Special Issues

Special Issue Title: State-of-the-Art Cardiovascular Medicine in Asia 2021

· Print Special Issue Flyer

· Deadline for manuscript submissions: 1 January 2022

Special Issue Editor

Guest Editor

Prof. Brian Tomlinson, BSc, MBBS, MD

Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau, China

Website | E-Mail

InterestsThe clinical pharmacology; Toxicology and pharmacogenetics of drugs; Particularly in the cardiovascular field; The pathogenesis and treatment of hyperlipidaemia; Hypertension; The metabolic syndrome and diabetes

Assoc. Prof. Takatoshi Kasai, MD, PhD

Juntendo University Hospital, Tokyo, Japan

Website | E-Mail

InterestsSleep apnea; Sleep disorders; Heart failure; Hemodynamics; Positive airway pressure; Telemedicine

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide a comprehensive overview of state-of-the-art of Cardiovascular Medicine in Asia. We invite research papers that will consolidate our understanding in this area. The Special Issue will publish full research articles and systematic reviews. Potential topics include, but are not limited to, the following research areas:
cardiovascular imaging
high blood pressure and cardiovascular disease
cardiovascular tissue engineering
meta‐analysis based on cardiovascular outcomes trials
pathophysiology of chronic heart failure
molecular genetics of cardiovascular disease: clinical implications
cardiac arrhythmias
biomarkers in Cardiovascular Medicine
It is my pleasure to invite you to submit manuscripts on the subject “State-of-the-Art Cardiovascular Medicine in Asia 2021” for this Special Issue. Full papers and communications, as well as comprehensive reviews, are welcome. Please feel free to contact me, the guest editor, in case of further questions.

Prof. Brian Tomlinson and Assoc. Prof. Takatoshi Kasai

Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at https://rcm.imrpress.org by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Reviews in Cardiovascular Medicine is an international peer-reviewed open access quarterly journal published by IMR Press.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is $1950. Submitted papers should be well formatted and use good English.


Cardiovascular anatomy
Cardiac physiology
Imaging techniques
Cardiac regeneration
Congenital heart disease
Animal models for cardiovascular diseases
Blood pressure

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Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study
Mohd Aizuddin Mohd Zulastri, Muhammad Imran Hafidz, Muhammad Dzafir Ismail, Ahmad Syadi Mahmood Zuhdi
Reviews in Cardiovascular Medicine    2021, 22 (2): 505-512.   DOI: 10.31083/j.rcm2202058
Abstract107)   HTML13)    PDF(pc) (117KB)(159)       Save
In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients' clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (ΔHCT >1.5%) or without hemoconcentration (ΔHCT ≤1.5%). The study's outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078–0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188–9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients' haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients.
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The pathomechanism of human myxomatous valvular degeneration at the mechanical and cellular level
Chang Hu, Qian Wang, Hui Xue, Hao Hong, Jiawei Shi, Nianguo Dong, Mingkui Zhang
Reviews in Cardiovascular Medicine    2021, 22 (2): 513-519.   DOI: 10.31083/j.rcm2202059
Abstract119)   HTML15)    PDF(pc) (1829KB)(325)       Save
The purpose of this study was to explore the pathomechanism of human myxomatous valve degeneration by investigating changes in the phenotype of valvular cells, the metabolism of the extracellular matrix and their mechanical properties. Mitral valve specimens were harvested from patients who had undergone valve replacement, and divided into two groups: patients with a myxomatous mitral valve and a control group. Histological investigation showed that the morphology of the extracellular matrix was looser and less coordinated in myxomatous valves than in controls. α-SMA (α-smooth muscle actin) and Vimentin were positive and DNA (deoxyribonucleic acid) assay of leaflets and expression of SMemb (embryonic smooth muscle myosin heavy chain), MMP-13 (matrix Metalloproteinases-13), MMP-1 mRNA (messenger Ribonucleic Acid) of the myxomatous valves were increased while the hydroxyproline content, expression of TIMP-1 (tissue inhibitor of metalloproteinase-1) mRNA and mechanical properties were decreased compared with controls. Compared to the quiescent interstitial cells in non-myxomatous valves, interstitial cells in myxomatous valves exhibit myofibroblast activation and express excessive levels of matrix metalloproteinases. The balance between MMP/TIMP was disrupted. We conclude that overactivation of VICs (Valvular interstitial cells) and the imbalance of MMP/TIMP could be important features of the pathomechanism of myxomatous mitral valve degeneration.
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Prevalence and treatment of high cardiovascular disease risk in Inner Mongolia, China
Yunfeng Xi, Ning Cao, Liwei Niu, Hao Zhu, Han Bao, Liying Qiao, Shuqi Ji, Tao Yan, Xiaoqian Xu, Wenrui Wang, Xingguang Zhang
Reviews in Cardiovascular Medicine    2021, 22 (2): 521-529.   DOI: 10.31083/j.rcm2202060
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Early identification of individuals with high risk is crucial to preventing cardiovascular disease (CVD). We aimed to determine the prevalence of high CVD risk in Inner Mongolia and to analyze the treatment of major risk factors among individuals with high CVD risk. We selected 70,380 participants aged 35–75 years in Inner Mongolia between 2015 and 2017 using multistage stratified sampling. All participants completed a questionnaire and their blood pressure, blood glucose and lipid levels, height, weight and waist circumference were measured. Participants without a history of CVD were defined as high CVD risk if the predicted 10-year risk for CVD exceeded 10%. We assessed rates of high CVD risk and the prevalence and treatment of major risk factors among individuals with high CVD risk. After excluding participants with previous CVD, 68,083 participants remained. The overall prevalence of high CVD risk was 24.96%. The age- and sex-standardized rate of high CVD risk was 22.92%. Among high-risk participants, the prevalence of risk factors was hypertension (91.9%), dyslipidemia (54.1%), obesity (34.6%), diabetes (27.6%), and smoking (24.5%); clustering of these risk factors was common. The percentage of high-risk individuals taking antihypertensive drugs was 45.94% in those with hypertension; 27.99% of those with diabetes took hypoglycemic drugs and only 5.01% of those with dyslipidemia took lipid-lowering drugs. Control rates of hypertension, diabetes, and dyslipidemia were 1.20%, 4.43%, and 2.78%, respectively. Therefore, the prevalence of high CVD risk was elevated in Inner Mongolia, and treatment and control rates were low.
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Lipocalin 2: could it be a new biomarker in pediatric pulmonary hypertension associated with congenital heart disease?
Hongju Zhang, Tao Sun, Jiao Yang, Yan Sun, Guowen Liu, Chayakrit Krittanawong, Edward A. El-Am, Rody G. Bou Chaaya, Liyuan Xu, Zankai Ye, Zhiqiang Li, Ning Ma
Reviews in Cardiovascular Medicine    2021, 22 (2): 531-536.   DOI: 10.31083/j.rcm2202061
Abstract141)   HTML16)    PDF(pc) (199KB)(223)       Save
The role of lipocalin 2 (LCN2) in pulmonary hypertension (PH) in pediatric patients with congenital heart disease (CHD) remains unclear. We sought to investigate whether LCN2 could be a potential biomarker for PH in pediatric patients who underwent surgery for CHD. From December 2018 to February 2020, patients undergoing surgical repair for congenital defects with and without PH were identified. Healthy children without CHD and PH served as controls. A mean pulmonary artery pressure (mPAP) >20 mmHg was used as the definition of PH. Blood samples and echocardiograms were obtained in all patients and right heart catheterization was performed in 79 patients. Multivariable logistic regression analysis was used to determine potential predictors for PH. Among 102 patients, the median age was 10 [Interquartile range (IQR) 7.0–13] months, and 37.5% were female. Compared to non-PH patients and controls, PH patients showed elevated levels of LCN2 (P < 0.001). In addition, LCN2 levels positively correlated with the invasive haemodynamic indices of PH. In univariate regression, LCN2 (odds ratio = 2.69 [1.06–5.31], P < 0.001), N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) (OR = 1.91 [1.21–7.56], P = 0.03) and high-sensitive troponin T (hsTnT) (OR = 1.36 [1.01–3.57], P = 0.01) were associated with PH; however, only LCN2 (OR = 1.68 [1.04–4.52], P = 0.03) was significantly associated with PH on multivariate analysis. In conclusion, children with PH had increased LCN2 expression. LCN2 levels positively correlated with invasive indices of PH. These results indicate LCN2 could be a useful biomarker for prediction of PH in pediatric CHD cases.
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The 'diamond' approach to personalized drug treatment of heart failure with reduced ejection fraction
Hongbo Gan, Heng Tang, Yujie Huang, Dan Wang, Peng Pu, Zhong Zuo
Reviews in Cardiovascular Medicine    2021, 22 (3): 573-584.   DOI: 10.31083/j.rcm2203069
Abstract192)   HTML23)    PDF(pc) (1150KB)(332)       Save
Heart failure (HF) is a complex clinical syndrome with symptoms and signs due to cardiac dysfunction, leading to high hospitalization and morbidity. HF treatment has rapidly developed in recent decades, and breakthroughs have been made. Although conventional neurohormonal blockade therapies, including β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and mineralocorticoid receptor antagonists (MRAs), significantly improve the prognosis of patients with heart failure with reduced ejection fraction (HFrEF), mortality and rehospitalization remain high. Therefore, new therapies are needed. Previous studies demonstrated that ivabradine, angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 (SGLT2) inhibitor, vericiguat, and omecamtiv mecarbil (OM) are beneficial for HFrEF. However, there is a lack of systematic review of the most optimal manner to use under various clinical conditions. This review summarizes the current knowledge regarding these therapies to give suggestions regarding clinical use timing, application scope, and optimal therapies under various conditions. Most importantly, we propose the HF diamond approach to express the necessity of conjunction of therapies. Different from the current guidelines, we suggest to use the diamond approach in an early and comprehensive manner at the beginning of ventricular remodeling in HFrEF to prevent further deterioration of HF and maximize the prognosis of patients.
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A scoping review of exercise-based cardiac rehabilitation for patients with aortic dissection
Danni Feng, Jian Ke, Sufang Huang, Xiaorong Lang
Reviews in Cardiovascular Medicine    2021, 22 (3): 613-624.   DOI: 10.31083/j.rcm2203072
Abstract86)   HTML10)    PDF(pc) (301KB)(132)       Save
Our objective was to provide evidence for exercise-based cardiac rehabilitation (ECR) for patients with aortic dissection (AD), so as to better improve the prognosis of patients and improve the quality of life (QoL) after discharge. The database PubMed, Embase, MEDLINE, Web of Science, Cochrane Library, WanFang Chinese database, ZhiWang Chinese database, Chinese Clinical Trials Registry from establishment of each database until February 2021 were included. A total of 1684 records were found by searching the database and clinical trial registry, 178 duplicate records were deleted, and 11 records met the inclusion criteria according to the screening process. We can conclude that ECR for patients with AD can effectively reduce complications and shorten the course of the disease. In addition, it is very safe because there are no serious adverse events occurring. Further research should be developed from three aspects, including the development of systematic evaluation indicators and standardized clinical exercise rehabilitation pathway, more randomized controlled trials, and the development of individualized exercise program so as to help patients with AD better improve the prognosis and QoL.
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Role of the ACE2/Ang-(1-7)/Mas axis in glucose metabolism
Shiyuan Zhao, Wenxue Sun, Pei Jiang
Reviews in Cardiovascular Medicine    2021, 22 (3): 769-777.   DOI: 10.31083/j.rcm2203083
Abstract93)   HTML10)    PDF(pc) (1456KB)(234)       Save
The renin-angiotensin system (RAS) helps to regulate cardiovascular function, the maintenance of electrolyte and fluid balance, and blood pressure. The RAS contains two axes; the angiotensin-converting enzyme/angiotensin II/Ang II type 1 receptors (ACE/Ang II/AT1) classic axis, which has a role in regulating blood pressure, vascular oxidative stress, coagulation, and cellular proliferation. The other is the angiotensin-converting enzyme 2/angiotensin-(1-7)/Mas receptors (ACE2/Ang-(1-7)/Mas) axis, which can inhibit the former axis, improve fat metabolism, reduce inflammation and oxidative stress, and enhance glucose tolerance and insulin sensitivity. The ACE2/Ang-(1-7)/Mas axis is found in blood vessels, kidneys, liver, pancreas and the brain. It can protect the body from abnormalities in glucose metabolism. The ACE2/Ang-(1-7)/Mas axis can enhance glucose tolerance and improve insulin sensitivity by protecting pancreatic β cells, increasing insulin secretion, improving glucose metabolism in adipose tissue, enhancing glucose uptake by skeletal muscle, and inhibiting hepatic gluconeogenesis. This article reviews the main characteristics and functions of the ACE2/Ang-(1-7)/Mas axis and its regulation of glucose metabolism in order to demonstrate its potential as a target for the treatment of metabolic diseases such as diabetes.
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Sudden cardiac death in patients with myocardial infarction: 1.5 primary prevention
Yun-Tao Feng, Xiang-Fei Feng
Reviews in Cardiovascular Medicine    2021, 22 (3): 807-816.   DOI: 10.31083/j.rcm2203087
Abstract72)   HTML11)    PDF(pc) (1775KB)(121)       Save
Sudden cardiac death (SCD) is one of the most common causes of death in the world. Coronary heart disease (CHD) is the root cause of most patients with SCD, and myocardial infarction (MI) is the main cause of SCD among all types of CHD. Early identification of high-risk patients after an MI, and the application of related prevention strategies and disease-specific treatments will be the key to reduce SCD. The mechanism of SCD after MI varies over time, and the relevant risk prediction indicators are also dynamic and different. In the existing guidelines for MI patients, the static and slightly single stratification of primary (PP) and secondary (SP) prevention has significant room for improvement. The 1.5 primary prevention (1.5PP) is defined as patients with PP who also had the following risk factors: non-sustained ventricular tachycardia (NSVT), frequent premature ventricular contractions (PVCs), severe heart failure (left ventricular ejection fraction, LVEF <25%), and syncope or pre-syncope. The emergence of 1.5PP has provided a new method for the stratification and management of SCD after an MI.
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Intravenous morphine use in acute heart failure increases adverse outcomes: a meta-analysis
Yaowang Lin, Yang Chen, Jie Yuan, Xinli Pang, Huadong Liu, Shaohong Dong, Qiuling Chen
Reviews in Cardiovascular Medicine    2021, 22 (3): 865-872.   DOI: 10.31083/j.rcm2203092
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Intravenous morphine is a controversial treatment for acute heart failure (AHF). This study aimed to evaluate and compare the efficacy of intravenous morphine treatment vs. no morphine treatment in AHF patients. Relevant research conducted before June 2020 was retrieved from electronic databases. One unpublished study of our own was also included. Studies were eligible for inclusion if they compared AHF patients treated with intravenous morphine and patients who did not receive morphine. This meta-analysis included three propensity-matched cohorts and two retrospective analyses, involving a total of 149,967 patients (intravenous-morphine group, n = 22,072; no-morphine group, n = 127,895). There was a non-significant increase in the in-hospital mortality in the morphine group (combined odds ratio [OR] = 2.14, 95% confidence interval [CI]: 0.88–5.23, p = 0.095, I2 = 97.1%). However, subgroup analyse showed that the rate of in-hospital mortality with odds of 1.41 times more likely (95% CI: 1.11–1.80, p = 0.005, I2 = 0%) in those receiving vs. not receiving intravenous morphine. No significant correlation was found between intravenous morphine and invasive mechanical ventilation (OR = 2.19, 95% CI: 0.84–5.73, p = 0.10, I2 = 94.2%; subgroup analysis: OR = 2.24, 95% CI: 0.70–7.21, p = 0.176, I2 = 95.1%) or long-term mortality (hazard ratio = 1.15, 95% CI: 0.96–1.34, p = 0.335; I2 = 8.6%). The administration of intravenous morphine to patients with AHF may be related to in-hospital mortality, but not to invasive mechanical ventilation and long-term mortality.
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Effects of alirocumab on cardiovascular events and all-cause mortality: a systematic review and meta-analysis
Wanting Wang, Zhaoqiang Feng, Jinghui Bai
Reviews in Cardiovascular Medicine    2021, 22 (3): 873-881.   DOI: 10.31083/j.rcm2203093
Abstract74)   HTML14)    PDF(pc) (1446KB)(81)       Save
Evaluation of the effects of alirocumab on cardiovascular (CV) events, CV mortality and all-cause mortality. Data search was carried out using the Cochrane Library, PubMed, Web of Science and Embase. The search time is up to November 18, 2020. All randomized clinical trials (AEs) comparing alirocumab with placebo were searched. Meta-analysis was performed by Review Manager version 5.3 (The Cochrane Collaboration, Copenhagen, Denmark), and the heterogeneity between studies was tested by Cochrane's Q test and measured with I2 statistics. A total of 13 randomized controlled trials with 24,815 participants were included. Alirocumab usage can considerably lower the incidence of CV events when compared to the control group (risk ratio(RR) 0.89, 95% confidence interval(CI) 0.83–0.95). No significant difference in CV mortality between the two groups was observed (RR 0.87, 95% CI 0.74–1.04). Treatment with alirocumab has been associated with a major decrease in all-cause mortality compared to placebo (RR 0.80, 95% CI 0.66–0.96). The incidence of serious adverse events (AEs) was similar in the two groups (RR 0.94, 95% CI 0.90–0.99). Alirocumab can reduce CV events and all-cause mortality. The AEs were mild and tolerable.
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Association of polymorphisms in endothelial dysfunction-related genes with susceptibility to essential hypertension in elderly Han population in Liaoning province, China
Na Ta, Mengwei Liu, Yue Wang, Fanxin Zeng, Fangfang Nie, Mengke Shang, Xiaotong Wang, Yuetian Yang, Man Liang, Lu Wen, Lanxin Ou, Zhibin Yang, Wanyang Liu, Xiuping Liu
Reviews in Cardiovascular Medicine    2021, 22 (3): 895-901.   DOI: 10.31083/j.rcm2203096
Abstract59)   HTML7)    PDF(pc) (121KB)(90)       Save
Hypertension is a complex disease which is mainly influenced by genetic factors. Recently, genome-wide association study (GWAS) found three novel endothelial dysfunction-related sites: Vascular endothelial growth factor A (VEGFA) rs9472135, Faciogenital dysplasia 5 (FGD5) rs11128722, Zinc Finger C3HC-type Containing 1 (ZC3HC1) rs11556924. Endothelial dysfunction is one of the early events in pathophysiology of essential hypertension. To investigate the association of endothelial dysfunction-related genes with essential hypertension, we conducted a case-control study of 431 patients with hypertension and 345 controls. The polymorphisms were detected using Taqman Probe. The alleles and genotypes of ZC3HC1 rs11556924 and VEGFA rs9472135 were not statistically different between the two groups, while the allele of FGD5 rs11128722 was different [P = 0.045, OR = 1.265, 95% CI = (1.009–1.586)], especially in the male [P = 0.035, OR = 1.496, 95% CI = (1.037–2.158)]. Analyzing the different of genotype distribution of 3 SNPs in the two groups under different genetic models, the genotypes of FGD5 rs11128722 showed difference in male under dominant model [P = 0.049, OR = 1.610, 95% CI = (1.018–2.544)]. The polymorphism of FGD5 rs11128722 had a significant difference in Body Mass Index (BMI) among different genotypes; In the additive genetic model, BMI of GA genotype was higher than that of GG (P = 0.038); GA + AA was higher than GG in the dominant genetic model (P = 0.011). In our study, we found that the polymorphisms of VEGFA rs9472135 and ZC3HC1 rs11556924 may not significantly associated with the risk of essential hypertension, and FGD5 rs11128722 may increase the risk of it, especially in elderly men.
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Comparison of standard versus modified stenting technique for treatment of tapered coronary artery lesions
Dan Ke, Xi He, Chaogui Lin, Lianglong Chen
Reviews in Cardiovascular Medicine    2021, 22 (3): 931-938.   DOI: 10.31083/j.rcm2203101
Abstract23)   HTML2)    PDF(pc) (121KB)(70)       Save
Tapered coronary artery lesions (TCALs) are often seen clinically, optimal stenting of TCALs remains challengeable. This study sought to compare clinical outcomes between the modified single stenting (MSS) and conventional overlapped stenting (COS) in treatment of TCALs. 150 patients were treated with MSS (MSS group), another 150 patients were matched with propensity score matching from 5055 patients treated with COS (COS group). Quantitative coronary angiography was performed to measure minimal lumen diameter (MLD), late lumen loss (LLL). The primary endpoint was immediate angiographic success, one-year cumulative major cardiac adverse events (MACEs) composing cardiac death, target vessel myocardial infarction (TVMI), target lesion/vessel revascularization (TLR/TVR) or stent thrombosis (ST). Post-procedural in-stent MLD (2.96 ± 0.34 versus 3.08 ± 0.33, P = 0.004) was smaller and diameter stenosis (11.7 ± 4.0% versus 9.0 ± 4.8%, P = 0.003) was higher in MSS group than COS group. At 1-year follow-up, in-stent MLD (2.76 ± 0.38 mm versus 2.65 ± 0.60 mm, P = 0.003) was reduced, LLL (0.20 ± 0.26 mm versus 0.42 ± 0.48 mm, P = 0.001), diameter stenosis (24.02 ± 20.94% versus 19.68 ± 11.75%, P = 0.028) and binary restenosis (18.7% versus 10.0%, P = 0.047) were increased in COS group. Angiographic success (96.7% versus 98.0%, P = 0.723) was similar between MSS group and COS group. At 1-year, the cumulative MACEs (12.0% versus 22.7%, P = 0.022) and TLR/TVR (10.0% versus 18.7%, P = 0.047) were reduced in MSS group as compared to COS group, there was no difference in cardiac death, TVMI and ST between the groups. Compared to conventional overlapped stenting, modified single stenting for TCALs is associated with similar angiographic success, fewer one-year cumulative MACEs and less treatment cost.
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Abnormal expression of TGFBR2, EGF, LRP10, and IQGAP1 is involved in the pathogenesis of coronary artery disease
Yanwei Du, Yanan Hu, Naiyan Wen, Shuang Fu, Guorong Zhang, Li Li, Tiantian Liu, Xuejiao Lv, Wenfeng Zhang
Reviews in Cardiovascular Medicine    2021, 22 (3): 947-958.   DOI: 10.31083/j.rcm2203103
Abstract65)   HTML12)    PDF(pc) (3545KB)(91)       Save
Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. In this study, we investigated the pathogenesis of CAD. We downloaded the GSE98583 dataset, including 12 CAD samples and 6 normal samples, from the Gene Expression Omnibus (GEO) database and screened differentially expressed genes (DEGs) in CAD versus normal samples. Next, we performed functional enrichment analysis, protein-protein interaction (PPI) network, and functional module analyses to explore potential functions and regulatory functions of identified DEGs. Next, transcription factors (TFs) and microRNAs (miRNAs) targeting DEGs were predicted. In total, 456 DEGs were identified in CAD and normal samples, including 175 upregulated and 281 downregulated genes. These genes were enriched in the intestinal immune network for immunoglobulin A production and the mitogen-activated protein kinase signaling pathway (e.g., TGFBR2 and EGF). The PPI network contained 212 genes, and HIST1H2BJ, HIST1H2AC, EGF, and EP300 were hub genes with degrees higher than 10. Four significant modules were identified from the PPI network, with genes in the modules mainly enriched in the inflammatory response, protein ubiquitination involved in ubiquitin-dependent protein catabolic processes, protein transport, and mitochondrial translational elongation, respectively. Two TFs (E2F1 and FOXK1) and five miRNAs (miR-122A, miR-516-5P, miR-507, miR-342, and miR-520F) were predicted to target 112 DEGs. miR-122A reportedly targets both LRP10 and IQGAP1 in the TF-miRNA target regulatory network. The abnormal expression of TGFBR2, EGF, LRP10, and IQGAP1 may be implicated in CAD pathogenesis. Our study provides targets and potential regulators for investigating CAD pathogenesis.
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Validity of SOFA score as a prognostic tool for critically ill elderly patients with acute infective endocarditis
Yaowang Lin, Feng Liu, Shuying Gong, Bihong Liao, Huadong Liu, Jie Yuan, Danqing Yu, Haiyan Qin, Meishan Wu, Shaohong Dong
Reviews in Cardiovascular Medicine    2021, 22 (3): 967-973.   DOI: 10.31083/j.rcm2203105
Abstract40)   HTML6)    PDF(pc) (795KB)(74)       Save
The prognostic value of the sequential organ failure assessment (SOFA) score for critically ill elderly patients with acute infective endocarditis (IE) remains unknown. From January 2015 to December 2019, 111 elderly (≥65 years) patients with acute IE were consecutively included and divided into a low SOFA (<6) group (n = 71) and a high SOFA (≥6) group (n = 40). Endpoints included in-hospital and long-term (12–36 month) mortality. A high SOFA score was related to higher incidence of in-hospital mortality (30.0%) with an area under the curve (AUC) of 0.796. In multivariate analysis, age [odds ratio (OR) = 2.21, 95% confidence intervals (CI), 1.16–6.79, p = 0.040], SOFA ≥6 (OR = 6.38, 95% CI, 1.80–16.89, p = 0.004) and surgical treatment (OR = 0.21, 95% CI, 0.05–0.80, p = 0.021) were predictive of in-hospital mortality. A Cox proportional-hazards model identified age [Hazard ratios (HR)= 2.85, 95% CI, 1.11–7.37, p = 0.031], diabetes mellitus (HR = 3.99, 95% CI, 1.35–11.80, p = 0.013), SOFA ≥6 (OR = 3.38, 95% CI, 1.26–9.08, p = 0.001) and surgical treatment (HR = 0.24, 95% CI, 0.08–0.68, p = 0.021) as predictors of long-term mortality. A high SOFA score predicts a poor outcome including in-hospital and long-term mortality in critically ill elderly patients with acute IE.
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Trends and distribution of coronary heart disease mortality rate in Hexi Corridor, Gansu, China from 2006 to 2015
Xinghui Li, Zhihe Da, Xiaolan Ren, Yan Qiao, Ping Xie, Xiaolong Sun, Lijun Wang, Junxian Han, Yongfeng Hua
Reviews in Cardiovascular Medicine    2021, 22 (3): 1003-1008.   DOI: 10.31083/j.rcm2203109
Abstract28)   HTML4)    PDF(pc) (600KB)(82)       Save

This study described the trend and distribution of coronary heart disease (CHD) in the Hexi Corridor region of Gansu. The CHD mortality rates from 2006–2015 were obtained through the Death Reporting System of Gansu Centers for Disease Control (CDC) for 2006–2015. The overall mortality rate of CHD in the Hexi Corridor showed a decreasing trend, increasing in winter and spring and lowest in summer. The CHD mortality rate was higher in men than in women (P < 0.05) and increased with age (P < 0.05). The mortality rate was higher in rural areas than in urban areas (P < 0.05). A ten-year mortality rate trend analysis showed that CHD mortality rate in women has significantly decreased. Specifically, women aged 18–39 years experienced increased There was little change in CHD mortality among women aged 40–59 years, and a declined in CHD mortality among women 60 years and older and women in urban areas. Further analysis showed that in the 18–39-year-old and 40–59-year-old groups and in urban areas, CHD mortality rate was higher in men than in women (P < 0.05). From 2006 to 2015, the mortality rate of CHD in the Hexi Corridor of Gansu was lower than in the national average, but in certain populations such as men, young and middle-aged group and rural areas, the CHD mortality rate was gradually increased. There has been a gradual and progressive decline in CHD mortality rate compared to the rising trend in China. This is due to fewer risk factors in the region, effective drug treatment and improvements in environmental pollution. However, there is still a need to enhance the experience of effective prevention and control for specific subgroups such as men, young people and rural residents, and to take appropriate measures to prevent the occurrence of CHD.

Table and Figures | Reference | Related Articles | Metrics
Predictive and prognostic value of v-set and transmembrane domain-containing 1 expression in monocytes for coronary artery disease
Xiao-Fei Wang, Meng-Cheng Xu, Cheng-Yu Mao, En-Zhou, Qing He, Xing-Qian Qu, Yu-Qi Fan, Chang-Qian Wang, Jun-Feng Zhang
Reviews in Cardiovascular Medicine    2021, 22 (3): 1009-1017.   DOI: 10.31083/j.rcm2203110
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The aim of this study was to investigate the correlation between v-set and transmembrane domain-containing 1 (VSTM1) expression and incidence of major adverse cardiac events (MACE) in patients with coronary heart disease (CHD). A total of 310 patients were divided into a non-acute coronary syndrome (non-ACS) group (containing the stable angina group, and the asymptomatic coronary artery diseaseand other patients group) and an ACS group (containing unstable angina and acute myocardial infarction patients). Monocytic VSTM1 expression levels (assessed via average fluorescence intensity derived from antibody binding to VSTM1) in each group were detected and analyzed. The cut-off value of monocytic VSTM1 expression to predict the onset of ACS and MACE was confirmed. VSTM1 expression in monocytes from the ACS group was lower than that of the non-ACS group. The incidence of MACEs in the high VSTM1-expression group was much less than that of those in the low VSTM1 expression group at the 1 year follow-up stage. VSTM1 expression had an independent-inversed association with increased incidence of MACE and ACS. VSTM1 expression in monocytes may help to predict the occurrence of ACS in patients with CHD, and moreover it may provide the means to evaluate MACE prognosis during CHD patient follow-up.

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Simulation of anticoagulation in atrial fibrillation patients with rivaroxaban—from trial to target population
Chi Zhang, Wei-Wei Wang, Mang-Mang Pan, Zhi-Chun Gu
Reviews in Cardiovascular Medicine    2021, 22 (3): 1019-1027.   DOI: 10.31083/j.rcm2203111
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The populations included in the randomized controlled clinical trials and observational studies were different. The effectiveness and safety of rivaroxaban for stroke prevention in patients with atrial fibrillation (AF) varied among studies. This study aimed to estimate the real-world outcomes of rivaroxaban in patients with AF accurately. A discrete event simulation (DES) was used to predict the counterfactual results of the ROCKET AF study. The hypothetical cohorts of patients were generated using Monte Carlo simulation according to the baseline covariate distributions that matched the marginal distribution of covariates reported in the ROCKET AF and three observational studies. The DES model structure was constructed based on a priori knowledge about disease progression and possible outcomes of patients with AF. The DES model accurately replicated the overall results of the ROCKET AF study. Both predicted stroke/systematic embolism (SE) and major bleeding rates were lower in the three observational studies than in the simulated ROCKET AF study. The risk difference of stroke/SE and major bleeding was not significant among the predicted outcomes of the three observational studies. Although some differences existed in the absolute rates of stroke/SE and major bleeding between observed and simulated studies, the results confirmed that rivaroxaban was noninferior to warfarin for the prevention of stroke/systematic embolism with no significance in the risk of major bleeding in large AF populations, which was similar to the results of ROCKET AF.

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Endovascular repair of traumatic aortic dissection: a single-center experience
Yingliang Wang, Tongqiang Li, Jiacheng Liu, Qin Shi, Chen Zhou, Chongtu Yang, Songjiang Huang, Yang Chen, Bin Xiong
Reviews in Cardiovascular Medicine    2021, 22 (3): 1029-1035.   DOI: 10.31083/j.rcm2203112
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The data on endovascular aortic repair (EVAR) for traumatic aortic dissection (TAD) are lacking. Hence, this study aimed to evaluate the efficacy of EVAR for TAD and report our experience based on patients from our medical center with a relatively long follow-up. A total of 25 consecutive patients with TAD underwent EVAR from October 2015 to October 2020. The demographics, imaging characteristics, clinical features, treatment details, and follow-up results were reviewed. Urgent EVAR was performed in 3 patients (12%), while the remaining 22 patients (88%) underwent delayed EVAR. Systematic heparinization was used in all patients during the endovascular procedure. The EVAR was technically successful in all patients, with no cases converted into open surgery. No death occurred during the perioperative period. One patient presented with a type II endoleak on postoperative 1-month CT images during a mean follow-up of 42.3 ± 17.7 months (5–67.5 months) and showed spontaneous regression of the endoleak without any intervention during the subsequent follow-up. All the patients survived until the time of writing, and none of them showed late endoleak, stent migration, paraplegia, and reintervention. The patients with left subclavian artery covered (n = 8) had no obvious ischemia of the arm and brain. The study results demonstrated that EVAR for TAD proved to be safe and effective, and most patients could undergo delayed EVAR. Systematically heparinization during EVAR under the setting of multi-trauma was safe.

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Histone deacetylase inhibitor, mocetinostat, regulates cardiac remodelling and renin-angiotensin system activity in rats with transverse aortic constriction-induced pressure overload cardiac hypertrophy
Gun Jik Kim, Hanna Jung, Eunjo Lee, Sung Woon Chung
Reviews in Cardiovascular Medicine    2021, 22 (3): 1037-1045.   DOI: 10.31083/j.rcm2203113
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Histone deacetylase (HDAC) inhibitors have shown cardioprotective or renoprotective effects in various animal models. Our study proposed that the HDAC inhibitor, mocetinostat, regulates cardiac remodelling and renin-angiotensin system (RAS) activity in rats with transverse aortic constriction (TAC)-induced pressure overload cardiac hypertrophy. Cardiac remodelling was evaluated using echocardiography. Cardiac hypertrophy was visualized with haematoxylin and eosin staining, and related gene (Nppa and Nppb) expression was quantified by quantitative real-time polymerase chain reaction (qRT-PCR). Cardiac and renal fibrosis were visualized with picrosirius red and trichrome staining, respectively. Fibrosis related gene (Collagen-1, Collagen-3, Ctgf, and Fibronectin) expression was determined by qRT-PCR. Serum concentrations of RAS components (renin, angiotensin II, and aldosterone) were quantified by enzyme-linked immunosorbent assay and related gene (Renin and Agtr1) expression was determined by qRT-PCR. TAC-induced pressure overload cardiac hypertrophy, which mimics hypertensive heart disease, increased cardiac remodelling, cardiac hypertrophy, and fibrosis in our rat models. Upon treatment with mocetinostat, there was a significant regression in cardiac remodelling, cardiac hypertrophy, and fibrosis in TAC rats. Additionally, pressure overload-induced renal fibrosis and activity of RAS-related components were increased in TAC rats, and were decreased on treatment with mocetinostat. The present study indicates that mocetinostat, an HDAC inhibitor, has cardiorenal protective effects in rats with TAC-induced pressure overload cardiac hypertrophy and offers a promising therapeutic agent for hypertension-related diseases.

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