To investigate the impact of blood pressure outcomes on the risk of arteriosclerosis in non-hypertensive populations. This study was a retrospective cohort study. All data were derived from Kailuan Cohort. Non-hypertens...To investigate the impact of blood pressure outcomes on the risk of arteriosclerosis in non-hypertensive populations. This study was a retrospective cohort study. All data were derived from Kailuan Cohort. Non-hypertensive individuals who completed two brachial-ankle pulse wave velocity (baPWV) measurements between January 2014 and December 2019 (using the first measurement as the baseline and the second as the follow-up) were enrolled, and clinical data such as blood pressure and baPWV were collected. According to the blood pressure level at baseline and follow-up, participants were divided into new-onset hypertension group (no hypertension at baseline but diagnosed at follow-up) and non-hypertension group (no hypertension at both baseline and follow-up). Multiple linear regression and multivariate logistic regression were used to analyze the impact of new-onset hypertension on arteriosclerosis progression. Subgroup analysis further classified participants into six blood pressure transition categories: normal-maintained, normal-to-high-normal, normal-to-hypertensive, high-normal-to-normal, high-normal-maintained, and high-normal-to-hypertensive groups. Multivariate logistic regression analysis was used to assess the impact of different blood pressure outcomes on arteriosclerosis progression. A total of 7 049 participants were enrolled, with the age of (40.45±9.04) years, including 3 645 males (51.71%). There were 800 cases in the new-onset hypertension group and 6 249 individuals in the non-hypertension group. During follow-up, arteriosclerosis occurred in 2 154 cases (30.56%). Multivariable linear regression analysis revealed a positive correlation between new-onset hypertension and baPWV levels. The baPWV in the new-onset hypertension group was significantly higher by 63.94 cm/s compared to the non-hypertension group (=63.94, <0.01). Additionally, the risk of arteriosclerosis in the new-onset hypertension group was 2.09 times that of the non-hypertension group (=2.09, 95%: 1.77-2.46, <0.01). Subgroup analysis revealed significantly higher arteriosclerosis risks in normal-to-high-normal (=1.65, 95% 1.38-1.98, <0.01), normal-to-hypertensive (=2.47, 95% 1.70-3.59, <0.01), high-normal-maintained (=1.50, 95% 1.21-1.86, <0.01), and high-normal-to-hypertensive groups (=2.86, 95% 2.20-3.73, <0.01) than normal-maintained group, except for a non-significant difference in high-normal-to-normal group (=0.95, 95% 0.74-1.20, >0.05). Blood pressure outcome in non-hypertensive populations is closely related to arteriosclerosis risk. Progression to or maintenance of high-normal blood pressure or higher levels substantially increases arteriosclerosis risk, while regression from high-normal to normal blood pressure shows no significant increase in arteriosclerosis risk.
To explore the diagnostic value of fractional flow reserve (FFR) based on optical coherence tomography (OCT) for coronary functional ischemia, and to investigate the feasibility of synchronously obtaining Doppler blood f...To explore the diagnostic value of fractional flow reserve (FFR) based on optical coherence tomography (OCT) for coronary functional ischemia, and to investigate the feasibility of synchronously obtaining Doppler blood flow velocity information with the help of OCT technology. This study was a single-center, prospective, self-controlled clinical study on coronary heart disease patients who underwent OCT and FFR assessment at Department of Cardiology, the Second Hospital of Jilin University from January 2024 to February 2025. Linear regression analysis was used to evaluate the correlation and consistency between OCT-FFR and FFR. With FFR≤0.80 as the gold standard for judging whether the target vessel was ischemic, the diagnostic performance of OCT-FFR was evaluated, and the diagnostic value of OCT-FFR for significant coronary artery ischemia was assessed using subject operating characteristic curves. Blood flow OCT data were analyzed by Doppler processing algorithm to obtain information on coronary blood flow velocity. A total of 31 vessels from 28 patients were analyzed, the correlation coefficient between OCT-FFR and FFR of the 31 vessels was 0.84 (<0.001). With FFR as the gold standard to determine whether a coronary artery is ischemic, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for OCT-FFR was 93.55%, 75.00%, 100.00%, 1.00, 0.92. In clinical practice, Doppler OCT was used for the first time to obtain information on coronary blood flow velocity. OCT-FFR had an excellent correlation and consistency with FFR in judging whether there is coronary artery ischemia. The feasibility of the simultaneous acquisition of OCT-FFR and Doppler flow velocity information in coronary stenosis was preliminarily verified.
To investigate the prevalence, comorbidity patterns, and associated factors of cardiometabolic multimorbidity (CMM) in China. From 2012 to 2015, a total of 34 994 residents aged ≥35 years were enrolled using a stratifie...To investigate the prevalence, comorbidity patterns, and associated factors of cardiometabolic multimorbidity (CMM) in China. From 2012 to 2015, a total of 34 994 residents aged ≥35 years were enrolled using a stratified multistage random sampling method across 31 provinces, autonomous regions, and municipalities in China. Data were collected through questionnaires, covering demographic characteristics, behavioral and lifestyle factors, and self-reported history of cardiometabolic diseases. CMM was defined as the coexistence of two or more cardiometabolic diseases in the same individual. Association rule analysis using the Apriori algorithm from the arules package was employed to identify strong CMM patterns. Multivariable logistic regression was employed to explore factors associated with CMM. The mean age of the participants was 55.6 years. Among them, 15 926 were male (45.51%). The prevalence of cardiometabolic multimorbidity (CMM) was 11.25% (3 937/34 994). A total of 35 distinct CMM combinations (each with a frequency ≥10) were identified. The most prevalent dyad, triad, and tetrad comorbidity patterns were hypertension+hyperlipidemia (1 036 cases), hypertension+hyperlipidemia+diabetes (352 cases), and hypertension+stroke+hyperlipidemia+diabetes (54 cases), respectively. Nine strong CMM patterns were identified using the Apriori association rule algorithm. Multivariable logistic regression analysis showed that older age (≥70 years: =17.39,95% 13.92-21.71,<0.01), junior high school education (=1.31, 95% 1.17-1.48, <0.01), senior high school or above education (=1.45, 95% 1.27-1.65, <0.01), retirement (=3.09, 95% 2.76-3.46, <0.01), unemployment or being laid-off (=1.16, 95% 1.06-1.28, <0.01), a family history of cardiometabolic disease (=4.37, 95% 4.04-4.72, <0.01), regular smoking (=1.38, 95% 1.24-1.53, <0.05), and occasional smoking (=1.21, 95% 1.00-1.49, <0.01) were significantly associated with an increased risk of CMM. The prevalence of cardiometabolic multimorbidity in China is relatively high, with the most common comorbidity patterns involving combinations of hypertension and hyperlipidemia, often accompanied by diabetes and stroke. Older age, retirement status, smoking, and a family history of cardiovascular disease are associated with an increased risk of both single and multiple cardiometabolic conditions. Greater attention should be paid to individuals with a single cardiometabolic disorder due to their elevated risk of developing multimorbidity.
To explore the value of cardiac magnetic resonance imaging (CMR) derived left ventricular late gadolinium enhancement (LV LGE) for the primary prevention of malignant ventricular arrhythmias in arrhythmogenic right ventr...To explore the value of cardiac magnetic resonance imaging (CMR) derived left ventricular late gadolinium enhancement (LV LGE) for the primary prevention of malignant ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. This was a single-center retrospective study. Consecutive ARVC patients who underwent CMR at Fuwai Hospital between January 2016 and September 2020, with no history of malignant ventricular arrhythmias at diagnosis, were enrolled. Clinical data and CMR characteristics were collected. The primary endpoint was defined as new-onset malignant ventricular arrhythmias related events, including sustained ventricular tachycardia, ventricular fibrillation/flutter, sudden cardiac death, cardiac arrest, and appropriate implantable cardioverter-defibrillator discharge. Follow-up via telephone interviews and medical records was conducted to confirm endpoint occurrences, and patients were categorized into event-free and event groups based on endpoint status. Univariable and multivariable Cox regression analysis were performed to identify independent risk factors for malignant ventricular arrhythmias in ARVC patients. Subgroup analyses were conducted based on the ARVC 5-year risk score (cutoff: 25%) and the median value of LV LGE percentage (cutoff: 13%). Kaplan-Meier curves were plotted, and log-rank tests were used to compare the difference in the incidence of primary endpoint events between subgroups. Receiver operating characteristic curves and likelihood ratio test were used to evaluate the incremental prognostic value of LV LGE percentage beyond the ARVC 5-year risk score. A total of 172 ARVC patients were enrolled, aged (39.0±16.6) years, including 73 females (42.4%). During a follow-up of 53.1 (25.4, 76.9) months, 51 patients (29.7%) experienced malignant ventricular arrhythmias related events, including 3 cases of sudden cardiac death, 1 cardiac arrest, 33 sustained ventricular tachycardia and 14 appropriate implantable cardioverter-defibrillator discharges. Multivariable Cox regression analysis indicated that the ARVC 5-year risk score (=1.028, 95% 1.015-1.041, <0.001) and LV LGE percentage (=1.059, 95% 1.032-1.087, <0.001) were independent risk factors of the primary endpoint events. Kaplan-Meier analysis using composite stratification (ARVC 5-year risk score cutoff: 25%; LV LGE percentage cutoff: 13%) demonstrated that patients with both high risk scores (≥25%) and extensive LV LGE (≥13%) had the highest risk of primary endpoint events. Notably, among patients with ARVC 5-year risk scores <25%, those with LV LGE≥13% had a higher incidence of primary endpoint events than those without (log-rank =0.037). The composite prediction model combining the 5-year risk score and left ventricular LGE percentage demonstrated significantly improved predictive performance (area under the curve ()=0.82, 95% 0.75-0.90; likelihood ratio test all <0.001) compared to single-variable models (left ventricular LGE percentage alone: =0.71, 95% 0.63-0.82, =0.01; 5-year risk score alone: =0.71, 95% 0.62-0.81, =0.02). LV LGE percentage independently predict new-onset malignant ventricular arrhythmias in ARVC patients and provided incremental prognostic value based on the existing ARVC 5-year risk score.
To explore the relationship between retinol-binding protein (RBP) levels and disease severity in patients with transthyretin cardiac amyloidosis (ATTR-CA), as well as its impact on therapeutic response to tafamidis. Thi...To explore the relationship between retinol-binding protein (RBP) levels and disease severity in patients with transthyretin cardiac amyloidosis (ATTR-CA), as well as its impact on therapeutic response to tafamidis. This retrospective study utilized data from the China National Rare Disease Registry System and included ATTR-CA patients treated with tafamidis between January 2018 and September 2022. Patients were stratified into two groups based on baseline RBP levels: the normal RBP group (≥36 mg/L) and the reduced RBP group (<36 mg/L). Baseline characteristics and clinical data after one year of treatment were collected and compared between the groups. Within the reduced RBP group, patients were further subclassified by changes in RBP levels after treatment (ΔRBP=post-treatment RBP-baseline RBP) into ΔRBP>0 and ΔRBP<0 subgroups. Worsening of global longitudinal strain (GLS) after treatment was defined as the primary outcome, logistic regression analysis was used to identify risk factors influencing therapeutic response to tafamidis in ATTR-CA patients. A total of 52 ATTR-CA patients were included (aged (58.5±12.0) years, 46 males (88%)). Among 39 patients who completed one-year tafamidis treatment, no statistically significant difference was observed in RBP levels post-treatment versus baseline ((27.0±14.3) mg/L vs. (25.9±15.4) mg/L, =0.261). Compared to the normal RBP group, the reduced RBP group had significantly higher estimated glomerular filtration rate-adjusted N-terminal pro-B-type natriuretic peptide levels (2 316.0 (1 161.5, 6 027.8) ng/L vs. 806.2 (349.5, 1 735.8) ng/L), higher left ventricular mass index ((164.4±46.5) g/m² vs. (123.9±31.8) g/m²), and lower left ventricular ejection fraction ((50.8±11.3)% vs. (58.8±6.2)%) (all <0.05). Among 31 patients in the reduced RBP group who completed one-year tafamidis treatment, 23 were classified as ΔRBP>0 and 8 as ΔRBP<0. The ΔRBP<0 group exhibited greater GLS worsening than the ΔRBP>0 group (0.7 (-0.1, 1.4)% vs. -0.4 (-1.4, 0.2)%, =0.027). Multivariate logistic regression analysis revealed that ΔRBP<0 was an independent risk factor for GLS worsening (=8.584, 1.186-62.150, =0.033) in ATTR-CA patients. ATTR-CA patients with reduced RBP levels exhibit more severe left ventricular structural and functional impairment compared to those with normal RBP levels. Decline in RBP during treatment (ΔRBP<0) is associated with poorer response to tafamidis treatment. Monitoring RBP dynamics may assist clinicians in assessing disease severity and therapeutic response in ATTR-CA patients.
To summarize and analyze the clinical characteristics and treatment outcomes of patients with recurrent pericarditis. This observational study consecutively recruited patients with recurrent pericarditis who were hospit...To summarize and analyze the clinical characteristics and treatment outcomes of patients with recurrent pericarditis. This observational study consecutively recruited patients with recurrent pericarditis who were hospitalized at Peking University People's Hospital between January 2017 and February 2024. Clinical characteristics and treatment outcomes were collected and summarized during follow-up. A total of 8 recurrent pericarditis patients including 3 males were included, with an age of 34.0 (22.0, 39.5) years. In terms of clinical features, all patients presented with acute-onset severe chest pain, accompanied by fever in 7 and an audible pericardial friction rub in 2 patients. Electrocardiogram showed no diffuse ST-segment elevation or PR-segment depression in any patient. Echocardiography revealed pericardial effusion in all cases, with extensive fibrinous exudate and transient pericardial thickening observed in 6 patients. CT identified concurrent pleural and/or peritoneal effusions in 6 patients. All patients exhibited marked elevations in C-reactive protein, erythrocyte sedimentation rate and D-dimer levels. Whole-exome sequencing identified MEFV gene mutations associated with familial Mediterranean fever in 3 cases. Two patients developed cardiac tamponade requiring pericardiocentesis, which revealed hemorrhagic effusion. In the aspect of treatment outcomes, the time from recurrence to first confirmed diagnosis of recurrent pericarditis of this cohort was 14.5 (13.3, 19.5) d. Upon diagnosis, all patients promptly received standard anti-inflammatory therapy with ibuprofen and colchicine, achieving rapid relief. However, during a follow-up of 12.0 (6.0, 25.3) months, 3 patients experienced recurrence, and 2 developed transient constrictive pericarditis. Patients with recurrent pericarditis typically exhibit characteristic clinical presentations, laboratory abnormalities, imaging findings and potential genetic associations. Although standard anti-inflammatory therapy demonstrates favorable short-term efficacy, long-term management remains challenging due to the risks of recurrence and progression to constrictive pericarditis.
Chinese Society of Cardiology, Chinese Medical Association, Chinese Diabetes Society, Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology
Zhang XL, Yang F, Liu HH
… +5 more, Wei TP, Dai YF, Zhang L, Qian LL, Wang RX
Zhonghua Xin Xue Guan Bing Za Zhi
· 2025 Aug · PMID 40662394
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To investigate the impact and potential mechanisms of Sorbin and SH3 domain-containing protein 2 (Sorbs2) on ventricular arrhythmias in mice. In the animal experiments, mating was performed using six 8-week-old Sorbs2 m...To investigate the impact and potential mechanisms of Sorbin and SH3 domain-containing protein 2 (Sorbs2) on ventricular arrhythmias in mice. In the animal experiments, mating was performed using six 8-week-old Sorbs2 mice (3 males and 3 females) weighing 20-22 g. Wild-type (Sorbs2, =8) and homozygous (Sorbs2, =6) offspring were selected as experimental subjects through genotyping. Echocardiography was performed at 16 weeks of age to record cardiac function parameters in both groups. Resting-state and caffeine-dobutamine-induced electrocardiograms were also conducted. Real-time quantitative reverse transcription polymerase chain reaction was used to detect Sorbs2 messenger RNA expression in the heart, liver, spleen, lung, kidney, brain, small intestine, and skeletal muscle tissues of wild-type mice. Western blotting was employed to measure the protein expression levels of Sorbs2 and voltage-dependent sodium channel alpha subunit 1.5 (Na1.5) in myocardial tissues from both groups. In the cell experiments, H9C2 cells were transfected with Sorbs2 small interfering RNA as the si-Sorbs2 group, with a corresponding si-negative control group established. Western blot was performed to detect the protein expression levels of Sorbs2 and Na1.5 in both groups. Sorbs2 was abundantly expressed in cardiac tissue. Compared with wild-type mice, homozygous mice exhibited larger left ventricular end-systolic diameter, along with lower left ventricular ejection fraction and fractional shortening ( all<0.05). Resting-state electrocardiograms revealed no spontaneous arrhythmias in either group; however, homozygous mice showed shorter RR intervals but longer QRS and QTc intervals versus wild-type mice ( all<0.05). Following caffeine and dobutamine induction, homozygous mice demonstrated a higher incidence of ventricular arrhythmias, longer arrhythmia duration, and higher ventricular arrhythmia scores than wild-type mice ( all<0.05). Western blot analysis revealed that Na1.5 protein expression was markedly lower in myocardial tissues of homozygous mice compared to wild-type mice. Similarly, si-Sorbs2-transfected H9C2 cells exhibited lower Na1.5 protein levels compared to the si-negative control group (<0.05). Sorbs2 plays a critical role in maintaining normal cardiac electrophysiological function. Deficiency of Sorbs2 may lead to impaired cardiac function and increased susceptibility to ventricular arrhythmias in mice, which could be associated with reduced expression of Na1.5 protein.