkerke’s R2) adverse event was multimorbidity and the majority of patients required the suspension of treatment.

2.
Rev. colomb. cardiol ; 31(3): 169-173, mayo-jun. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1576249

ABSTRACT

Resumen El prolapso de la válvula mitral es una enfermedad ampliamente conocida, la cual es benigna en la mayoría de casos; sin embargo, puede estar en asociación con alteraciones del ritmo cardiaco, específicamente arritmias ventriculares malignas y muerte cardiaca súbita. Pese a que esta asociación y su desenlace están descritos en la literatura médica, su baja incidencia conduce a la falta de evidencia en cuanto a su manejo y estratificación. Se presenta el caso de una mujer joven, cuya manifestación inicial fue síncope, con posterior desarrollo de insuficiencia mitral grave, con hallazgo de extrasístoles ventriculares frecuentes, en quien se realizó tratamiento quirúrgico con plastia mitral y crioablación del músculo papilar anterolateral. La evolución clínica fue satisfactoria, ya que se evidenció mejoría de la sintomatología y control de la carga arrítmica.


Abstract Mitral valve prolapse is a well-known condition that is generally benign, but it can be associated with cardiac arrhythmias, particularly malignant ventricular arrhythmias and sudden cardiac death. This association and its outcome have been described in medical literature, but the low incidence leads to a lack of evidence regarding its management and stratification.The case of a young woman is presented, whose initial manifestation was syncope, with subsequent development of severe mitral insufficiency, followed by severe mitral regurgitation and the discovery of frequent ventricular extrasystoles. She underwent surgical repair with mitral valve plasty and cryoablation of the anterior papillary muscle. The clinical outcome was favorable, as evidenced by an improvement in symptoms and control of arrhythmia burden.

3.
Article | IMSEAR | ID: sea-233744

ABSTRACT

Potassium is one of the major intracellular electrolytes in the body and is normally maintained between 3.5 and 5.5 mEq/L. A serum K+ concentration below 3.5 mEq/L is considered hypokalemia. Electrolyte imbalances, particularly potassium disorders, are common in clinical practice. Potassium homeostasis plays a key role in regulating cell membrane excitability. Potassium is a major determinant of the electrophysiologic properties of the myocardial membrane, and it plays an important role in the occurrence of arrhythmia. Hypokalemia can lead to clinically significant, life-threatening arrhythmia. Typical electrocardiographic (ECG) features of hypokalemia include widespread ST depression, T wave inversion, and prominent U waves. However, hypokalemia may present with different types of arrhythmias as well. Herein, we present 3 cases presenting with hypokalemia-induced arrhythmias in different clinical scenarios with documented low potassium levels and treated with timely diagnosis and effective management.

4.
Arq. bras. cardiol ; Arq. bras. cardiol;121(6): e20230684, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1568780

ABSTRACT

Resumo Fundamento Não existem estudos randomizados comparando a manutenção do ritmo sinusal após ablação por cateter (AC) em relação ao tratamento com fármacos antiarrítmicos (AA) em pacientes idosos portadores fibrilação atrial (FA) paroxística. Objetivos Comparar os resultados clínicos do isolamento das veias pulmonares (VPs) com o cateter PVAC Gold de segunda geração com o uso de AA em idosos com FA paroxística sintomática, recorrente, apesar do uso de fármacos AA. Métodos Sessenta pacientes com FA paroxística ≥ 65 anos e sem cardiopatias estruturais foram randomizados para duas formas de tratamento: grupo 1: AC e grupo 2: AA. O desfecho primário foi a taxa livre de recorrência de FA após pelo menos um ano de seguimento. Os desfechos secundários foram: progressão para formas persistentes de FA, impacto na qualidade de vida (QVFA) e complicações. O nível de significância adotado na análise estatística foi de 5% (p<0,05). Resultados A taxa livre de recorrência de FA foi de 80% (10% com amiodarona) no grupo AC, após 1,3 procedimentos por paciente e de 65% no grupo AA (60% com amiodarona), (p = 0,119) num seguimento médio de 719 dias (Q1: 566; Q3: 730). A taxa livre de FA persistente foi de 83,4% no grupo AC e de 67,7% no grupo AA (p = 0,073). Ambas as estratégias apresentaram melhora no escore de QVFA durante o seguimento (p < 0,001), sem diferença entre os grupos. Embora sem repercussão clínica ou impacto no teste de avaliação intelectual, 25% dos pacientes do grupo PVAC apresentou sinais de embolização cerebral na RNM cerebral. Conclusões Ambas as estratégias para manutenção do ritmo sinusal promoveram melhora na qualidade de vida de pacientes idosos com FA sintomática, sem diferença estatística nos desfechos clínicos preconizados. Estudos adicionais usando tecnologias com melhor perfil de segurança são necessários para avaliar os benefícios da AC em pacientes idosos com FA.


Abstract Background There are no randomized studies comparing the maintenance of sinus rhythm after catheter ablation (CA) concerning treatment with antiarrhythmic drugs (AA) in elderly patients with paroxysmal atrial fibrillation (AF). Objectives To compare the clinical results of pulmonary vein (PV) isolation with the second-generation PVAC Gold catheter against AA treatment in elderly people with recurrent symptomatic paroxysmal AF, refractory to at least one AA, and without structural heart disease. Methods Sixty patients with paroxysmal AF ≥ 65 years old were randomized to two forms of treatment: group 1: CA and group 2: AA drugs. The primary outcome was the AF recurrence-free rate after at least one year of follow-up. Secondary outcomes were: progression to persistent forms of AF, impact on quality of life (QOLF), and complications. The significance level adopted in the statistical analysis was 5% (p<0.05). Results The AF recurrence-free rate was 80% (10% with amiodarone) in the CA group, after 1.3 procedures per patient and 65% in the AA group (60% with amiodarone), (p = 0.119) in an average follow-up of 719 days (Q1: 566; Q3: 730). The persistent AF free rate was 83.4% in the AC group and 67.7% in the AA group (p = 0.073) Both strategies showed an improvement in the AFQoL score during follow-up (p < 0.001), with no difference between the groups. Although without clinical repercussions or impact on the intellectual assessment test, 25% of patients in the CA group showed signs of cerebral embolization on brain MRI. Conclusions Both strategies for maintaining sinus rhythm promoted an improvement in the quality of life of elderly patients with symptomatic AF, with no statistical difference in the clinical outcomes. Additional studies using technologies with a better safety profile are needed to evaluate the benefits of CA in elderly patients with AF.

5.
Article in Chinese | WPRIM | ID: wpr-1028123

ABSTRACT

Objective To investigate the efficacy of dronedarone combined with low dose metoprol-ol in the treatment of atrial tachycardia.Methods A total of 175 elderly patients with atrial tachy-cardia admitted in Northern Jiangsu People's Hospital during January 2020 to January 2022 were enrolled and then randomly divided into dronedarone group(n=57),metoprolol group(n=55)and combined group(dronedarone+metoprolol,n=48).The frequency,duration and symptom changes of arrhythmia were compared before and after treatment.Results After 3 and 6 months of administration,the total effective rate was significantly higher in the combination group than the dronedarone group and the metoprolol group(P<0.05).The frequency of atrial fibrillation(AF)attacks[(2.31±1.78)/48 h vs(11.56±18.68)/48 h],AF duration[(4.86±6.73)h/48 h vs(10.92±9.61)h/48 h],atrial flutter(AFL)attacks[(2.33±1.53)/48 h vs(4.33±1.53)/48 h]and AFL duration[(5.15±4.87)h/48 h vs(21.54±20.08)h/48 h]in the combined group,and AFL duration[(2.75±1.94)h/48 h vs(10.29±8.04)h/48 h]in the dronedarone group were reduced after 6 months of treatment(P<0.05).Conclusion In the treatment of atrial tachycardia,dronedarone combined with low dose metoprolol can not only obviously improve symptoms,but also significantly reduce the atrial premature and atrial tachycardia attacks,decrease the number and duration of AF and AFL attacks,and control heart rate effectively.

6.
Zhongnan Daxue xuebao. Yixue ban ; (12): 153-158, 2024.
Article in Chinese | WPRIM | ID: wpr-1018538

ABSTRACT

Bipolar affective disorder refers to a category of mood disorders characterized clinically by the presence of both manic or hypomanic episodes and depressive episodes.Lithium stands out as the primary pharmacological intervention for managing bipolar affective disorder.However,its therapeutic dosage closely approaches toxic levels.Toxic symptoms appear when the blood lithium concentration surpasses 1.4 mmol/L,typically giving rise to gastrointestinal and central nervous system reactions.Cardiac toxicity is rare but serious in cases of lithium poisoning.The study reports a case of a patient with bipolar affective disorder who reached a blood lithium concentration of 6.08 mmol/L after the patient took lithium carbonate sustained-release tablets beyond the prescribed dosage daily and concurrently using other mood stabilizers.This resulted in symptoms such as arrhythmia,shock,impaired consciousness,and coarse tremors.Following symptomatic supportive treatment,including blood dialysis,the patient's physical symptoms gradually improved.It is necessary for clinicians to strengthen the prevention and recognition of lithium poisoning.

7.
Article in Chinese | WPRIM | ID: wpr-1023163

ABSTRACT

Objective To investigate the characteristics,clinical indicators and risk factors of levofloxacin-induced arrhythmias in large hospitalized populations.Methods Using the"Adverse Event Active Monitoring and Intelligent Assessment Alert System-Ⅱ"(ADE-ASAS-Ⅱ),the electronic medical record of inpatients using levofloxacin in 2019 was monitored to obtain relevant data for patients with arrhythmias.Patients without arrhythmia were selected by propensity score matching,and the risk factors of levofloxacin-induced arrhythmias were analyzed by univariate and multivariate conditional logistic regression.Results The incidence of levofloxacin-induced arrhythmias was 1.64%in 12 879 people who used levofloxacin.The incidence in people over 65 years was 3.22%.The main manifestations of levofloxacin-induced arrhythmias were extrasystole(0.84%),tachycardia(0.63%),QT interval prolongation(0.44%),and no severe arrhythmias such as torsades de pointes and ventricular fibrillation.Multivariate Logistic regression analysis showed that the course of administration(OR=1.030,95%CI 1.009 to 1.050,P=0.004)and intravenous administration(OR=2.392,95%CI 1.478 to 3.870,P<0.001)independent risk factors for levofloxacin-induced arrhythmias.Conclusion Arrhythmias caused by levofloxacin are common and have various types,among which the occurrence of QT interval prolongation is occasional.We should pay more attention to elderly patients who receive intravenous levofloxacin and try to avoid long courses of medication.

8.
Article in Chinese | WPRIM | ID: wpr-1024415

ABSTRACT

Objective To investigate the difference between the management of patients in arrhythmia ward and non-arrhythmia wards and optimize the management plan of patients with atrial fibrillation.Methods Data of 1 537 patients with atrial fibrillation admitted to the arrhythmia ward and non-arrhythmia ward in the Department of Cardiology of the Second Hospital of Tianjin Medical University from September 2019 to September 2021 were collected.Baseline data,use of oral anticoagulants,use of heart rate control drugs and antiarrhythmic drugs,and use of antiplatelet drugs were compared between the two groups.Results The mean CHA2DS2-VASc score in the non-specialized atrial fibrillation(AF)management group was higher than that in the specialized AF management group,and the difference was statistically significant[(4.76±1.71)vs.(3.46±1.87),P<0.001].There were statistically significant differences between the two groups in terms of gender,age,comorbidities such as heart failure,hypertension,diabetes,stroke,and vascular disease(all P<0.001).The proportion of paroxysmal and permanent AF types in the non-specialized AF management group was higher(P<0.001).The usage rates of rate control drugs(56.0%vs.40.1%),beta-blockers(50.7%vs.36.6%),and digoxin(17.6%vs.5.2%)were significantly higher in the non-specialized AF management group compared to the specialized AF management group,all with statistical significance(all P<0.001).The usage rates of antiarrhythmic drugs(49.8%vs.22.6%),amiodarone(26.2%vs.5.6%),dronedarone(3.1%vs.0.4%),and propafenone(2.9%vs.0.1%)were significantly higher in the specialized AF management group compared to the non-specialized AF management group,all with statistical significance(all P<0.001),while there was no statistical difference in the usage rate of sotalol between the two groups.The proportion of patients undergoing coronary artery examination in the non-specialized AF management group(43.6%)was significantly higher than that in the specialized AF management group(25.7%),with statistical significance(P<0.001).Conclusions The treatment of patients with atrial fibrillation varies greatly due to the management of different specialized wards.

9.
Chinese Circulation Journal ; (12): 204-208, 2024.
Article in Chinese | WPRIM | ID: wpr-1025455

ABSTRACT

Ablation of ventricular arrhythmia originating from the epicardial and intramural sites tends to be challenging in clinical practice.As the reflux system of cardiac blood flow,tributaries of the coronary venous system widely covers the surface and the myocardium tissue of the heart,which could serve as alternative access route for auxiliary mapping and ablation.This review updated the research progress on the novel ablation methods via the coronary venous system.

10.
Article in Chinese | WPRIM | ID: wpr-1026216

ABSTRACT

A GC-LSTM model is proposed based on the characteristics of global optimization of genetic algorithm.The model automatically and iteratively searches the optimal hyper-parameter configuration of the C-LSTM model through the genetic algorithm of a specific genetic strategy,and it is configured using the genetic iteration results and validated on the MIT-BIH arrhythmia database according to the classification criteria of the Association for the Advancement of Medical Instrumentation.The testing shows that the classification accuracy,sensitivity,accuracy and F1 value of GC-LSTM model are 99.37%,95.62%,95.17%and 95.39%,respectively,higher than those of the manually established model,and it is also advantageous over the existing mainstream methods.Experimental results demonstrate that the proposed method can achieve better classification performance while avoiding a large number of experimental parameters.

11.
Article in Chinese | WPRIM | ID: wpr-1026235

ABSTRACT

Aiming at the non-stationarity and temporal characteristics of variable-length electrocardiogram(ECG)signals,an arrhythmia identification algorithm is proposed based on continuous wavelet transform and higher-order statistics.Considering the varying number of data points for each sample in variable-length ECG signals,the RR interval interpolation method is employed for data preprocessing,and the signal is decomposed into different time-frequency components using continuous wavelet transform,which enables the network to better extract both temporal and frequency features from the ECG signals.Regarding the issue of insufficient utilization of temporal information,a temporal mining module is introduced based on higher-order statistics and long short-term memory network to capture and learn long-term dependencies in the ECG signals,thereby facilitating the identification and understanding of specific arrhythmia categories.Extensive experiments conducted on the publicly available MIT-BIH ECG database validate the effectiveness and superiority of the proposed method.

12.
Article in Chinese | WPRIM | ID: wpr-1031403

ABSTRACT

ObjectiveTo observe the effect of Yangyin Xifeng Tongluo Formula (养阴熄风通络方) and its core herbs combination on prevention of ventricular precontraction (PVC). MethodsExperiment 1: Forty SD rats were randomly divided into model group, formula group, core herb-pairs medium-dose group and amiodarone group, with 10 rats in each group. Rats in the model group were given 10 ml/(kg·d) of pure water by gavage, rats in the formula group were given 1.125 g/(kg·d) of Yangyin Xifeng Tongluo Granules (养阴熄风通络方颗粒) by gavage, rats in the core herb-pairs medium-dose group were given 0.585 g/(kg·d) of granules of core herb-pairs by gavage, and rats in the amiodarone group were given 18 mg/(kg·d) of amiodarone hydrochloride tablets by gavage. The rats in each group were gavaged once a day for 14 consecutive days, and then a PVC model was established using rat tail vein injection of aconitine 25 μg/kg to compare the mortality and incidence of PVC, ventricular tachycardia (VT) and ventricular fibrillation (VF), the time of the appearance of PVC, and the duration of PVC in the rats in each group. Experiment 2: Sixty SD rats were randomly divided into model group, the amiodarone group, and the core herb-pairs of low, medium and high dose groups, 12 rats in each group. Rats in the model group were gavaged with 10 ml/(kg·d) of purified water, rats in the low, medium, and high dose groups were gavaged with 0.2925, 0.585, and 1.17 g/(kg·d) of the core herb-pairs granules respectively, and rats in the amiodarone group were gavaged with 18 mg/(kg·d) of amiodarone hydrochloride tablets. All of them were gavaged once a day. After 14 days, rats in each group were injected intravenously into the tail vein with aconitine 25 μg/kg, and then the rats in each group were observed to show the mortality and incidence of PVC, VT and VF, and the time of appearance and duration of PVC. ResultsExperiment 1: Compared with the model group, The difference in the incidence of PVC in rats of all groups was not statistically signi-ficant (P>0.05), and the mortality and incidence of VT and VF in rats in the formula group, the core herb-pairs medium-dose group, and the amiodarone group significantly reduced, with delayed time of the occurrence of PVC and shorter duration of the PVC (P<0.05 or P<0.01) as compared with the model group, whereas the difference between each group with medication intervention was not statistically significant (P>0.05). Experiment 2: There was no statistically significant difference in the incidence of PVC in all groups (P>0.05), and the mortality and incidence of VT and VF reduced in the core herb-pairs of low-, medium-, and high-dose groups and in the amiodarone group, and the appearance of PVC delayed and its duration shortened (P<0.05 or P<0.01) as compared with the control group, whereas the differences were not statistically significant in the comparison among groups with medication (P>0.05). ConclusionBoth Yangyin Xifeng Tongluo Formula and its core herb-pairs could delay the time of occurrence and shorten the duration of PVC.

13.
Article in Chinese | WPRIM | ID: wpr-1031405

ABSTRACT

This study searched the clinical researches on traditional Chinese medicine (TCM) for cardiovascular diseases registered in Chinese Clinical Trial Registry and the US Clinical Trial Registry, the cardiovascular disease-related studies funded by the National Natural Science Foundation of China, as well as those published in China National Knowledge Infrastructure (CNKI), Wanfang database, VIP.com, China Biology Medicine disc (CBMdisc), Embase, Medline, Cochrane Library, and other databases published cardiovascular disease-related studies from 1 January 2021 to 30 June 2023. In order to analyse and evaluate the research progress of TCM treatment for coronary heart disease, hypertension, heart failure, and arrhythmia, this study aimed at recent research hotspots and research direction. It is found that the research on TCM for cardiovascular diseases was gradually deepening and the high-quality evidence continued to emerge. It is believed that studies related to the prevention and treatment of common cardiovascular diseases by TCM reflected the multi-angle integration of modern technology and pattern differentiation and treatment, closer integration of clinical and basic research, and further optimisation of pattern identification and interventions. On this basis, the research programme and implementation process should be further standardized, and the translation of research results should be emphasized to promote the standardized application and promotion of TCM diagnosis and treatment of cardiovascular diseases.

14.
Article in Chinese | WPRIM | ID: wpr-1031692

ABSTRACT

@#Objective To investigate the risk factors for arrhythmia after robotic cardiac surgery. Methods The data of the patients who underwent robotic cardiac surgery under cardiopulmonary bypass (CPB) from July 2016 to June 2022 in Daping Hospital of Army Medical University were retrospectively analyzed. According to whether arrhythmia occurred after operation, the patients were divided into an arrhythmia group and a non-arrhythmia group. Univariate analysis and multivariate logistic analysis were used to screen the risk factors for arrhythmia after robotic cardiac surgery. Results A total of 146 patients were enrolled, including 55 males and 91 females, with an average age of 43.03±13.11 years. There were 23 patients in the arrhythmia group and 123 patients in the non-arrhythmia group. One (0.49%) patient died in the hospital. Univariate analysis suggested that age, body weight, body mass index (BMI), diabetes, New York Heart Association (NYHA) classification, left atrial anteroposterior diameter, left ventricular anteroposterior diameter, right ventricular anteroposterior diameter, total bilirubin, direct bilirubin, uric acid, red blood cell width, operation time, CPB time, aortic cross-clamping time, and operation type were associated with postoperative arrhythmia (P<0.05). Multivariate binary logistic regression analysis suggested that direct bilirubin (OR=1.334, 95%CI 1.003-1.774, P=0.048) and aortic cross-clamping time (OR=1.018, 95%CI 1.005-1.031, P=0.008) were independent risk factors for arrhythmia after robotic cardiac surgery. In the arrhythmia group, postoperative tracheal intubation time (P<0.001), intensive care unit stay (P<0.001) and postoperative hospital stay (P<0.001) were significantly prolonged, and postoperative high-dose blood transfusion events were significantly increased (P=0.002). Conclusion Preoperative direct bilirubin level and aortic cross-clamping time are independent risk factors for arrhythmia after robotic cardiac surgery. Postoperative tracheal intubation time, intensive care unit stay, and postoperative hospital stay are significantly prolonged in patients with postoperative arrhythmia, and postoperative high-dose blood transfusion events are significantly increased.

15.
Article in Chinese | WPRIM | ID: wpr-1014564

ABSTRACT

AIM: To predict the core targets and related signaling pathways of Yi-xin-yin oral liquid for the treatment of arrhythmia, heart failure and myocarditis based on UHPLC-Q-TOF/MS, network pharmacology, molecular docking methods, cell experiments, according to the“homotherapy for heteropathy”theory in traditional Chinese medicine. METHODS: UHPLC-Q-TOF / MS was used to analyze and identify the chemical composition of Yi-xin-yin oral liquid Extract and the blood-absorbing components of rats oral administrated with Yi-xin-yin oral liquid extract, which compounds were applied in the databases searching for the potential targets (TCMSP, SwissTargetPrediction) and disease targets (OMIM, Genecard). Venn diagram was used for target intersection, and the subsequent protein-protein interaction network obtained core targets by STRING11.5 database, and then construct a "disease-component-target" network by cytoscape3.9.0. Finally, DAVID database was used to analysis GO function and KEGG enrichment analysis of core targets, and molecular docking validation was performed using Autodock vina software. And, validated with H9c2 cells for potential active ingredients and targets. RESULTS: A total of 156 compounds were identified from Yi - xin-yin Oral Liquid extract; 34 compounds were identified from rat serum, including 6-gin-gerol, isoliquiritigenin, glycyrrhizic acid and other compounds, and 139 intersecting targets were obtained. The KEGG pathway enrichment analysis mainly involved the TNF signaling pathway, IL-17 signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway and so on. The TNF and IL-6 targets were selected for molecular docking with the main compounds, and the docking results were good (less than -5 kcal/mol). In vitro cellular experiments have shown that Yi-xin-yin oral liquid can exert therapeutic effects by regulating TNF and IL-6. CONCLUSION: The main potential active ingredients of Yi-xin-yin oral liquid may be isoliquiritigenin, glycyrrhetinic acid, calycosin-7-glucoside, salvianolic acid B, and 6-gingerol, which mainly act on TNF, IL-6 and other targets to regulate specific signaling pathways and exert therapeutic effects.

16.
Yao Xue Xue Bao ; (12): 143-151, 2024.
Article in Chinese | WPRIM | ID: wpr-1005448

ABSTRACT

Melatonin (Mel) has been shown to have cardioprotective effects, but its action on ion channels is unclear. In this experiment, we investigated the inhibitory effect of Mel on late sodium currents (INa.L) in mouse ventricular myocytes and the anti-arrhythmic effect at the organ level as well as its mechanism. The whole-cell patch clamp technique was applied to record the ionic currents and action potential (AP) in mouse ventricular myocytes while the electrocardiogram (ECG) and monophasic action potential (MAP) were recorded simultaneously in mouse hearts using a multichannel acquisition and analysis system. The results demonstrated that the half maximal inhibitory concentration (IC50) values of Mel on transient sodium current (INa.T) and specific INa.L opener 2 nmol·L-1 sea anemone toxins II (ATX II) increased INa.L were 686.615 and 7.37 μmol·L-1, respectively. Mel did not affect L-type calcium current (ICa.L), transient outward current (Ito), and AP. In addition, 16 μmol·L-1 Mel shortened ATX II-prolonged action potential duration (APD), suppressed ATX II-induced early afterdepolarizations (EADs), and significantly reduced the incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) in Langendorff-perfused mouse hearts. In conclusion, Mel exerted its antiarrhythmic effects principally by blocking INa.L, thus providing a significant theoretical basis for new clinical applications of Mel. Animal welfare and experimental process are in accordance with the regulations of the Experimental Animal Ethics Committee of Wuhan University of Science and Technology (2023130).

17.
Article in Chinese | WPRIM | ID: wpr-1006530

ABSTRACT

@#The cardiac conduction system (CCS) is a set of specialized myocardial pathways that spontaneously generate and conduct impulses transmitting throughout the heart, and causing the coordinated contractions of all parts of the heart. A comprehensive understanding of the anatomical characteristics of the CCS in the heart is the basis of studying cardiac electrophysiology and treating conduction-related diseases. It is also the key of avoiding damage to the CCS during open heart surgery. How to identify and locate the CCS has always been a hot topic in researches. Here, we review the histological imaging methods of the CCS and the specific molecular markers, as well as the exploration for localization and visualization of the CCS. We especially put emphasis on the clinical application prospects and the future development directions of non-destructive imaging technology and real-time localization methods of the CCS that have emerged in recent years.

18.
Article in Chinese | WPRIM | ID: wpr-1007267

ABSTRACT

Cardiac pacing is an effective treatment for cardiac pacing and conduction dysfunction and severe heart failure. However, the conventional right ventricular pacing may increase the incidences of heart failure and atrial fibrillation, and biventricular pacing has a relatively high non-response rate. As a new technique of physiological pacing, a number of studies in recent years have been conducted to show the stability of pacing parameters and good cardiac synchronization of his-purkinje system pacing. This article reviews the current status of research and progress in the effects of his-purkinje conduction system pacing on cardiac function, so as to provide a theoretical basis for promoting the development of this technology.

19.
Article in Chinese | WPRIM | ID: wpr-1011355

ABSTRACT

Objective@#To research the prevalence and influencing factors of asymptomatic arrhythmia among college students, and provide scientific basis for heart rate control and health management of asymptomatic arrhythmia among college students.@*Methods@#Using cluster sampling method, 3 012 college students who studied in the First Clinical Medical College of Henan University of Traditional Chinese Medicine and the Second Clinical Medical College of Henan University of Traditional Chinese Medicine were selected as the research objects from September to November 2022. After entering school in autumn (September in 2022), all college students were investigated by questionnaire, and the general data and living habits of asymptomatic arrhythmia college students and normal college students were compared. Logistic regression was used to analyze the influencing factors of asymptomatic arrhythmia among college students.@*Results@#A total of 62 patients with asymptomatic arrhythmia were found. The detection rates of the patients with body mass index(BMI)≥24.0 kg/m 2 , systolic blood pressure(SBP)≥120 mmHg, diastolic blood pressure(DBP)≥80 mmHg, family history of cardiovascular disease, smoking, drinking, exercising less than three times a week, heavy study pressure, irregular work and rest, depression tendency and anxiety tendency were 5.58%, 4.49%, 5.63%, 6.18%, 4.26%, 4.50%, 3.72%, 4.29%, 4.28%, 9.15%,9.03%, which were significantly higher than those of patients with BMI<24.0 kg/m 2, SBP<120 mmHg, DBP<80 mmHg, no family history of cardiovascular disease, no smoking, no drinking, exercise more than three times a week, little study pressure, regular work and rest, no depression tendency and no anxiety tendency (1.20%, 1.37%, 1.35%, 1.53%, 1.55 %, 1.59%, 1.27%, 1.52%, 1.38%, 1.71%,1.71%), and the differences were statistically significant ( χ 2=45.33, 25.20, 37.74, 32.24, 16.69, 17.25, 19.57, 17.83, 22.36, 37.23,39.42, P <0.01). Logistic regression analysis showed that the higher of BMI,SBP and DBP, family history of cardiovascular disease, smoking, drinking, times of exercise, heavy study pressure, irregular work and rest, depression tendency and anxiety tendency were positively correlated with asymptomatic arrhythmia of college students ( P <0.05).@*Conclusions@#The higher of BMI and blood pressure, family history of cardiovascular diseases, bad living habits and psychological status are related to asymptomatic arrhythmia in college students. It is of great significance to control weight and blood pressure reasonably and maintain good living habits and mental state for preventing and improving asymptomatic arrhythmia.

20.
Rev. colomb. cardiol ; 30(6): 361-371, nov.-dic. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1576213

ABSTRACT

Resumen Introducida inicialmente en la década de los cincuenta para la evaluación de las presiones de la aurícula izquierda y posteriormente para la realización de valvuloplastia mitral, la punción transeptal es, con frecuencia, la vía de acceso para efectuar procedimientos que involucren las cavidades izquierdas. En la actualidad, se usa comúnmente en los laboratorios de electrofisiología, tanto para la ablación de arritmias en cavidades izquierdas como para los procedimientos de cierre percutáneo de orejuela. No obstante, con la llegada de diversas técnicas para el manejo percutáneo de la válvula mitral, se espera un aumento progresivo de su uso por parte de cardiólogos intervencionistas. En este artículo, se revisa la técnica para hacer una punción transeptal segura y se dan recomendaciones y estrategias para el manejo de la punción transeptal difícil.


Abstract Initially described in 1959 as a technique to measure left atrial pressures, and later used during balloon mitral valvuloplasty, transeptal puncture (TSP) is frequently the access route for procedures involving the left heart chambers. Currently, it is mostly used in electrophysiology laboratories for arrhythmia ablation and during left atrial appendage occlusion procedures. However, with the ongoing development of percutaneous mitral valve interventions, it is expected that a greater number of interventional cardiologists will be using this technique in the near future. In this article, we review the technique to perform TSP safely, and we provide recommendations and different strategies to deal with difficult TSPs.

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