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Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fabry disease (FD) is an X-linked genetic disorder caused by mutations in the GLA gene. It leads to reduced or complete deficiency of the activity of α-galactosidase A (α-Gal A), resulting in an accumulation of the metabolic substrate globotriaosylceramide (Gb3) and its derivative, globotriaosylsphingosine (Lyso-Gb3), in a wide range of cells and tissues, which causes multiple organ pathologies. In the cardiovascular system, FD predominantly leads to left ventricular hypertrophy and/or conduction abnormalities known as FD cardiomyopathy. Since FD cardiomyopathy is the leading cause of death in adult patients with FD, early diagnosis combining cardiac imaging, enzyme and substrate activity, genetic testing, and tissue biopsy, as well as early specific enzyme replacement therapy are important to improve patient prognosis. This consensus comprehen-sively summarizes the published evidence related to the diagnosis and treatment of FD cardiomyopathy at home and abroad, and provides a basis for the diagnosis and management of FD cardiomyopathy.

Transthyretin cardiac amyloidosis (ATTR-CA) has been considered as a rare cardiac dysfunction with occult onset, rapid progression and high mortality, caused by the accumulation of transthyretin fibrils in the myocardium. Recently, with the development of diagnostic techniques, its detection rate has been increasing. The continuous emergence of various small molecule drugs has also changed the previous situation of lacking therapeutic agents, and its mortality has been reduced. This paper mainly summarizes the latest advances in the diagnosis and treatment of ATTR-CA in recent years. [ABSTRACT FROM AUTHOR]

Adenine nucleotide translocases（ANTs）are crucial for mitochondrial integrity and bioenergetic metabolism. There are four isoforms of ANTs. Under physiological conditions，ANTs primarily engage in the exchange of adenosine diphosphate（ADP）and adenosine triphosphate（ATP）across mitochondrial membranes. ANT isoforms are also potentially significant components of the mitochondrial permeability transition pore（mPTP），contributing to processes such as cellular apoptosis and proton leakage. Impairment of ANTs leads to mitochondrial dysfunction，which holds significant pathological implications in metabolic diseases， cardiomyopathies，and cancer progression. This review summarizes recent advancements and knowledge regarding ANTs，aiming to offer new insights into potential therapeutic strategies targeting ANTs in diseases. [ABSTRACT FROM AUTHOR]

Cardiomyopathy is a group of heterogeneous myocardial diseases with a variety of specific phenotypes that can lead to cardiovascular death or progressive heart failure in severe cases. Because of the severity and complexity of these diseases, the search for new regulatory mechanisms to prevent and treat cardiomyopathy is particularly urgent. Iron death is a form of programmed cell death that differs from other forms of iron dependence and is characterized by the accumulation of iron-dependent lipid peroxides. Studies have shown that iron death can be involved in the occurrence and progression of cardiomyopathy through different signaling pathways. Therefore, targeted regulation of iron death is a new strategy to prevent cardiomyopathy. In this paper, the mechanism of iron death and its important role in cardiomyopathy were reviewed to find the potential relationship between iron death and cardiomyopathy and provide more ideas for the treatment of various cardiomyopathies in the future. [ABSTRACT FROM AUTHOR]

Sepsis is an organ dysfunction caused by the host′s uncontrolled response to infection, and is a common cause of death in critically ill patients. Sepsis-induced myocardial injury（SIMI）directly related to the poor prognosis of sepsis. The pathogenesis of SIMI is complex and related to mechanisms such as excessive inflammatory response, mitochondrial damage, cell apoptosis, and autophagy. Deeply exploring the pathogenic mechanism of SIMI can help develop more effective targeted drugs, thereby improving the prognosis of sepsis patients. [ABSTRACT FROM AUTHOR]

Objective To review the cardiac clinical characteristics of patients undergoing endoscopic transsphenoidal approach for the treatment of growth hormone-secreting pituitary adenoma complicated with cardiomyopathy, and summarize the nursing measures to improve nursing quality. Methods The clinical data of 38 cases of patients who underwent endoscopic endonasal transsphenoidal approach for the treatment of growth hormone-secreting pituitary adenoma complicated with cardiomyopathy were collected and analyzed, Using echocardiography to detect the growth hormone(GH) level, left ventricular end-diastolic diameter(LVEDD), septal thickness(ST), left ventricular posterior wall thickness(LVPWT), left ventricular ejection fraction(LVEF) to comparative analysis of cardiac function were made in these patients before surgery and after 3 months. Results GH level, LVIDD, ST, LVPWT and LVEF after resection of pituitary tumor were significantly improved compared with those before resection(P

Iron overload cardiomyopathy (IOC) is a type of cardiac dysfunction caused by several factors resulting in iron overload in the myocardium. Two major causes of IOC include hereditary hemochromatosis and transfusion-dependent anemia. IOC significantly reduces long-term survival of patients. Since IOC is a rare disease in Asian populations that also lacks etiology-specific manifestations, early diagnoses in clinical practice are challenging. Two groups of patients with high risk of IOC should be further investigated: those who present heart failure of unknown origin will be screened for iron overload followed by confirmation of IOC; and those who have high risk of iron overload or an established diagnosis will be monitored for the development of IOC. Serum ferritin is recommended as the first-line screening test for iron overload, while cardiac magnetic resonance T2* should be used to confirm iron overload in the myocardium. Phlebotomy and iron chelating agents can effectively remove the extra iron from the body, preventing IOC, as well as reverse the disease at an early stage and slow down its progession. Timely diagnosis and treatment is critical in improving the prognosis of patients with IOC. Therefore, this review aims to help clinicians to understand IOC in multiple dimensions including pathogenesis, clinical manifestations, diagnostic methods and treatment choices.

Background and purpose: Adriamycin also named as doxorubicin, is one of the most widely used cytotoxic chemotherapeutic agents for clinical practice for the treatment of various tumors, and belongs to anthracycline antitumor drugs. Unfortunately, this drug will cause serious side effects, especially dose-dependent cardiotoxicity, which has become a concern in the field of onco-cardiology. At present, there is no universally recognized, unified and robust method to construct Doxorubicin-induced cardiomyopathy model. This experiment was designed to explore the optimal dose and frequency of doxorubicin-induced cardiomyopathy in a mouse model.Methods: Forty 8-10-week-old male C57BL/6J mice were randomly divided into 4 groups (control group and 3 model groups). The model group was divided into model 1 (M1) group (15 mg/kg, single dose) and M2 group (5 mg/ kg, once a day for 3 days continuously) and M3 group (7.5 mg/kg, twice on alternate days). General vital signs (body weight change and survival rate), echocardiography, body surface electrocardiogram (ECG), N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI) and myocardial tissue morphological changes were evaluated comprehensively.Results: Compared with the control group, the body weight of mice in M1, M2 and M3 groups decreased significantly (P

Background and purpose: Adriamycin, also named as doxorubicin, is an effective antineoplastic anthracycline drug used worldwide. However, its cardiotoxicities characterized as dilated cardiomyopathy and congestive heart failure have limited its clinical application. This study aimed to compare the effects of benazepril, atorvastatin, sacubitril/valsartan and carvedilol on the protection of adriamycin-induced cardiomyopathy, which are commonly used as cardioprotective agents for hypertension, hyperlipidemia and cardiomyopathy, and then preliminarily explored the underlying mechanisms. Methods: Adult male C57BL/6 mice were divided into saline, adriamycin, adriamycin+atorvastatin, adriamycin+benazepril, adriamycin+sacubitril/valsartan and adriamycin+carvedilol groups. In addition to the saline group, adriamycin solution (4 mg/kg per week) was injected intraperitoneally for 5 weeks to establish the dox-induced cardiomyopathy model in vivo. Different groups were pretreated with different cardioprotective agents 0.2 mL per day for each mouse by gavage for a total of 6 weeks. The dose was: atorvastatin 10 mg/kg per day, benazepril 10 mg/kg per day, sakubactro/valsartan 60 mg/kg per day (sakubactro 28.8 mg/kg per day, valsartan 31.2 mg/kg per day) and carvedilol 5 mg/kg per day, respectively. Two-dimensional echocardiography, cell apoptosis, fibrosis and inflammation markers were analyzed in these mice. Real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to detect the total mRNA in cardiomyocytes, and Western blot was used to detect the expression levels of Bax and Bcl-2. Among BALB/c mice inoculated with 4T1 breast tumor cells, the tumor volume and mass were studied before and after treatments with different cardioprotective drugs to evaluate the effects of cardioprotective drugs on tumor growth. Results: The data revealed that all these four cardioprotective agents effectively inhibited adriamycin-induced left ventricular dysfunction, ameliorated histopathological damage, suppressed adriamycin-induced cell apoptosis and modulated the expressions of Bcl-2 and Bax proteins. They also attenuated adriamycin-mediated expressions of proinflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in the myocardium. Furthermore, sacubitril/valsartan not only enormously improved left ventricular ejection fraction (LVEF) (65.1%±3.8%, 63.5%±4.6%, 61.6%±4.1% and 62.1%±5.2%, P

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

RNA binding motif protein (RBM) is a type of RNA binding protein, which contains RNA recognition motif, RNA binding motif and ribo-nucleo-protein motif. The alternative splicing mediated by members of the RBM family is closely related to myocardial contractile proteins, myocardial development and myocardial sodium channels, which play an important role in pathogenesis of myocardial diseases and even heart failure.

It has been demonstrated that cardiomyocyte metabolism and cell death are the fundamental progresses in the development of cardiomyopathy. Increasing evidences suggest that metabolic imbalance of iron appears to be involved in the pathophysiology of cardiomyopathy. As we well known, iron is an essential mineral required for various functions, including cellular respiration, lipid and oxygen metabolism, as well as protein synthesis. However, cardiomyocyte homeostasis and viability are inclined to be jeopardized by iron-induced toxicity under pathological stress, which is defined as ferroptosis. In the pathogenesis of cardiomyopathy, excessive iron is transported into cells that drives cardiomyocytes more vulnerable to ferroptosis by the accumulation of reactive oxygen species through Fenton reaction. The enhanced induction of reactive oxygen species in ferroptosis leads cardiomyocytes to become more sensitive to oxidative stress under the exposure of excess iron. Thus, ferroptosis might play an important role in the pathogenic progression of cardiomyopathy, and precisely targeting ferroptosis mechanisms may be a promising therapeutic option to revert myocardial remodeling. This review summarizes the pathophysiological alterations from iron homeostasis to ferroptosis together with signaling transduction with regard to ferroptosis in cardiomyopathy.

Background and purpose: Adriamycin, also named as doxorubicin, is an effective antineoplastic anthracycline drug used worldwide. However, its cardiotoxicities characterized as dilated cardiomyopathy and congestive heart failure have limited its clinical application. This study aimed to compare the effects of benazepril, atorvastatin, sacubitril/valsartan and carvedilol on the protection of adriamycin-induced cardiomyopathy, which are commonly used as cardioprotective agents for hypertension, hyperlipidemia and cardiomyopathy, and then preliminarily explored the underlying mechanisms. Methods: Adult male C57BL/6 mice were divided into saline, adriamycin, adriamycin+atorvastatin, adriamycin+benazepril, adriamycin+sacubitril/valsartan and adriamycin+carvedilol groups. In addition to the saline group, adriamycin solution (4 mg/kg per week) was injected intraperitoneally for 5 weeks to establish the dox-induced cardiomyopathy model in vivo. Different groups were pretreated with different cardioprotective agents 0.2 mL per day for each mouse by gavage for a total of 6 weeks. The dose was: atorvastatin 10 mg/kg per day, benazepril 10 mg/kg per day, sakubactro/valsartan 60 mg/kg per day (sakubactro 28.8 mg/kg per day, valsartan 31.2 mg/kg per day) and carvedilol 5 mg/kg per day, respectively. Two-dimensional echocardiography, cell apoptosis, fibrosis and inflammation markers were analyzed in these mice. Real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to detect the total mRNA in cardiomyocytes, and Western blot was used to detect the expression levels of Bax and Bcl-2. Among BALB/ c mice inoculated with 4T1 breast tumor cells, the tumor volume and mass were studied before and after treatments with different cardioprotective drugs to evaluate the effects of cardioprotective drugs on tumor growth. Results: The data revealed that all these four cardioprotective agents effectively inhibited adriamycin-induced left ventricular dysfunction, ameliorated histopathological damage, suppressed adriamycin-induced cell apoptosis and modulated the expressions of Bcl-2 and Bax proteins. They also attenuated adriamycin-mediated expressions of proinflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1β (IL1β) and interleukin-6 (IL-6) in the myocardium. Furthermore, sacubitril/valsartan not only enormously improved left ventricular ejection fraction (LVEF) (65.1%±3.8%, 63.5%±4.6%, 61.6%±4.1% and 62.1%±5.2%, P＜0.05) and fractional shortening (FS) (34.2%±3.7%, 33.9%±3.3%, 32.6%±2.8% and 33.0%±3.6%, P＜0.05), but also alleviated cardiac fibrosis compared with the other three medicaments. Benazepril and sacubitril/valsartan manifested curative effect in limiting the size of the heart, the ratio of heart weight to tibia length (HW/TL), and cardiomyocyte cross-sectional area (CSA). Atorvastatin owned a moderate level of anti-apoptotic and anti-inflammatory properties. Among these medications, carvedilol provided the best anti-inflammatory effects. Conclusion: We compared different agents for their effects on the protection of adriamycin-induced cardiomyopathy and preliminarily explored underlying mechanisms. In the future, large-scale clinical studies could further explore the potential of different cardioprotective drugs at the patient level to alleviate adriamycin-induced cardiotoxicities. [ABSTRACT FROM AUTHOR]

Background and purpose: Adriamycin also named as doxorubicin, is one of the most widely used cytotoxic chemotherapeutic agents for clinical practice for the treatment of various tumors, and belongs to anthracycline antitumor drugs. Unfortunately, this drug will cause serious side effects, especially dose-dependent cardiotoxicity, which has become a concern in the field of onco-cardiology. At present, there is no universally recognized, unified and robust method to construct Doxorubicininduced cardiomyopathy model. This experiment was designed to explore the optimal dose and frequency of doxorubicin-induced cardiomyopathy in a mouse model. Methods: Forty 8-10-week-old male C57BL/6J mice were randomly divided into 4 groups (control group and 3 model groups). The model group was divided into model 1 (M1) group (15 mg/kg, single dose) and M2 group (5 mg/ kg, once a day for 3 days continuously) and M3 group (7.5 mg/kg, twice on alternate days). General vital signs (body weight change and survival rate), echocardiography, body surface electrocardiogram (ECG), N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI) and myocardial tissue morphological changes were evaluated comprehensively. Results: Compared with the control group, the body weight of mice in M1, M2 and M3 groups decreased significantly (P＜0.001); M3 group had higher survival rate than M1 and M2 group (80% vs 40% and 50%, P＜0.05). Compared with the control group, M1 group and M2 group, the body surface ECG showed that the PR interval of M3 group [(0.064 2±0.003 8)s vs (0.042 3±0.000 9)s, (0.052  7±0.007  9) s and (0.062  0±0.001  2)s, P＜0.05] and QT interval [(0.047  5±0.000  2)s vs (0.022 0±0.000 9)s, (0.038 6±0.004 4)s and (0.044  4±0.003  0)s, P＜0.05] were significantly prolonged. Cardiac ultrasound showed that M3 ejection fraction decreased significantly (40.40%±2.24% vs 54.72%±1.64%, 46.00%±4.41% and 54.68%±3.38%, P＜0.05). M3 short-axis shortening rate decreased significantly (19.40%±1.20% vs 27.88%±1.05%, 22.57%±2.50% and 27.86%±2.20%, P＜0.05). Cardiac markers showed that compared with CON, the serum NT-proBNP levels of M1, M2 and M3 in adriamycin group were significantly increased [(638.13±12.69) pg/mL vs (1 271.36±11.76) pg/mL, (1 270.85±36.19) pg/mL and (1 225.26±24.19)  pg/ mL, P＜0.05] . Histomorphology showed that the vacuoles in cardiomyocyte of M3 group was significantly increased compared with CON, M1 and M2 group (81/field vs 3/field, 65/field and 34/field, P＜0.05). Conclusion: Intraperitoneal injection of adriamycin in acute heart failure model is simple and reliable. The model in which adriamycin is administered by intraperitoneal injection at a dose of 7.5 mg/ kg, twice on alternate days, with cumulative dose of 15 mg/kg is optimal. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of ivabradine on cardiomyopathy and heart failure(HF) with non-ischemic etiology. Methods A single-center retrospective study was carried out. Patients who admitted to Peking Union Medical College Hospital from January 2018 to February 2020, with non-ischemic heart failure, left ventricular ejection fraction (LVEF) less than 50%, and treatment of ivabradine for at least 3 months were enrolled. Results Thirty-eight patients (24 males), with a median age of 31.5 (26.0-44.0) years old, were divided into primary (n=17) and secondary (n=21) cardiomyopathies groups. Ivabradine of 5 mg/d was taken in 65.8% of the patients as the initial dose, and 10-15 mg/d was tolerated in 57.9% of patients after 3 months. Six patients withdrew the ivabradine treatment. The mean value of heart rates decreased from (93.7±13.5) beats/min to (75.9±12.4) beats/min after 3 months in all patients and from (99.0±11.4) beats/min to (78.6±13.8) beats/min in the group with secondary cardiomyopathies (P＜0.001, respectively), while no significant changes in blood pressure were observed. NYHA classification, left ventricular end-diastolic diameter and LVEF were signifi- cantly improved in both groups after treatment (P＜0.05). After a median follow-up of 9.5 months, 4 patients died, all of them were patients with secondary cardiomyopathies; Thirteen patients with heart failure re-admitted to hospital, including 10 with secondary and 3 with primary cardiomyopathies (47.6% vs 17.6%,P＜0.001). Only one case of ivabradine-related bradycardia was observed. Conclusions Ivabradine is safe and effective in patients with non-ischemic cardiomyopathy to control heart rates and to improve cardiac functions, especially for heart failure secondary to systemic diseases accompanied by sinus tachycardia.

Objective To study the reversal effect of Shenfu decoction (SFD) on adriamycin-induced cardiomyopathy and explore its mechanism by using serum metabolomic technology. Methods The BALB/c mouse model of cardiomyopathy induced by adriamycin was established. The corresponding intervention was given. The serum lactate dehydrogenase (LDH) and creatine phosphatase isoenzyme MB (CK-MB) were measured. The ejection fraction (EF) and shortening fraction (FS) were measured by echocardiography. Mouse serum was collected for gas chromatography-mass spectrometry (GC-MS) analysis. The data obtained was analyzed by multivariate and univariate statistical analysis to compare the changes of endogenous metabolites in the serum of mice in the normal group, model group and Shenfu decoction treatment group, to find the potential biomarkers of Shenfu decoction to reverse the adriamycin-induced cardiomyopathy. Metabolic pathway analysis was used to explore the targeted metabolic pathway of Shenfu decoction. Results The levels of serum LDH and CK-MB in the model group were increased significantly, and the values of EF and FS decreased significantly, indicating that the model was successfully established. The above indicators were significantly improved after treatment with Shenfu decoction. 13 potential biomarkers of adriamycin-induced cardiomyopathy were identified by metabonomic analysis, and Shenfu decoction had significant reversal effect on 11 metabolites. Metabolic pathway analysis showed that the synthesis of phenylalanine, tyrosine and tryptophan, arachidonic acid metabolism, phenylalanine metabolism, tricarboxylic acid cycle and dicarboxylic acid metabolism were the main targeted metabolic pathways of Shenfu decoction. Conclusion Shenfu decoction can reverse adriamycin-induced cardiomyopathy by regulating the unbalanced synthesis of phenylalanine, tyrosine and tryptophan, as well as the metabolism of arachidonic acid, phenylalanine, dicarboxylic acid and tricarboxylic acid cycle. [ABSTRACT FROM AUTHOR]

Premature ventricular contraction-induced cardiomyopathy is a potentially reversible disease, and frequent premature ventricular contraction will cause left ventricular dysfunction and remodeling. Previous studies on adults and animal models have found that cardiac myocytes and extracellular mechanisms may be involved in the development of cardiac dysfunction, but the exact pathophysiological mechanism is still unclear. Moreover, there is no clear guidance for early diagnosis and intervention strategies in children. A series of adult studies have proved that a variety of high-risk factors lead to premature ventricular contraction-induced cardiomyopathy, including premature ventricular burden and ventricular premature contraction variability. However, studies on children are limited to case reports and retrospective, small-sample-size, single center series. This review summarizes and analyzes the high-risk factors of premature ventricular contraction-induced cardiomyopathy in children and the current intervention strategies. [ABSTRACT FROM AUTHOR]

Propionic acidemia (PA) is an autosomal recessive disorder of organic acidemia. In addition to developmental delay and central nervous system damage, its most important mid- and long-term complications include dilated cardiomyopathy and arrhythmia (long Q-T syndrome and ventricular fibrillation, etc.), which are also major causes of mortality. The mechanisms of cardiovascular involvement include disorder of mitochondrial energy metabolism, oxidative stress and ion channel damage caused by excessive metabolites such as propionic acid. There are no recognized guidelines for the treatment of PA-related cardiomyopathy. Liver transplantation is recognized as a method to correct metabolic disorders and reverse cardiomyopathy. Antioxidants and drugs that increase myocardial energy supply are expected to become the future treatment options for PA-related cardiomyopathy. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is an important cause of maternal death with non-obstetric factors. Noncompaction of the ventricular myocardium (NVM) is a rare congenital cardiomyopathy. The serious complications are heart failure, arrhythmia, and thromboembolism. Transthoracic echocardiography is the main diagnostic method. At present, the main treatment method of pregnancy combined with NVM is control symptom by medication. Meanwhile, the safety of mother and infant should be considered. It is considered appropriate to terminate pregnancy by cesarean section. This article analyzed the diagnosis and treatment of three cases of pregnancy with NVM and one case of twin pregnancy with NVM reported in our hospital, hoping to improve the clinical cognition and diagnosis of this disease during pregnancy. [ABSTRACT FROM AUTHOR]

The diagnosis of homologous ventricular separation is still controversial. Based on the literature, this paper puts forward some opinions about the diagnosis and differential diagnosis of homologous ventricular separation, such as how wide the QRS complex of the source ventricular separation is to be called "extremely widened". [ABSTRACT FROM AUTHOR]

Noncompaction of ventricular myocardium (NVM) is a rare cardiomyopathy. In recent years, more and more cases have been reported due to the improvement of diagnosis of the disease, but most of them are dilated left ventricular noncompaction (LVNC), with few other types.This case was a hypertrophic and dilated LVNC.We hope to improve the diagnosis and treatment of the rare LVNC by combining the characteristics of this case with the summary of relevant literature. [ABSTRACT FROM AUTHOR]

Objective To investigate the role and mechanism of serine/threonine kinase (Akt)-ion channel Kv4.3 (Kv4.3) - calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) signaling pathway in aerobic exercise inhibited pressure overload-induced cardiac hypertrophy. Methods Sixty mice were divided into five groups: Sham group, transverse aortic constriction (TAC) group, SHAM+ aerobic exercise (E) group, TAC + E group and TAC+ E + AKt inhibitor perifosine (Peri) group. Transthoracic echocardiography was used to assess the cardiac function and extent of myocardial hypertrophy. The cross-sectional area of myocardial cells was measured by WGA staining. The mRNA expression of ANP was detected by RTqPCR. The protein expression levels of ANP, p-AKt, Kv4.3 and p-CaMKⅡ were detected by Western-blot assay. Results Compared with Sham group, the cardiac function of mice was deteriorated in TAC group (P＜0.01), and the extent of cardiac hypertrophy was increased (P＜0.01). After aerobic exercise training, the cardiac function was improved in TAC + E group, and the level of myocardial hypertrophy was alleviated compared with TAC group (P＜0.01). Western-blot assay showed that the expressions of p-AKT and Kv4.3 were down-regulated, p-CaMKⅡ was up-regulated in TAC group than those in Sham group (P＜0.01). However, the expressions of p-AKT and Kv4.3 were higher, p-CaMKⅡ was lower in TAC+E group than those in TAC mice (P＜0.01). Furthermore, pretreatment with the AKT inhibitor perifosine, deteriorated cardiac function, augmented myocardial hypertrophy and ANP, increased cross-sectional area were observed in TAC+E+Peri group compared with those of TAC+E group (P＜0.01). Meanwhile, the downregulation of p-AKT、Kv4.3 and upregulation p-CaMKⅡ were detected in the TAC+E+Peri group compared with the TAC+E group. Conclusion Aerobic exercise training can inhibit pressure overload-induced cardiac hypertrophy by regulating Akt-Kv4.3-CaMKⅡ. [ABSTRACT FROM AUTHOR]

Objective: To explore the key points of pharmaceutical care for angiotensin receptor-neprilysin inhibitor (ARNI) drugs in patients with dilated cardiomyopathy by clinical pharmacists. Methods: The clinical pharmacists offered pharmaceutical care to a patient with dilated cardiomyopathy from the perspectives of heart failure and anti-infection. In the course of treatment, attention was paid to the indications, application, dosage and adverse drug reactions of ARNI drugs, and at the same time, medication education and pharmaceutical care were provided to the patient. Results: In accordance with the features of the drugs, adverse drug reactions and drug interactions, the clinical pharmacist provided valuable advice for the physicians to adjust treatment regimen, and offered pharmaceutical monitoring for the patient. In the application of ARNI drugs, the blood pressure of the patient was relatively low, with normal renal function and normal blood potassium level, and symptoms of heart failure were obviously controlled. Conclusion: Individualized pharmaceutical care by clinical pharmacists for the patient with dilated cardiomyopathy treated with ARNI drugs could effectively avoid drug interactions and adverse drug reactions, and more importantly could improve therapeutic effects. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To report our experience with levosimendan in refractory heart failure caused by left ventricular noncompaction. Methods A total of 122 patients with refractory heart failure were collected in the cardiac intensive care unit of Tianjin Chest Hospital from January 2016 to December 2017. According to the causes of heart failure, the patients were divided into three groups including left ventricular noncompaction group (LVNC, n=6), ischemic cardiomyopathy group (ICM, n=91) and dilated cardiomyopathy group (DCM, n=25). All patient received continuous infusion of levosimendan for 24 hours on the basis of the failure of conventional treatment. The biological and echocardiographic data before and after 48 hours of levosimendan administration were analyzed and compared between three groups. Results Compared with data before administration, there were no significant improvement in the left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP) and N-terminal pro-brain natriuretic peptide (NTproBNP) after 48 hours of levosimendan infusion in LVNC group (P ＞0.05). The LVEDD, LVEF, PASP and NTproBNP were all improved in ICM group (P ＜0.01). And LVEF and NTproBNP were improved in DCM group (P ＜0.01). After 48 hours of levosimendan administration, the improvement of LVEDD, LVEF, NTproBNP and PASP was more significant in ICM group than that in LVNC group (P ＜0.05), and the improvement of LVEF and NTproBNP was more significant in DCM group than that in LVNC group (P ＜0.05). Conclusion Levosimendan has poor efficacy in refractory heart failure caused by left ventricular noncompaction, and it may not be suitable for this type of patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between late gadolinium enhancement (LGE) in magnetic resonance and the slope of dynamic electrocardiogram QTe / RR in hypertrophic cardiomyopathy (HCM). Methods According to the presence of LGE in cardiac magnetic resonance imaging (CMR), 96 patients with HCM who were admitted to our hospital from January 2016 to June 2017 were divided into LGE positive group and LGE negative group. The LGE transmurality of LGE positive group was evaluated by scoring method. All subjects underwent 24 h dynamic echocardiography, and heart rate (HR), QT interval and QTe/RR slope were calculated. The correlation between total LGE score and the slope of QTe/RR in LGE positive group was analyzed. And the relationships between the transmural degree of LGE and the slope of QTe/RR with the prognosis of patients were also analyzed. Results CMR results showed that there were 51 cases of positive LGE (53.13%), 45 cases of negative LGE (46.87%). There were significant differences in left ventricular ejection fraction (LVEF: 0.412±0.092 vs. 0.508±0.083), left ventricular end-diastolic volume [LVEDV (mL): 173.91±43.68 vs. 148.52±31.77] and left ventricular end-diastolic wall thickness [LVPWD (mm): 13.26±2.81 vs. 12.15± 2.37] between LGE positive group and LGE negative group (t=5.301, 3.219 and 2.077, P＜0.05). The QT interval (439.67± 25.82 vs. 411.53±31.66) and QTe/RR slope (0.20±0.05 vs. 0.16±0.03) were significantly longer in LGE positive group than those of LGE negative group (t=4.794 and 4.674, P＜0.05). The total LGE score was 26.37±7.52, which was positively correlated with the slope of QTe/RR in LGE positive group (r=0.742, P＜0.001). The incidence of adverse reactions such as ventricular arrhythmia and sudden cardiac death were significantly higher in LGE positive group than those in LGE negative group (c2=4.107, P＜0.05). The total LGE score and QTe/RR slope were related to ventricular arrhythmia and sudden cardiac death (P＜0.05). Conclusion The LGE degree of HCM patients is significantly correlated with the slope of QTe/ RR. The comprehensive evaluation of the two indicators may be more helpful to predict the prognosis of HCM. [ABSTRACT FROM AUTHOR]

A case of dilated cardiomyopathy complicated with complete left bundle branch block was reported. After admission, the patient was treated with cardiotonic, dilatation, diuresis, inhibition of myocardial remodeling, improvement of myocardial metabolism and so on. The patient was with recurrent ventricular fibrillation during hospitalization and poor heart function, and the patient's symptoms improved significantly after CRT-D (cardiac resynchronization therapy-defibrillator) implantation. Followed up for nearly 2 years, echocardiography showed that left ventricular end diastolic dimension reduced from 70mm to 42 mm, left atrium dimension reduced from 34 mm to 30 mm, and left ventricular ejection fraction increased from 0.35 to 0.62. The patient was generally in good condition and no restrictions on daily activities, which was the CRT-D hyperreactivity. The reason for this patient's hyperreactivity might be that CRT-D has corrected the progressive enlargement of the heart caused by conduction block. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinical features, efficiency of anti-arrhythmic medications and prognosis of children with tachycardia-induced cardiomyopathy(pTIC). Methods: The clinical data of 15 cases of children with pTIC admitted in the children’s hospital of Anhui province from January 2009 to October 2016 were retrospectively analyzed and followed up. The clinical features,cardiac function, electrocardiographic and echocardiographic evaluation were analyzed. The ventricular rate, the size of the left ventricular diameter and the recovery of cardiac function were observed after cardiac arrhythmia was controlled. Results: The supraventricular arrhythmia was the commonest arrhythmia in 15 cases of pTIC(14 cases), there were 10 cases of pure drug therapy, 3 patients received radiofrequency ablation, and 2 cases were lost. The ventricular heart rates of was decreased compared with those of pretherapy [(116±27)bpm vs.(189±28)bpm], NT-proBNP was decreased[(404±355)pg/mL vs.(6280±3155)pg/mL], left ventricular end-diastolic diameter was shrunken [(3.12 ±0.48)cm vs.(3.69 ±0.70)cm], ejection fraction was increased [(57.9 ±9.3)% vs.(42.2 ±9.5)%], and Modified Ross score as decreased [1 vs. 7] after six months to 3 years. Conclusions: PTIC was caused by a variety of rapid arrhythmias. Heart enlargement and cardiac dysfunction could be fully restored. Children given early recognition and effective treatment had better prognosis [ABSTRACT FROM AUTHOR]

Arrhythmic cardiomyopathy is common in clinical practice, but it is easy to be misdiagnosed and mistreated. Because of the extremely similar clinical manifestations, it is difficult to make differential diagnosis between this kind of cardiomyopathy and dilated cardiomyopathy. The pathogenesis of arrhythmic cardiomyopathy is related to hemodynamic change, oxidative stress, abnormality of myocardial metabolic energy and so on. This paper illustrates the pathogenesis of tachycardiainduced cardiomyopathy in order to improve clinicians’ understanding of the disease. [ABSTRACT FROM AUTHOR]

Objective: To analysis the clinical features of a familial hypertrophic cardiomyopathy. Methods: A family with Hypertrophic cardiomyopathy history was investigated and the clinical features were analyzed in our hospital. Results: The disease was continued for 4 generations in this family. There 11 cases out of 35 family members. Among them there were 3 cases of sudden death and2 cases of death. One patient had atrial fibrillation and cerebral infarction. Permanent pacemaker had been implanted into 2 patients. The minimum age of death was 3. All of these conform to the characteristics of high incidence, high death rate, and early onset in patients.Conclusion: By investigating whole family of familial hypertrophic cardiomyopathy in detail, we will gain more knowledge about this disease and better revealing its genetic regularity. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical impact of percutaneous coronary intervention (PCI) on left ventricular myocardial remodeling and main adverse cardiovascular and cerebrovascular events (MACE) in ischemic cardiomyopathy patients with different left ventricular ejection fraction and SYNTAX score≤22. Methods: A total of 191 ischemic cardiomyopathy patients who underwent PCI in Department of Cardiology from May 2017 to October 2018 were enrolled in this study, and they were divided into three groups according to preoperative left ventricular ejection fraction (≥50% group, 36%~49% group and ≤35% group). The main outcomes and left ventricular ejection fraction, left ventricular end-diastolic volume were analyzed at 12 months follow-up. The main outcomes were the recurrence of acute left ventricular failure, recurrent angina, restenosis, revascularization, non-fatal myocardial infarction, cardiovascular death and non-cardiovascular death. Results: The incidence of MACE was 32.6% (15 cases) in ≥50% group, 32.0% (31 cases) in 36%-49% group, 45.8% (22 cases) in ≤35% group, respectively, which was lower in the first two groups than in ≤35% group, but there was no statistically significant difference among the 3 groups ( P =0.231). The incidence of acute left ventricular failure in the three groups was 2.2%, 12.4% and 22.9%, respectively, and there was statistically significant difference among the 3 groups ( P = 0.01). Multivariate analysis indicated that preoperative left ventricular ejection fraction ≤35% was an independent predictor of acute left ventricular failure ( OR =2.696, 95% CI : 1.099-6.612, P =0.030). Compared with baseline data, left ventricular end-diastolic volume ((62±4) mm vs (56±5) mm, P <0.001), left atrium ((42±6) mm vs (40±6) mm, P <0.001) decreased significantly 1 year after PCI. However, left ventricular ejection fraction ((43±10)% vs (51±13)%, P <0.001) increased significantly. At 1 year, left ventricular remodeling related parameters were detected in 3 groups, and there was statistically significant difference in left ventricular end-diastolic volume ((53.1±0.6) mm vs (55.1±0.5) mm vs (59.1±0.7) mm, P <0.001), left ventricular ejection fraction ((62.1±1.1)% vs (51.4±1.0)% vs (37.0±1.5)%, P <0.001) among the 3 groups. Conclusions: Coronary vascular reopening with PCI in patients with ischaemic cardiomyopathy and SYNTAX score≤22, can improve prognosis of patients with preoperative left ventricular ejection fraction>35% significantly, but not in those with preoperative left ventricular ejection fraction≤35%. Preoperative left ventricular ejection fraction may be an independent predictor of acute left ventricular failure in patients with ischemic cardiomyopathy and SYNTAX score≤22, postoperative left ventricular remodeling and left ventricular systolic function correlate with preoperative left ventricular ejection fraction.

Objective: To summarize the clinical characteristics of cardiomyopathy complicated with ventricular thrombosis. Methods: The clinical data of inpatients suffered from cardiomyopathy complicated with ventricular thrombosis in Fuwai Hospital between January 2015 and May 2019 were analyzed retrospectively. Results: A total of 125 cases were reviewed, and 24.8% were female. Dilated cardiomyopathy was the most common disease (62.4%), followed by arrhythmogenic right ventricular cardiomyopathy (ARVC) (13.6%) and hypertrophic cardiomyopathy (11.2%). There were 74.4% thrombosis in left ventricle, 12.8% in right ventricle and 12.8% in biventricle. The proportions of right ventricle thrombosis were higher in ARVC than in other cardiomyopathies (52.9% vs 6.5%, P< 0.01). The majority suffered from cardiac function New York Heart Association (NYHA) Class Ⅲ (45.6%) and class Ⅳ (39.2%). The ratio of NYHA Class Ⅳ was higher in female patients than in male ones (25.8% vs 10.6%, P< 0.05). In lab detection, positive results of D-Dimer and N terminal-pro B type natriuretic peptide (NT-proBNP) accounted for 72.8% and 97.6%, respectively. There were 2.5% patients died in the hospital or discharged because of the worsening of illness, the chances were higher in female than male patients (9.7% vs 0, P< 0.01). Among these patients, one succumbed to massive ischemic stroke caused by ventricular thrombus detachment under standard anticoagulation therapy. Conclusions: Dilated cardiomyopathy is the most common cardiomyopathy complicated with ventricular thrombosis. The most common location of thrombosis is left ventricle. Right ventricle thrombosis is more common in ARVC. The majority suffer from moderate or severe cardiac dysfunction. Higer proportion of female patients suffer from anemia, severe condition and poor prognosis.

Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group ( n =135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group ( n =69). The baseline characteristics, disease status, other history of surgery and echocardiography parameters before and after septal reduction were collected, as well as the complication within 1 week after operation. Results: The mean age in surgery group was (46±14) years old, with 76 males (56.3%); mean age was (47±11) years old and with 51 males (73.9%) in PTMSA group. There was no significant difference in age, gender, the time of symptom and diagnosis, syncope, family history and atrial fibrillation between the two groups (all P >0.05). The proportion of mitral valve prolapse in the surgery group was higher than that in PTMSA group (75.8% vs 44.2%, P <0.05). Baseline left ventricular outflow tract (LVOT) gradient was comparable (82.7 mmHg in surgery group vs 77.7 mmHg in PTMSA group, P >0.05). The mean resting LVOT gradient after septal reduction therapy was lower (16.55 mmHg in surgery group, 26.68mmHg in PTMSA group) than that before operation, with lower gradient in surgery group ( P <0.05). Compared with PTMSA group, the duration of hospitalization was longer in surgery group ( P <0.05). There was similar rate of operation related complications in the two groups. Conclusions: Both septal reduction therapies can improve the LVOT obstruction, more significant in surgery group, but with longer hospital stay. The rate of operation related complication is similar in both groups.