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Arrhythmogenic cardiomyopathy (ACM), a fatal heart disease characterized by fibroadipocytic replacement of cardiac myocytes, accounts for 20% of sudden cardiac death and lacks effective treatment. It is often caused by mutations in desmosome proteins, with Desmoglein-2 (DSG2) mutations as a common etiology. However, the mechanism underlying the accumulation of fibrofatty in ACM remains unknown, which impedes the development of curative treatment. Here we investigated the fat accumulation and the underlying mechanism in a mouse model of ACM induced by cardiac-specific knockout of Dsg2 (CS-Dsg2 -/-). Heart failure and cardiac lipid accumulation were observed in CS-Dsg2 -/- mice. We demonstrated that these phenotypes were caused by decline of fatty acid (FA) β-oxidation resulted from impaired mammalian target of rapamycin (mTOR) signaling. Rapamycin worsened while overexpression of mTOR and 4EBP1 rescued the FA β-oxidation pathway in CS-Dsg2 -/- mice. Reactivation of PPARα by fenofibrate or AAV9-Pparα significantly alleviated the lipid accumulation and restored cardiac function. Our results suggest that impaired mTOR-4EBP1-PPARα-dependent FA β-oxidation contributes to myocardial lipid accumulation in ACM and PPARα may be a potential target for curative treatment of ACM.
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Objective To study the efifcacy of interferon IFN-αon chronic hepatitis B, analyze the inlfuencing factors of therapeutic effect. Methods 62 cases with hepatitis B collected in our hospital from January 2008 to December 2012 were treated with interferon IFN-αfor one year, and divided into response group and non-response group according to the efficacy, biochemical indicators, viral load, host factors of patients in both two groups were analyzed. Results After one year’s treatment, the response patients were 38 cases(61.29%), non-response patients were 24 cases(38.71%). The male to female ratio in response group was 26/12, 13/11 in non-response group. The mean disease duration in response group was (3.3 ± 1.3)years, (5.4 ± 1.4) years in non-response group. The mean age in response group was (31.9 ± 8.6) years, (32.7 ± 5.6) years in non-response group. The difference between two groups was statistically signiifcant(P<0.05) Conclusion There is good therapeutic effect for most patients. and no reply for some patients. Analysing clinical data and the results of the study, we found that the course of disease,age, male/female ratio and level of ALT and AST are inlfuencing factors in interferon IFN-αtreatment for chronic hepatitis B.They can be use to predict clinical effect of interferon IFN-αtreatment for chronic hepatitis B.
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Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.
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Objective To investigate the relationship between serum uric acid level and atrial fibrillation in patients with coronary heart disease.Methods Two hundred and forty-seven inpatients with coronary heart disease were selected.All the patients were divided into simple coronary heart disease group (90 cases),coronary heart disease with paroxysmal atrial fibrillation group (85 cases) and coronary heart disease with continuous/permanent atrial fibrillation group (72 cases).The age,history of cardiovascular events,uric acid,echocardiographic characteristics and drug-taking history were carefully recorded.The risk factors of atrial fibrillation in patients with coronary heart disease were analyzed by Logistic regression.Results The level of history of smoking,diastolic blood pressure,body mass index,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,creatinine,fasting plasma glucose,postprandial 2 h plasma glucose,interventricular septal thickness,carotid intima-media thickness and drug-taking history among the 3 groups showed no statistical differences (P ＞ 0.05).The age,systolic blood pressure,uric acid,left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD) in coronary heart disease with paroxysmal atrial fibrillation group and coronary heart disease with continuous/permanent atrial fibrillation group were significantly higher than those in simple coronary heart disease group,the left ventricular ejection fraction (LVEF) was significantly lower than that in simple coronary heart disease group,and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The result of Logistic regression analysis showed high uric acid,high age,expanded LAD and LVEDD were the independent risk factors of atrial fibrillation in patients with coronary heart disease,and uric acid showed the most significant correlation (P =0.001,OR =1.061,95％ CI 1.026-1.096).Conclusion High serum uric acid level maybe a risk factor of atrial fibrillation in patients with coronary heart disease.
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Objective: To explore the correlation between glycosylated hemoglobin (HbA1c) level and severity of coronary artery disease in patients with coronary heart disease (CHD). Methods: Clinical data of 515 patients, who hospitalized in department of cardiology and received coronary angiography (CAG) examination, were analyzed. According to CAG results, they were divided into CHD group (n=370) and normal CAG group (n=145); according to HbA1c level, CHD patients were further divided into HbA1c<7% group (n=282) and HbA1c≥7% group (n=88), according to SYNTAX score, they were divided into SYNTAX score low risk group (n=181, 1~22 scores), intermediate risk group (n=125, 23~32 scores) and high risk group (n=64, ≥33 scores). HbA1c level was compared and analyzed among all groups. Results: Coronary SYNTAX score of HbA1c≥7% group was significantly higher than that of HbA1c<7% group [(25.6±9.97) scores vs. (20.92±10.26) scores, P<0.01]. HbA1c levels in high risk and intermediate risk groups were significantly higher than those of normal CAG group and low risk group [(8.74±0.83) scores, (7.74±0.62) scores vs. (5.12±0.49) scores vs. (5.68±0.59) scores], P<0.01 all, and that of low risk group was significantly higher than that of normal CAG group, , P<0.01 all. Pearson correlation analysis indicated that HbA1c level was positively correlated with coronary SYNTAX score (r=0.764, P<0.01). Conclusion: Glycosylated hemoglobin level is positively correlated with severity of coronary artery disease. Its level in those with higher SYNTAX score is significantly higher than those with low SYNTAX score.
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Objective To investigate the impact and significance of the vagus nerve intervention on the atrial electrical emodeling.Methods 30 mongrel dogs were given metoprolol in order to eliminate the effects of sympathetic nerve on atrial electrical remodeling;observe the atrial effective refractory period (ERP) and atrial fibrillation susceptible window(VW) in the high right atrial(SA) and coronary sinus (CS) by the vagus nerve stimulation(VS) or vagus nerve stimulation(Non-VS) before and after using atropine and after atrial electrical remodeling was observed.Results Before using vagus nerve blocking agents atropine,ERP shortened significantly [(54.83 ± 46.23) ms] and VW increased significantly [(19.86±13.23) ms] after VS,this time with atrial fibrillation-prone ; After using atropine,ERP increased significantly [(112.33 ± 9.63) ms] under VS,did not induce atrial fibrillation; After atrial electrical remodeling,the value of ERP was no significant difference under basis and VS (t =2.116,0.853,all P ＞0.05).Conclusion VS can increase the atrial electrical remodeling,an increase of atrial fibrillation susceptibility;vagus nerve block can reduce atrial electrical remodeling and atrial fibrillation susceptibility decreased.
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ObjectiveTo determine whether simvastatin alleviates lower urinary tract symptoms (LUTS) in patients with metabolic syndrome (MS) coexisting with benign prostate hyperplasia (BPH) and explore an optimized scheme of treatment. MethodsFrom February to June in 2011,30 male subjects with MS and LUTS caused by BPH in out-patients and in-patients from geriatric department were recruited.The patients were randomly assigned to receive orally simvastatin (40 mg) and tamsulosin (0.2 mg) quaque noete as combination treatment group or only tamsulosin (0.2 mg,quaque nocte) as single treatment group for 8 weeks.International prostate symptoms score (IPSS),quality of life (QOL),maximum flow rate (MFR) and prostate volume (PV),liver enzymes,creatinine and routine urine test were monitored to evaluate the effectiveness and safety before and after the treatment.Results In the two groups,the significant differences were found in the levels of IPSS,QOL and MFR,while there was no difference in PV between pre-treatment and post-treatment.The scores of IPSS after treatment were (6.4 ± 4.4) in combination treatment group and(4.2±3.3)in single treatment group (P＜0.05),and there were significant difference in scores of IPSS before and after the treatment between two groups (P＜0.05),suggesting better improvement in combination treatment group than in single treatment group.In two groups,there were no adverse events,and no changes were found in liver and kidney function,muscle enzymes and routine urine test.Conclusions Combined tamsulosin and simvastatin treatment may alleviate LUTS caused by BPH and are well tolerated with no adverse events.
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Objective To evaluate the effects of impaired glucose tolerance (IGT) on ventricular remodeling. Methods Parameters of every subject including left ventricular mass ( LVM), left ventricular mass index (LVMI), E/A ratio, 75 g oral glucose tolerance test (OGTT), ambulatory blood pressure monitoring(ABPM) data including 24-hour mean systolic blood pressure(mSBP) and 24-hour mean diastolic blood pressure(mDBP) were collected. Then the relationship of IGT and myocardial remodeling related parameters were analyzed. Results The rate of diastolic dysfunction was higher in the IGT combined with hypertensive group(74% ) compared with the hypertensive group( 39% )( x2 = 6. 5, P ＜ 0. 05 ). The rate of diastolic dysfunction was higher in the IGT group( 34% ) compared with the normal group( 10% ) (x2 = 5.2,P ＜0. 05). The rate of Left Ventricular Hypertrophy (LVH)in the IGT combined with hypertensive group (24%) was higher than the other three groups (Hypertension group 7%, IGT group 0, Normal group 0) (x2 =4.561,P ＜0.05), and there was no significance between the rest three groups (P ＞0.05).Stepwise multiple regression showed age and 2 Hours' Postprandial Blood Glucose were independent risk factors of E/A ratio. Conclusions These results suggested that IGT is a possible contributor to left ventricular hypertrophy and diastolic dysfunction, and is one of the histopathology of left ventricular remodeling.
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Objective To investigate the relationship between lipid abnormality and benign prostatic hyperplasia (BPH) in men receiving physical examination. MethodsFour hundred and one people who participated health examination in our hospital in May 2008 were included in the study. They were divided into two groups according to history of disease, IPSS score, the results of digital rectal examination and transrectal ultrasound: BPH group (192 cases) and no BPH group (209 cases). The blood lipid level and risk factors were compared in two groups. ResultsThere were no statistical differences in blood lipid level and risk stratification of cardiovascular disease between the two groups (TG:P=0. 698;TC:P=0. 654;LDL-C:P=0. 880; HDL-C:P=0. 531; risk stratification: P= 0. 251). IPSS score had no obvious correlation with blood lipid level (TG: P = 0. 054 ; TC: P =0. 149; LDL-C: P = 0. 427; HDL-C:P=0. 193) .Conclusions BPH complicated with lipid abnormality is common in the clinics, but the correlation between BPH and lipid abnormality in patients with light BPH is not so clear as that in patients with mild or severe BPH.
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Objective To detect plasma leval of FⅦa?Fig and LP(a) in patients with coronary heart diseases and their relationship with coronary heart diseases and severity of coronary artery stenosis.Methods The level of FⅦa?Fig and LP(a) were detected in100 patients with coronary heart diseases,and coronary artery tomography were performed. Results The level of FⅦa?Fig and LP(a) were significantly higher in patients with coronary heart diseases than those of control (P
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Objective\ To evaluate the importance of coronary arteriography with acute coronary syndromes (ACS).Methods\ The clinical data of 271 ACS patients with coronary arteriography and electrocardiogram were compared.Results\ The incidence of normal coronary arteriography with ACS patients occurred in 21 03%,220 of 271 patients had ischemic ST-T change or abnornal Q wave (81 1%).The change of anterior wall was system frequently accompanied by LAD or three branch lesions,inferior wall and inferior wall system frequently accompanied by RCA,Lcx and RCA or three branch lesions,anterior wall and inferior wall system freguently by LAD and RCA or three branch lesions,respectively.The lesions were more than one branch and severe in patients with unstable angina.Q-wave myocardal infarction usually occurred in single branch and severe lesione,non-Q wave myocardial infarction usually occurred in other branches and severe lesion.Conclusion\ Patients with ACS should be performed coronary arteriography,it is very significant in correct diagnosis of coronary heart disease,fixed position and severe degree of lesion vessel.
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Objective To sdudy the percentage of defect size following acute coronary syndromes(ACS) before and after percutaneous coronary intervention(PCI)therapy by myocardial tomography.Methods ~(99m)Tc-MIBI myocardial imaging was performed on 106 ACS patients to estimate the defect size before and after reperfusion.Results A significant difference in defect size was found between groups before and after PCI[(26.7?4.9)% vs (12.8?4.6)%,P