Age-related changes of elements in thoracic and abdominal aortas and coronary, common carotid, pulmonary, splenic, common iliac, and uterine arteries and relationships in elements among their arteries

To elucidate whether the accumulation of elements occurred simultaneously in the various arteries with aging, the authors investigated age-related changes of elements in the eight arteries, such as the thoracic and abdominal aortas and the coronary, common carotid, pulmonary, splenic, common iliac, and uterine arteries, and the relationships in the element contents among their arteries. After ordinary dissection by medical students was finished, the thoracic and abdominal aortas and the coronary, common carotid, pulmonary, splenic, common iliac, and uterine arteries were resected from the subjects, who ranged in age from 58 to 94 yr. The element contents were analyzed by inductively coupled plasma-atomic emission spectrometry. It was found that the accumulation of Ca was the highest in the common iliac artery and decreased in the order of the uterine artery, abdominal aorta, coronary artery, thoracic aorta, splenic artery, common carotid artery, and pulmonary artery. Regarding the relationships in the element contents among the eight arteries, it was found that there were significant direct correlations in the contents of Ca, P, Mg, Zn, Fe, and Na between the coronary and splenic arteries, and there were significant correlations in the contents of Ca, P, and Mg between the abdominal aorta and pulmonary artery.     

盆腔疾病髂内动脉栓塞术的研究进展

髂内动脉栓塞是盆腔出血性疾病和肿瘤治疗的重要治疗方法,常规采用Seldinger技术,从一侧股动脉径路两侧髂内动脉选择性与超选择性插管。髂内动脉是盆腔脏器主要供血来源,根据数字减影动脉造影术（Digital subtraction arteriography,DSA）功能可分为：常规DSA,旋转DSA,平板数字减影旋转血管造影与三维血管重建和路图技术。栓塞剂可分为颗粒型和液态型栓塞剂。本文综述了盆腔疾病髂内动脉栓塞术近年来的研究进展。     

Serum antibody titers against heat shock protein 27 are associated with the severity of coronary artery disease

Antibody titers to several heat shock proteins (anti-Hsps) have been reported to be associated with the severity and progression of cardiovascular disease. However, there are little data regarding anti-Hsp27 titers in patients with coronary artery disease (CAD). A total of 400 patients with suspected CAD were recruited. Based on the results of coronary angiography, these patients were classified into CAD⁺ (n = 300) and CAD⁻ (n = 100) groups defined as patients with ≥50% and <50% stenosis of any major coronary artery, respectively. Eighty-three healthy subjects were also recruited as the control group. Serum anti-Hsp27 IgG titers were measured using an in-house enzyme-linked immunosorbent assay. CAD⁺ patients had significantly higher anti-Hsp27 titers compared with both CAD⁻ and control groups. Anti-Hsp27 titers were also higher in the CAD⁻ group compared with the control group. With regard to the number of affected vessels in the CAD⁺ group, patients with three-vessel disease had higher anti-Hsp27 titers compared with both two-vessel disease (2VD) and one-vessel disease (1VD) subgroups. However, there was no significant difference between 1VD and 2VD subgroups. In multiple linear regression analysis, the number of narrowed vessels and smoking were significant independent determinants of serum anti-Hsp27 titers. The present findings indicate that serum anti-Hsp27 titers may be associated with the presence and severity of coronary artery disease.     

川崎病患儿肠道菌群构成及分布与其冠状动脉病变的相关性分析

摘要 目的：分析川崎病患儿肠道菌群构成及分布与其冠状动脉病变的相关性。方法：选择我院自2020年1月至2023年2月接诊的86例川崎病患儿作为研究对象,根据是否出现冠状动脉病变,分为冠状动脉病变组（35例）和非冠状动脉病变组（51例）。检测所有患儿的肠道菌群多样性[肠道菌群丰度（Ace指数）、肠道菌群多样性（Shannon指数）]、肠道菌群构成比例[门水平（变形菌门、厚壁菌门、拟杆菌门）、属水平（乳杆菌属、拟杆菌属、韦荣球菌属）],使用多因素Logistic回归分析肠道菌群构成及分布与冠状动脉病变的关系。结果：冠状动脉病变组Ace指数大于非冠状动脉病变组（P＜0.05）;冠状动脉病变组与非冠状动脉病变组的Shannon指数比较无差异（P＞0.05）;冠状动脉病变组肠道厚壁菌门占比低于非冠状动脉病变组,拟杆菌门占比高于非冠状动脉病变组（P＜0.05）;冠状动脉病变组与非冠状动脉病变组的肠道变形菌门占比比较无差异（P＞0.05）;冠状动脉病变组肠道乳杆菌属占比、韦荣球菌属占比均低于非冠状动脉病变组（P＜0.05）;冠状动脉病变组与非冠状动脉病变组的肠道拟杆菌属占比比较无差异（P＞0.05）;经多因素Logistic回归分析,肠道Ace指数、厚壁菌门、拟杆菌门、乳杆菌属、韦荣球菌属均是川崎病患儿发生冠状动脉病变的独立影响因素（P＜0.05）。结论：川崎病患儿肠道菌群构成及分布与其冠状动脉病变密切相关,为改善肠道菌群失调、增加患儿的临床获益提供依据,应引起临床重视。     

Toll-like receptor 8 polymorphism and coronary artery disease

Toll-like receptors (TLRs) play roles in innate and adaptive immune responses. Some TLRs are involved in the pathogenesis of cardiovascular diseases. Coronary artery disease (CAD) has an inflammatory and immunological basis. We investigated whether TLR8 Met1Val and TLR8-129G>C single nucleotide polymorphisms (SNPs rs3764879 and rs3764880) are associated with CAD in the Chinese population. We enrolled 412 consecutive patients (185 with coronary stenosis ≥50% or previous myocardial infarction and 227 controls). Ligase detection reaction was performed to detect SNPs rs3764879 and rs3764880 of TLR8. The SNP at rs3764879 is in complete linkage disequilibrium with rs3764880. No significant difference was found in genotypic or allelic frequencies of these two common SNPs between CAD cases and controls (P > 0.05, respectively). No associations existed between these two SNPs and the severity of coronary artery stenosis (All P > 0.05). These results do not support an involvement of SNPs rs3764879 and rs3764880 of TLR8 in predisposition to CAD. Z. Chen and G. Ma contributed equally to this paper.     

血清尿酸水平与冠心病的相关性研究

目的:众多关于血清尿酸水平与冠心病发展预后的相关性研究结果不一。本研究旨在通过对上海市第一人民医院入院患者的临床资料分析,研究血清尿酸水平与冠心病之间关系。方法:选择2008年7月至2009年4月上海地区、汉族就诊于我院的患者(123例),按入选排除标准,将入院患者分为冠心病组和对照组,分析尿酸水平与冠心病的关系。结果:男性(81.4%vs 51.6%)、吸烟(49.2%vs 21.9%)、血清尿酸水平升高(6.10±1.2 mg/dl vs 5.37±1.5 mg/dl)为冠心病的危险因素,统计值分别为0.02,0.02,0.005。血尿酸水平升高与血管病变严重程度成正相关,除单支血管病变外,双支血管病变患者尿酸水平为(6.11±1.07)mg/dl,对照组为(5.37±1.55)mg/dl,P0.05,三支病变患者尿酸水平为(6.84±1.29)mg/dl,P0.05。结论:血清尿酸水平升高与冠心病的发生、及病变严重程度密切相关。对冠心病患者的预防和治疗中,应重视对尿酸水平的监测。尿酸水平能否作为冠心病患者预后、转归的预测因子以及降低尿酸水平的治疗能否给冠心病患者带来收益有待进一步的研究。     

不同途径行PCI治疗高龄冠心病患者的临床疗效和安全性比较

目的:比较不同动脉途径行经皮冠状动脉介入(PCI)治疗高龄冠心病患者的临床疗效和安全性。方法:选取214例高龄冠心病患者,按动脉途径不同分为对照组(107例)与研究组(107例),对照组行经股动脉PCI(TFI),研究组行经桡动脉PCI(TRI),比较两组的手术情况、手术前后心功能相关指标的变化及不良反应的发生情况。结果:两组手术成功率、支架置入数量、造影剂用量比较无显著差异(P0.05);研究组动脉穿刺时间、导管插入时间、X线曝光时间均显著长于对照组(P0.05),术后卧床时间、住院时间均显著少于对照组(P0.05)。手术后1 d,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左心射血分数(LVEF)较手术前均明显改善,但两组比较无显著性差异(P0.05)。研究组治疗期间外周血管并发症的发生率显著低于对照组(P0.05),但治疗期间及术后6个月心血管不良事件的发生率与对照组间无显著差异(P0.05)。结论:经桡动脉途径与股动脉PCI用于治疗高龄冠心病患者对患者心功能的改善作用相当,但经桡动脉行PCI术后卧床时间及住院时间较短,外周血管并发症的发生率较低,安全性更高。     

A preliminary study of human paraoxonase and PON 1 L/M55–PON 1 Q/R 192 polymorphisms in Turkish patients with coronary artery disease

Paraoxonase 1 (PON 1) is a high‐density lipoprotein (HDL)‐associated enzyme with antioxidant function protecting low‐density lipoprotein (LDL) from oxidation. PON 1 has two amino acid polymorphisms in coding region; L/M 55 and Q/R 192. These polymorphisms modulate paraoxonase activity of the enzyme. PON 1 activity decreases in coronary artery disease (CAD). In the present study, distribution of PON 1 L/M 55 and Q/R 192 polymorphisms and the effect of these polymorphisms on the activities of PON 1, and on the severity of CAD in 277 CAD (+) patient and 92 CAD (?) subjects were examined. PON 1 L/M 55 and Q/R 192 genotypes were determined by PCR, RFLP and agarose gel electrophoresis techniques. Genotype distributions and allele frequencies for PON 1 Q/R 192 polymorphism were not significantly different between controls and CAD (+) patient group (p > 0.05), but in genotype and allele distribution of PON 1 L/M55 polymorphism, there was significantly difference among groups (p < 0.05). Genotype distributions for both polymorphisms were not significantly different between subgroups of single‐vessel disease (SVD), double‐vessel disease (DVD) and triple‐vessel disease (TVD). Serum PON 1 activity was lower in CAD (+) group than in controls and this was also statistically significant (p < 0.001). In both groups, the highest PON activities were detected in LL and RR genotypes. In summary, our results suggest that there is an association between the PON 1 L/M 55 polymorphism of paraoxonase and CAD in Turkish patients but not with PON 1 Q/R 192 polymorphism. However, it is hard to correlate these polymorphisms and severity of CAD. Copyright © 2009 John Wiley & Sons, Ltd.     

Promoter methylation and functional variants in arachidonate 5-lipoxygenase and forkhead box protein O1 genes associated with coronary artery disease

Coronary artery disease (CAD) is a multifactorial chronic inflammatory disease, which is the most common form of heart disease. This is one of the main causes of death in the United States. Inflammation is one of the key drivers of atherosclerotic plaque development. Forkhead box protein O1 (FOXO1s) family and 5-lipoxygenase make an important contribution to atherosclerosis. The aim of this study was to investigate the methylation pattern and polymorphism analysis of FOXO1 and arachidonate 5-lipoxygenase (ALOX5) promoter genes. We studied 50 patients with CAD and 50 age- and sex-matched healthy controls by high resolution melt technique. Overall, we found significant differences between patients and controls in terms of the promoter methylation of ALOX5 (P > 0.05). But there was no significant difference in FOXO1 promoter methylation between patient and controls. Single nucleotide polymorphisms genotyping of rs12762303 and rs2297627, in ALOX5 and FOXO1 genes were demonstrated a significant correlation between mutant allele and the risk of CAD, respectively. Furthermore, there were significant associations between CT + CC genotype and ALOX5 expression. Our findings demonstrated functional effects of single nucleotide polymorphisms (SNPs) and DNA methylation in ALOX5 on mentioned genes expression and they resulted in CAD progression.     

ST段抬高性和非ST 段抬高性急性心肌梗死患者的冠状动脉病变特点比较

目的:比较ST段抬高性和非ST段抬高性急性心肌梗死患者的冠状动脉病变特点。方法:选取100例在我院接受24h动态心电图和冠状动脉造影检查的急性心肌梗死患者,根据心电图结果分为观察组和对照组各50例。对照组为ST段抬高性心肌梗死(STEMI)患者,观察组为非ST段抬高性心肌梗死(NSTEMI)患者,比较两组患者冠状动脉病变的差异。结果:对照组LAD(左前降支)闭塞血管比例(52.00%)显著高于观察组(18.00%),差异具有统计学意义(P0.05)。对照组LCX(回旋支)闭塞血管比例(8.00%)显著低于观察组(50.00%),差异具有统计学意义(P0.05)。对照组RCA(右冠脉主干)闭塞血管比例(40.00%)和观察组(30.00%)比较,差异无统计学意义(P0.05)。对照组单支病变比例(46.00%)明显高于观察组(12.00%),对照组三支病变比例(20.00%)明显低于观察组(48.00%)比较,差异均具有统计学意义(P0.05)。对照组二支及正常血管比例与观察组比较,差异均无统计学意义(P0.05)。对照组罪犯血管狭窄程度在76%-90%、91%-99%及完全闭塞的比例与观察组比较差异均具有统计学意义(P0.05)。罪犯血管狭窄程度在50%及50%-75%时,两组差异无统计学意义(P0.05)。两组并发症发生情况比较,差异无统计学意义(P0.05)。结论:1NSTEMI罪犯血管闭塞以LCX多见,STEMI罪犯血管闭塞以LAD多见;2NSTEMI以三支血管病变较多见,STEMI以单支病变较多见。     

Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis

Although there is robust evidence that revascularisation of non-culprit vessels should be pursued in patients presenting with an acute coronary syndrome (ACS) and multivessel coronary artery disease (MVD), the optimal timing of complete revascularisation remains disputed. In this systematic review and meta-analysis our results suggest that outcomes are comparable for immediate and staged complete revascularisation in patients with ACS and MVD. However, evidence from randomised controlled trials remains scarce and cautious interpretation of these results is recommended. More non-biased evidence is necessary to aid future decision making on the optimal timing of complete revascularisation.Supplementary InformationThe online version of this article (10.1007/s12471-022-01687-7) contains supplementary material, which is available to authorized users.     

Coronary computed tomographic angiography as gatekeeper for new-onset stable angina

Patients with new-onset stable angina constitute a substantial part of the population seen by cardiologists. Currently, the diagnostic workup of these patients depends on the pre-test probability of having obstructive coronary artery disease. It consists of either functional testing for myocardial ischaemia or anatomical testing by using coronary computed tomographic angiography (CCTA) or invasive coronary angiography. In case the pre-test probability is > 5%, the current guidelines for the management of chronic coronary syndromes do not state a clear preference for one of the noninvasive techniques. However, based on the recently published cost-effectiveness analysis of the PROMISE trial and considering the diagnostic yield in patients with angina and nonobstructive coronary artery disease, we argue a more prominent role for CCTA as a gatekeeper for patients with new-onset stable angina.     

超声在完全与不完全川崎病患儿冠状动脉病变评估中的应用价值

摘要 目的：探讨超声在完全与不完全川崎病（Kawasaki Disease,KD）患儿冠状动脉病变（Coronary artery lesions,CAL）评估中的应用价值。方法：2019年6月到2021年5月选择在西安医学院第二附属医院住院诊治的83例川崎病患儿,其中完全川崎病患儿43例（完全组）,不完全川崎病患儿40例（不完全组）。所有患儿都给予超声检查,评估两组的临床表现、血液学指标、冠状动脉病变情况以及超声的诊断价值。结果：完全组的球结膜充血、皮疹、口唇破裂、手足硬肿、颈部淋巴结肿大等发生率高于不完全组（P>0.05）。两组的白细胞计数、血红蛋白对比差异有统计学意义（P<0.05）,C反应蛋白、血小板、白蛋白对比差异无统计学意义（P>0.05）。完全组的冠状动脉病变发生率为60.5 %,高于不完全组的27.5 %（P<0.05）。在83例患儿中,超声诊断为完全川崎病42例,不完全川崎病41例,超声对完全与不完全川崎病患儿的鉴别诊断敏感性与特异性为97.7 %（42/43）和100.0 %（40/40）。结论：完全与不完全川崎病患儿在临床表现、冠状动脉病变与实验室检测指标上都存在一定的差异,超声能鉴别诊断完全与不完全川崎病患儿的敏感性与特异性都比较好。     

Comparisons of predictive values of binary medical diagnostic tests for paired designs

Positive and negative predictive values of a diagnostic test are key clinically relevant measures of test accuracy. Surprisingly, statistical methods for comparing tests with regard to these parameters have not been available for the most common study design in which each test is applied to each study individual. In this paper, we propose a statistic for comparing the predictive values of two diagnostic tests using this paired study design. The proposed statistic is a score statistic derived from a marginal regression model and bears some relation to McNemar's statistic. As McNemar's statistic can be used to compare sensitivities and specificities of diagnostic tests, parameters that condition on disease status, our statistic can be considered as an analog of McNemar's test for the problem of comparing predictive values, parameters that condition on test outcome. We report on the results of a simulation study designed to examine the properties of this test under a variety of conditions. The method is illustrated with data from a study of methods for diagnosis of coronary artery disease.     

A common variant on chromosome 9p21 affects the risk of early-onset coronary artery disease

Background Two single nucleotide polymorphisms (SNPs, rs10757278 and rs2383207) on chromosome 9p21 have been proved to be associated with myocardial infarction. We investigated whether these two genetic markers are determinants of early-onset coronary artery disease. Methods and results A total of 444 consecutive patients were studied including 212 cases with coronary stenosis ≥50% or previous myocardial infarction and 232 controls without documented coronary artery disease. Ligase detection reaction was performed to detect two SNPs. After adjustment of clinical parameters, significant associations were identified for the rs2383207 and rs10757278 SNPs, with A/G and G/G genetypes at rs10757278 and G/G genetype carriers at rs2383207 having a higher risk of early-onset coronary artery disease than carriers of A/A genotype (odds ratio [OR] 2.207, 95% CI: 1.069–4.394, P = 0.028; OR 3.051, 95% CI: 1.086–8.567, P = 0.004; OR 2.964, 95% CI: 1.063–8.265, P = 0.038, respectively). There were no associations between rs10757278 and rs2383207 genotypes and the severity of coronary artery disease (both P > 0.05). Conclusions The rs10757278 and rs2383207 variants are determinants for early-onset coronary artery disease. These markers may help the identification of patients at increased risk for early-onset coronary artery disease. Zhong Chen and Qi Qian contributed equally to this paper.     

冠心病患者颈动脉粥样硬化与血管内皮功能的临床研究价值

目的:探讨颈动脉粥样硬化与血管内皮功能与冠心病患者的相关性。方法:选取114例冠心病患者(54例单支病变和60例多支病变)为观察组和60例健康体检者为对照组,对两组患者动脉粥样硬化及血管内皮功能进行分析。结果:观察组患者TC、TG、HDL及血糖水平均高于对照组,观察组LDL水平显著低于对照组,两组比较差异有统计学意义(P<0.05);观察组患者颈动脉IMT、斑块积分及斑块数明显高于对照组(P<0.05),观察组FMD显著降低(P<0.05),多支病变组病变程度更严重(P<0.05)。结论:颈动脉粥样硬化与血管内皮功能可作为预测冠心病的重要指标,对预防和治疗冠心病具有重要意义。     

Association of polymorphisms in the chemokine receptor CX3CR1 gene with coronary artery disease

Two chemokine receptor CX3CR1 gene variants, V249I and T280M, have been implicated in coronary artery diseases (CAD). Currently no consistent effect has been revealed and their role in cardiovascular disease is still conflicting. In the present study the association of CX3CR1 genotypes with CAD and myocardial infarction (MI) was investigated in the Ludwigshafen Risk and Cardiovascular Health (LURIC) cohort, including 3316 individuals in whom cardiovascular disease angiographically has been defined or ruled out. Similarly to previous studies, the alleles I249 and M280 were in strong linkage disequilibrium and formed an I₂₄₉M₂₈₀ haplotype. However, there was no relationship between CX3CR1 genotypes or corresponding haplotypes and the prevalence of CAD or MI. Adjusted for classical risk factors (age, sex, hypertension, dyslipidemia, diabetes mellitus and smoking), the odds ratio (OR) of V249I for CAD was 0.95 (95% confidence interval (CI) = 0.78–1.15, p = 0.61). The OR of T280M for CAD was 0.83 (95% CI = 0.66–1.04, p = 0.11). Furthermore, CX3CR1 variants were not associated with C-reactive protein levels, age at onset of CAD, severity of CAD and MI. In conclusion, present data of LURIC do not support the hypothesis that common variants of the CX3CR1 gene are associated with the presence of CAD or MI.     

The cerebral artery in cynomolgus monkeys (Macaca fascicularis)

Cerebral artery structure has not been extensively studied in primates. The aim of this study was to examine the cerebrovascular anatomy of cynomolgus monkeys (Macaca fascicularis), which are one of the most commonly used primates in medical research on human diseases, such as cerebral infarction and subarachnoid hemorrhage. In this study, we investigated the anatomy and diameter of cerebral arteries from 48 cynomolgus monkey brain specimens. We found three anatomical differences in the vascular structure of this species compared to that in humans. First, the distal anterior cerebral artery is single. Second, the pattern in which both the anterior inferior cerebellar artery and posterior inferior cerebellar artery branch from the basilar artery is the most common. Third, the basilar artery has the largest diameter among the major arteries. We expect that this anatomical information will aid in furthering research on cerebrovascular disease using cynomolgus monkeys.     

Depression treatment patterns among women veterans with cardiovascular conditions or diabetes

The study aimed to examine treatment patterns for depression among women veterans diagnosed with cardiovascular conditions or diabetes. We used longitudinal data from the 2002-2003 merged Veteran Health Administration (VHA) and Medicare files. Chi-square tests and multinomial logistic regression were performed to analyse depression treatment among veteran women with incident depressive episode and one of the following chronic conditions: diabetes or coronary artery disease or hypertension. Overall, 77% received treatment for depression, 54% with only antidepressants, 4% with only psychotherapy, and 19% with both. Multinomial logistic regression revealed that African American women were more likely to be in the no treatment group and were more likely than white women to receive psychotherapy rather than antidepressants. Older women and women with coronary artery disease only were less likely to receive treatment.