LncRNA SNHG1 exerts a protective role in cardiomyocytes hypertrophy via targeting miR‐15a‐5p/HMGA1 axis

Heart failure preceded by pathological cardiac hypertrophy is a leading cause of death. Long noncoding RNA small nucleolar RNA host gene 1 (SNHG1) was reported to inhibit cardiomyocytes apoptosis, but the role and underlying mechanism of SNHG1 in pathological cardiac hypertrophy have not yet been understood. This study was designed to investigate the role and molecular mechanism of SNHG1 in regulating cardiac hypertrophy. We found that SNHG1 was upregulated during cardiac hypertrophy both in vivo (transverse aortic constriction treatment) and in vitro (phenylephrine [PE] treatment). SNHG1 overexpression attenuated the cardiomyocytes hypertrophy induced by PE, while SNHG1 inhibition promoted hypertrophic response of cardiomyocytes. Furthermore, SNHG1 and high‐mobility group AT‐hook 1 (HMGA1) were confirmed to be targets of miR‐15a‐5p. SNHG1 promoted HMGA1 expression by sponging miR‐15a‐5p, eventually attenuating cardiomyocytes hypertrophy. There data revealed a novel protective mechanism of SNHG1 in cardiomyocytes hypertrophy. Thus, targeting of SNHG1‐related pathway may be therapeutically harnessed to treat cardiac hypertrophy.     

Outflow-tract ventricular tachycardia: Can 12 lead ECG during sinus rhythm identify underlying cardiac sarcoidosis?

BackgroundPatients with outflow tract ventricular tachycardia (OTVT) with normal echocardiogram are labeled as idiopathic VT (IVT). However, a subset of these patients is subsequently diagnosed with underlying cardiac sarcoidosis (CS). Objective:Whether electrocardiogram (ECG) abnormalities in sinus rhythm (SR) can differentiate underlying CS from IVT.MethodsWe retrospectively analyzed the SR-ECGs of 42 patients with OTVT/premature ventricular complexes (PVC) and normal echocardiography. All underwent advanced imaging with cardiac magnetic resonance (CMR)/¹⁸FDG PET-CT for screening of CS. Twenty-two patients had significant abnormalities in cardiac imaging and subsequently had biopsy-proven CS (Cases). Twenty patients had normal imaging and were categorized as IVT (Controls). SR-ECGs of all patients were analyzed by 2 independent, blinded observers.ResultsBaseline characteristics were comparable. Among the ECG features analyzed – fascicular (FB) or bundle branch block (BBB) was seen in 9/22 Cases vs. 1/20 controls (p = 0.01). Among patients without FB or BBB, fragmented QRS (fQRS) was present in 9/13 cases but in none of the controls (p < 0.001). Low voltage QRS was more often seen among cases as compared to controls (10/22 vs. 3/20 p = 0.03). A stepwise algorithm based on these 3 sets of ECG findings helped to diagnose CS among patients presenting with OTVT/PVC with sensitivity of 91%, specificity of 75%, a PPV of 80%, and a NPV of 88%.ConclusionsIn patients presenting with OTVT/PVC: FB/BBB, fQRS, and low QRS voltage on the baseline ECG were more often observed among patients with underlying CS as compared to true IVT. These findings may help to distinguish underlying CS among Cases presenting with OTVT/PVC.     

Machine Learning Approach to Detect Cardiac Arrhythmias in ECG Signals: A Survey

Cardiac arrhythmia is a condition when the heart rate is irregular either the beat is too slow or too fast. It occurs due to improper electrical impulses that coordinates the heart beats. Sudden cardiac death may occurs due to some dangerous arrhythmias conditions. Hence the main objective of the electrocardiogram (ECG) analysis is to detect the life-threatening arrhythmias accurately for appropriate treatment in order to save life. Since the last decades, several methods were reported for automatic ECG beat classifications. In this work, we present a systematic review of the current state-of-the-art methods used to detect cardiac arrhythmia using on ECG signals. It includes the signal decomposition, feature extraction and machine learning approaches used for automatic detection and decision making process. The articles covers the pre-processing, detection of QRS complex, feature extraction and classification of ECG beats. Based on the past studies, it is understood that the automated approach using computer-aided decision making process is highly required for real-time detection of cardiac arrhythmias. The advantages and limitations of different methods are discussed and also the future scopes is highlighted in the process of effective detection of cardiac arrhythmias. This study could be beneficial for researchers to analyze the existing state-of-art techniques used in detection of arrhythmia conditions.     

益心康泰胶囊联合硫氮唑酮对不稳定型心绞痛患者心功能及血清ET-1、Hcy、cTnT水平的影响

摘要 目的：探讨益心康泰胶囊联合硫氮唑酮对不稳定型心绞痛（UAP）患者心功能及血清ET-1、Hcy、cTnT水平的影响。方法：选择2019年3月到2021年3月期间在我院接受治疗的UAP患者84例,按照随机数字表法分为研究组和对照组各42例,对照组给予阿司匹林、硝酸酯类、?茁-受体阻滞剂及他汀类药物等常规治疗,研究组在其基础上给予益心康泰胶囊联合硫氮唑酮治疗,两组均治疗30 d。对比两组患者的心绞痛疗效、心功能指标、血清学指标、心绞痛发作次数和持续时间、不良反应发生率。结果：研究组临床总有效率高于对照组（P<0.05）。研究组治疗后的QT间期离散度(QTd)、左室舒张末径(LVEDD)、左室收缩末径(LVESD)均低于对照组,而左室射血分数(LVEF)高于对照组 (P<0.05)。治疗后研究组心绞痛发作次数和持续时间均低于对照组（P<0.05）。治疗后研究组患者的血管内皮素1(ET-1)、同型半胱氨酸(Hcy)、心肌肌钙蛋白T(cTnT)水平均低于对照组(P<0.05)。两组不良反应总发生率无明显差异（P>0.05）。结论：益心康泰胶囊联合硫氮唑酮治疗UAP患者疗效较好,能减少患者心绞痛持续时间和发作次数,增强患者的心功能,降低ET-1、Hcy、cTnT水平,且具有较好的安全性,具有一定临床应用价值。     

冠状动脉磁共振血管成像和CT对可疑冠心病患者心脏事件的预测价值的比较研究

摘要 目的：探讨与比较冠状动脉核磁共振(MR)血管成像和CT对可疑冠心病患者心脏事件的预测价值。方法：2018年4月到2020年10月选择在本院诊治的103例可疑冠心病患者作为研究对象,所有患者都给予冠状动脉MRI血管成像与64层螺旋CT冠状动脉成像检查,记录影像学特征。随访患者的预后并进行预测价值分析。结果：103例可疑冠心病患者随访到2021年4月1日,发生心血管不良终点事件23例(不良事件组),发生率为22.3%。不良事件组的MRI血管成像显示右冠状动脉血管长度与内径都低于非不良事件组(P<0.05)。不良事件组的CT显示斑块率、斑块性质等与非不良事件组对比差异有统计学意义(P<0.05),两组斑块位置对比差异无统计学意义(P>0.05)。多因素Cox回归分析显示斑块性质、斑块率、右冠状动脉血管长度与内径都为导致心血管不良终点事件的重要因素(P<0.05)。结论：冠状动脉MRI血管成像和CT都可有效预测可疑冠心病患者心脏事件发生情况,能满足临床诊断可疑冠心病与预测预后的要求。     

LncRNA Kcnq1ot1/miR-214-3p/caspase-1通路调控高糖处理的心脏成纤维细胞焦亡

摘要 目的：探讨长链非编码RNA Kcnq1ot1在高糖处理的心脏成纤维细胞中调控焦亡的作用及具体机制。方法：培养C57BL/6乳鼠原代心脏成纤维细胞,分别用5.5 mM和30 mM葡萄糖培养,用免疫荧光、qRT-PCR和western blot方法检测NLRP3、caspase-1和IL-1β的表达。高糖处理的成纤维细胞抑制Kcnq1ot1,检测caspase-1的表达。生物信息学和荧光素酶报告基因检测验证与Kcnq1ot1和caspase-1存在共同互补结合位点的microRNA。应用qRT-PCR和western blot方法检测高糖诱导的心脏成纤维细胞干扰Kcnq1ot1后miR-214-3p的表达,以及过表达或干扰miR-214-3p后caspase-1的表达水平。高糖诱导的细胞单独干扰Kcnq1ot1或同时抑制Kcnq1ot1和miR-214-3p,检测caspase-1、NLRP3和IL-1?茁的表达水平。结果：高糖诱导的成纤维细胞中焦亡激活,Kcnq1ot1表达明显升高;抑制Kcnq1ot1后caspase-1表达显著下调。生物信息学和荧光素酶报告基因检测发现miR-214-3p与Kcnq1ot1和caspase-1存在共同互补结合位点。高糖诱导的心脏成纤维细胞干扰Kcnq1ot1后miR-214-3p表达升高;过表达 miR-214-3p 后caspase-1表达降低,抑制miR-214-3p后caspase-1表达升高。同时抑制Kcnq1ot1和miR-214-3p可逆转干扰Kcnq1ot1对caspase-1的降低作用。结论：干扰Kcnq1ot1能够通过抑制miR-214-3p/caspase-1信号转导通路,抑制高糖诱导的心脏成纤维细胞焦亡。     

老年慢性心力衰竭患者甲状腺激素水平与认知功能、心功能及心血管事件的关系研究

摘要 目的：探讨老年慢性心力衰竭（CHF）患者甲状腺激素（TH）水平与认知功能、心功能及心血管事件的关系。方法：将我院2018年6月～2020年6月收治的140例老年CHF患者纳入研究,检测患者TH指标[血清三碘甲状腺原氨酸（T₃）、游离三碘甲状腺原氨酸（FT₃）、甲状腺素（T₄）、游离甲状腺素（FT₄）、促甲状腺激素（TSH）]水平。按蒙特利尔认知评估量表（MoCA）评分将患者分为认知障碍组（MoCA评分＜26分）、非认知障碍组（MoCA评分≥26分）,比较两组各TH指标与MoCA评分。比较不同纽约心脏病协会（NYHA）分级患者的TH指标与心功能指标[左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）]。根据患者住院期间是否发生心血管事件分为心血管事件组和非心血管事件组,比较两组各TH指标。经Pearson线性相关分析TH指标与MoCA评分、心功能指标的相关性。结果：认知障碍组血清T₃、FT₃水平及MoCA评分较非认知障碍组明显降低（P＜0.05）。Ⅲ级、Ⅳ级组的血清T₃、FT₃水平及LVEF较Ⅰ级、Ⅱ级组显著降低,其中Ⅳ级组低于Ⅲ级组（P＜0.05）。Ⅲ级、Ⅳ级组的LVEDD、LVESD较Ⅰ级、Ⅱ级组明显升高,且Ⅳ级组高于Ⅲ级组（P＜0.05）。心血管事件组血清T₃、FT₃水平较非心血管事件组显著降低（P＜0.05）。Pearson线性相关分析显示：血清T₃、FT₃水平与MoCA评分、LVEF呈正相关（均P＜0.05）,与LVEDD、LVESD呈负相关（均P＜0.05）。结论：老年CHF患者血清T₃、FT₃水平下调与其认知功能、心功能降低及心血管事件的发生密切相关,通过检测其血清T₃、FT₃水平,有利于进一步了解其病情变化。     

Pyridostigmine improves cardiac function and rhythmicity through RyR2 stabilization and inhibition of STIM1-mediated calcium entry in heart failure

Heart failure (HF) is characterized by asymmetrical autonomic balance. Treatments to restore parasympathetic activity in human heart failure trials have shown beneficial effects. However, mechanisms of parasympathetic-mediated improvement in cardiac function remain unclear. The present study examined the effects and underpinning mechanisms of chronic treatment with the cholinesterase inhibitor, pyridostigmine (PYR), in pressure overload HF induced by transverse aortic constriction (TAC) in mice. TAC mice exhibited characteristic adverse structural (left ventricular hypertrophy) and functional remodelling (reduced ejection fraction, altered myocyte calcium (Ca) handling, increased arrhythmogenesis) with enhanced predisposition to arrhythmogenic aberrant sarcoplasmic reticulum (SR) Ca release, cardiac ryanodine receptor (RyR2) hyper-phosphorylation and up-regulated store-operated Ca entry (SOCE). PYR treatment resulted in improved cardiac contractile performance and rhythmic activity relative to untreated TAC mice. Chronic PYR treatment inhibited altered intracellular Ca handling by alleviating aberrant Ca release and diminishing pathologically enhanced SOCE in TAC myocytes. At the molecular level, these PYR-induced changes in Ca handling were associated with reductions of pathologically enhanced phosphorylation of RyR2 serine-2814 and STIM1 expression in HF myocytes. These results suggest that chronic cholinergic augmentation alleviates HF via normalization of both canonical RyR2-mediated SR Ca release and non-canonical hypertrophic Ca signaling via STIM1-dependent SOCE.     

心脏手术后视幻觉发生与肠道菌群变化的研究

目的探究心脏术后患者视幻觉症状发生情况及体内肠道菌群变化。方法选取2020年1月-2021年1月中国科学院大学宁波华美医院接受择期体外循环心脏手术的成年患者21例作为研究对象。分别在术前、术后第1次或第2次排便、术后6～8 d进行微生物分析和粪便短链脂肪酸(SCFAs)浓度测定。采用实时荧光定量PCR法检测肠道菌群组成,高效液相色谱检测SCFAs。术后1周进行视幻觉评价。结果21例患者中,视幻觉3例。与术前相比,术后第1和第2份粪便样本的微生物总数显著降低(P<0.05)。在专性厌氧菌中,第一次术后粪便样本中的球形梭菌数量、柔嫩梭菌数量显著低于术前样本。兼性厌氧菌中,术后第1次和第2次标本的乳酸杆菌总数均显著降低。植物乳杆菌数量在第1次术后粪便样本中较低。L. sakei数量在第2次术后标本中明显下降。术后第1次粪便样本中肠杆菌科的数量明显高于术前样本。与术前相比,术后第1次粪便样本中的肠球菌数量显著升高。术后第2次粪便标本中葡萄球菌数量明显高于术前标本。术后视幻觉组葡萄球菌数量明显高于非视幻觉组,第2次术后粪便样本中术后视幻觉组葡萄球菌数量也明显高于非幻视觉组。视幻觉组的假单胞菌数量明显高于非视幻觉组和术后第2次粪便样本。术后第1次粪便标本中,视幻觉组肠杆菌数量高于非视幻觉组。视幻觉组术后第一次粪便样本中总SCFAs浓度显著低于非视幻觉组。以上差异均具有统计学意义(P<0.05)。结论心脏手术后视幻觉的发生与肠道菌群变化存在一定联系,表现为肠道内肠杆菌科和肠球菌属数量增多,乳杆菌数量降低,同时还伴随着SCFAs浓度的降低。     

人成体心源间充质样细胞表型分析及向心脏谱系诱导分化潜能的研究

目的探讨成人心源性间充质样细胞 (CDMCs)的分子表型及向心脏谱系的分化潜能。方法实验分为:不同培养时间CDMCs (第3、5、7代),并以脐带间充质干细胞 (UCMSCs)为对照。分析各细胞分子表型并向心脏谱系诱导分化。显微镜观察细胞形态;计算生长倍增时间并绘制细胞生长曲线;流式细胞术分析表面标志抗原表达;实时定量PCR和Western blot分别测干细胞多能分子及组织特异性分子mRNA和蛋白表达。结果采用重复测量资料方差分析、单因素方差分析和配对t检验。结果 CDMCs具有UCMSCs形态特征与增殖能力,体外培养1 ~ 7 d,与UCMSCs比较,P3、5、7代CDMCs增殖能力差异无统计学意义 (P> 0.05)。与UCMSCs相比,不同培养时间CDMCs表面标志抗原 (CD90)表达 (冻存前:97.13%±2.00%比59.87%±34.14%、38.83%±11.04%、34.77±14.78%;冻存后:99.83%±0.17%比56.00%±19.47%、47.48±11.88%、41.15±8.68%)降低(P< 0.05)。与UCMSCs相比,不同培养时间CDMCs中Rex1 (0.00±0.00比0.68±0.50、0.29±0.17、0.38±0.50)、Oct3/4 (1.00±0.02比5.28±0.78、3.88±0.95、3.63±0.34)、Nanog(1.00±0.16比7.57±4.69、5.40±3.58、5.34±0.76)以及心脏特异转录因子Nkx2.5 (1.00±0.12比30.60±22.43、19.69±9.65、8.82±4.94)、Gata4 (1.00±0.85比60467±25266、44350±25800、35067±23113)表达均增高,差异有统计学意义 (P均< 0.05)。与诱导前比较,向心肌诱导分化15 d后,不同培养时间CDMCs中cTnT蛋白表达水平 (0.40±0.13比0.98±0.16、0.38±0.18 比0.69±0.15、0.17±0.11比0.70±0.17)增高 (P< 0.05)。结论 CDMCs不仅具备部分干细胞和间充质细胞表型,还具有心脏组织特异性。其具备心脏谱系分化潜能,心肌细胞分化能力可能优于UCMSCs。