| 1. |
- Guan, Ruicong, et al.
(författare)
-
Dexmedetomidine alleviates oxygen and glucose deprivation-induced apoptosis in mesenchymal stem cell via downregulation of MKP-1
- 2022
-
Ingår i: Biocell (Mendoza). - : Tech Science Press. - 0327-9545 .- 1667-5746. ; 46:11, s. 2455-2463
-
Tidskriftsartikel (refereegranskat)abstract
- Bone marrow mesenchymal stem cell (MSC)-based therapy is a novel candidate for heart repair. But ischemia-reperfusion injury leads to low viability of MSC. Dexmedetomidine (Dex) has been found to protect neurons against ischemia-reperfusion injury. It remains unknown if Dex could increase the viability of MSCs under ischemia. The present study is to observe the potential protective effect of Dex on MSCs under ischemia and its underlying mechanisms. Specific mRNAs related to myocardial ischemia in the GEO database were selected from the mRNA profiles assessed in a previous study using microarray. The most dysregulated mRNAs of the specific ones from the above study were subject to bioinformatics analysis at our laboratory. These dysregulated mRNAs possibly regulated apoptosis of cardiomyocytes and were validated in vitro for their protective effect on MSCs under ischemia. MSCs were pre-treated with Dex at 10 mu M concentration for 24 h under oxygen-glucose deprivation (OGD). Flow cytometry and TUNEL assay were carried out to detect apoptosis in Dex-pretreated MSCs under OGD. The relative expressions of mitogen-activated protein kinase phosphatase 1 (MKP-1) and related genes were detected by quantitative polymerase chain reaction and western blotting. Microarray data analysis revealed that Dex regulates MAPK phosphatase activity. Dex significantly reduced in vitro apoptosis of MSCs under OGD, which suppressed the synthesis level of Beclin1 and light chain 3 proteins. Dex down-regulated MKP-1 expression and attenuated an OGD-induced change in the mitogen activated protein kinase 3 (MAPK3) signaling pathway. Dex increases the viability of MSC and improves its tolerance to OGD in association with the MKP-1 signaling pathway, thus suggesting the potential of Dex as a novel strategy for promoting MSCs efficacy under ischemia.
|
|
| 2. |
- Guan, Ruicong, et al.
(författare)
-
Plasma Exosome miRNAs Profile in Patients With ST-Segment Elevation Myocardial Infarction
- 2022
-
Ingår i: Frontiers in Cardiovascular Medicine. - : Frontiers Media SA. - 2297-055X. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundCirculating microRNAs (miRNAs) have been found to have different expressions in different phases of acute myocardial infarction. The profiles of plasma exosome miRNAs in patients with ST-segment elevation myocardial infarction (STEMI) at 3-6 months postinfarction are unknown. ObjectiveThe aim of this study was to assess the profiles of plasma exosome miRNAs in patients with STEMI in comparison with healthy volunteers and to select specific exosome miRNAs related to pathophysiological changes post-STEMI. MethodsPlasma and echocardiography parameters were collected from 30 patients 3-6 months after STEMI and 30 healthy volunteers. Plasma exosome miRNAs were assessed by using high-throughput sequence (Illumina HiSeq 2500) and profile of the plasma exosome miRNAs was established in 10 patients and 6 healthy volunteers. The specific exosome miRNAs related to heart diseases were selected according to the TargetScan database. The specificity of the selected exosome miRNAs was evaluated in additional 20 post-STEMI patients and 24 healthy volunteers by using quantitative PCR (qPCR). Left ventricular remodeling (LVR) was defined using the European Association of Cardiovascular Imaging criteria according to echocardiography examination. Correlations between expression of the specific miRNAs and echocardiography parameters of LVR were assessed using the Spearman correlation analysis. ResultsTwenty eight upregulated miRNAs and 49 downregulated miRNAs were found in patients 3-6 months after STEMI (p < 0.01) in comparison with the healthy volunteers. The two least expressed and heart-related exosome miRNAs were hsa-miR-181a-3p (0.64-fold, p < 0.01) and hsa-miR-874-3p (0.50-fold, p < 0.01), which were further confirmed by using qPCR and demonstrated significant specificity in another 20 patients with post-STEMI comparing to 24 healthy volunteers [area under the curve (AUC) = 0.68, p < 0.05; AUC = 0.74, p < 0.05]. The expression of hsa-miR-181a-3p was downregulated in patients with LV adverse remodeling in comparison with patients without LV adverse remodeling and healthy volunteers. ConclusionCirculating exosome miR-874-3p and miR-181a-3p were downregulated in patients with STEMI postinfarction. Exosome hsa-miR-181a-3p might play a potential role in the development of LVR in patients with post-STEMI.
|
|
| 3. |
- Jiang, Huiqi, 1981-, et al.
(författare)
-
Impact of underlying heart disease per se on the utility of preoperative NT-proBNP in adult cardiac surgery
- 2018
-
Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 13:2
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The primary aim was to investigate the role of underlying heart disease on preoperative NT-proBNP levels in patients admitted for adult cardiac surgery, after adjusting for the known confounders age, gender, obesity and renal function. The second aim was to investigate the predictive value of preoperative NT-proBNP with regard to severe postoperative heart failure (SPHF) and postoperative mortality. Methods A retrospective cohort study based on preoperative NT-proBNP measurements in an unselected cohort including all patients undergoing first time surgery for coronary artery disease (CAD; n = 2226), aortic stenosis (AS; n = 406) or mitral regurgitation (MR; n = 346) from April 2010 to August 2016 in the southeast region of Sweden (n = 2978). Concomitant procedures were not included, with the exception of Maze or tricuspid valve procedures. Results Preoperative NT-proBNP was 1.67 times (pamp;lt;0.0001) and 1.41 times (pamp;lt;0.0001) higher in patients with AS or MR respectively, than in patients with CAD after adjusting for confounders. NT-proBNP demonstrated significant discrimination with regard to SPHF in CAD (AUC = 0.79, 95% CI 0.73 +/- 0.85, pamp;lt;0.0001), MR (AUC = 0.80, 95% CI 0.72 +/- 0.87, pamp;lt;0.0001) and AS (AUC = 0.66, 95% CI 0.51 +/- 0.81, p = 0.047). In CAD patients NT-proBNP demonstrated significant discrimination with regard to postoperative 30-day or in-hospital mortality (AUC = 0.78; 95% CI 0.71 +/- 0.85, pamp;lt;0.0001). The number of deaths was too few in the AS and MR group to permit analysis. Elevated NT-proBNP emerged as an independent risk factor for SPHF, and postoperative mortality in CAD. Conclusions Patients with AS or MR have higher preoperative NT-proBNP than CAD patients even after adjusting for confounders. The predictive value of NT-proBNP with regard to SPHF was confirmed in CAD and MR patients but was less convincing in AS patients.
|
|
| 4. |
|
|
| 5. |
- Jiang, Huiqi, et al.
(författare)
-
Mixed venous oxygen saturation as an index of goal-directed therapy in postoperative care after cardiac surgery.
- 2015
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Adequate mixed venous oxygen saturation (SvO2) indicates sufficient oxygen supply and better prognosis after cardiac surgery.Aim: In this study, clinical significance of SvO2 as an index of goal-directed therapy in postope-rative care after cardiac surgery was retrospectively assessed.Methods: SvO2 was collected postoperatively from 741 consecutive adult patients under-going different types of cardiac surgery. SvO2 on admission to ICU was defined as base point (SvO2base). SvO2 was followed every 6 hours or whenever necessary to evaluate efficacy of postoperative therapy in the first 24 hours. Receiver operating characteristic (ROC) analysis was used to analyze changes of SvO2 (△SvO2) in relation to hospital mortality.Results: SvO2base demonstrated significant discriminatory power with regard to hospital mortality ( AUC 0.70; 95% CI 0.57-0.81; P=0.000). The best cutoff for SvO2base was 56.8%. Average △SvO2A for patients with SvO2base ≤56.8% (Group A ) was 10.6%. The best cutoff for △SvO2A with regard to hospital mortality was 6.6%, with a sensitivity of 0.68 and speci-ficity of 0.72. The negative predictive value was 91.2%. Average △SvO2B for patients with SvO2base>56.8% (Group B) was -2.4%. The best cutoff for △SvO2B with regard to hospital mortality was -4.5%, with a sensitivity of 0.61 and specificity of 0.79.The negative predictive value was 99.5%.Conclusion: An increase of SvO2 by more than 6.6% in patients with SvO2base≤56.8% may improve prognosis significantly. Goal of ICU therapy for patients with SvO2base> 56.8% should be to avoid a drop of SvO2 by more than 4.5%, in order to prevent from worsened prognosis.
|
|
| 6. |
- Jiang, Huiqi, et al.
(författare)
-
NT-proBNP and postoperative heart failure in surgery for aortic stenosis
- 2019
-
Ingår i: Open heart. - : BMJ Publishing Group Ltd. - 2053-3624. ; 6:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objective Postoperative heart failure (PHF) after aortic valve replacement (AVR) for aortic stenosis (AS) may initially appear mild and transient but has serious long-term consequences. Methods to assess PHF are not well documented. We studied the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PHF after AVR for AS.Methods This is a prospective, observational, longitudinal study of 203 patients undergoing elective first-time AVR for AS. Plasma NT-proBNP was assessed at preoperative evaluation, the day before surgery, and the first (POD1) and third postoperative morning. A clinical endpoints committee, blinded to NT-proBNP results, used prespecified haemodynamic criteria to diagnose PHF. The mean follow-up was 8.6±1.1 years.Results No patient with PHF (n=18) died within 30 days after surgery, but PHF was associated with poor long-term survival (HR 3.01, 95% CI 1.45 to 6.21, p=0.003). NT-proBNP was significantly higher in patients with PHF only on POD1 (6415 (3145–11 220) vs 2445 (1540–3855) ng/L, p<0.0001). NT-proBNP POD1 provided good discrimination of PHF (area under the curve=0.82, 95% CI 0.72 to 0.91, p<0.0001; best cut-off 5290 ng/L: sensitivity 63%, specificity 85%). NT-proBNP POD1 ≥5290 ng/L identified which patients with PHF carried a risk of poor long-term survival, and PHF with NT-proBNP POD1 ≥ 5290 ng/L emerged as a risk factor for long-term mortality in the multivariable Cox regression (HR 6.20, 95% CI 2.72 to 14.1, p<0.0001).Conclusions The serious long-term consequences associated with PHF after AVR for AS were confirmed. NT-proBNP level on POD1 aids in the assessment of PHF and identifies patients at particular risk of poor long-term survival.
|
|
| 7. |
- Jiang, Huiqi, 1981-
(författare)
-
NT-proBNP as a marker of postoperative heart failure in adult cardiac surgery
- 2019
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Postoperative heart failure (PHF) remains the major cause of mortality after cardiac surgery. Unfortunately, generally accepted diagnostic criteria for PHF are lacking. This may explain why the evidence for the efficacy and safety of current treatment of PHF with inotropes is insufficient. In cardiology practice N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an established biomarker for heart failure. However, the association between NT-proBNP and PHF after cardiac surgery needs further clarification. Glutamate is a key intermediate in myocardial metabolism, which may improve myocardial tolerance to ischemia and facilitate post-ischemic recovery. Glutamate was associated with a reduced risk of developing severe PHF in high-risk patients undergoing coronary artery bypass surgery (CABG). The aim of this thesis was to study the role of NT-proBNP for prediction and assessment of PHF in cardiac surgery (Paper I-III) and the impact of intravenous glutamate infusion on postoperative NTproBNP after CABG (Paper IV).Paper I: We retrospectively studied the role of underlying heart disease for preoperative NT-proBNP in patients admitted for first time CABG (n=2226), aortic valve surgery (AVR) for aortic stenosis (AS) (n=406) and mitral valve surgery for mitral valve regurgitation (MR) (n=346) by adjusting for non-cardiac confounders (age, gender, obesity and renal function). The level of NT-proBNP in AS or MR was 1.67 (p<0.0001) and 1.41 times (p<0.0001) higher respectively than in coronary artery disease (CAD) after adjusting for confounders. Preoperative NT-proBNP was predictive of severe PHF in CAD and MR patients but less so in AS patients. Preoperative NT-proBNP emerged as an independent risk factor for severe PHF and postoperative mortality in CAD patients.Paper II-III: We prospectively studied the association between postoperative NT-proBNP and PHF in two cohorts, patients undergoing AVR for AS (n=203) and patients undergoing isolated CABG for acute coronary syndrome (ACS) from the GLUTAMICS-trial (n=382). NT-proBNP was measured preoperatively, on the first (POD1) and third postoperative morning (POD3). An end-points committee blinded to NT-proBNP used prespecified criteria to diagnose PHF and its severity. After AVR for AS only NT-proBNP level on POD1 provided good discrimination of PHF. PHF with NT-proBNP POD1 ≥ 5290 ng•L-1 emerged as an independent risk factor for long-term mortality (Paper II). After isolated CABG for ACS both absolute postoperative levels on POD1 and POD3 and postoperative increases of NT-proBNP were associated with PHF and the levels reflected the severity of PHF (Paper III).Paper IV: We prospectively studied the impact of intravenous glutamate infusion on postoperative NT-proBNP in a randomized double-blind study on patients undergoing CABG for ACS from the GLUTAMICS-trial (n=399). Patients were randomly allocated to intravenous infusion of L-glutamate (n=200) or saline (n=199). No effect of glutamate on postoperative NT-proBNP levels was detected in the whole cohort. According to post-hoc analysis glutamate was associated with less increase of NT-proBNP from preoperative level to POD3 and significantly lower absolute levels on POD3 among high risk patients with EuroSCORE II ≥4.15 (upper quartile).Conclusion: Patients with AS or MR have higher preoperative NT-proBNP than CAD patients after adjusting for confounders. The predictive value of NT-proBNP with regard to severe PHF and postoperative mortality was confirmed in CAD patients. Postoperative NTproBNP may prove a useful tool for assessment of PHF after AVR for AS and isolated CABG. NT-proBNP POD1 identifies patients with PHF at risk of a poor long-term survival after AVR for AS. Intravenous infusion of glutamate may prevent or mitigate PHF in highrisk patients undergoing CABG but these results need to be confirmed.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Jiang, Huiqi, 1981-, et al.
(författare)
-
The impact of glutamate infusion on postoperative NT-proBNP in patients undergoing coronary artery bypass surgery : a randomized study
- 2020
-
Ingår i: Journal of Translational Medicine. - : BioMed Central. - 1479-5876. ; 18:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundGlutamate, a key intermediate in myocardial metabolism, may enhance myocardial recovery after ischemia and possibly reduce the incidence and severity of postoperative heart failure in coronary artery bypass surgery (CABG). N-terminal pro-B-type natriuretic peptide (NT-proBNP) can be used to assess postoperative heart failure (PHF) after CABG. Our hypothesis was that glutamate enhances myocardial recovery in post-ischemic heart failure and, therefore, will be accompanied by a mitigated postoperative increase of NT-proBNP.MethodsSubstudy of the GLUTAmate for Metabolic Intervention in Coronary Surgery (GLUTAMICS) trial (ClinicalTrials.gov Identifier: NCT00489827) a prospective triple-center double-blind randomized clinical trial on 399 patients undergoing CABG with or without concomitant procedure for acute coronary syndrome at three Swedish Cardiac Surgery centres (Linköping, Örebro, and Karlskrona) from May 30, 2007 to November 12, 2009. Patients were randomly assigned to intravenous infusion of 0.125 M L-glutamic acid or saline (1.65 mL/kg of body weight per hour) intraoperatively and postoperatively. Plasma NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A Clinical Endpoints Committee, blinded to both intervention and NT-proBNP used prespecified criteria to diagnose PHF. The primary endpoints were the absolute levels of postoperative NT-proBNP and the difference between preoperative and postoperative levels of NT-proBNP.ResultsOverall no significant difference was detected in postoperative NT-proBNP levels between groups. However, in high-risk patients (upper quartile of EuroSCORE II ≥ 4.15; glutamate group n = 56; control group n = 45) glutamate was associated with significantly lower postoperative increase of NT-proBNP (POD3-Pre: 3900 [2995–6260] vs. 6745 [3455–12,687] ng•L−1, p = 0.012) and lower NT-proBNP POD3 (POD3: 4845 [3426–7423] vs. 8430 [5370–14,100] ng•L−1, p = 0.001). After adjusting for significant differences in preoperative demographics, NT-proBNP POD3 in the glutamate group was 0.62 times of that in the control group (p = 0.002). Patients in the glutamate group also had shorter ICU stay (21 [19–26] vs. 25 [22–46] h, p = 0.025) and less signs of myocardial injury (Troponin T POD3 (300 [170–500] vs. 560 [210–910] ng•L−1, p = 0.025).ConclusionsPost hoc analysis of postoperative NT-proBNP suggests that intravenous infusion of glutamate may prevent or mitigate myocardial dysfunction in high-risk patients undergoing CABG. Further studies are necessary to confirm these findings.Trial registration Swedish Medical Products Agency 151:2003/70403 (prospectively registered with amendment about this substudy filed March 17, 2007). ClinicalTrials.gov Identifier: NCT00489827 (retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT00489827?term=glutamics&draw=1&rank=1
|
|
| 11. |
- Jiang, Huiqi, et al.
(författare)
-
Utility of NT-proBNP as an objective marker of postoperative heart failure after coronary artery bypass surgery : a prospective observational study
- 2021
-
Ingår i: Perioperative Medicine. - : BMC. - 2047-0525. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Postoperative heart failure (PHF) is the main cause for mortality after cardiac surgery but unbiased evaluation of PHF is difficult. We investigated the utility of postoperative NT-proBNP as an objective marker of PHF after coronary artery bypass surgery (CABG). Methods: Prospective study on 382 patients undergoing isolated CABG for acute coronary syndrome. NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A blinded Endpoints Committee used prespecified criteria for PHF. Use of circulatory support was scrutinized. Results: After adjusting for confounders PHF was associated with 1.46 times higher NT-proBNP on POD1 (p = 0.002), 1.54 times higher on POD3 (p < 0.0001). In severe PHF, NT-proBNP was 2.18 times higher on POD1 (p = 0.001) and 1.81 times higher on POD3 (p = 0.019). Postoperative change of NT-proBNP was independently associated with PHF (OR 5.12, 95% CI 1.86-14.10, p = 0.002). The use of inotropes and ICU resources increased with incremental quartiles of postoperative NT-proBNP. Conclusions: Postoperative NT-proBNP can serve as an objective marker of the severity of postoperative myocardial dysfunction. Due to overlap in individuals, NT-proBNP is useful mainly for comparisons at cohort level. As such, it provides a tool for study purposes when an unbiased assessment of prevention or treatment of PHF is desirable.
|
|
| 12. |
- Jiang, Qiyun, et al.
(författare)
-
Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China.
- 2022
-
Ingår i: Risk management and healthcare policy. - 1179-1594. ; 15, s. 553-562
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China.A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance.Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797-0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance.We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.
|
|
| 13. |
- Wang, J., et al.
(författare)
-
Effectiveness of an integrative programme in reducing hypertension incidence among the population at risk for hypertension: A community-based randomized intervention study in Shanghai, China
- 2022
-
Ingår i: Journal of global health. - : International Society of Global Health. - 2047-2986 .- 2047-2978. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate the effectiveness of a community-based integrative programme in reducing hypertension incidence among populations at high risk for hypertension in Shanghai, Eastern China. Methods: We conducted a cluster-randomized intervention trial with a total of 607 participants (intervention, n=303; control, n=304) between October 2019 and October 2020. A total of 605 participants (intervention, n=302; control, n=303) completed the follow-up survey. The intervention group received an integrative programme that included health education, physician follow-up, and self-management, while the control group received usual care only. We used questionnaires to investigate risk factors, knowledge, attitudes, and behaviours regarding hypertension prevention for all participants at baseline and follow-up. We measured the incidence of hypertension according to the predefined protocol based on the national definition during the four follow-ups (only applicable to the intervention group) and the physical examination at the end of the intervention/programme/study. The difference-in-difference (DID) effects of the intervention were estimated using Generalized Estimating Equations. Results: There were no significant differences in age group, gender, and educational level between intervention and control groups at baseline. The integrative programme reduced the incidence of hypertension in the intervention group compared to the control group (odds ratio (OR)=0.27, 95% confidence interval (CI)=0.12-0.61). The DID analysis found that the one-year intervention has improved the level of hypertension-related knowledge and attitudes regarding diagnostic criteria, complications of hypertension, and lifestyle modification (P<0.05). The intervention was also associated with a 3.7% increase in the behaviour change rate of "not smoking" (OR=2.50, 95% CI=1.45-4.30) and a 34.8% increase in the rate of "monitoring blood pressure regularly" (OR=29.61, 95% CI=13.02-67.35). Conclusions: The integrative programme could reduce the risk for hypertension and improve the level of hypertension-related knowledge and attitudes, affecting the formation of healthy behaviours in high-risk populations. The community-based management for high-risk groups should be scaled up and incorporated into national hypertension control programmes, which may potentially reduce the substantial burden of hypertension and cardiovascular disease in China. Registration: ISRCTN registration number: ISRCTN74154693.
|
|
