The correlation of left atrial diameter with preserved ejection fraction, reduced ejection fraction, and mid-range ejection fraction.

BACKGROUND: In patients with heart failure, left atrial remodeling often occurs to varying degrees. Left atrial enlargement has been proved to be an important predictor of cardiovascular-related adverse events. However, the relationship between left atrial diameter (LAD) with heart failure (HF) with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF) and mid-range ejection fraction (HFmrEF) remains unclear. HYPOTHESIS: We want to explore the correlation between left atrial diameter and HFpEF, HFmrEF, and HFrEF. METHODS: A total of 210 patients with heart failure who underwent hospitalization in Ningbo Medical Center Lihuili Hospital, Zhejiang, China, from January 1, 2020, to June 31, 2021, were reviewed. The basic demographic characteristics, blood test, and the related indexes of echocardiography of the subjects were collected and analyzed. RESULTS: There is a significant difference between HFpEF and HFrEF group in LAD (p = .007), and LAD is negatively correlated with left ventricular ejection fraction (LVEF) (p = .002, r = -.209). CONCLUSION: LAD is negatively correlated with LVEF, which may predict the prevalence of HFrEF.

The characteristics of choriocapillaris flow void in the unilateral polypoidal choroidal vasculopathy fellow eyes.

To evaluate the morphological characteristics of flow void (FV) in the fellow eyes of the unilateral polypoidal choroidal vasculopathy (PCV). Fifty PCV fellow eyes (PCVF) and 31 age-matched normal ocular circulation controls were recruited in this retrospective study. The number of FV was analyzed according to the size in a centered 5 × 5 mm swept source optical coherence tomography angiography scans. We used indocyanine green angiography images to determine whether choroidal vascular hyperpermeability (CVH) has occurred. For the PCVF, the prevalence rate of CVH was 70% (35 of 50) The number of FVs was significantly lower in 400-25,000 µm2 (P = 0.005), 400-500 µm2 (P = 0.001), 525-625 µm2 (P = 0.001) and 650-750 µm2 (P = 0.018). compared to the controls. And showed no difference in size from 775 to 1125 µm2 between the two groups. The area under the receiver operating characteristic curve of PCVF with CVH and controls was 0.94 (95% CI 0.88-1.00) (P < 0.001). We found that the number of small FVs was significantly lower in the PCV fellow eyes than that in the eyes with control group.

A modified measuring method to investigate the choriocapillaris flow void of polypoidal choroidal vasculopathy with swept source optical coherence tomography angiography.

BACKGROUND: To propose a modified method to investigate the flow void of polypoidal choroidal vasculopathy (PCV) choriocapillaris. METHODS: This paper involves a retrospective study. Included 30 PCV affect eyes, 30 old control eyes, 20 young control eyes, 15 affect eyes with anti-VEGF intravitreal injection treatment, and 8 fellow eyes of anti-VEGF intravitreal injection treatment group. After the choriocapillaris slab [10 µm thick starting 30 µm beneath to the retinal pigment epithelium (RPE)-fit reference] was extracted from macular optical coherence tomography angiography 6×6-mm scans, the flow void was segmented by the Phansalkar method. We analyzed the flow void sizes-frequency histogram in order to investigate the differences of flow void proportion between groups. Then we verified the differences between groups after anti-VEGF intravitreal injection treatment. RESULTS: On the difference curve between the PCV group and Old control group, there was a peak appeared at the flow void sizes range from 900 to 1,125 µm2. The average number of flow void sizes from 900 to 1,125 µm2 was significantly higher in the Old control group than that in the Young control group (P<0.05) and there was no difference between the affect eyes group and the Old control group. The proportion of flow void sizes from 900 to 1,125 µm2 were remarkably higher in the affect eyes group compared to the Old control group (P<0.05), showing no difference between the Young control group and the Old control group. The average number of flow void sizes from 900 to 1,125 µm2 and the proportion of flow void sizes range from 900 to 1,125 µm2 were significantly higher in the treatment group after the treatment (P<0.05) and there was no difference in the fellow eyes of treatment group. The choroidal thickness was significantly reduced after the treatment of the treatment group (P<0.001), while the fellow eyes of the treatment group had no difference. CONCLUSIONS: Our method was specific for the pathological changes in choriocapillaris structures of PCV affect eyes, fellow eyes, and the affect eyes after anti-VEGF treatment.

Multiple molecular targets in breast cancer therapy by betulinic acid.

Breast cancer is the second most common type of cancer in the world, and is by far the most prevalent form of cancer in women. However, the efficacy of current treatments for breast cancer is limited. In addition to the high risk of recurrence, some of these have side effects that significantly reduce the quality of life. Therefore, new avenues of treatment for breast cancer are needed. Betulinic acid (BA), a pipeline anticancer drug, exerts anti-proliferative effects on breast cancer cells is mainly through inhibition of cyclin and topoisomerase expression, leading to cell cycle arrest. It induces apoptosis through mitochondrial pathway and anti-angiogenesis effect by inhibiting the expression of transcription factor nuclear factor kappa B (NF-κB), specificity protein (Sp) transcription factors, and vascular endothelial growth factor (VEGF) signaling. In addition, it exerts anti-metastatic effect by inhibiting the expression of matrix metalloproteases. The specific targets of BA in breast cancer are reported to be the estrogen receptor and various multidrug resistance proteins. Synergistically interactions of BA with other chemotherapeutics are also described in the literature. In this review, we describe the detailed published mechanisms of action of BA, a pentacyclic triterpene with a lupine skeleton, on multiple molecular targets to treat breast cancer. We hope that this review will provide basic information in support of future studies of effects of BA on breast cancer cells.