Cystatin C and cardiovascular or all-cause mortality risk in the general population: A meta-analysis.

BACKGROUND: Elevated cystatin C level was associated with excessive risk of cardiovascular events and mortality in the highly cardiovascular risk populations. We conducted this meta-analysis to investigate the relationship between serum cystatin C level and cardiovascular or all-cause mortality risk in the general population. METHODS: We searched for all relevant studies published through May 2015 using PubMed, Embase, and Cochrane Library. Prospective studies that assessed the relationship between serum cystatin C level and cardiovascular or all-cause mortality risk in the general population were selected. Pooled adjust hazard risk (HR) and the corresponding 95% confidence intervals (CI) were calculated for continuous and category of cystatin C level. RESULTS: Nine studies composed of 38,854 participants were analyzed. Elevated serum cystatin C level was associated with excessive risk of all-cause mortality (HR 1.72; 95% CI 1.37-2.16) and cardiovascular mortality (HR 2.74; 95% CI 2.04-3.68) comparing the highest to lowest category of cystatin C. Each standard deviation increment in serum cystatin C level increased 32% all-cause (HR 1.32; 95% CI 1.12-1.55) and 57% cardiovascular mortality (HR 1.57; 95% CI 1.31-1.88) risk. CONCLUSIONS: Elevated serum cystatin C level is independently associated with excessive cardiovascular and all-cause mortality risk in elderly persons.

The expression and functional evidence for voltage-dependent potassium channel Kv1.3 in lymphocytes during aging in spontaneously hypertensive rats.

AIMS: Our previous studies showed that expression and functional profile of voltage-dependent potassium channels Kv1.3 were increased in lymphocytes of spontaneously hypertensive rats (SHR) compared to normotensive rats, suggesting a crucial role for lymphocyte Kv1.3 in the development of hypertension. Here, we further investigated whether the expression and functional profile of Kv1.3 was related to increased blood pressure in SHR with age of 4, 8, 16 and 24 wk. METHODS: Systolic blood pressure was measured through pressure device around the tail. mRNA and protein expression were assessed by real-time PCR and western blot in lymphocytes of SHR. Current density of Kv channels in lymphocytes was measured by patch-clamp. RESULTS: Systolic blood pressure was elevated in an age-dependent manner (ANOVA P < 0.05). mRNA and protein level of Kv1.3 were significantly increased in an age-dependent manner in lymphocyte of SHR (ANOVA P < 0.05). Moreover, the current density of Kv was dramatically enhanced in an age-dependent manner (ANOVA P < 0.05). CONCLUSION: The systolic blood pressure positively correlated with expression as well as current density of potassium channels in lymphocytes of SHR at age of 8, 16 and 24 wk. In conclusion, Kv1.3 channels were upregulated in an age-dependent manner in SHR and correlates with systolic blood pressure during aging. The present study implies that Kv1.3 blockers may be applied as a therapeutic treatment for the development of hypertension during aging.

[The prevalence and distributing feature of atrial fibrillation in Xinjiang Uygur Autonomous Region Kazaks adult population].

OBJECTIVE: To investigate the prevalence and distributing feature of atrial fibrillation (AF) in Xinjiang Kazaks adult population. METHODS: Four-stage selected random samples aged 30-89 years from Tacheng, Yili and Aletai were analyzed. An epidemical study of AF was performed including inquiring medical history, recording electrocardiogram and auscultation. RESULTS: A total of 22 514 adults were surveyed. The prevalence of AF in Xinjiang Kazaks adult population was 0.37%, which was increasing with aging. The prevalence was higher in men than in women (0.5% vs 0.2%, P < 0.01). In AF patients, 23 was valvular AF. Ischemic stroke was the most frequent type and the stroke rate in the patients with AF was significantly higher than that without AF (6.0% vs 1.2%, P < 0.01). CONCLUSIONS: The prevalence of AF in Xinjiang Kazaks adult population is lower than the reported national prevalence but patients with AF in this population would not like to take the necessary medicine. Therefore, the control of AF need to be reinforced.

[Viable myocardium detecting by CARTO voltage mapping in swine model of acute myocardial infarction].

OBJECTIVE: To evaluate the accuracy and practicability of detecting viable myocardium by CARTO voltage mapping in swine model of acute myocardial infarction (MI). METHODS: MI was induced in 13 anesthetized swines via occluding the distal of left anterior descending coronary arteries by angioplasty balloon for 60-90 minutes. The viable myocardium detection by CARTO voltage mapping was made after reconstruction of the left ventricle using CARTO and the results were compared with TTC staining. The standard of CARTO voltage to detect viable myocardium was 0.5 - 1.5 mV while viable myocardium showed pink color by TTC staining. RESULTS: Eleven out of 13 swines survived the operation and 2 swines died of ventricular fibrillation at 45 and 65 minutes post ischemia. Left ventricle was divided into 16 segments and 176 segments from 11 swines were analyzed. Viable myocardium detected by CARTO voltage mapping was identical as identified by TTC staining (Kappa = 0.816, P < 0.001). Taken the TTC result as standard, the sensitivity, specificity and accuracy rate of CARTO voltage mapping are 71.8%, 96.5% and 90.9% respectively. CONCLUSION: CARTO voltage mapping could be used as a reliable tool to detect viable myocardium in this model.

[Efficacy of cardiac resynchronization therapy for patients with refractory congestive heart failure].

OBJECTIVE: To observe the efficacy of cardiac resynchronization therapy for patients with refractory congestive heart failure. METHODS: Thirty-one patients with refractory congestive heart failure received cardiac resynchronization therapy. Before operation, all patients received standard drug therapy (28 cases) or integrated with CRRT (3 cases). Coronary sinus and its branches were shown by direct angiography with hollow angiographic catheter (11 cases) and by balloon angiographic catheter (20 cases). Left ventricle and right ventricle electrodes were implanted to 3 patients with atrial fibrillation, 4 patients with paroxysmal ventricular tachycardia or ventricular fibrillation received CRT-D implantation. electrocardiogram, 24 hours Holter, echocardiography and physical clinical examinations were made at baseline, 6, 12, 18 and 24 months post resynchronization therapy. RESULTS: Pacemakers were successfully implanted in all 31 patients. One patient implanted with CRT-D died of multiple organ failure on third day after operation, 1 patient suffered sudden cardiac death 5 months after therapy and 2 patients were lost to fellow up 6 and 12 months after operation, respectively. Results from the remaining 27 patients showed that QRS duration was significantly decreased (153 +/- 8.4 at baseline vs. 132 +/- 9.8 at 24 months follow up) and cardiac function significantly improved (LVEF 0.29 +/- 0.10 at baseline vs. 0.41 +/- 0.11 at 24 months follow up, P < 0.05 vs. baseline) during follow up compared to baseline. Malignant ventricular arrhythmia occurred in 3 patients with CRT-D and successfully terminated and converted to sinus rhythm. CONCLUSIONS: Cardiac resynchronization therapy could improve cardiac function for patients with refractory congestive heart failure. CRT-D can effectively terminate the malignant ventricular arrhythmia.